Benchmark – Evidence-Based Practice Project Proposal Final Paper
Benchmark – Evidence-Based Practice Project Proposal Final Paper
Benchmark – Evidence-Based Practice Project Proposal Final Paper
Benchmark – Evidence-Based Practice Project Proposal Final Paper
Healthcare providers and organizations use evidence-based practice (EBP) approaches and strategies to optimize outcomes and enhance the quality of care offered to patients. The healthcare sector and its workers face a myriad of challenges that require stakeholders, especially organizations, to deploy EBP interventions to attain better care and prevent poor workplace environment and issues like nurse burnout. Reducing burnout among emergency department (ED) nurses is a critical part of enabling them to provide quality care and meet the ever-rising care demands from patients and health population.
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According to Hopper (2023), the nursing profession and health care in general is on the verge of implosion as nurses of all ages leave in record numbers due to different factors that include retiring, some due to the need to advance their education yet those training to join the profession are not sufficient. Due to these aspects, the nursing shortage increases as more trained nurses leave the profession entirely. The turnover rates in nursing is at an unprecedented level of over 27.1%. The registered nurse (RN) turnover rates in areas like step down units, emergency department, and behavioral health as well as telemetry rose from 101.3% to 111.4% in the last five years. Again, the average turnover cost for a nurse is about $46,100 which is about 15% increase in the last five years (Russell, 2023). As such, the shortage of nurses in different areas of care provision, including the emergency department (ED) leads to fatigue, burnout, and high turnover rates.
Burnout in the emergency department means that nurses cannot offer quality care since they may be overwhelmed by the different obligations and the level of demand from patients. Imperatively, healthcare organizations and their management seek effective evidence-based practice (EBP) interventions to address the issue and ensure that nurses offer quality and safe patient care. Studies show that 95% of nurses have reported feeling burned out in the last three years, especially at the height of the COVID-19 pandemic (Dall’Ora et al., 2020). Before the pandemic, about 15% of nurses felt burn out but the figures rose to 62% leading to close to 30% quitting their jobs in 2021. The implication is that developing interventions for the remaining nurses is essential to ensuring that they are resilient and can offer quality patient care. About 27% of nurses who quit have cited burnout as the primary reason for leaving the profession (Berlin et al., 2023). The purpose of this evidence-based practice project proposal final paper is to discuss and show how nurses in emergency department can use mindfulness meditation breathing to overcome burnout by reducing and preventing its occurrence. Implementing mindfulness meditation breathing can reduce and prevent burnout among these nurses and ensure that they offer quality and safe patient care for the different individuals presenting in the emergency department to get appropriate care.
Problem Statement
Burnout among nurses is a critical patient safety issue and reduces the possibility of nurses offering quality care. For instance, over 100,000 nurses left the nursing workforce due to pandemic-related burnout and stress. The National Council of State Boards of Nursing asserts that another 610, 000 RNs with over 10 years of experience with an average age of 57 years plan to leave the nursing workforce by 2027 due to stress, burnout, and retirement. These figures demonstrate that nurses will continue experiencing burnout due to the endemic nurse shortage emanating from different factors, from retirement to increased workload and advancing education. Emergency department nurses are highly susceptible to burnout because of continual exposure to traumatic events, varying work schedules and violence aimed at them by different individuals. Again, stressors related to the COVID-19 pandemic have also exacerbated the burnout syndrome that makes it impossible for nurses to cope with the level of work in their practice setting (Philip et al., 2022). Developing resilience through EBP interventions is a critical part of ensuring that nurses in the ED do not experience adverse outcomes emanating from burnout.
The use of mindfulness meditation is considered as an EBP intervention to reduce burnout that nurses in the emergency department experience. In their study, Argyriadis et al. (2023) assert that through mindfulness meditation, nurses can enhance their cognitive functions that include attention, thinking, memory, and concentration. They can also improve their professional interpersonal interactions, gain personal satisfaction and communicate well with patients and caregivers. The nurses practicing mindfulness meditation also have better sleep and reduced levels of negative emotions and development of better behavioral approaches while dealing with all people presenting in the emergency department. As such, the implementation of mindfulness meditation is critical to attaining better resilience levels for nurses in emergency department and is considered an EBP intervention, which this project proposes to lower burnout by 50%.
i). PICOT Statement
Population- Nurses in emergency department
Intervention-Mindfulness meditation
Comparison-Normal measures
Outcome-Reduce burnout syndrome by 50%
Time-Three months
ii). Refined PICOT Question
The refined PICOT question for the EBP proposed project is;
Among emergency department nurses experiencing burnout (P), does the use of mindfulness meditation (I) compared to normal measures (C), reduce and prevent burnout syndrome by 50% (O) within three months (T)?
Organizational Culture and Readiness
Healthcare organizations should commit to offering high quality care aimed at optimal patient outcomes and safety. Attaining this important milestone implores organizations to embrace a culture rooted in change and one ready to implement new approaches to care delivery. Understanding an organizational culture and its readiness for change allows nursing professionals to implement evidence-based practice (EBP) change. At the core of an organizational culture is its leadership, approaches to work, the interactions between employees, values and belief-system that exists among all stakeholders (Van Huyn et al., 2020). Developing a clan culture that embraces teamwork, employee engagement, staff welfare, and value-based recruitment is essential when implementing changes, especially EBP interventions. In this case, the assessment of an organization that supports change should demonstrate an entity that is focused on innovation and growth.
In implementing the EBP in the selected healthcare setting, the organization’s readiness level should be assessed using appropriate tools and models. In this case, the assessment employed the organizational readiness for knowledge translation (OR4KT). The tool evaluates readiness by using six different variables that include climate for change, contextual aspects, change content, leadership, motivation and organizational support (Gagnon et al., 2021). The survey of the respective components in each group gave an overall score of 85% readiness as depicted in the appendix. This implies that the organization is ready for change. The environment can also maintain the change since it is focused on growth and better outcomes. Having such an environment is critical for the overall success of the proposed project.
The project’s primary strength is to align with the organization’s commitment to continuous quality improvement. As such, the proposed project focuses on having one-hour education session on mindfulness meditation every week for nurses experiencing burnout in the emergency department. The project is outcome-centered hence the need for increased organizational support and addressing of any barrier that may derail the implementation. While barriers are inevitable, ensuring the integration of all stakeholders would be critical in attaining the expected outcomes. Getting support implies that stakeholders will commit their resources, time, and expertise to actualize the project to reduce burnout syndrome among nurses in the ED.
The organization should demonstrate its readiness by considering several aspects of their processes and systems, especially those implemented in the emergency department. For instance, teaching nurses improves their clinical skills and enables them to be effective communicators leading to provision of empathetic care. Again, empowering employees to understand and respond effective to change will enhance the overall readiness of the organizations. The entity can also improve the overall readiness through effective and progressive evaluation of outcomes which will determine the impact of the proposed intervention. Knowledge emanating from continuous evaluation allows stakeholders to always accept and be ready for changes (Dall’Ora et al., 2020). The involvement of stakeholders and integration of information and communication technologies will also enhance the overall readiness and implementation of the proposed EBP intervention. The use of technology in healthcare cannot be overemphasized because the present health environment is data-driven with implementation of interventions like electronic health records (EHRs) and telehealth among other aspects to improve care delivery. As such, the overall assessment demonstrates that the organization is ready and willing to implement the suggested interventions to reduce burnout syndrome among nurses in its emergency department.
Literature Review
Existing studies and literature demonstrate that mindfulness meditation can help nurses in the ED to reduce burnout syndrome and attain resilience to enhance patient safety. Salvado et al. (2021) in their systematic review and meta-analysis show that mindfulness-based interventions reduce burnout among healthcare professionals. The findings show that while there is need for further research, mindfulness-based activities are critical for primary healthcare providers like nurses in the emergency department due to the traumatic events that they are exposed to while in the workplace. Again, the study by Argyriadis et al. (2023) emphasizes the critical role that mindfulness interventions play in reduce and managing work-related stress and development of a positive working environment for nurses. The article asserts that nurses using mindfulness meditation interventions attain better cognitive functions and improved inter-professional interactions. Besides these interventions help them manage negative emotions and improve their sleep rates. The implication is that having such intervention is important for nurses and other health professionals.
In their study, Wong et al. (2021) explored the impact of mindfulness on burnout among nurses in pediatric emergency department. Using pediatric emergency department (PED) staff that include nurses and physicians as well as nurse practitioners and technicians, the study found that few staff used personal mindfulness activities away from work. However, the study showed that for a majority who participated in the on-shift mindfulness meditation, there was no significant variation in scores before and after the intervention in relation to emotional exhaustion, depersonalization, and personal accomplishments. As such, the study shows that mindfulness meditation is effective when it is regularly used among the affected nurses. The authors are categorical that on-shift mindfulness meditation activities are not sufficient to reduce burnout levels. However, dedicating more resources to more intense mindfulness meditation activities can combat burnout levels among emergency department staff.
The study by Luo et al. (2023) shows that mindfulness decompression therapy can improve the mental health of nurses and reduce job burnout. The study focuses on frontline nurses who worked at the height of the novel COVID-19 pandemic. The authors assert that clinical settings can apply the intervention to reduce burnout among nurses in their ED, especially in handling critical patients presenting in the department. The authors assert that while randomized controlled trials are still required, mindfulness decompression therapy is an effective intervention to reduce burnout syndrome among nurses and other healthcare workers in different areas of care provision.
In their article, Seppala et al. (2020) posit that anxiety in the workplace, including in healthcare, is a serious wellness issue for employees. The combination of the Covid-19 pandemic, the increased demand for care, and the ever-ending nursing shortage as well as battles for social justice pile pressure on nurses leading to increased anxiety. These stress levels interfere with one’s ability to do their best work. As such, the use of mindfulness meditation and breathing is effective in helping nurses and other health professionals to remain resilient and sustain patient safety measures. According to Seppala et al. (2020), having the right mindfulness meditation exercise allows one to handle and manage negative emotions, especially those related to their work practices and activities.
Lin et al. (2019) use a randomized controlled trial to evaluate the effects of a modified mindfulness-based program to lower levels of stress among nurses. The study evaluates 110 nurses assigned in the intervention and control groups with the former group participating in a modified 8-week program (MBSR). According to the findings, the intervention group demonstrated reduce stress levels and negative affect and rises in positive affect and resilience. The study also showed that using this intervention (MBSR) could also enhance job satisfaction among the nurses. The implication is that the modified program is an effective model to reduce burnout syndrome among nurses that emanates from increased levels of stress related to work and dealing with patient demands. The program also enhanced nurses’ overall resilience in their workplace. Again, the article by Tellhed et al. (2019) supports the use of breathing and mindfulness through yoga as an effective way that nurses can use to cope with stress and have positive health outcomes while dealing with patients. Exposure to traumatic events means that nurses get increased levels of stress and require effective mechanisms to cope with these levels. The article advances that yogic breathing and mindfulness can help individuals learn to cope with their everyday stressors and reduce the risk of developing stress and mental health illness due to anxiety and depression. In its conclusion, the article emphasizes the core role of yoga in improving the psychological health of individuals in different areas of life, including professional nursing. The authors recommend the integration of these interventions by policymakers aimed at improving overall health, including public health.
In their article, Zhu et al. (2018) evaluate the use of mindfulness breathing to reduce stress. The study asserts that stress reduction tools like relaxed breathing as part of mindfulness meditation is critical in lowering stress and its associated aspects like burnout syndrome. Using mindfulness technology, the authors demonstrate that individuals at increased risk for stress and burnout should leverage mindfulness breathing to reduce negative effects and enhance positive affects in their activities of daily living. Again, the article by Sulosaari et al. (2022) emphasizes that mindfulness-based interventions help nurses to attain a positive psychological well-being. Using a systematic review, the authors illustrate that mindfulness-based interventions can improve the wellbeing of nurses as they become aware of the possible risk factors and need for better training on different aspects that may affect their overall care delivery.
The study by Ameli et al. (2020) also emphasizes the role of mindfulness meditation in reducing stress and burnout among healthcare professionals at a US biomedical research hospital. Using a randomized clinical trial, the authors illustrate that participants in their mindfulness program reported lowered stress and anxiety compared to those who uses life-as-usual or normal measures at the end of the intervention. The implication is that nurses in ED can integrate these measures to reduce different aspects of care that lead to burnout when handling different patients.
Change Model or Framework
Change models are a core part of the evidence-based practice (EBP) interventions as they allow professionals to implement proposed projects in an effective manner. The selected model for the proposed EBP project is the Iowa evidence-based practice model. The Iowa model is an effective approach as it focuses on the entire health organization and its network comprising patients, practitioners, systems and processes that impact care delivery. The model helps and guides the project team in execution of the practice decisions based on accessible research evidence. The model is appropriate for this project since it is detailed and uses a pragmatic problem-solving approach in implementing EBP projects. It also assumes an organizational system approach aimed at generating the desired outcomes to the clinical intervention (LoBiondo-Wood et al., 2021). The use of this model is essential in this project as it will allow nurses to identify the effects of burnout on their performance and patient outcomes in the ED. Through the use of the model, nurses will use research to understand the proposed solution and its effectiveness in addressing burnout and promoting patient safety as well as delivery of quality care.
a). Stages of the Iowa EBP Model
Developed in 1992 at the University of Iowa Hospitals and Clinics, the Iowa model of evidence-based practice consists of eight stages or steps to guide nurses and organizations in implementation of any proposed project. The initial stage is to identify the triggers that need an EBP change. These triggers are either knowledge-focused or problem-centered. In this case, the burnout issue in the ED is problem-centered while the proposed intervention is knowledge-focused since it improves nurses’ knowledge levels by adopting mindfulness meditation to reduce burnout (Tucker et al., 2021). The second stage of the model is determination of the issue as a priority for the healthcare organization. In this case, resolving burnout syndrome in the ED is a priority issue for the organization to enhance patient safety and improve nurses’ wellness and health.
The third stage is reflection on the topic of interest and engaging interested stakeholders. Through their engagement, the stakeholders create a team to develop, implement, and evaluate the proposed EBP change. In this case, the implementation team should include ED nurses and their leaders, the project team manager, administrative representatives, physician representative and other critical professionals to help design and allocate resources for the overall implementation. The fourth stage is collecting and analyzing research associated to the desired change (Tappen et al., 2022). At this stage, the team evaluates the level and merit of the current evidence, especially from existing literature through a comprehensive review and analysis. The team also formulates and refines the PICOT question and statement to conduct targeted and effective research to collect necessary evidence.
The fifth stage of the Iowa model is to review and analyze the collected literature to ascertain that the evidence supports the proposed EBP and it is scientifically sound. Upon ascertaining the credibility and reliability of the available evidence, the team can implement a pilot change to assess the overall effectiveness of the intervention in addressing the identified practice issue. The pilot change constitutes the sixth stage of the Iowa EBP model. The seventh stage is to implement the changes realized through the pilot initiative and evaluate the expected outcomes. Through this approach, the team can determine if the outcomes are cost-effective and should be sustained or if there is need for more changes.
The last stage is the evaluation which determines if the project implementation impacts the targeted population and lead to behavioral changes among healthcare workers, especially nurses in the ED department to cope with burnout (Hanrahan et al., 2019). The evaluation will be founded on the real transformation that will happen among nurses in helping them be resilient and cope with burnout syndrome to improve their wellness and performance to guarantee patient safety and better outcomes. While other models can be implemented in this project, the Iowa model is the most appropriate as it is straight forward to use and aligns with the overall expected outcomes.
Implementation Plan
Implementing changes in an organization comprises various aspects that implore the project team to create an effective plan to actualize the developed ideas in the proposed EBP project. At the core of this implementation is the provision of weekly education sessions and practice sessions on mindfulness meditation for nurses in the ED to reduce and prevent burnout by 50%. The implementation has several aspects and steps that include setting, timelines and resources, stakeholders to implement the plan, the methods and instruments required, the delivery of the intervention and data collection model. The implementation plan also focuses on other areas like the challenges, facilitators and the overall feasibility of the project.
i). Setting and Access to Subjects
The implementation of this proposed project will occur in the emergency department where nurses encounter increased workload due to high care demand. The excessive workload and high patient care demands increase the risk of nurses to get burned out. The approval of this project is essential because it involves human subjects. The approval is a critical component of getting informed consent to access the subjects who are ED nurses. The approval form is attached in the appendix.
ii). Implementation Timeline
The implementation of projects takes time in phased processes. The project leader requires sufficient time and specify each step, including the type of tasks, those responsible and the time requires. The project will take about six months as outlined in the timeline attached in the appendix. During this time, the project team and manager will introduce the initiative to the organization’s leaders, source for appropriate materials and ensure effective training for the nurses. The evaluation of the project’s outcomes will occur in the fifth month and strategies to sustain it will be developed in the sixth month.
iii). Budget and Resource List
The project sponsors should ensure that there are available resources for the project to avoid financial setbacks. Resources are a core aspect of ensuring that this proposed project is implemented successfully by the organization. For example, experienced trainers in mindfulness meditation would be required to train nurses and evaluate the outcomes. Materials required for training like stationery, a laptop for lead trainer, a project and training space are essential. The team also requires access to the Internet to demonstrate the integration of mindfulness meditation among the research subjects. The estimated cost for all the required resources for the implementation of this EBP change project is about $ 600 as captured in the appendix.
iv). Data Collection and Evaluation Design
EBP projects consume much time and are tedious. As such, having sufficient and accurate data to evaluate the overall effectiveness of the proposed project is important. The present project will be evaluated qualitatively and quantitatively. The qualitative approach will entail collecting and analyzing data to understand nurses’ experiences. The project team will use this approach to get insights into the study issue. The quantitative approach entails collecting and analyzing numerical data. The approach would be effective in determining the quantifiable differences between cases of nurses experiencing burnout before the intervention and after it implementation (Smith et al., 2021). Imperatively, based on this comparative analysis, the project will use a quantitative design in collecting and evaluating the effectiveness of the proposed project or intervention. The approach offers objectivity as it uses concrete numbers that can assist avoid biased interferences while enhancing the accuracy of the study. For instance, the approach will allow the project team to quantify the degree of project’s impact on nurses and burnout experiences among them. The model will also offer a chance to derive patterns and make predictions about the problem of nurse burnout in the ED (LoBiondo-Wood et al., 2021). Imperatively, the outcomes can be generalized to a wide range of settings and even nursing populations. Again, collection of data using the quantitative design is easy and leads to better understanding and application.
v). Methods and Instruments to Monitor the Implementation
At the core of monitoring the implementation will be the deployment of a comparative analysis of outcomes. Phased monitoring will be critical in ensuring complex challenges at each stage are tackled or addressed by the project team. The project team will use a rating scale to effectively monitor the multi-dimensional aspects of the initiative (Tappen et al., 2022). Based on the rating scale, every step would be categorized as successful or failed based on the projected completion date and level of content gained. The other area of focus would be the outcomes based on the level of reduction in nurse burnout. Under this category, the cases will be recorded and the percentage variations calculated to get the difference. Reducing nurse burnout by 50% will be considered a successful implementation of the intervention.
vi). Delivery of the Intervention
The delivery of the intervention will entail training ED nurses and using practice exercises to demonstrate the effects of mindfulness meditation. The implementation process will begin by getting approval to ensure the project is carried out within the expected ethical requirements. This will be followed by organization of the required resources for the weekly training on mindfulness meditation while engaging the management and leaders in different departments to be aware of the intervention Nurses will then get weekly training as progressive monitoring occurs. At the end of the fifth month, a summative project evaluation will be conducted to determine if the desired outcomes were attained.
vii). Stakeholders in Implementing the Plan
The project needs collaboration of different stakeholders based on their roles. These include organizational leaders, trainers to empower nurses with appropriate skills for practicing mindfulness meditation, and nurses who shall benefit from the intervention. The organizational leaders will offer resources and ensure that all project goals are attained based on the implementation approaches. Nurse leaders and nurses in the ED will also ensure that the project attains its goals and objectives through sufficient allocation of resources.
viii). Possible Challenges and Interventions
The overall success of this project will depend on how the team manages different aspects that include facilitators, barriers, and development of effective strategies to respond appropriately to all situation that may obstruct the implementation. Organizational leaders and managers will play a core role in the overall implementation by providing the required resources and support upon approving the project and embracing it. Core challenges may include insufficient support and time for nurses to engage in the training due to the nature of their workplace, attitudes towards change, and possible limited support from organizational leaders. Change resistance is a prevalent challenge and may arise due to individuals preferring the status quo and may demonstrate bias towards the new interventions to reduce burnout in the ED (Cho et al., 2021).
Overcoming these challenges will be critical in attaining its goals and objectives. The first approach would be to ensure that all stakeholders are involved in the project. Through this engagement, they will understand its effects and overall outcomes to all stakeholders. Other interventions to overcome these barriers will include effective communication, teamwork approach and allocation of sufficient resources, especially time.
Feasibility of the implementation is also critical. In this case, the project manager and the tem will evaluate the feasibility of the interventions using a cost-benefit analysis model. The overall cost of implementing this project will be assessed against the expected benefits that it shall have on the targeted population. These approaches will ensure that that the trained nurses can reduce burnout and be resilient in their nursing processes and activities.
Evaluation Plan
Evaluation is an essential part of project implementation as it assesses whether the execution is successful, what needs to be changed and if the work offers proof for funding and getting support from the stakeholders (Albarqounis et al., 2018). The evaluation of the EBP project proposal to reduce burnout among nurses in the ED will entail assessing the expected outcomes, a review of data collection tools, choosing of an appropriate statistical test and methods to collect data and measure the expected outcomes.
i). Expected Outcomes of the EBP Project Proposal
The main expected outcome from this project is a reduction of burnout levels and attainment of resilience among nurses in the ED. The implementation will lead to better awareness about the effects of burnout and use of mindfulness meditation to reduce the syndrome and enhance the performance levels of the nurses. The project will also enhance overall access to care and reduce the occurrence of adverse events like medication errors and even falls in the ED. The project will also improve collaboration among nurses and other providers in the department and the entire healthcare organization.
ii). Data Collection Tools and Research Design
As mentioned, the project will adopt a quantitative approach in data collection and research design. While it would be imperative to document nurses’ experiences using a phenomenological model, having the quantitative approach will allow the project team to quantify outcomes and determine with high levels of precision the impact of the intervention. The project team and manager will use surveys questionnaires and semi-structured interviews to gather data from nurses going through the program to determine overall effectiveness. These tools and design will help the team to have effective strategies based on what works and what does not while dealing with the subjects in the process.
iii). Statistical Test for the Project & Outcome Evaluation
Statistical tests determine if predictor variables develop a critical relationship with the outcome variables. In this case, the EBP project will use a regression test, particularly multiple linear regression that focuses on two or more predictors with one continuous outcome. Regression test will explore the effects of having the intervention on the overall performance of nurses in the ED, particularly in containing the adverse outcomes of burnout while serving patients. The regression test is the most appropriate as it highlights the associated benefits of mindfulness meditation among ED nurses in the facility.
The project will collect data using various approaches or methods, from self-reporting benefits among the nurses to reduction in burnout level and integration of resilient approaches among patients coming to the ED. The evaluation and measurement of outcomes will also leverage data collecting on aspects like medication errors and even falls happening in the ED, feedback from patients and families and feedback from nurses concerning their approaches in implementing the suggested measures. The evaluation will determine areas for improvement and recommend effective measures to achieve the expected positive outcomes.
iv). Sustainability of the Project
The overall sustainability of this project will ensure that nurses perform their tasks and duties based on better preparation and without any undue duress emanating from burnout. Plans to maintain the project will entail integration of mindfulness meditation as a core part of developing a wellness organizational culture and allocating sufficient resources to conduct the sessions regularly to benefit the participants (Carrasco et al., 2020). The team and the organizational leadership will continually review and revise the components of this project to align with new trends, emerging scientific evidence from research, especially through translational research evidence to reduce burnout among nurses. The implication is that the team should align project goals and objectives with those of the organization to attain best practices and quality patient outcomes.
Conclusion
The proposed EBP project illustrates that using mindfulness meditation can help improve ED nurses’ performance and resilience because it mitigates burnout syndrome. As indicated, over 30% of nurses’ experience burnout with recent statistics showing that about 93% have reported feeling burnout within the last five years. Burnout is one of the leading causes of nurse turnover and leaving the profession altogether. Emergency department (ED) nurses are at increased rates of susceptibility to burnout due to their clinical settings. As such, the use of mindfulness meditation will help these providers reduce their burnout rates and enhance their overall performance. The implementation of this intervention will require the team to use the Iowa EBP model based on its steps and integration of a learning environment. ED nurses and nurse managers should embrace this intervention to reduce burnout syndrome and improve overall performance for better patient outcomes.
References
Albarqouni, L., Hoffmann, T., & Glasziou, P. (2018). Evidence-based practice educational
intervention studies: a systematic review of what is taught and how it is measured. BMC medical education, 18(1), 1-8. https://doi.org/10.1186/s12909-018-1284-1
Ameli, R., Sinaii, N., West, C. P., Luna, M. J., Panahi, S., Zoosman, M., … & Berger, A. (2020).
Effect of a brief mindfulness-based program on stress in health care professionals at a US biomedical research hospital: a randomized clinical trial. JAMA network open, 3(8), e2013424-e2013424. DOI:10.1001/jamanetworkopen.2020.13424
Argyriadis, A., Ioannidou, L., Dimitrakopoulos, I., Gourni, M., Ntimeri, G., Vlachou, C., &
Argyriadi, A. (2023, March). Experimental Mindfulness Intervention in an Emergency
Department for Stress Management and Development of Positive Working Environment. Healthcare, 11(6): 879). DOI: 10.3390/healthcare11060879
Berlin, G, Burns, F., Essick, C., Lapointe, M. & Murphy, M. (2023 May 5). Nursing in 2023:
How hospitals are confronting shortages. https://www.mckinsey.com/industries/healthcare/our-insights/nursing-in-2023
Carrasco, J., García, S., Rueda, M. M., Das, S., & Herrera, F. (2020). Recent trends in the use of
statistical tests for comparing swarm and evolutionary computing algorithms: Practical guidelines and a critical review. Swarm and Evolutionary Computation, 54, 100665.
Cho, Y., Kim, M., & Choi, M. (2021). Factors associated with nurses’ user resistance to change
of electronic health record systems. BMC Medical Informatics and Decision Making, 21(1), 218. https://doi.org/10.1186/s12911-021-01581-z
Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: a theoretical
review. Human resources for health, 18, 1-17. DOI: https://doi.org/10.1186/s12960-020-00469-9
Gagnon, M. P., Attieh, R., Dunn, S., Grandes, G., Bully, P., Estabrooks, C. A., Légaré, F., Roch,
G., & Ouimet, M. (2018). Development and content validation of a transcultural instrument to assess organizational readiness for knowledge translation in healthcare organizations: The OR4KT. International Journal of Health Policy and Management, 7(9), 791–797. https://doi.org/10.15171/ijhpm.2018.17
Hanrahan, K., Fowler, C., & McCarthy, A. M. (2019). Iowa model revised: Research and
evidence-based practice application. Journal of pediatric nursing, 48, 121-122.
DOI: 10.1016/j.pedn.2019.04.023.
Hooper, V. (2023). Nursing Post Pandemic: The Path Forward. Journal of Peri-Anesthesia
Nursing, 38(1), 1-2. DOI: 10.1016/j.jopan.2022.12.001
Lee, M. M., Gensimore, M. M., Maduro, R. S., Morgan, M. K., & Zimbro, K. S. (2021). The
impact of burnout on emergency nurses’ intent to leave: a cross-sectional survey. Journal of Emergency Nursing, 47(6), 892-901. https://doi.org/10.1016/j.jen.2021.07.004
Lin, L., He, G., Yan, J., Gu, C., & Xie, J. (2019). The effects of a modified mindfulness-based
stress reduction program for nurses: a randomized controlled trial. Workplace Health & Safety, 67(3), 111-122. https://doi.org/10.1177/2165079918801633
LoBiondo-Wood, G., & Haber, J. (2021). Nursing research E-book: methods and critical
appraisal for evidence-based practice. Elsevier Health Sciences.
Luo, L. X., Peng, X., Hou, J., Xie, Y., Dong, H., Peng, S., … & Zhang, J. (2023). Effects of
mindfulness decompression therapy on mental health and job burnout among nurses working in the frontline of the novel coronavirus pandemic: a retrospective study. Journal of Occupational Health, 65(1), e12398. https://doi.org/10.1002/1348-9585.12398
Petkovic, J., Riddle, A., Akl, E. A., Khabsa, J., Lytvyn, L., Atwere, P., … & Tugwell, P. (2020).
Protocol for the development of guidance for stakeholder engagement in health and healthcare guideline development and implementation. Systematic Reviews, 9(1), 1-11. https://doi.org/10.1186/s13643-020-1272-5
Phillips, K., Knowlton, M., & Riseden, J. (2022). Emergency department nursing burnout and
resilience. Advanced Emergency Nursing Journal, 44(1), 54-62.
DOI: 10.1097/TME.0000000000000391.
Russell, K. (2023 April 14). About 100,000 nurses left the workforce due to pandemic-related
burnout and stress, survey finds. https://edition.cnn.com/2023/04/13/health/nurse-burnout-post-pandemic/index.html
Salvado, M., Marques, D. L., Pires, I. M., & Silva, N. M. (2021, October). Mindfulness-based
interventions to reduce burnout in primary healthcare professionals: A systematic review and meta-analysis. Healthcare, 9(10): 1342). DOI: 10.3390/healthcare9101342
Seppala, E., Bradley, C. & Goldstein, M. R. (2020 September 29). Research: Why Breathing Is
So Effective at Reducing Stress. https://hbr.org/2020/09/research-why-breathing-is-so-effective-at-reducing-stress
Smith, J. D., & Hasan, M. (2020). Quantitative approaches for the evaluation of implementation
research studies. Psychiatry Research, 283, 112521. https://doi.org/10.1016/j.psychres.2019.112521
Sulosaari, V., Unal, E., & Cinar, F. I. (2022). The effectiveness of mindfulness-based
interventions on the psychological well-being of nurses: A systematic review. Applied Nursing Research, 64, 151565. https://doi.org/10.1016/j.apnr.2022.151565
Tappen, R. M. (2022). Advanced nursing research: from theory to practice. Jones & Bartlett
Learning.
Tellhed, U., Daukantaitė, D., Maddux, R. E., Svensson, T., & Melander, O. (2019). Yogic
breathing and mindfulness as stress coping mediate positive health outcomes of yoga. Mindfulness, 10, 2703-2715. DOI: https://doi.org/10.1007/s12671-019-01225-4
Tucker. S, McNett. M, Mazurek. M. B, Hanarahan. K, Hunter. S.C, Kim. B, Callen. L & Kitson.
A (2021). Implementation science: Application of Evidence-Based Practice Models to Improve Healthcare Quality. Worldviews on Evidence-Based Nursing, 18:76-84. https://doi.org/10.1111/wvn.12495.
Van Huy, N., Thu, N. T. H., Anh, N. L. T., Au, N. T. H., Cham, N. T., & Minh, P. D. (2020).
The validation of organizational culture assessment instrument in healthcare setting: Results from a cross-sectional study in Vietnam. BMC Public Health, 20(1), 1-8. https://doi.org/10.1186/s12889-020-8372-y
Wong, K. U., Palladino, L., & Langhan, M. L. (2021). Exploring the effect of mindfulness on
burnout in a pediatric emergency department. Workplace Health & Safety, 69(10), 467-473. https://doi.org/10.1177/21650799211004423
Zhu, B., Hedman, A., Feng, S., Li, H., & Osika, W. (2017). Designing, prototyping and
evaluating digital mindfulness applications: a case study of mindful breathing for stress reduction. Journal of medical Internet research, 19(6), e197. DOI: 10.2196/jmir.6955
Appendices
Appendix A: OR4KT Questionnaire
|
1 = Strongly disagree; 2 = Disagree; 3 = Neutral; 4 = Agree; 5 = Strongly agree |
- Organizational Climate
| In the organization: | 1 | 2 | 3 | 4 | 5 |
| Staff work as a team | 5 | ||||
| Staff members free to ask questions and express concerns | 5 | ||||
| The management is open to staff ideas for improving change | 5 | ||||
| The heavy workload reduces intervention effectiveness | 4 | ||||
| Managers encourage trying new and different practices | 4 |
- Organizational Contextual Features
| The organization, | 1 | 2 | 3 | 4 | 5 |
| Has necessary supporting facilities and equipment | 4 | ||||
| Has necessary support in staffing members | 4 | ||||
| Staff members are receptive to change in clinical processes | 5 | ||||
| Has necessary support in terms of training. | 5 | ||||
| Staff members have a sense of personal responsibility for improving patient care and outcomes | 5 |
- Change Content
| In the organization, | 1 | 2 | 3 | 4 | 5 |
| There is willingness to adjust to change | 4 | ||||
| There is flexibility to deal with change | 4 | ||||
| The proposed change considers patient needs and preferences | 5 | ||||
| There is ability to exchange ideas and impact upon decisions related to delivery of patient care. | 5 | ||||
| The proposed changes take into consideration the needs and preferences of patients. | 5 |
- Leadership
| In the organization, | 1 | 2 | 3 | 4 | 5 |
| Managers provide effective management for continuous patient care improvement | 4 | ||||
| Managers are involved in the change process | 5 | ||||
| Clinicians are involved in the change process | 5 | ||||
| Managers hold staff members accountable for achieving results. | 4 | ||||
| Managers provide staff members with feedback/data on effects of clinical decisions. | 5 |
- Organizational Support
| In the organization, | 1 | 2 | 3 | 4 | 5 |
| Assistance to develop new ideas is readily available | 4 | ||||
| Team members cooperate to develop new ideas | 4 | ||||
| Outcomes are monitored continuously | 5 | ||||
| The change progress is monitored continuously | 5 | ||||
| The evaluation and improvement of the change implementation include periodic outcome measurement | 5 |
- Motivation
| In the organization, | 1 | 2 | 3 | 4 | 5 |
| Patients make pressure to make changes | 4 | ||||
| Pressure to make changes come from staff members | 4 | ||||
| Senior leaders make pressure to make changes | 4 | ||||
| There is implementation change experience gained from projects or pilot programs and their evaluation. | 3 | ||||
| Senior managers promote change by behaving in a manner consistent with it | 4 |
Overall score= 85/100= 85%
Appendix B: Iowa EBP Model
Appendix C: Approval Form
Title of the Project: ________________________________________________________
Student’s Name: __________________________________________________________
Implementation Period ____________________________________________________
Participants _____________________________________________________________
Benefits ________________________________________________________________
Potential risks ___________________________________________________________
Resources ______________________________________________________________
Administration Remarks (project approved/rejected) ____________________________________________________________________________________________________________________________________________________________
Approving Authority Signature __________________________ Date _______________
Student’s Signature ___________________________________ Date _______________
Appendix D: Timeline
| Month/Period | Project Phase |
| 1 | Introduction to leaders |
| 1 | Sourcing materials |
| 2 | Training commences |
| 3 | Training continues |
| 4 | Training (final phases) |
| 5 | Outcome evaluation |
| 6 | Developing sustainability mechanisms |
Appendix E: Budget and Resource List
| Resource | Projected Cost |
| Human resources (training charges) | $400 |
| Stationery | $50 |
| Projector hiring | $80 |
| Internet | $45 |
| A laptop (available) | $0 |
| Total | $575 |
Appendix F: Methods and Instruments
Rating Scale
| Project Phase | Rating (Successful/not) |
| Introduction to leaders | |
| Sourcing materials | |
| Training commences | |
| Training continues | |
| Training (final phases) | |
| Outcome evaluation | |
| Developing sustainability mechanisms |
Outcomes Determination/Rating
| Parameter: Nurse Burnout | |
| Reported cases of burnout before the project | |
| Reported cases of burnout after the project | |
| Percentage difference (50% reduction or above shows success) | |
Appendix G: APA Writing Checklist
© 2022. Grand Canyon University. All Rights Reserved.
APA Writing Checklist
Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.
X APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.
X The title page is present. APA format is applied correctly. There are no errors.
X The introduction is present. APA format is applied correctly. There are no errors.
X Topic is well defined.
X Strong thesis statement is included in the introduction of the paper.
X The thesis statement is consistently threaded throughout the paper and included in the conclusion.
X Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.
X All sources are cited. APA style and format are correctly applied and are free from error.
X Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.
Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.
Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.
Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.
Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.
Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.
X The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.
ORDER A PLAGIARISM-FREE PAPER HERE
Assessment Description
For this assignment, you will synthesize the independent evidence-based practice project proposal assignments from NUR-550 and NUR-590 into a 4,500-5,000-word professional paper.
Final Paper
The final paper should:
Incorporate all necessary revisions and corrections suggested by your instructors.
Synthesize the different elements of the overall project into one paper. The synthesis should reflect the main concepts for each section, connect ideas or overreaching concepts, and be rewritten to include the critical aspects (do not copy and paste the assignments).
Contain supporting research for the evidence-based practice project proposal.
Main Body of the Paper
The main body of your paper should include the following sections:
Problem Statement
Organizational Culture and Readiness
Literature Review
Change Model, or Framework
Implementation Plan
Evaluation Plan
Appendices
The appendices at the end of your paper should include the following:
All final changes or revisions for the drafts that will be included in the appendices of your paper.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper. In each preceding course you have been directed to the Student Success Center for assistance with APA style, and have submitted the APA Writing Checklist to help illustrate your adherence to APA style. This final paper should demonstrate a clear ability to communicate your project in a professional and accurately formatted paper using APA style.
General Requirements
You are required to cite 10-12 peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing
1.1: Translate research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice.
5.1: Design ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care.
