Grand Canyon University Nurse Burnout Final Project Outline Create a professional presentation of your evidence-based intervention and change proposal to b | Course Hero
Grand Canyon University Nurse Burnout Final Project Outline Create a professional presentation of your evidence-based intervention and change proposal to be disseminated to an interprofessional audience of leaders and stakeholders. Include the intervention, evidence-based literature, objectives, resources needed, anticipated measurable outcomes, and how the intervention would be evaluated. SUBJECT: NURSE BURNOUT Running Head: CAPSTONE PROJECT CHANGE PROPOSAL
Capstone Project Change Proposal
Michelle Kolibas
Grand Canyon University-NRS-493
July 12, 2020
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CAPSTONE PROJECT CHANGE PROPOSAL
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Capstone Project Change Proposal
Background
Positive patient outcomes are dependent on the care extended by practitioners and,
most notably, nurses. Nurses who experience exhaustion may fail to reach the necessary care,
which affects the final patient outcomes. In the United States, 35-45 percent of nurses in
2019, reported having suffered from professional burnout (Drybye et al., 2019). Another
report from the department of professional employees indicates that a third of the total
number of nurses in the country report suffering from emotional exhaustion. This often leads
to disengagement from the patient and the loss of work morale. The final product of these
behaviors is that there is a gap in the provision of care, adversely affecting the patient.
Clinical Problem Statement
Nurses are required to have a sharp memory and attention to detail. This ensures that
they provide the necessary medication and track the patient progress and needs accordingly.
However, for the nurses suffering from burnout, this may not be the case. They usually
disengage from work and the patients due to emotional exhaustion. This leads to a wide range
of mistakes from simple ones such as forgetting the patient’s requests to more complex ones
that may include messing up patient medication and ignoring patient safety protocol. When
such scenarios occur, it is not only the facility’s and the nurse’s reputation at stake but also the
patient’s life, which is the most critical element under consideration here. Other effects may
be an increased length of stay due to avoidable medical errors. Nurse burnout may also lead
to high staff turnover and cases of depression among the practitioners, which affects the
quality of delivery of healthcare. This is because nurse replacement may take quite some time
within which there may be a shortage or a decreased patient-nurse ration affecting the quality
of care.
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Purpose of the Change Proposal Concerning Providing Patient Care in the Changing
Health Care System
This change proposal aims to reduce avoidable medical errors in the course of nursing
care service delivery. These medical errors usually extend the patient to stay in the hospitals
and, in some cases, may be fatal, which may bring about legal consequences for the hospitals.
Since medical errors occur as a result of nurse burnout, the other purpose of this change
proposal is to develop strategies that may reduce burnout among nurses in the facility. For the
nurses who may be already suffering from exhaustion, the aim is to ensure that there are
adequate management strategies of the same to ensure that they feel revamped and reenergized to take on their roles appropriately.
PICOT Question
The PICOT question lies in preventing avoidable medical errors by putting in place
relevant nurse burnout prevention mechanisms. The problem, in this case, is nurse burnout
affecting both the nurse and patient populations. Several interventions would be considered to
help in the reduction of nurse burnout. One of the strategies under consideration here is to
ensure that there are stress management strategies in the workplace. These may include the
introduction of stress-relieving and relaxation spaces within the facility. It can also involve
having professional mental health specialists to help the nurses cope with the burnout. The
last intervention is the reduction of the current nurse-patient ratio and the adoption of the
right working hours for nurses to avoid working overtime. The comparison strategy for
reducing nurse burnout would be the introduction of coping mechanisms without eliminating
the causative factors of burnout. Here, the coping strategies will only be useful in the short
term, While this change proposal aims to have a plan that can work in the long run. The target
outcome is to have reduced medical errors and increased quality of care due to the
elimination or reduction of nurse burnout cases in the facility. This change proposal is meant
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to be a permanent element of the organization. Therefore, there is no time frame allocated to
it as it is a continuous plan.
Literature Search Strategy Employed
This change proposal was sorted from different medical databases, including
CINAHL, EMBASE, and Medline. Here, there were helpful nursing researches, and literature
reviews, necessitating the use of keywords. The keywords used were nurse burnout, medical
errors, and quality of care. For the articles to be included in the study, they had to be
published in the last five years and be available in full, not only an abstract. The exclusion
criteria were articles that did not discuss the quality of care from the perspective of nurse
burnout.
Evaluation of the Literature
One of the emergent themes from the literature review was that nurse burnout affected
the quality of care. Poghosyan et al. (2017), note that nurses who suffer from burnout are
more likely to be disengaged from the patient and offer substandard services. Similarly,
Maslach and Leiter (2016) note that nurses’ disengagement may bring adverse effects to the
entire hospital with poor relations with other practitioners affecting teamwork, which is a
needed element in the course of care. White & Mc Gugh (2019) bring forth the theme of job
dissatisfaction among the practitioners due to burnout. Shanafelt (2017), on a study of
economic impacts of nurse burnout, note that it brings about job dissatisfaction in that they
have to seek medical attention when the emotional exhaustion takes a toll and results in
complex conditions such as depression. Additionally, the discontent arising from burnout
may lead to adverse economic effects of the healthcare facilities as they keep incurring hiring
costs due to the high rates of turnover.
Applicable Change or Nursing Theory Utilized
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The theory that will guide this change proposal is the Lewin’s three-stage change
process involving unfreezing, changing, and refreezing. Unfreezing consists of letting go of
an old method of doing work that was bringing in the problem. This stage will involve
changing the mentality or thought processes of the nurse leaders to accept that nurses’
overworking is a poor practice as it leads to burnout. The change stage involves the actual
steps taken for the implementation of the projected change. This will include the introduction
of strategies to increase the number of nurses and stress management strategies to ensure the
elimination of burnout. The last stage, refreezing, will be the establishment of the new change
as a habit. The hospital culture will be adapted so that nurses have stress management
strategies, work for regular hours, and have an appropriate nurse-patient ratio.
Proposed Implementation Plan with Outcome Measures
The expected outcome is the reduction of medical errors arising from nurse burnout
problems and the reduction of nurse turnover. The plan is to ensure that nurses have time for
stress management mechanisms and facilities within the hospital. The second stage of the
project is to increase the number of nurses so that there can be a reduction in working hours.
After this, there will be a measure of whether this strategy has reduced the feelings of burnout
among the practitioners and the reduction in overall nursing medical errors. This will be
measured through nurse surveys and hospital length of stay and medical error records since
the intervention.
Discussion of How Evidence-Based Practice Was Used In Creating the Intervention
Plan
Mudallal et al. (2017), note that leader behaviors play an essential role in the
reduction of nurse burnout instances. Leaders have the responsibility to identify the causative
factors of burnout and implement stress management mechanisms to ensure that there I a
decrease in nurse burnout. The leader also has the role of providing a healthy work-life
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balance by ensuring that the nurse schedules are not overwhelming. This informed the change
proposal utilized herein.
Plan for Evaluating the Proposed Nursing Intervention
The proposed nursing intervention’s evaluation plan is to analyze the percentage
decrease in the medical errors resulting from nurse errors. The expectation is that there will
be a 60 percent decrease in medical errors. There will also be a measure of nurse turnover
decrease levels where the hope is that this will amount to a 40 percent decrease.
Identification of Potential Barriers to Plan Implementation, And a Discussion of How
These Could Be Overcome
One of the primary barriers to implementation is hiring new nurses so that the current
ones can have reduced workload. The costs of hiring nurses may be quite expensive,
especially if it is not in the hospital’s budget. The other cost challenge would also lie in
implementing the facilities that would act as stress relievers in the workplaces, such as
relaxation spaces. The hospital should ensure the implementation of this without a
compromise on quality, which could be quite tricky. However, the solution for this would be
to measure the long term returns of implementation since this is an investment, and there are
no possible ways of reducing it.
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References
Dyrbye, L.N., Shanafelt, T.D., Johnson, P.O. et al. (2019). A cross-sectional study exploring
the relationship between burnout, absenteeism, and job performance among American
nurses. BMC Nursing. 18, 57
Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research
and its implications for psychiatry. World Psychiatry, 15(2): 103111
Mudallal, R., Wafaa, M. Othman., & Al Hassan, N. (2017). Nurses Burnout: The Influence
of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. The
Journal of Health Care Organization, Provision, and Financing
physician burnout: A systematic review and meta-analysis. The Lancet, 388(10057):
22722281
Poghosyan, L., Clarke, S., Finlayson, M., & Aiken, L. (2017). Nurse Burnout and Quality of
Care: Cross-National Investigation in Six Countries. Research in Nursing and Health
Shanafelt, T., Goh, J., & Sinsky, C. (2017). The business case for investing in physician
wellbeing. JAMA Internal Medicine, 177(12): 18261832
White, E., & Mc Gugh, M. (2019). Registered Nurse Burnout, Job Dissatisfaction, and
Missed Care in Nursing Homes. The American Geriatrics Society
Running Head: CAPSTONE PROJECT CHANGE OBJECTIVES
Capstone Change Project Objectives
Michelle Kolibas
Grand Canyon University: NRS-493
June 7, 2020
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CAPSTONE CHANGE PROJECT OBJECTIVES
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Capstone Change Project Objectives
Objectives for Proposed Intervention
The proposed intervention revolves around nurse leadership through the formulation of stressrelieving policies to promote the avoidance of nurse burnout. The objectives include;
1. To ensure that nurses achieve a kind of balance between their social and professional
environments.
Although it is hard to achieve an actual balance, nurse leaders by arranging workable
schedules can ensure that the nurse has time to relax and to work. This way, the nurse gets a
place to break from the usual, which helps relieve stress.
2. To facilitate the positive outcomes for patients.
There is a suggestion for nurse leaders to have stress-relieving mechanisms in the workplace.
This ensures that if they feel burnt out within the work premises, they can visit these places
to get a break from work; consequently, they can go back to treating the patients with a less
exhausting mind promoting the patient outcomes.
3. Ensuring that the nurses lead a mentally and emotionally healthy life even after retirement.
Nurse burnout has the potential to hinder positive, healthy outcomes, especially from a
mental perspective for the nurse. However, the nursing interventions aim to prevent this by
ensuring the nurse does not suffer from burnout. If they do, there is the alleviation of the
same before it becomes too severe.
The rationale for Autonomy and Social Justice
The proposed project advocates for autonomy in that it first helps to create awareness of
the problem that nurse burnout presents to society. The knowledge of any societal issue is what
promotes the search for an intervention. The project gives an in-depth understanding of the
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situation on the ground, i.e., what a nurse is experiencing burnout may behave and the effects.
This prompts the nurse leaders to act following their moral authority, which is to ensure that all
stakeholders are satisfied. They, therefore, get into advocating for better working conditions for
the nurses. This promotes the common good, which will want to ensure people get proper
treatment for healthy lives, an element that is only possible with the presence of nurses.
The second way in which the project helps in promoting autonomy and social justice is
through the suggestion of interventions. Since the project brings awareness of the real problem,
the responses help in providing solutions to help these nurses. Through the introduction of
interventions such as better nursing schedules will ensure that there is equality across all
professions. If a person working as a business consultant can work for eight hours, then a nurse
should also have the opportunity to do the same. These suggestions ensure that there can be the
actualization of this. Consequently, nurses will even be in the position to feel dignified working
in the nursing profession.
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