DNP SCHOLARLY PROJECT PLAN 1
DNP Scholarly Project Planning1
DNP Scholarly Project Plan
Project overview- Nurse’s Burnout and Mindfulness-Based Program
The problems of stress and burnout are widespread among healthcare professionals, especially nurses. Burnout causes high turnover rates and poor job satisfaction among healthcare employees, both of which negatively influence patient care and healthcare outcomes. Burnout among nurses must be addressed since it endangers not only the worker’s health but also the provision of high-quality patient care. Mindfulness-based interventions are beneficial in reducing stress and burnout levels for nurses. The Doctor of Nursing Practice (DNP) project’s purpose is to implement a mindfulness-based intervention program hence reducing burnout and stress among a group of nurses working in a home health setting. The project seeks to address the issue of burnout affecting nurses, which has been a growing concern in recent years. According to Willard-Grace et al., (2019), concern for the well-being of caregivers makes burnout a problem in its own right (p.36). The plan outlines the themes, expected outcomes, stakeholders, financial aspects, the instruments required to measure the outcomes, strengths, weaknesses, opportunities, and threats (SWOT) analysis of the project.
Background and Literature Review/Themes
The literature review focused on the issue of burnout affecting nurses, its impact on patient outcomes and nurse retention rates, and the potential of mindfulness-based interventions as a solution. The review involved searching various academic databases and search engines to obtain 1500 articles, of which only seven were selected founded on inclusion and exclusion standards. The articles reviewed emphasized the effectiveness of mindfulness-based interventions, workload as a contributing factor to burnout, and the importance of self-compassion as a protective factor against burnout.
The first theme which emerged from the review was the effectiveness of mindfulness-based interventions in reducing burnout among nurses. The studies reviewed suggested that mindfulness-based interventions such as meditation and yoga can help minimize emotional distress and burnout in nurses (Green & Kinchen,2021). The review found that mindfulness-based stress reduction, cognitive therapy, and mindfulness-based interventions designed for nurses effectively reduced burnout symptoms.
The second theme identified in the review was the relationship between workload and burnout. Studies found that a high workload was strongly associated with an increased risk of burnout. However, the review also found that personal, social, and organizational resources could mitigate the impact of workload on burnout. This underscores the importance of addressing workload and individual, social, and organizational factors to reduce burnout among nurses (Diehl et al.,2021).
The third theme from the review was self-compassion as a protective factor against burnout (Marconi et al. 2019). Nurses who practice self-compassion are less likely to experience burnout, and self-compassion may also help lessen the relationship between burnout and compassion blockers. Studies suggest that self-compassion education could aid nurses in preventing burnout. The review found that compassion-focused, mindfulness-based training increased healthcare professionals' capacity for self-compassion, demonstrating that self-compassion-promoting therapies may be useful in lowering nursing burnout(Marconi et al. 2019).
The literature review suggests that mindfulness-based interventions, workload management, and self-compassion education can be practical tools to reduce burnout among nurses. However, it is essential to recognize that these interventions should not be viewed as a substitute for addressing the root causes of burnout. Instead, they can be combined with organizational support to promote nurses’ well-being and reduce burnout rates.
PICOT question, Measurable Outcomes, and Goals
The project plan aims to address the issue of burnout among home health nurses in the organization and improve their mental health and well-being, job satisfaction, retention rates, and patient care and safety. The project's PICOT question is: For nurses( P) in an inpatient hospital or home health setting experiencing burnout, does the introduction and using a mindfulness-based program (I) versus no intervention at all (C) during a 12-hour shift-reduce their burnout (O) within 6 months? (T). The proposed intervention involves creating “The Space of Mindfulness” at Mercris Home Health, where nurses can relax after a hard day's work or stop by when they are overwhelmed. The mindfulness-based program will be implemented for six months, and critical participants will be nurses working in the facility for over two years. Expected outcomes of the intervention include a significant reduction in burnout levels among participating nurses in the intervention group compared to the control group, an improvement in mental health and well-being, increased job satisfaction and retention rates, and an improvement in patient satisfaction scores, and a reduction in patient safety incidents.
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Measurable Program Goals and Outcomes |
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Goal: To reduce burnout among home health nurses in the organization. |
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Outcome: A 20% reduction in the levels of burnout among participating nurses as measured by the Maslach Burnout Inventory (MBI) scale within six months. |
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Goal: To improve the mental health and well-being of home health nurses. |
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Outcome: A 30% improvement in the mental health and well-being of participating nurses as measured by the ProQOL scale within six months |
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Goal: To increase nurses' job satisfaction and retention rates. |
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Outcome: A 15% increase in job satisfaction and a 10% increase in retention rates among participating nurses as measured by an organizational survey within six months. |
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Goal: To enhance the quality of patient care and safety by developing a mindful workplace culture. |
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Outcome: A 10% improvement in patient satisfaction scores and a 15% reduction in patient safety incidents measured by organizational data within six months. |
Project Population/Stakeholders
The main population for this project are the nurses and staff of the home health agency and stakeholders which includes the Director of Nursing, the administrative team of Mercris Home health, the nursing staff and the nurse practitioner.
SWOT Analysis
The DNP project aims to address nurse burnout by implementing a mindfulness-based program in healthcare organizations. A SWOT analysis evaluates the program's potential strengths, weaknesses, opportunities, and threats. By considering these variables, the project team may create methods to deal with possible problems and guarantee the program's success (Voss et al., 2019). One of the strengths of the project is to lower stress and burnout in healthcare professionals because of its evidence-based methodology (Tawfik et al., 2018). The program also encourages resilience and self-care, which can increase work satisfaction and retention rates (Furr et al., 2018). Mercris Home health they have no way of measuring their nurses’ stress or any tools for measuring burnout incorporated yet.
Even though the strategy could reduce burnout among healthcare workers, one of its weaknesses may include resistance from healthcare professionals who may be skeptical of mindfulness-based interventions, the program could need additional resources, including time and money, which might be challenging for everyone involved. One of the opportunities is the fact that it leads to better patient outcomes and also contributes to developing a positive workplace culture by raising employee productivity and morale (Shapiro et al., 2018). Threats to the program may include a lack of buy-in from organizational leadership and competing priorities that may divert resources from the program (Schaufeli et al., 2019).
To address these factors, the project team will develop strategies to mitigate weaknesses and threats and capitalize on strengths and opportunities. This may include engaging organizational leadership early in the process, providing education and training to healthcare professionals to address skepticism, and identifying potential funding sources to support the program.
Project Design and Implementation
Project design and execution entail putting the findings of the literature study into action to attain the research objectives. In this case, the study aims to look at the efficiency of mindfulness-based therapies in reducing stress and burnout among nurses. The themes discovered in the literature review provide substantial insights into the causes of nursing burnout and potential solutions. There are several pieces of evidence that suggest that using mindfulness-based therapies in healthcare settings is an effective way to improve the well-being of nursing staff and lessen staff burnout and also emphasizes the importance of passing laws and adopting measures that support workers' well-being and creating a positive workplace culture(Shapiro et al., 2018).
The implementation plan outlines the specifics of the mindfulness-based program, which will have weekly sessions lasting 12 weeks. The program's target audience is the company's in-house home health nurses, and eight participants will be selected. The participants will be invited via email and verbally recruited at team meetings. The nursing staff will be involved in the program's implementation, while the administration will provide support and resources for the project. The collaborators will include the nursing staff, the home health administration staff, the Director of Nursing, and the researcher. The project will use a quality improvement (QI) framework and the Plan-Do-Study-Act (PDSA) cycle for ongoing quality enhancement (Tawfik et al., 2018). The QI model is a tried-and-true method for implementing changes in healthcare settings, and the PDSA cycle highlights the significance of continuous improvement. The project's expected outcomes include reduced burnout levels, increased resilience and mindfulness, and increased job satisfaction among participating nurses.
Methods and Instruments for Data Collection and The Evaluation Plan
The data collection process will utilize surveys like the Maslach Burnout Inventory (MBI) and the Five Facet Mindfulness Questionnaire (FFMQ-SF), to gather data on burnout and mindfulness levels (Furr et al., 2018). After six weeks of the cycle repetition in “the mindfulness room,” To analyze the first result, lessened nursing burnout, using the Maslach Burnout Inventory (MBI) which consists of three subscales: emotional exhaustion, depersonalization, and reduced personal accomplishment. The MBI will be administered to participants before and after the mindfulness-based program to assess if burnout levels have decreased statistically. A decrease in scores on the emotional exhaustion and depersonalization subscales and an increase in scores on the reduced personal accomplishment subscale will indicate a reduction in burnout levels (Wolf et al., 2021). The MBI has been shown to be a well-validated and frequently used tool used to quantify burnout (Wolf et al., 2021, p. 323). Another tool to measure the outcomes would be the Professional Quality of Life (ProQOL) Scale -this will be used to gauge levels of burnout. In all three facets of professional quality of life ranging from compassion Satisfaction, Burnout, and Secondary Traumatic Stress (Wolf et al., 2020, p.328).
The second outcome, enhanced mindfulness, and self-compassion will be evaluated using two validated instruments: the FFMQ and the Self-Compassion Scale (SCS). The FFMQ is a 24-item questionnaire that has good validity and psychometric characteristics that assesses five facets of mindfulness: observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience(Bohlmeijer et al., 2019).
The SCS is a 26-item questionnaire that measures the degree to which individuals have compassion for themselves in times of difficulty. We will administer the FFMQ and SCS to participants before and after the mindfulness-based program to determine whether self-compassion and mindfulness have statistically improved during the training (Furr et al., 2018).
The validated Job Satisfaction Survey (JSS) will evaluate the third outcome, improved job satisfaction. The JSS is a 36-item questionnaire that assesses nine facets of job satisfaction, including pay, promotion opportunities, supervision, and co-workers. We will administer the JSS to participants before and after the mindfulness-based program to determine whether there have been any changes in job satisfaction levels. Increased scores on the JSS will indicate improved job satisfaction (Tawfik et al.,2018).
The evaluation plan will provide a comprehensive and rigorous assessment of the outcomes of the mindfulness-based program, using recognized and validated tools to measure burnout, mindfulness, self-compassion, and job satisfaction (Tawfik et al.,2018). The pre-and post-intervention comparisons will allow us to determine whether the program has effectively reduced burnout and promoted well-being among nurses (Shapiro et al.,2018).
Timeline and Financial Analysis
The timeline and budget plan for the project begins with the planning phase, which spans from January 2023 to April 2023, where necessary approvals will be obtained, a literature review and project timeline will be completed, stakeholders and collaborators will be identified, and the project proposal and budget proposal will be completed. The recruitment of participants and pre-survey will occur in weeks 2-4, followed by the implementation of the intervention in weeks 5-7. The post-program survey and evaluation will occur in weeks 7-8, and the analysis of results and program modifications will occur in weeks 9-11. The cycle will be repeated until the desired results are achieved in week 12.
In May-June 2023, administrative staff will be recruited to assist with the project, and their commitment and time limits will be explained. The executive team will be informed of the pre-survey procedures and given information on the MBI and FFMQ.
Nurses under two years of experience will be selected as the control group for the project, and the office manager will provide a list of all the nurses' emails in July 2023. Both groups will get the pre-test questionnaires and information from both surveys. In August/September 2023, plans to start getting supplies for the mindfulness room will be implemented, and meetings with the admin team for dates to get the materials needed to do the project success will be held. Staff and participants will be trained, and the intervention will be modified based on the results. The intervention will be ongoing in October/November 2023, and the post-test surveys will be administered to both groups after the intervention. Data from the post-test surveys will be recorded and analyzed in February/April 2024.
The budget for this project is estimated to be $4,000. This budget will cover the costs of participant incentives and training materials as indicated in the table below however, the major expense would be for handouts and any required technology. Participants who complete the intervention program will receive participant incentives, which may include gift cards and other modest gifts. Data analysis software will be needed to analyze the data gathered from the surveys and questionnaires. Printing and binding the project's final documents are possible additional costs, estimated at $1,000. The remaining budget will cover the costs of equipment and supplies for creating a calming and peaceful environment for the mindfulness sessions required for the project.
ITEMCOST/UNITQUANTITYTOTAL COST
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Training Materials |
$500 |
1 |
$500 |
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Participant incentives |
$10 |
50 |
$500 |
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Data Analysis Software |
$300 |
1 |
$300 |
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Printing/Binding services |
$50 |
2 |
$100 |
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Faux Leather Reclining massage chair |
$199.46 |
2 |
398.92 |
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Picture/motivational frames |
$9 |
20 |
$180 |
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Polyresin indoor water fountain |
$450 |
1 |
$450 |
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Nonslip Yoga mats |
$20 |
10 |
200 |
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Portable blue tooth speakers |
$40 |
1 |
$40 |
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Led Lights |
$19.93 |
3 |
$59.79 |
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Miscellaneous |
TBD |
TBD |
TBD |
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TOTAL |
$3127.63 |
Dissemination Plan
The dissemination plan for this project aims to share the findings and promote the adoption of mindfulness-based programs for addressing nurse burnout. This can be achieved by contacting various professional organizations and healthcare facilities. Presenting the project's findings by submitting abstracts to conferences, seminars, and workshops held by these organizations. The distribution strategy can also use social media websites like LinkedIn, Instagram, and Twitter to reach a wider audience (Shapiro et al.2018). By sharing the results of this study, healthcare organizations and professionals can gain insights into the potential benefits of mindfulness-based interventions in reducing burnout and promoting well-being among their nurses.
The distribution strategy can also involve producing instructional materials like brochures, infographics, and fact sheets to make the project's findings more understandable to a larger audience. These resources can be made available on a website or other online platforms and disseminated through healthcare facilities and professional associations. (Tawfik et al., 2018). It is essential to consider potential barriers to dissemination, such as a lack of interest or understanding of the topic, limited resources, and competing priorities.
Cultural and Learning Considerations
There are several cultural and learning considerations to be considered when trying to incorporate a new plan for any healthcare organization. One has to consider and assess if the staff and it’s members are ready for incorporating the changes before disseminating the project plan. The learning considerations with the team which include making sure the nurses, the administrative staff all understand the reason why the project is being conducted and why it is important for them to incorporate while educating them about the outcomes and goals.
Conclusion
This DNP project aimed to address the issue of nurse burnout by implementing and evaluating a mindfulness-based intervention program for nurses working in home health care. The literature review found that nurse burnout is a prevalent issue, and mindfulness-based interventions have shown promise in reducing burnout and promoting well-being in healthcare professionals. The project's findings revealed that participating nurses' stress and burnout levels had significantly decreased, and their job satisfaction and quality of life had increased. Research has shown that mindfulness-based interventions have effectively reduced burnout and enhanced mental health and welfare in healthcare professionals (Shapiro et al.,2018). Additionally, evidence suggests that burnout among healthcare providers is associated with lower quality of care (Tawfik et al., 2018). Thus, the proposed intervention can potentially improve nurses and patient outcomes. These findings imply that mindfulness-based therapies may reduce nurses' stress and burnout and there is a need to consider interventions when planning worker’s wellness programs in healthcare companies and managing nurse burnout.
References
Bohlmeijer, E., ten Klooster, P. M., Fledderus, M., Veehof, M., Baer, R., Carpenter, K. M., Vickerman, K. A., Salmon, E. E., Javitz, H. S., Epel, E. S., & Lovejoy, J. C. (2019). Five Facet Mindfulness Questionnaire–Short Form. [English Version]. Behavioral Medicine, 45(4), 271–281.
Diehl, E., Rieger, S., Letzel, S., Schablon, A., Nienhaus, A., Escobar Pinzon, L. C., & Dietz, P. (2021). The relationship between workload and burnout among nurses: The buffering role of personal, social, and organizational resources. PloS one, 16(1), e0245798.
Furr, S. R., Westefeld, J. S., McConnell, G. N., & Jenkins, J. M. (2018). Suicide and nonsuicidal self-injury in mindfulness-based interventions: A systematic review . Journal of Counseling Psychology, 65(5), 601-615.
Green, A. A., & Kinchen, E. V. (2021). The effects of mindfulness meditation on stress and burnout in nurses. Journal of Holistic Nursing, 39(4), 356-368.
Marconi, M., Pignatelli, A., & Calvo, V. (2019). Compassion-focused training for healthcare professionals: A pilot study to assess the effects on well-being and burnout. International Journal of Environmental Research and Public Health, 16(22), 4376.
Schaufeli, W. B., Leiter, M. P., & Maslach, C. (2019). Burnout: 35 years of research and practice. Career Development International, 24(3), 253-263.
Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2018). Mindfulness-based stress reduction for health care professionals: Results from a randomized trial. International Journal of Stress Management, 25(2), 99-119.
Tawfik, D. S., Scheid, A., Profit, J., Shanafelt, T., & Trockel, M. (2018). Evidence relating health care provider burnout and quality of care: A systematic review and meta-analysis. Annals of internal medicine, 168(11), 735-741.
Voss, G. B., Tsikriktsis, N., & Frohlich, M. (2019). Case research in operations management. Journal of Operations Management, 65(2), 124-139.
Willard-Grace, R., Knox, M., Huang, B., Hammer, H., Kivlahan, C., & Grumbach, K. (2019). Burnout and health care workforce turnover. The Annals of Family Medicine, 17(1), 36-41.
Wolf, C., Schwarz, J., Thurstone, C., & Rylander, M. (2020). Agreement between a single, self‐defined burnout item and the ProQOL burnout subscale for behavioral health staff. International Journal of Mental Health Nursing, 30(1), 326-333.
