Capstone Project Change Proposal Presentation for Faculty Review and Feedback
Running head: BENCHMARK-CAPSTONE PROJECT CHANGE PROPOSAL 1
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BENCHMARK-CAPSTONE PROJECT CHANGE PROPOSAL
Organizational Leadership Approach to Improve Retention of Nurses Related to Burnout
Sunday, November 08, 2020
Organizational Leadership Approach to Improve Retention of Nurses Related to Burnout
Nurses working in health care settings, hospitals included experience a high levels of stress due to multiple reasons some of them being, dissatisfaction with the management team and superiors, negative working environments and long working hours (Gensimore, Maduro, Morgan, McGee & Zimbro, 2020). Over time, this stress leads to burnout which is characterized by reduction in energy levels, emotional exhaustion, reduced work productivity, increased frustration and lack of motivation (Mudallal, Othman & Al Hassan, 2017). Nurses who do not constantly experience high stress levels at work tend to work in the same organization for a long time and those who constantly experience high levels of burnout tend to leave the organization they work for. Effective nursing leadership approaches have been proven to reduce burnout, thus ensuring retention of nurses. This paper will address evidence-based research interventions that nurse leaders can adopt to address burnout in their organization to ensure retention of nurses.
Background
It has been estimated that nurses’ burnout ranges from about 40 % of nurses who work in a hospital report feelings of burnout (Reith, 2018). Almost one out of 5 employed nurses leave her job within the first year of enrolment, and about 1 in 3 quit their job within their second year. A study conducted by Haddad, Annamaraju & Toney-Butler (2020), shows that the number one reason as to why nurses are leaving their jobs is because of heavy workloads. If the underlying issues causing burnout are not targeted and fixed by nursing leaders, nurses will continue to quit their organization, creating even more shortage of nurses.
Clinical Problem Statement
About 43% of nurses who work in a hospital report feelings of burnout (Reith, 2018). Burnout in nurses is a serious issue which can lead to depression, fatigue, sleep issues, feelings of dread about the work, and physical exhaustion. These effects can cause nurses to disengage from their patients resulting in poor patient outcomes. Patient safety is supposed to be the number one priority in healthcare but research has proven that when healthcare professionals including nurses experience burnout, quality patient care and patient safety will be compromised. High levels of burnout experienced by nurses have been linked to high mortality rates of patients (Hall, Johnson, Watt, Tsipa & O'Connor, 2016). Burnout should not be viewed as “normal” and be accepted because as research as proven, nursing leaders can employ various approaches to reduce feelings of burnout at work and burnout adversely affects patient care. Some ways nursing leaders can address burnout are by maintaining adequate staffing levels and providing emotional support. Therefore, this project seeks to address leadership strategies that can be put in place help reduce staff burnout to increase nursing retention in an organization.
Purpose of change proposal
The purpose of the change proposal is to provide evidence-based suggestions to support leadership strategies that reduce nurses' burnout, therefore increasing nursing retention. It demonstrates how leaders have a tasked responsibility in ensuring the nurses work in favorable work environment safe practicing environment. As such, it showcases that effective leadership strategies can indeed improve nursing retention by reducing burnout.
PICOT Statement
“Among nurses employed in an organization, can an effective leadership approaches improve retention of nurses by reducing feelings of burnout as compared to an ineffective leadership approach which increases feelings burnout, leading to turnover in 3 months?”
Population (P): Nurses employed in an organization
Intervention (I): Effective leadership approaches
Comparison (C): Effective leadership approaches and ineffective leadership approaches
Outcome (O): Prevent nurse burnout and improve retention of nurses (prevent nurse turnover)
Time (T): 3 months
Literature Search Strategy
The literature search strategy focuses on gathering information from peer-reviewed scholarly journals that address burnout, causes and evidence-based suggestions that nursing leaders can apply in their various organizations to reduce burnout and retain nurses. It involves gathering information from the studies done regarding effective leadership strategies resourceful in reducing burnout. The search involves looking at possible search terms, keyword and phrases, and subject heading where applicable. Searching for information relevant to the topic is vital in addressing the PICOT question paper.
Evaluation of Literature
The literature evaluation involves focusing on the authority, usefulness, validity, and reliability of the sources. The studies have author(s) who took part in the study, the authors' names, and the publication year. To ensure that the studies are current and not outdated, care was taken to make sure that the sources are within 5 years of publication. Each source presented was questioned on its usefulness, reliability, randomization, participant flow, validity, and result in the analysis (Umesh, Karippacheril, & Magazine, 2016). It was also focused on methods, and study design used, not forgetting that the studies all provide information that can help towards supporting the PICOT question.
Applicable Change or Nursing Theory
The theory utilized is “Kurt Lewin's Change theory suggests that in an organization, people are mostly resistant to change because they are used to the status quo. With any change initiative, they may be driving and hindering forces in the form of employee behavior. In order to initiate change in an organization, the driving forces need to be increased and the hindering forces decreased (Hussain et al., 2018). For this project, because the interventions are focused on leadership approaches, educating leaders as to why different approaches need to be taken to reduce burnout in nurses is paramount because only then, will they be ready to initiate change.
Proposed Implementation Plan with Outcome Measures
To attain the desired changes, organizational leaders should be consulted on whether they support the proposed changes, and if not, educated on the pressing need to. Also, keeping in mind that the changes proposed must be specific, measurable, achievable, and realistic and must have a time-bound. Lastly, other stakeholders affected by the project should be consulted. Getting testimonies from as many nurses as possible as to how burnout affects their working habit and patient care will be useful in convincing leadership and management of the importance of managing burnout in their nurses. Because heavy workloads largely accounts for burnout related to stress, leaders and their management team need to plan and allocate budgeting for hiring of more nurses, so that nurses would not feel overworked, and also not leave the organization (Dall’Ora, Ball, Reinius & Griffiths, 2020) If leaders apply this intervention, retention of nurses will improve within a period of 3 months.
How Evidence-Based Practice was used
All interventions utilized for this project are evidence-based. Research literature has proves that effective leadership approaches in an organization reduces burnout experienced by nurses. One intervention is to train leaders to effectively identify and rectify signs of burnout in nurses such as anger and frustration, disconnectedness, emotional withdrawals, frequent callouts before they get out of hand is important to ensure retention of nurses. (Mudallal, Othman & Al Hassan, 2017). Nursing leaders should try to ensure adequate nurse to patient ratio reduces the physical and emotional stress levels experienced by nurses. Also, making available, wellness and support programs like comfortable resting lounges and departmental counseling programs can help decrease stress and burnout levels (Jones, 2020). Literature has also proven that when nurse managers allow nurses to have a say in their schedules and rotation, this helps in maintaining their work and life balance, lessening stress and burnout which will ensure retention.
Plans for Evaluating Interventions.
To evaluate these interventions, calls will be made to my organization to determine if the retention rate of nurses has actually improved. This step is important in order to determine if the interventions were effective. Communication will be made with nurse leaders and managers to determine if they actually utilized the evidence-based practice suggestions to reduce burnout. It would be appropriate to communicate with nurses to determine if their levels of burnout have decreased with leadership initiated interventions. Also, follow ups will be made with other members of the board of trustees to determine if effective follow-ups were made with their leaders to see if they are actually implementing the EBP suggestions to reduce burnout in their nurses.
Potential Barriers and How to Overcome them
Potential barriers to this project will be resistance to change by leaders and the management team because they are used to the status quo of getting things done with the present nurse to patient ratio. To convince them on the need for change, this will be overcome by letting them testimonials from their nurses and the level of burnout experienced, intent to leave the job and how they have missed key patient interventions due to heavy workloads. Also, statistics on nurses leaving their jobs due to stress will be presented to them so they understand the need for change. Another potential barrier is the lack of support from the administration, such as laxity in hiring more nurses due in an effort to make more profit. This can overcome by explaining to them the importance of having more nurses because if more nurses are not hired, the ones they have left will also leave, and the patient population will suffer the consequences which should not be the case.
Conclusion
To sum all, nurse's burnout has been a significant problem in healthcare organizations. With increased burnout, a high turnover will negatively impact the organization, including overworking the remaining staff, poor patient outcomes, increased medical errors, and job dissatisfaction. Leadership approaches are vital in reducing cases of increased burnt out and, thus, increasing nursing retention.
References
Gensimore, M. M., Maduro, R. S., Morgan, M. K., McGee, G. W., & Zimbro, K. S. (2020). The effect of nurse practice environment on retention and quality of care via burnout, work characteristics, and resilience: A moderated mediation model. JONA: The Journal of Nursing Administration, 50(10), 546-553. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/32925666/
Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses' burnout: The influence of leader empowering behaviors, work conditions, and demographic traits. Inquiry: A Journal of Medical Care Organization, Provision and Financing, 54, 46958017724944. https://doi.org/10.1177/0046958017724944
Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493175/
Reith T. P. (2018). Burnout in United States healthcare professionals: A narrative review. Cureus, 10(12), e3681. https://doi.org/10.7759/cureus.3681
Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O'Connor, D. B. (2016). Healthcare staff wellbeing, burnout, and patient safety: A systematic review. PloS One, 11(7), e0159015. https://doi.org/10.1371/journal.pone.0159015
Umesh, G., Karippacheril, J. G., & Magazine, R. (2016). Critical appraisal of published literature. Indian journal of anesthesia, 60(9), 670–673. https://doi.org/10.4103/0019-5049.190624.
Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin's change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127.
Dall'Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: a theoretical review. Human resources for health, 18(1), 41. https://doi.org/10.1186/s12960-020-00469-9
Jones B. (2019). Fifteen minutes may decrease nursing burnout: A discussion paper. International journal of nursing sciences, 7(1), 121–123. https://doi.org/10.1016/j.ijnss.2019.11.004
Benchmark - Capstone Project Change Proposal |
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In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.
Develop a 1,250-1,500 written project 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. Clinical problem statement.
3. Purpose of the change proposal in relation to providing patient care in the changing health care system.
4. PICOT question.
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. Discussion of how evidence-based practice was used in creating the intervention plan.
10. Plan for evaluating the proposed nursing intervention.
11. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
12. Appendix section, if tables, graphs, surveys, educational materials, etc. are created.
Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.
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.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
RN to BSN
1.1: Exemplify professionalism in diverse health care settings.
2.2: Comprehend nursing concepts and health theories.
3.2: Implement patient care decisions based on evidence-based practice.