Improving Nursing Staff Retention by Reducing Nursing Burnout.

This is a capstone project. I have to implement a change within a organization. My change is (how to reduce nurse retention due to burnout)? I have the 8 references to use.
In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course.Improving Nursing Staff Retention by Reducing Nursing Burnout. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

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Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:Improving Nursing Staff Retention by Reducing Nursing Burnout.
1. Background
2. Problem statement
3. Purpose of the change proposal
4. PICOT
5. Literature search strategy employed
6. Evaluation of the literature
7. Applicable change or nursing theory utilized
8. Proposed implementation plan with outcome measures
9. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
10. Appendix section, if tables, graphs, surveys, educational materials, etc. are created

Background

Nursing burnout (NB) is dominant among people who work demanding environments that is primarily characterized by depersonalization, emotional exhaustion, and decreased individual accomplishment. NB is a common occurrence among Emergency Department (ED) nurses. According to Isa et al (2019), the high prevalence has been attributed to the nature of ED care where nurses witness a lot of human suffering, high work pressure, and a shortage of resources. Besides, ED nurses are at a high risk of workplace violence from both visitors and patients. It is for this reason that researchers have associated burnout with exposure to violence.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Currently, existing evidence reveals that ED nurses and have been exposed to aggression while in the line of duty have potentially high levels of depersonalization and emotional exhaustion. McDermid, Judy & Peters (2020) highlights that burnout impacts the physical and psychological health of nurses negatively; it decreases the rates of patient satisfaction and quality of care. In most healthcare organizations, OB increases the rates of job dissatisfaction, absenteeism, healthcare costs, turnover rates, and financial losses.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Burned out nurses can express dissatisfaction through poor communication, negative behaviors, and incivility towards co-workers. When burned out, most nurses feel demotivated, perform their responsibilities below the required standards, and have low self-esteem. Apart from having a decreased personal accomplishment and dissatisfaction in responding to job-related stressors, most of them eventually leave the profession. Nurses’ leaving their profession has been linked to significant costs of care approximated from $11,000-$90,000 for each nurse and an additional $8.5 million in indirect healthcare costs. Most past studies on NB focused on addressing nursing staffing as a major cause of NB and high turnover. In this PICOT paper, the author examines the effectiveness of nurse retention programs to decrease NB, improve patient and nurse satisfaction. Improving Nursing Staff Retention by Reducing Nursing Burnout.

Problem Statement

A nursing shortage is a global issue according to the World Health Organization (WHO) that potentially interferes with global and national efforts to improve the overall health and well-being of people.  The nursing profession in the United States is facing a gradual increase in the annual rates of nursing turnover as a result of nursing burnout, poor working conditions, and labor migration that have resulted in a serious shortage of experienced and skilled nurses.Improving Nursing Staff Retention by Reducing Nursing Burnout. According to Wubetie, Taye & Girma (2020), the nursing shortage has directly been associated with personal and work conditions such as poor working conditions,   collegial relations, unrealistic job expectations, work-related demands which exceed resources, poor control, and autonomy over the practice, and an increase in work-related hazards. This has increased nurses’   burnout and dissatisfaction levels. Burnout reduces nurses’ level of performance, QoL (quality of life), and commitment towards an organization. It also increases their intention to leave the nursing profession.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Hamdan, Abu Hamra & Hamra (2017) describe nursing as one of the most stressful occupations. It is for this reason that burnout syndrome is a common finding among nurses. Although some nurses are usually able to deal with burnout symptoms, poor communication, and a nursing shortage feel emotionally and physically exhausted. Among nurses, burnout decreases their productivity and ability to deliver care.  Daily, nurses encounter clinical dilemmas that require an empathetic, human, and sensitive approach to address several responsibilities. Patient scenarios such as non-recovery or costly-recovery, the inability to address dark situations especially death can result in feelings of professional dissatisfaction and impotence. This reveals that preventing burnout among nurses has a lot of significance in promoting nurses’ productivity and clinical performance.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Purpose of the Change Proposal

In the author’s healthcare organization, burnout hinders the ability of ED nurses to deliver high-quality care and jeopardizes the safety value and quality of the organization as well as external regulators. The symptoms of NB among most nurses who work in the ED include absenteeism, easy-frustration with co-workers, clinical errors, exhaustion, poor provider-patient communication, and sarcasm. This has not only resulted in the poor financial performance of the organization but has also impacted nurse and patient satisfaction negatively by increased nursing burnout and nursing turnover rates.Improving Nursing Staff Retention by Reducing Nursing Burnout.

The institution bears both the indirect and direct costs of nursing burnout. The direct costs of burnout are recruitment and advertising costs for nursing personnel who perform the recruitment, interviewing, background checks, training, and orientation. The indirect costs are associated with labor replacement for temporary nurses who are more expensive than staff nurses. This change proposal aims at increasing nurse and patient satisfaction by decreasing nursing burnout among ED nurses through a nurse retention program. The author also expects that post-implementation; there will be a significant improvement in the organization’s financial performance and a decrease in the nursing turnover.Improving Nursing Staff Retention by Reducing Nursing Burnout.

PICOT

Among nurses working in the ED (P) does implement a   nurse retention program (I) compared to not implementing a nurse retention program(C) decrease nursing burnout, increase patient and nurse satisfaction rates (O) within 12 weeks (T)?

Literature Search Strategy

The author conducted an initial search for literature in the electronic databases of CINAHL, EBSCOhost, and PubMed using the following key terms; “emergency nurses”,  “burnout”, “retention”, and “nursing”. For a more refined search outcome, the author used the Boolean search operators “OR” and “AND” to transition between the search terms. The author limited the search to articles published between the years 2014 and 2020.  These dates were selected because, since the year 2014, there has been a lot of focus on literature with a focus on nursing burnout and nursing retention in EDs. Improving Nursing Staff Retention by Reducing Nursing Burnout. The electronic database search yielded 60 articles. An inclusion criterion of English peer-reviewed full-text articles with a focus on EDs was applied. Articles that failed to meet these criteria were excluded. After applying the aforementioned inclusion and exclusion criteria, the author identified 10 articles that met the inclusion criterion and were included in the literature synthesis.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Evaluation of Literature

The study by McDermid, Judy & Peters (2020) identified the contributory factors to high nursing turnover rates among nurses in the ED. The researchers conducted a systematic review of literature in Google Scholar, Medline, and CINAHL databases for literature published between the years 2006-2018. Data collected was analyzed thematically using the six phases of thematic analysis by Braun and Clarke’s. From the 20 articles obtained, three major themes emerged from the review namely: violence and aggression, work environment, and critical incidents. McDermid, Judy & Peters (2020) concluded that ED nurses face multiple challenges that cause stress and NB, PTSD (post-traumatic stress disorder), and compassion fatigue. Improving Nursing Staff Retention by Reducing Nursing Burnout.

These findings are similar to those of the study by Wubetie, Taye & Girma, (2020) who also acknowledge that ED nurses are the most vulnerable to turnover due to a high risk of compassion fatigue and nursing burnout, which are associated with the ED work environment. The objective of their study was to assess the factors and intention of ED nurses to leave practice. The researchers used structured self-administered questionnaires to collect data from 102 nurses working in government hospitals. Collected data were analyzed using logistic regression models using an odds ratio with a CI of 95%. The response rate was 91.1% and among the participants, 77.5% had the intention to leave practice in the ED. The most important factors that predicted the intention to leave practice were; < 3145 Birr monthly income (p < 0.043, OR = 6.05), education status (p < 0.048, OR =4.700), and professional autonomy (p < 0.037, OR = 0.191). The findings of this study revealed that more than 77%  of  ED nurses intent to leave ED practice and this intention is directly associated with monthly income, education status, and professional autonomy. To address this issue, hospital managers must team up with emergency leaders to improve nurses’ decision making with regards to patient care, unit, and routine care-related activities.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Helbing (2017) recommends in his descriptive study the need to improve job satisfaction rates of ED nurses by improving working relations among healthcare staff and issuing recognition and achievement awards. The best way to implement nurse burnout prevention strategies as proposed by Nascimento et al (2019) is through nurse retention programs. According to Twigg & McCullough (2014), nurse retention programs create and enhance positive practice environments.

The most effective nurse retention programs focus on a shared structure of governance, creating an empowering work environment, promoting professional autonomy in practice, supportive leadership, professional development, ensuring adequate staffing, collegial relationships among staff, and skill mix. Twigg & McCullough (2014) further emphasizes that nurse retention programs do not only promote nurses’ retention but also promotes quality care. However, before implementation, nursing administrations and managers should conduct thorough organizational assessments using validated tools as this will guide the implementation and evaluation of interventions.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Change Model/Theory

Kurt Lewin’s theory of change will guide the implementation of this change initiative.  This theory has three major stages namely the unfreezing, change, and refreezing phases (Manchester et al, 2014). The theory will help to create a notion on the need for organizational change which will be implemented and solidified as a norm in the following stages; problem identification and description, initiation of action, implementation, and change institutionalization.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Proposed Implementation Plan with Outcome Measures

The implementation will be facilitated by a multidisciplinary team comprising of different stakeholders in nursing leadership, management, staff, and unit-based roles. The team will form an implementation timeline that highlights specific dates and activities to perform.  This team will primarily conduct an organizational assessment to identify potential gaps that contribute to nursing burnout. The team will also collaborate with other healthcare staff to develop a nurse retention program that addresses autonomy in practice, communication channels, how to reward/recognize ED nurses. Before and after implementation, participants (patients and nurses) will fill satisfaction surveys. The author purposes to use the McCloskey-Mueller Satisfaction Survey (MMSS) for data collection. Nurses will also fill the Maslach Burnout Inventory questionnaire (MBI), which will be used to assess pre and post-implementation ED nursing staff levels of stress and burnout. Before implementation, the author will obtain permission from the hospital’s board. Both male and female nurses working in the ED and stable patients who will be in the ED at the time of the study will be randomly selected to fill the pre and post satisfaction surveys while nurses will additionally fill the MBI questionnaire. The main outcome measures will be ED nurses and patient satisfaction rates and ED nurses’ burnout rates.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Potential Barriers and Strategies to Overcome Them

The main barriers to implementing this change proposal are resistance from staff, fear, and minimal organizational support. However, the purpose to address these barriers by directly involving all staff in each step of the change initiative, obtaining and providing feedback. To address staff-related fear, the author will conduct a 45-minute training that will address the significance of the change initiative and any other concerns that might emerge. To increase organizational support, the author will officially communicate to the nursing leadership how the change initiative will not only benefit patients and healthcare staff but also improve the organization’s overall reputation, sustainability, and financial performance.Improving Nursing Staff Retention by Reducing Nursing Burnout.

this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background
2. Problem statement
3. Purpose of the change proposal
4. PICOT
5. Literature search strategy employed
6. Evaluation of the literature
7. Applicable change or nursing theory utilized
8. Proposed implementation plan with outcome measures
9. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
10. Appendix section, if tables, graphs, surveys, educational materials, etc. are created

Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.Improving Nursing Staff Retention by Reducing Nursing Burnout.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Improving Nursing Staff Retention by Reducing Nursing Burnout.