NURS 6052 EVIDENCE-BASED PROJECT, PART 2: ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS

Improving access to mental health is essential in dealing with the growing problem of mental health disorders. Millions of Americans with mental health do not get care services due to various reasons that include limited resources and associated stigma. More than half (56%) of individuals with mental health issues do not get treatment (CDC) Additionally, Mental Health America opines that over 27 million Americans with mental health never get treated (MHA, 2023). The prevalence of mental health illness among adults is high; ranging from 42.6% in Vermont to over 67% in Hawaii. As such, this presentation focuses on selected research articles based on the developed PICOT question on the issue. The presentation describes the level of evidence by the articles and significance of using systematic review articles.

The PICOT framework is a critical part of research process as researchers employ it to develop research questions and search for literature to answer the developed questions. The PICOT ensures that nursing researchers contextualize the identified health issue and develop evidence-based practice interventions. In this case, the issue is access to mental health services for millions of Americans. As such, the PICOT questions considers the population, intervention, comparison, outcomes and time required to implement the suggested solutions to such a problem.

Introduction 

The provision of safe, high quality and efficient care in nursing is important for the health and wellbeing of the patients. Often, nurses utilize practice interventions such as patient centeredness and evidence-based practices to ensure that the care needs of the patients are met. They also use the interventions to minimize the risk of occurrence of safety and quality issues in patient care. An example is the use of best practice interventions to ensure that the risk of medication errors in nursing practice is reduced. Despite the efforts adopted by nurses to ensure safety and quality, institutional and provider factors may still predispose patients to unintended safety and quality issues. For example, provider factors such as burnout due to the influence of institutional factors such as staff shortage may threaten the safety and quality of patient care. Therefore, this presentation examines the proposed intervention that can be used to reduce and prevent burnout among registered nurses. 

Selected Clinical Issue 

The selected clinical issue that relates to nursing practice is burnout among nurses. Burnout has been defined as the consequence of prolonged, persistent and chronic exposure of nurses to work-related stressors. The prolonged exposure to work stressors result in depersonalization, exhaustion, and reduced personal accomplishments. Nurses affected by burnout experience challenges in undertaking their clinical roles due to low levels of motivation and job satisfaction. Burnout among nurses has an adverse effect on the quality and safety of patient care (Ahola et al., 2017). For example, it increases the risk of medication errors by nurses due to lack of concentration in the care giving process. Burnout also causes low level of job satisfaction and motivation among the nurses. As a result, the rate of turnover among them increases significantly. In addition, the operational costs in healthcare organization rises due to the need for frequent hiring of new staffs to replace those who left the organization. Therefore, burnout among nurses should be addressed to ensure safety, quality and efficiency in healthcare organizations (Melnyk et al., 2020). ​

Development of PICOT

The developed question is: In acute care nurses, does the use of cognitive interventions result in the reduction of burnout levels when compared to no intervention, within eight month period?​

I developed the above PICOT question through a number of steps. The first one was performing a clinical inquiry of the common issues that affect quality and safety of patient care in healthcare settings. I also utilized knowledge from my clinical experience to identify issues in practice that can be addressed by adopting evidence-based interventions. This led to the identification of the clinical issue of burnout in nursing. The second step entailed the determination of the populations that the problem affect. This led to the identification of nurses as the most prone group of professionals to be affected by burnout. The other step was performing a literature search of the databases to determin