NR 505 Week 7 Assignment

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NR 505 Week 7 Assignment

 

The nursing sector represents the largest professional sector, with almost 4 million nurses in the United States (National Association of School Nurses, 2016). Even though nursing practitioners are responsible for the health and well-being of millions, they often suffer high stress and burnout levels that risk their own health and the quality of patient care. According to Lavalais, Jackson, Kagure, DeBose and McClinton (2018), the nursing workforce has constantly been facing increased workload due to shorter hospital stays, increased average patient acuity, decreased support services, and a national nursing staff shortage. Nantsupawat, Nantsupawat, Kunaviktikul, Turale and Poghosyan (2016) link higher nurse workloads with burnout and job dissatisfaction and precursors to nurse turnover that heighten nurse shortage. A plethora of research has established that nursing staff stress and burnout often result in decreased quality of patient care and patient (Lavalais et al., 2018). Many scholars have studied the impact of educational intervention on nurse burnout and have established a positive impact of self-care management education in reducing nurse burnout for improving of the quality of patient care. In this regard, this project is aimed at studying the impact of educational intervention in addressing nurse burnout to improving of the quality of patient care and total patient health outcomes. The paper includes the project’s data collection, analysis, evaluation, dissemination of results and a conclusion.

Data Collection

The developed PICOT question for this project is as follows: “Can nurse leaders/managers (P) use educational intervention for nurse burnout self-care strategies (I) compared to no education (C) to improve quality of patient care (O) in 6 weeks (T)?”

 NR 505 Week 7 Assignment

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 NR 505 Week 7 Assignment

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As described by Moore et al. (2015), data collection involves gathering and measuring variables of interest in study research by application of established systematic approaches in order to enable the researcher to test hypotheses, answer research questions, and evaluate study outcomes. It is highly crucial to ensure that data collection is conducted in an accurate and honest manner with the use of appropriate data collection tools in order to maintain the integrity of the research (Moore et al., 2015). In this regards, the data collection process for this project will take into account the use of questionnaires and observations methodologies. The questionnaires will be pre-constructed and pre-tested with 15 nursing practitioners not involved in the study in order to establish the time needed to complete as well as the potential challenges faced in completing it.                                                                                                                     The questionnaire will contain various measures including (i) demographic questions concerning participant’s gender, age, marital status, education, race, ethnicity, nurse-manager status, work setting, years in nursing practice, and years at the healthcare facility; (ii) Nursing Stress Scale (NSS) will include sub-scales of death and dying, inadequate preparation, work load, conflict with physicians, conflict with other nurses, uncertainty concerning treatment, and lack of support; (iii) Symptoms of Distress will consist of a 15-item scale describing physical or emotional distress symptoms (nervousness, muscle tension, etc.) with a 4-point response scale (1-nearly every day to 4-never) for indicating the degree in which the symptom was experienced in the last 30 days; (iv) Coping with Stress that includes 12-items for assessing the strategies used to manage difficult events and situations with each item answered in a 4-point scale (1-never to 4-almost always); higher scores will translate to better coping; (v) Work Limitations Questionnaire (WLQ) will include four distinct scales: a 5-item scale for assessing difficulties in meeting timelines and schedules, a six-item scale for assessing nurses’ ability to carry out job tasks, focus and concentration, a 3-item scale for assessing interpersonal professional demands, and a 5-item scale nurses ability to maintain quantity and quality of their job requirements; and  (v) Nurses Job Satisfaction Scale will consist of 24-item measuring nurses’ job satisfaction levels with 7 work factors including administration, career, nursing education, relation with supervisor, co-workers, patient care, and communications.

 NR 505 Week 7 Assignment

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The observational method, on the other hand, will involve the collection of data from the healthcare electronic health records in regards to patient factors of quality care including patient falls, medical errors, HAI, bedsores, readmission, morbidity, and mortality rates. The data collection points for this study include at pre-intervention (at baseline), during the intervention (self-care management education) and post-intervention. In this regards, the pre-intervention data collection process will comprise filling of the questionnaires by nurses in both intervention and control groups following the acquisition of their informed consent. In addition, data regarding quality of patient care and health outcomes will be collected and recorded in terms of the number of patient falls, HIAs, bedsores incidences, readmissions, medical errors, morbidity, and mortality. This process will be conducted for a period of two days whereby nurses will fill the questionnaires in groups of 20 allocated 2 hours each.

The intervention step data collection will involve continuous collection of data concerning patient outcomes from the EHR. At this point, nurses’ will not be required to fill the questionnaires but their feedback and recommendations will be accepted. During the intervention, the nurses in the intervention group will be divided into 5 groups each containing 20 participants. Each group will be educated on self-care strategies for burnout by randomly selected and informed nurse leaders and managers 5 days a week for 6 weeks. The educational intervention will make use of different educational methodologies including power-point presentation, photographs, writing boards, printed handouts, videos, and simulations all available in the English language. The control group participants will not receive any self-care management education for burnout but will continue to serve their patients in the normal routine. It is important to note that the patients for the intervention group are in a different healthcare setting from the patients for the control group to ensure maintenance of the quality of the study research.

The post-intervention data collection process will take place six weeks after the commencement of self-care management educational intervention. It will involve filling of the questionnaires by nurses from both intervention and control group to reassess nurses’ knowledge of self-care management strategies as well as attitudes towards their jobs and burnout. At this point, patient data will be obtained again from the EHR to assess the differences in patient health outcomes before and after intervention implementation by evaluating a number of patient falls, HIA, medical errors, bed sores, readmissions, morbidity, and mortality. The pre-intervention data collection process will take a period of two days to allow the participants to fill out the questionnaires without feeling pressured and limited by time.

To ensure production of high-quality data, it is vital to check and critically assess data collection methods used to ensure that the process is carried out with credibility, conforms to research protocols and can withstand scrutiny from reviewers (Cai & Zhu, 2015). The aspects of the quality of research data include relevance, validity, reliability, objectivity, completeness, generalizability, integrity, and utility (Cai & Zhu, 2015). The two key strategies that will be used for enhancement of quality of data include standardization and validation of questionnaires and screening of data collected from the questionnaires. To standardize and validate the questionnaires, the research will make sure that the questionnaires used are the same for all participants and that all participants adhere to similar procedures in responding to the questionnaires. More so, the researcher will educate the participants on how to fill the questionnaires prior to actual filling in order to minimize aspects of human errors or failure to complete the questionnaires. Regarding data screening, the research will use various screening tools and functionalities to screen the data collected prior to inputting it into databases. In addition, the research will put in place a dependable data coding system that can be used or /and replicated for future use.  The data-coding systems will re-double check data entered to eliminate any data redundancy, and to check for data accuracy and completeness. In addition, codebooks for coding all crucial information for interpretation of study data including participants’ demographics, variables’ formats and descriptions, as well as methodologies of data collection employed (Vindrola-Padros, Pape, Utley & Fulop, 2017). With all these strategies in place, data produced will be expected to be of high quality and thus result in the production of quality research outcomes.

Analysis

 NR 505 Week 7 Assignment

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Data analysis is usually the next step after data collection in research and it involves data inspection, cleaning, transformation, and remodeling with the purpose of reaching a conclusion regarding a particular situation. According to Mertler and Reinhart (2016), data analysis is highly crucial as it provides the researcher(s) with an explanation in light of various frameworks, theories, concepts, and methodologies employed. Eventually, this helps in responding to research questions, proving the research hypothesis, and reaching a conclusion. In addition, data analysis assists in structuring findings from distinct data sources, breaking macro problems into smaller (micro) parts, and acting like a filter in the acquisition of meaningful insightful from large amounts of data sets (Mertler & Reinhart, 2016). Furthermore, data analysis aids in eliminating human bias from the conclusion of a research study to help in the realization of proper statistical treatment (Simonsohn, Simmons & Nelson, 2015).

In this regards, this project will apply descriptive statistics and inferential statistics in data analysis. Descriptive statistics consists of description, summarization, and organization of data a way that is easily understandable without making a conclusion to the entire population from the sample (Simonsohn, Simmons & Nelson, 2015). In using descriptive statistics, this study’s data will be organized and tabulated using the statistical package for social science (SPSS) 18. At that point the mean, mode, median, variance, percentile ranks, quartile ranks, standard deviation, and range of participants scores and patient outcomes as collected from the questionnaires and observation respectively will be described and summarized to a more meaningful and understandable format manner.

Conversely, inferential statistics involves the use of a random sample of data obtained from a whole population to describe and draw inferences about the entire population from the sample (Mertler & Reinhart, 2016). The key purpose of inferential statistics is to test or answer the research hypothesis to facilitate the researcher(s) in deducing rational decisions in light of the reality of the observed effects (Simonsohn, Simmons & Nelson, 2015). This study will use inferential statistics to test and answer the hypothesis: Whether self-care management educational intervention for nurse burnout helps in improving patients’ quality of care. It will attempt to establish the relationship between nurse burnout and the quality of patient care and ultimately establish whether educational intervention can improve nurse burnout and ultimately patient care quality. One type of inferential statistics that will be applied is mean. The research will use the paired (t) test to compare the mean of participants’ scores and patients’ outcomes in between the intervention group and control group and ultimately draw a conclusion about the population under study (nurses) from the sample populations (study’s participants).

Evaluation

 NR 505 Week 7 Assignment

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Project evaluation plays a fundamental role in the research process as it enables the researcher(s) to illustrate and communicate the project’s progress, impact, and achievement to the stakeholders. Omae, Mitsui and Takahashi (2016) define study evaluation as the process of critical examination of a research project through gathering and analysis of information about the attributes, activities, and outcomes of the project. Essentially the purpose of drawing judgments about a study project, is aimed at improving its effectiveness, as well as informing decisions. The evaluation of this project will take into cognizance the impact of its implementation by explaining how its stakeholders (nurse leaders/managers, nurses, and patients) will experience enhanced outcomes. Taking this into account, this project evaluation explains how its stakeholder will experience improved outcome form the implementation of the project.

Nurse leaders/ managers will experience positive and improved outcomes in terms of total health outcomes and resource management. By educating the nurses about self-care management strategies, the nurse leaders will empower the nurses to perform productively and thus improving patient outcomes for the healthcare facility. Again, resource management will include taking control of human resources, time and related costs. The leaders/ managers will experience reduced nursing stress and burnout and ultimately reduced nurse turnover rates. This will mean that the nursing shortage will be easily manageable with positive attitudes and perceptions from the nurses following reduced stress and burnout. Regarding time and cost, the leaders and managers will save a lot of time and costs as the quality of patient care will improve and as a consequent, reduce admission and readmission, medical errors, HIAs, patient falls, and bedsores which are a major cause of excessive use of healthcare time and money.

The nurses will experience positive and improved outcome in their health including physical, mental, and social health and well-being, particularly in work-life balance. In addition, with reduced burnout and stress, nurses will improve their performance and productivity resulting in improved nursing outcomes and job satisfaction.

The patients will experience improved outcomes from improved nurse performance and productivity. With reduced burnout, the nurses will be a better position to create health patient-provider relationship and to deliver quality care. Consequently, patients will experience improved health outcomes through reduction of medical errors, bedsores, HIAs, patient falls, morbidity and mortality. More so, patients will experience the reduced cost of healthcare as they will receive quality care resulting in faster and effective recuperation.

As put forward by Krawczyk et al. (2018), implementing evidence-based practice (EBP) leads to various changes and improvements to the nursing practice within the micro-level, meso-level, as well as micro-levels projects. The macro-level entails the policy level; meso-level involves the healthcare organization and community level; and micro-level includes the patient interaction level (Krawczyk et al., 2018). This project’s implementation will impact various changes to the micro-level family nursing practice (FNP). Firstly, improvement in patient-provider interaction as nurses will be happier about their jobs with positive attitudes and thus lead to the creation of a positive atmosphere for interactions. Secondly, patient safety will be improved as the nurses will be more active in patient care without stress, fatigue, and high workloads. Improvement in patient safety will result in improvement in the quality of patient care and ultimately improvement in total health outcomes.

Dissemination of Results

Dissemination of research results is a very essential aspect of the research project as it enables the research to reach the intended audience in an effective and efficient approach (Brownson, 2017). There are myriad strategies for dissemination of research results which in most cases are used together for the achievement of a complete dissemination process. According to Fussy (2018), using multiple dissemination strategies produces a stronger plan for dissemination as each of the strategy’s strengths combines to complement each other. The key categories of this project’s audience include the project stakeholders (nurse leaders/managers, nurses, and patients) and the members of the nursing practice, community, state, and national levels.

 NR 505 Week 7 Assignment

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Considering the stakeholders, as argued by Brownson (2017), it is highly fundamental to share research results with the stakeholders in order to allow for critical review, recommendations, and constructive criticism. In disseminating the results to the stakeholders, the project will adopt the strategy of involving them in all steps of project planning, design, development, and implementation to develop in them a sense of ownership while ensuring that they get constantly equipped with well-grounded, relevant, accessible, as well as applicable research results. More so, the researcher will hold meetings, workshops, community forums, and seminars with the stakeholders and subsequently present to them the research by use of power-point presentations. Additional strategies will be through sending letters of appreciation, flyers, summary documents, brochures, and research briefs to the stakeholders

In regards to the future members of FNP, community, state, and national levels, various long-term approaches will be employed with first being publication of the research study to peer-reviewed journals such as The Bulletin of the World Health Organization; Global Public Health; Health Policy and Planning; Journal of Student Research; Community Health Education; Tropical Medicine and International Health; Journal of Nursing Scholarship; Social Science and Medicine; and Human Resources for Health. Through publication, the article will be readily available in all medical and healthcare databases including PubMed, Cinahl, Embase, Popline, Cochrane, and Medline among others. Fussy (2018) asserts that publishing research results into peer-reviewed articles indicates the community’s acceptance as well as acknowledgment of the research and facilitates the visibility of the research’s contribution to the research field. The research will be sure to allow for “Open Access” to the article to allow unlimited access and use/ reuse of research results.

The second approach will be the use of short documents, commonly referred to as policy briefs to allow for research results to reach the non-specialized audience especially lobbyists and policymakers at the community, state and national levels. Brownson (2017) argues that it is essential to share study results with policymakers and lobbyists to facilitate the change of policy or practice as guided by the study results. The project will also make use of the media including internet-based media, television, radio, and newspapers. Considering that social media platforms are widely used in today’s world, using them as a medium of result dissemination will reach many audiences from all over the world.

Conclusion

Nurse burnout and stress is a common problem affecting not only the nurses but also patient quality of care and total health outcomes and thus needs to be addressed. This research is aimed at establishing the effectiveness of self-care management education of nurse burnout in improving quality of care through a randomized controlled trial. The data collection methods will include questionnaires and observations where the quality of data will be highly monitored. Data analysis will involve descriptive statistics and inferential statistics. The project implementation will have various impacts on all the stakeholders. Nonetheless, its results will be disseminated to the stakeholders, and future FNPs, local community, state, and national levels through various dissemination strategies. The project potential contribution includes expansion of knowledge of EBP practices for self-care, adding to existing research about nurse burnout, and forming a point of reference to future related research studies.

 

 NR 505 Week 7 Assignment

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References

Brownson, R. C. (2017). Dissemination and implementation research in health: translating science to practice. Oxford University Press.

Cai, L., & Zhu, Y. (2015). The challenges of data quality and data quality assessment in the big data era. Data Science Journal, 14. DOI: http://doi.org/10.5334/dsj-2015-002

Fussy, D. S. (2018). Research dissemination practices in Tanzania: Limitations and potentialities. International Journal of Educational Development, 62, 209-216. https://doi.org/10.1016/j.ijedudev.2018.05.003

Krawczyk, M., Sawatzky, R., Schick-Makaroff, K., Stajduhar, K., Öhlen, J., Reimer-Kirkham, S., … & Cohen, R. (2018). Micro-Meso-Macro Practice Tensions in using patient-reported outcome and experience measures in hospital palliative care. Qualitative Health Research, 1049732318761366. doi: 10.1177/1049732318761366.

Lavalais, E. A. L., Jackson, T., Kagure, P., DeBose, M. M., & McClinton, A. (2018). Factors Influencing Nurse Burnout and Recommendations. Journal of Student Research, (1).

Mertler, C. A., & Reinhart, R. V. (2016). Advanced and multivariate statistical methods: Practical application and interpretation. Routledge.

Moore, G. F., Audrey, S., Barker, M., Bond, L., Bonell, C., Hardeman, W., … & Baird, J. (2015). Process evaluation of complex interventions: Medical Research Council guidance. Bmj, 350, h1258. doi: https://doi.org/10.1136/bmj.h1258

Nantsupawat, A., Nantsupawat, R., Kunaviktikul, W., Turale, S., & Poghosyan, L. (2016). Nurse burnout, nurse‐reported quality of care, and patient outcomes in Thai hospitals. Journal of Nursing Scholarship, 48(1), 83-90. doi: 10.1111/jnu.12187

National Association of School Nurses. (2016). Framework for 21st century school nursing practice: National Association of School Nurses. NASN School Nurse, 31(1), 45-53. doi: 10.1177/1942602X15618644

Omae, Y., Mitsui, T., & Takahashi, H. (2016, December). Rubric evaluation for project research as active learning in super science high school. In System Integration (SII), 2016 IEEE/SICE International Symposium on (pp. 827-831). IEEE. DOI: 10.1109/SII.2016.7844102.

Simonsohn, U., Simmons, J. P., & Nelson, L. D. (2015). Specification curve: Descriptive and inferential statistics on all reasonable specifications. DOI: 10.2139/ssrn.2694998

Vindrola-Padros, C., Pape, T., Utley, M., & Fulop, N. J. (2017). The role of embedded research in quality improvement: a narrative review. BMJ Qual Saf, 26(1), 70-80. http://dx.doi.org/10.1136/bmjqs-2015-004877

 NR 505 Week 7 Assignment

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