EVIDENCE-BASED PROJECT, PART 4: RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE

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Cho, H., & Steege, L. M. (2021). Nurse fatigue and nurse, patient safety, and organizational outcomes: A systematic review. Western Journal of Nursing Research, 43(12), 1157-1168.

Montgomery, A. P., Patrician, P. A., & Azuero, A. (2022). Nurse burnout syndrome and work environment impact patient safety grade. Journal of Nursing Care Quality, 37(1), 87-93.

Al Ma'mari, Q., Sharour, L. A., & Al Omari, O. (2020). Fatigue, burnout, work environment, workload, and perceived patient safety culture among critical care nurses. British Journal of Nursing, 29(1), 28-34.

Swamy, L., Mohr, D., Blok, A., Anderson, E., Charns, M., Wiener, R. S., & Rinne, S. (2020). Impact of workplace climate on burnout among critical care nurses in the Veterans Health Administration. American Journal of Critical Care, 29(5), 380-389.

Evidence Level *

(I, II, or III)

III

III

III

III

Conceptual Framework

Describe the theoretical basis for the study ( If there is not one mentioned in the article, say that here).**

N/A

N/A

N/A

N/A

Design/Method

Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).

The present meta-analysis includes only quantitative studies conducted from January 2000 to July 2020 only. Given the topic of focus, only the quantitative studies with relevance to nurse fatigue and its effects on the nurse, patient safety as well as organizational consequences were considered.

The study design used in this research study is the cross-sectional descriptive survey design. Self-completed cross-sectional questionnaires were obtained from 928 registered nurses employed in AL AC hospitals.

Cross-sectional and prediction design. Self-developed cross-sectional survey conducted on 270 critical care nurses in Oman. Used descriptive statistics as well as inferential statistics.

This study applied a cross-sectional survey design and targeted 2,352 employed nurses in 94 organizations. Self-administered anonymous questionnaires were used, and data was collected in the year 2017.

Sample/Setting

The number and characteristics of

patients, attrition rate, etc.

The kind of studies that were included in this review involved different samples and different scenarios.

928 respondents in this study were nurses coming from 19 acute care hospitals in the state of Alabama.

Concerning 270 critical care nurses from two of the public hospitals in Oman.

2,352 critical care nurses from 94 Organizations in the group of Veterans Health Administration.

Major Variables Studied

List and define dependent and independent variables

Independent variables: nurse fatigue.

Dependent variables: the health of the nursing personnel, the health of the patients, the security of the patients, and the general performance of the health facility.

Independent variables: Again, nurse burnout and the work environment they experience are identified mostly by students.

Dependent variables: patient safety grade is the numerical rating assigned to the patient safety of an organization.

Independent variables: employee fatigue, burnout, workload, and work environment.

Dependent variables: The findings highlight the %each and every one of the hospitals' overall picture of the perceived patient safety culture.

Independent variables: workplace climate.

Dependent variables: burnout.

Measurement

Identify primary statistics used to answer clinical questions ( You need to list the actual tests done).

Secondary analysis of quantitative data /Analysis of quantitative findings.

CBI, Descriptive statistics, Inferential statistics.

Survey research, correlation analysis, and regression analysis.

Exploratory study, cross-sectional.

Findings either Data analysis is statistical or Qualitative.

Data Analysis Statistical or

Qualitative findings

( You need to enter the actual numbers determined by the statistical tests or qualitative data).

The various outcomes are analyzed into three main groupings, namely: Nurses’ outcomes, outcomes generated by nurses about patients, and Organizational outcomes.

Moderate to strong associations were found between the burnout rate, the index of the work environment, and the patient safety grades.

The correlations between the study variables are, Fatigue, Burnout, Workload, and Perceived Patient Safety Culture.

As it will be identified, the climate being witnessed at the workplace has a direct influence on burnout levels of critical care nurses.

Findings and Recommendations

Findings and Recommendations

General findings and recommendations of the research

Fatigue harms the nurse, the patient, and the organization in various aspects of performance. How the findings may be of use for more examination & intercession.

People’s burnout level and work environment quality directly influence patient safety. Organizational strategies are crucial.

Fatigue, burnout, workload as well as work environment have a direct impact on the perception of the patient safety culture. Recommendations for targeted interventions.

The organizational environment also has a critical influence on the burnout of the nurses. Structural interventions are necessary.

Appraisal and Study Quality

Describe the general worth of this research to practice.

What are the strengths and limitations of the study?

What are the risks associated with the implementation of the suggested practices or processes detailed in the research?

What is the feasibility of use in your practice?

Complements existing literature by discussing the general effects of nurse fatigue.

Strengths: the framework of a significant number of reviewed research.

Limitations: This aspect may be attributed to variations in the study designs chosen by the authors of the surveys.

Large subject sample and reliable measuring tools.

Strengths: robust statistical analysis.

Limitations: As it is mentioned that the current study used a cross-sectional design, this type of research design restricts causality.

Most research studies and surveys have a large sample size and achieve a high response rate.

Strengths: detailed analysis.

Limitations: self-reported data.

Therefore, this study has a large sample size and multilevel analysis.

Strengths: addresses organizational factors.

Limitations: cross-sectional design.

Key findings

Various studies demonstrate the costly effects of shift work and employee fatigue on the nurse and the patient.

Directions for the future of nurse burnout and work environment quality patient safety.

Employment burnout, employment fatigue, and the employment workload are some of the determinants of perceived patient safety culture.

Thus, there is a positive correlation between the workplace climate and the critical care nurses’ burnout level.

Outcomes

Another implication evident in the study focuses on the need for interventions that are aimed at reducing the level of nurse fatigue.

The a need to upgrade the workplace to minimize burnout and increase safety for the patients.

Lack of workload and burnout engagement related to the intervention's effectiveness as per the patient safety perception.

System-level changes that can be implemented in the workplace include the following with a view to preventing burnout.

General Notes/Comments

Stresses that more attention should be paid to the problem and research on the subject of nurse fatigue.

Emphasizes the organizational action plan in the prevention of burnout.

Identifies existing obstacles to the formation of the desired patient safety culture in the workplace.

Implied that interventions should be aimed at structures more so than people.