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Evidence-based interventions (EBI) can reduce nursing burnout and improve retention and healthcare quality. Nursing school is an ideal time to implement EBI to mitigate burnout and increase resilience in pre-professional populations.
The current study tested whether Mindfulness-Based Stress Reduction (MBSR) significantly improved stress, burnout, and wellness in a university-based nursing school.
Using a non-randomized clinical trial design, multilevel modeling for repeated measures tested intervention effects over time in MBSR participants (n = 73) and matched controls (n = 73), as well as potential moderation of intervention effects by modality (online vs. in-person MBSR) and subpopulation (students vs. faculty/staff).
MBSR effectively reduced perceived stress, exhaustion, and total burnout and increased positive affect and frequency of using two key mindfulness skills: observing and nonreactivity. No significant effects of the intervention were observed for disengagement from work, satisfaction with life, negative affect, or the mindfulness skills of describing, acting with awareness, and nonjudgment. Effects were similar across modality and subpopulation.
MBSR increases stress resilience and can be delivered effectively online and in person. Moreover, MBSR appears equally impactful for nursing students and faculty/staff. Implications for integrating EBI into schools of nursing to improve well-being are discussed.
The Evidence-Based Practice Mentoring Program (EBPMP) is a 12-month initiative offered at a large acute care facility in Hawai'i. The EBPMP provided two layers of mentoring, with experienced evidence-based practice (EBP) faculty supporting EBP mentors who, in turn, guide mentees or novice EBP team members.
The primary aim of this pilot initiative was to promote the Value, Implementation, and Knowledge of EBP.
A literature search, appraisal, and synthesis were conducted, and the results informed the development of the EBPMP. The pilot was initiated from July 2022 to June 2023 and consisted of a nurse-led interdisciplinary team. Outcome measurements involved the Quick-EBP-VIK survey, a faculty-developed Self-Confidence in EBP Mentoring Skills Inventory, feasibility measures, and the program cost.
Pre- and post-EBPMP outcome measures demonstrated that the mentors' and mentees' scores increased in the domains of EBP Value (11.14%), Implementation (80.87%), and Knowledge (99.46%). Mentors' self-confidence increased over time (Baseline: 0.06, 6-months: 2.33, 12-months: 3.03). Feasibility measures showed that the majority (80%) of the mentees were able to complete > 75% of assigned modules by the due date, most (80%) spent 1–2 h to complete the didactic modules, and the monthly mentee meeting attendance rate was 88.1%. The program cost was 1.2 FTE per month.
EBP mentoring was an effective strategy for supporting staff's EBP development. Continued leadership support is crucial to the EBPMP's success and sustainability. The EBPMP may be an effective strategy to contribute to the development of an organization's culture of EBP.
On average, about 17% of new graduate registered nurses (NGN) leave within the first year of employment, leading to high turnover costs. A mentorship program can improve NGN retention and positively impact patient care. A significant opportunity exists for healthcare organizations to protect the investment of NGN.
To implement an evidence-based mentorship program to improve NGN retention.
A 3-month mentorship program was implemented at a Magnet-designated Midwest 1300-bed integrated community-based healthcare center. Twenty matched pairs participated in the program, which was guided by the American Medical-Surgical Nurses Mentorship Program.
Data included results from 18 mentor-to-mentee pairs that completed the 3-month program. Post-implementation confidence/competency scores showed a slight increase from baseline. Intent to stay and job satisfaction scores were moderately high post-implementation. The average program satisfaction score for both groups was 69.5%. The cost of the program was about $4000. All mentees remained employed 3 months post-implementation, which resulted in the organization avoiding a turnover loss of approximately $480,000.
An evidence-based practice approach was used to address NGN turnover at a midwestern healthcare center. The initiative retained the first cohort of NGN while showing an organizational return on investment. Implementation of a 3-month mentorship program is cost-effective and can impact NGN retention and turnover.
The cumulative stress toll on nurses increased during the COVID-19 pandemic. An evidence-based practice (EBP) project was conducted to understand what is known about the impacts of cumulative stress within nursing and if there are ways to mitigate stress during a nurse's shift.
A project team from three clinical units completed an extensive literature review and identified the need to promote detachment while supporting parasympathetic recovery. Based on this review, leaders from three pediatric clinical units (neonatal intensive care unit, cardiovascular intensive care unit, and acute pulmonary floor) implemented respite rooms.
Follow-up outcomes showed a statistically significant stress reduction. For all shifts combined, the Wilcoxon Signed-Rank Test revealed that perceived stress scores from an 11-point Likert scale (0 = no stress and 10 = maximum perceived stress) were significantly lower in the post-respite room (Md = 3, n = 68) compared to in the pre-respite room (Md = 6, n = 68), Z = −7.059, p < .001, with a large effect size, r = .605. Nurses and other staff frequently utilized respite rooms during shifts.
Clinical inquiry and evidence-based practice processes can mitigate cumulative stress and support staff wellbeing. Respite rooms within the hospital can promote a healthy work environment among nurses and promote a self-care culture change. Evidence-based strategies to mitigate cumulative stress using respite rooms are a best practice to promote nurse wellbeing and mitigate cumulative stress.
Elopement jeopardizes patient safety, affects the hospital's reputation, and results in financial ramifications. In an academic community hospital, executive leadership approached a team of nurse leaders for expertise following the elopement of a vulnerable patient.
The team's goal was to identify evidence-based strategies to mitigate future elopement events. Following an extensive literature review and gap analysis, the organization recognized opportunities pertaining to elopement management, including patient assessment, prevention strategies, and facility-wide response when events occur. The nurse leader team thoroughly searched current literature to answer the Population, Intervention, Comparison, and Outcome (i.e., PICO) questions of interest. Following a critical appraisal of 55 articles, 26 were utilized to make practice change recommendations. The body of evidence included a variety of age groups and diagnoses.
After the synthesis of the literature, the team provided recommendations to the organization. These recommendations included the assessment of patient-specific risks and the implementation of elopement prevention measures as fundamental elements for incidence reduction. The team partnered with multidisciplinary stakeholders for the revision of policies, processes, and electronic medical record documentation.
The organization monitored elopement events and the duration of each event throughout the phases of implementation. Pre-implementation data, collected from January to June 2021, demonstrated 34 individual elopement cases lasting an average of 118 min each. In comparison, post-implementation data collected during the same time frame in 2022 found only 12 events lasting an average of 24 min each.
The organization implemented evidence-based recommendations to standardize the facility's approach to elopement. With structured assessment, precautions, and response, the organization demonstrated a notable decline in the number and duration of elopement events. Hardwiring processes, analyzing data, and adjusting expectations within an evidence-based framework should assist the organization's drive to further enhance patient safety surrounding elopement events.
Daily huddles positively influence staff satisfaction and perception; standardization of a daily huddle should be prioritized to benefit from its effects.
The aim of this project initiative was to implement an evidence-based, standardized daily huddle on an inpatient medical-surgical oncology unit.
A searchable question was developed, and the identified literature was critically appraised and synthesized for evidence-based recommendations. The recommendations for the structure and content of a daily huddle were implemented using a standardized format.
Pre-implementation and post-implementation staff perception and satisfaction surveys yielded positive results. Improvements in effective communication and staff satisfaction were identified.
An effective daily huddle is essential for communicating pertinent information that can affect workflows and patient safety, as well as promoting teamwork and staff satisfaction.
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