Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
NURS 6052 Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Clinical issue of interest- nurse burnout
Characteristics: fatigue, cognitive dysfunction, depression, and impaired sleep (Rudman et al., 2021).
Causes: Job dissatisfaction, poor quality of the work environment, and unhealthy work relationships
Implications: reduced output and high turnover (Rudman et al., 2021).
Nurses should work as comfortably as possible in order to maintain a healthy work environment and maximize patient outcomes. Nurse burnout, on the other hand, has a negative impact on nurses’ output and work relationships. It is also a major source of nurse turnover. According to Rudman et al. (2021), nurse burnout is characterized by fatigue, cognitive dysfunction, depression, and poor sleep. In this case, it affects multiple aspects of nurses’ health, implying that they are unable to provide efficient and effective care. Job dissatisfaction and increased workload are common causes. Evidence-based interventions are required due to the negative consequences of unhealthy workplaces and turnover. One of the most effective interventions is resilience training.
Burnout in nurses is a problem.
Resilience training is an intervention.
Contrast: no intervention
Reduced burnout as a result
Timeline: six months
The PICOT process aids in the development of a thoughtful question that will guide the search for evidence. I used the same method to
Assignment Evidence-Based Project, Part 2 Advanced Levels of Clinical Inquiry and Systematic Reviews
create the PICOT question. The entire process begins with identifying the patient or problem that requires intervention. Nurses experiencing burnout are the target population in this scenario. Resilience training is the proposed intervention to improve nurses’ resilience to burnout. Other alternatives are considered in the comparison, but none have been considered. The result indicates the desired goal, which is to reduce nurse burnout. Because evidence-based practice projects must be completed within a specific time frame, the time required to achieve the desired outcome must be specified.
PICOT Question: Can resilience training (I) reduce nurse burnout (O) in six months (T) in nurses with burnout (P) compared to no intervention (C)?
Scholarly and peer-reviewed sources should be used to obtain evidence-based practice research. The university library has access to numerous nursing databases that contain numerous articles on a variety of topics. CINAHL Plus with Full Text, an extensive collection of journals and e-books on nursing topics, was one of the research databases I used. The Cochrane Database of Systematic Reviews contains full-text versions of evidence-based sources to help inform nursing and health-care decision-making. PubMed provides access to full-text journal articles. The CINAHL/MEDLINE Combined Search includes peer-reviewed articles from the nursing and allied health literature, as well as case studies, systematic reviews, and EBP reports.
| Article | Focus Area |
| Deldar et al. (2018) | relationship between resiliency and burnout |
| Yu et al. (2019) | Personal and work-related factors associated with nurse resilience |
| De Oliveira et al. (2019) | prevention actions of burnout syndrome |
| Klein et al. (2019) | benefits of mindfulness-based interventions on burnout
|
The above four studies met the inclusion criteria for scholarly and peer-reviewed articles. Besides being scholarly and peer-reviewed, the studies recommend resilience training as an evidence-based strategy for addressing nurse burnout. Deldar et al. (2018) conducted a meta-analysis examining the effects of resiliency on nurse burnout. Yu et al. (2019) deduced that increased nurse resilience reduces emotional exhaustion and increases work engagement. Resilience is a key theme in de Oliveira et al. (2019) article, which can be taught or developed through coping skills training. Klein et al. (2019) examined the effectiveness of interventions that increase resilience, such as mindfulness-based activities. Their primary objective is to pursue a state of mind characterized by self-control and free from self-judgmental feelings.
| Article | Type | Evidence Level |
| Deldar et al. (2018) | a systematic review and meta-analysis | Level 1 |
| Yu et al. (2019) | a systematic review | Level 1 |
| De Oliveira et al. (2019) | an integrating literature review | Level 1 |
| Klein et al. (2019) | a systematic review | Level 1
|
In the evidence pyramid, systematic reviews and meta-analyses occupy the first level of evidence (Level 1). At this level, research studies contain evidence from systematic reviews or meta-analyses of good quality sources on a given topic. Systematic reviews provide a summary of the clinical literature. In this case, the chosen studies critically assess and evaluate many other research studies that address nurse burnout and resilience. On the other hand, a meta-analysis combines the results of independent studies. It also synthesizes summaries and conclusions from the same studies quantitatively. The defining element of a meta-analysis is being an overview of clinical trials, which differentiates such studies from systematic reviews.
Answer a focused research question
Clear and comprehensive evidence overview
Identify research gaps
Enhanced precision of effect estimate
Minimal research bias
As sources of high level of evidence, systematic reviews are designed to answer a focused research question. In this process, researchers using the systematic review approach identify and synthesize the available scholarly research on a particular topic. For instance, Deldar et al. (2018) first extracted 227articles that were screened to end up with 108 studies for their review on resiliency and burnout. Such in-depth exploration of a nursing topic provides a clear and comprehensive overview of research evidence. The other dominant strength is identifying research gaps. After the synthesis and analysis, systematic reviews indicate areas where further research is required. Importantly, systematic reviews are associated with better precision of effect estimate and minimal bias compared to individual studies.
de Oliveira, S. M., de Alcantara Sousa, L. V., Vieira Gadelha, M., & do Nascimento, V. B. (2019). Prevention Actions of Burnout Syndrome in Nurses: An Integrating Literature Review. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 15, 64–73. https://doi.org/10.2174/1745017901915010064
Deldar, K., Froutan, R., Dalvand, S., Gheshlagh, R. G., & Mazloum, S. R. (2018). The Relationship between Resiliency and Burnout in Iranian Nurses: A Systematic Review and Meta-Analysis. Open access Macedonian Journal of Medical Sciences, 6(11), 2250–2256. https://doi.org/10.3889/oamjms.2018.428
Klein, A., Taieb, O., Xavier, S., Baubet, T., & Reyre, A. (2020). The benefits of mindfulness-based interventions on burnout among health professionals: A systematic review. Explore, 16(1), 35-43. https://doi.org/10.1016/j.explore.2019.09.002
Rudman, A., Arborelius, L., Dahlgren, A., Finnes, A., & Gustavsson, P. (2020). Consequences of early career nurse burnout: A prospective long-term follow-up on cognitive functions, depressive symptoms, and insomnia. EClinicalMedicine, 27, 100565. https://doi.org/10.1016/j.eclinm.2020.100565
Yu, F., Raphael, D., Mackay, L., Smith, M., & King, A. (2019). Personal and work-related factors associated with nurse resilience: A systematic review. International Journal of Nursing Studies, 93, 129-140. https://doi.org/10.1016/j.ijnurstu.2019.02.014