Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence

Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence

Nursing Staff Shortages

The clinical issue of interest I selected is nursing staff shortages in relation to nurse burnout and patient outcomes. For as long as I have been a nurse, I have experienced this issue firsthand. I wonder, though, how many people are affected by this. How many other nurses are putting in almost double the workload and resulting in burnout? How many patients are affected from a safety and quality of care standpoint?

Evidence-Based Practice

Evidence-based practice (EBP) is a problem-solving approach used in order to develop and provide the highest quality of care for the best patient outcomes (Stillwell et al., 2010). In order to retrieve relevant information, it is first necessary to establish a clearly defined question. The approach most commonly used to define this information is the PICO framework: P- Patient or Problem, I- Intervention, C- Comparison, and O- Outcome (Davies, 2011).

Research

To begin, I started a broad search on the nursing research page through Walden. I first typed in “nursing staff shortages” which produced 850 results. In an attempt to narrow down my research, I added “patient outcomes” in addition. This cut my options down to only 15, so I removed the “patient outcomes” phrase and replaced it with “quality of care” which resulted in 148. I then performed an advanced search to limit articles to “peer-reviewed scholarly journals only”, bringing the results down to 124. Finally, I wanted to be sure I was reviewing the most recent data, so I set a parameter to include articles only between the years 2018 to 2022. This really helped to simplify the process by reducing the number of articles to a manageable 65.

PICO

My PICO question for my chosen topic became more solidified as I continued my research. The problem (P) is nursing shortages have an impact on patient safety and quality of care (Tang et al., 2019). Interventions (I) are aimed at autonomy, recognition, and communication. Comparison (C) is done via three different instruments: the Maslach Burnout Inventory, the Job Satisfaction Scale, and the Basel Extent of Rationing of Nursing Care-R (BERNCA-R) and included feedback from 594 nurses (Uchmanowicz et al., 2020). Finally, the outcome (O) reveals that retaining expert nurses will have a positive effect on quality patient care.

References

Davies, K. S. (2011). Formulating the Evidence Based Practice Question: A Review of the Frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. https://doi.org/10.18438/B8WS5N

Stillwell, S. B. , Fineout-Overholt, E. , Melnyk, B. M. & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question. AJN, American Journal of Nursing, 110 (3), 58-61. doi: 10.1097/01.NAJ.0000368959.11129.79.

Tang, J. H.-C., Hudson, P., Smith, M., & Maas, R. (2019). Evidence-Based Practice Guideline: Nurse Retention for Nurse Managers. Journal of Gerontological Nursing, 45(11), 11–19. https://doi.org/10.3928/00989134-20191011-03

Uchmanowicz, I., Karniej, P., Lisiak, M., Chudiak, A., Lomper, K., Wiśnicka, A., Wleklik, M., & Rosińczuk, J. (2020). The relationship between burnout, job satisfaction and the rationing of nursing care—A cross‐sectional study. Journal of Nursing Management (John Wiley & Sons, Inc.), 28(8), 2185–2195. https://doi.org/10.1111/jonm.13135