EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS NURS 6052

Introduction

The provision of safe, high quality and efficient care in nursing is important for the health and wellbeing of the patients. Often, nurses utilize practice interventions such as patient centeredness and evidence-based practices to ensure that the care needs of the patients are met. They also use the interventions to minimize the risk of occurrence of safety and quality issues in patient care. An example is the use of best practice interventions to ensure that the risk of medication errors in nursing practice is reduced. Despite the efforts adopted by nurses to ensure safety and quality, institutional and provider factors may still predispose patients to unintended safety and quality issues. For example, provider factors such as burnout due to the influence of institutional factors such as staff shortage may threaten the safety and quality of patient care. Therefore, this presentation examines the proposed intervention that can be used to reduce and prevent burnout among registered nurses.

Selected Clinical Issue

The selected clinical issue that relates to nursing practice is burnout among nurses. Burnout has been defined as the consequence of prolonged, persistent and chronic exposure of nurses to work-related stressors. The prolonged exposure to work stressors result in depersonalization, exhaustion, and reduced personal accomplishments. Nurses affected by burnout experience challenges in undertaking their clinical roles due to low levels of motivation and job satisfaction. Burnout among nurses has an adverse effect on the quality and safety of patient care (Ahola et al., 2017). For example, it increases the risk of medication errors by nurses due to lack of concentration in the care giving process. Burnout also causes low level of job satisfaction and motivation among the nurses. As a result, the rate of turnover among them increases significantly. In addition, the operational costs in healthcare organization rises due to the need for frequent hiring of new staffs to replace those who left the organization. Therefore, burnout among nurses should be addressed to ensure safety, quality and efficiency in healthcare organizations (Melnyk et al., 2020).

Development of PICOT

The developed question is: In acute care nurses, does the use of cognitive interventions result in the reduction of burnout levels when compared to no intervention, within eight month period?

I developed the above PICOT question through a number of steps. The first one was performing a clinical inquiry of the common issues that affect quality and safety of patient care in healthcare settings. I also utilized knowledge from my clinical experience to identify issues in practice that can be addressed by adopting evidence-based interventions. This led to the identification of the clinical issue of burnout in nursing. The second step entailed the determination of the populations that the problem affect. This led to the identification of nurses as the most prone group of professionals to be affected by burnout. The other step was performing a literature search of the databases to determine practice interventions that can be used to address the issue. This stage led to the identification of cognitive therapies as the most effective intervention to address burnout in nursing. The next step was determining a way in which I could determine the effectiveness of the intervention. As a result, I considered a comparative intervention to be no use of any approach to address the issue of burnout among nurses. I then developed the outcomes to be achieved by the implementation of the intervention and the timeline of evaluating its effectiveness.

Identified Articles

The database search led to the above articles that explore the effectiveness of cognitive interventions in reducing and preventing burnout among nurses.

Levels of Evidence

The study by Ahola et al., (2017) provides level I evidence. The study was a systematic review of randomized controlled trials without meta-analysis. The study by Melnyk et al., (2020) provided level I evidence too. It was a systematic review of randomized controlled trials without meta-analysis. The study by Nayeri et al., (2021) provided level III evidence. It was a systematic review of a combination of quasi-experimental, randomized controlled trials, and non-experimental studies. It also lacked meta-analysis. The study  by Zhang et al., (2020) provided level II evidence. The study was a systematic review of quasi-experimental and randomized controlled trials with meta-analysis.

Strengths of Using Systematic Reviews

One of the strengths of using systematic reviews is the transparency in its processes. The processes of each of the phases of a systematic review are transparent, increasing the trust towards the obtained findings. Transparency also enables readers to determine th

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