EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH NURS 6052

EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH NURS 6052

EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH NURS 6052

Introduction

 

A critical appraisal assists in reducing the research burden by enabling a researcher to identify and focus more on relevant articles to their research question. The research can either provide support or disapprove the claims made by the researcher through the utilization of quality, and evidence-based practice interventions. The selected topic for the research study is use of resilience training to redice the problem of nurse burnout among nurses in different care settings. Nurse burnout remains a critical problem that impacts the quality of care and patient outcomes in different care setting. Resilience training allows nurses to develop and use evidence-based interventions to reduce burnout and enhance their overall performance and improve the quality of care.

Evidence-based practice (EBP) incorporates best practices from studies and patient care information with clinician experience and patient preferences leading to the delivery of highest quality of care, and improving patient outcomes. The use of EBP requires care providers to formulate a clinical question of interest. In this case, the PICOT question is: Among nurses with burnout (P), does resilience training (I) compared to no intervention (C) reduce burnout(O) in six months (T)? The purpose of this assignment is to appraises critically peer-reviewed article for evidence to support resilience training among nurses with burnout to reduce its prevalence.

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Full APA formatted Article #1 Article #2 Article #3 Article #4
citation of selected article Wang, Q. Q., Lv, W. J., Qian, R. L., & Zhang, Y. H. (2019). Job burnout and quality of working life among Chinese nurses: A cross‐sectional study. Journal of Nursing Management27(8), 1835-1844. https://doi.org/10.1111/jonm.12884 Yu, F., Raphael, D., Mackay, L., Smith, M., & King, A. (2019). Personal and work-related factors associated with nurse resilience: A systematic review. International Journal of Nursing Studies, 93, 129-140. https://doi.org/10.1016/j.ijnurstu.2019.02.014 Brook, J., Aitken, L. M., MacLaren, J. A., & Salmon, D. (2021). An intervention to decrease burnout and increase retention of early career nurses: A mixed methods study of acceptability and feasibility. BMC Nursing, 20(1), 1-12. https://doi.org/10.1186/s12912-020-00524-9 Deldar, K., Froutan, R., Dalvand, S., Gheshlagh, R. G., & Mazloum, S. R. (2018). The Relationship between Resiliency and Burnout in Iranian Nurses: A Systematic Review and Meta-Analysis. Open access Macedonian Journal of Medical Sciences, 6(11), 2250–2256. https://doi.org/10.3889/oamjms.2018.428
         
         
         
         
         
         
         

 

 

 

 

Evidence Level *

(I, II, or III)

II I III I
Conceptual Framework

 

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

Not provided Not mentioned Behavioral change involving use of interventions like cognitive realignment, mindfulness and psychological skills training Behavior change through increased resiliency training and interventions to improve coping mechanisms.
Design/Method

 

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

Cross-sectional survey where 2504 nurses participated in Eastern China. The researchers invited nurses to complete self-report questionnaire online. Systematic Review with the aims of identifying the linked personal and work-related factors of nurse resilience. The article’s design was explanatory sequential mixed methods. The participants were final year pre-registration nursing students in a UK university and healthcare organizations. The article used a meta-analysis to conduct the study aimed at determining the effects of resiliency on various components of nurses’ professional burnout.

 

 

Sample/Setting

 

The number and characteristics of patients, attrition rate, etc.

The study was conducted virtually with 2504 nurses completing self-report online questionnaires The study used data from literature review in five databases based on terms like resilience, occupation, job, nursing and work. The sample included 74 pre-registration nursing students and 7 academics in a UK university and healthcare organizations. The researchers used data based on targeted literature review in national and international databases in Persian and English.
Major Variables Studied

List and define dependent and independent variables

Dependent-Quality of life

Independent- Job burnout

Dependent Variable-Various components in nursing care

Independent Variable-Job burnout

Dependent Variable-Multiple Interventions

Independent-Retention of nurses

Dependent-Resiliency & burnout

Independent-Conducting nursing education

Measurement

 

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

The researchers measured the quality of working life based on different aspects like age, income and patient-nurse ratio.  The study used a total of 38 articles that met the criteria through a systematic review and narrative synthesis. The authors also used different scales leading to being unfeasible to synthesize the evidence. Pre and Post measure of acceptability using an Acceptability Theoretical Framework Researchers used heterogeneity to measure the results by I2 test.
Data Analysis Statistical or Qualitative findings

 

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

The study used Pearson’s correlation and multiple regression to analyze collected data.  The study used a quality assessment tool to analyze articles that met the criteria where 23 were rated as good, 15 as fair and 20 as risky due to significant levels of bias. The researchers used the COREQ guidelines to analyze collected data in a thematic manner. The researchers used STATA software v.14 to analyze the data.

 

 

 

Findings and Recommendations

 

General findings and recommendations of the research

The findings show that close to two-thirds of nurses experienced job burnout leading to a moderate level of quality of life. Knowing nurse resilience can assist proactively in the identification and potential issues, this fostering job resources and ultimately attaining personal and professional growth. The study recommends more research to explore resilience and develop a regular instrument to measure resilience. The authors assert that the interventions equipped nursing students with skills and experience to attain personal endurance. The authors assert that the meta-analysis conducted on the observational studies illustrated a correlation between resiliency and burnout with values of -0.57 at a 95% confidential interval. The authors assert that there is a relationship between resiliency and burnout and recommend the planning for the interventional and resilient training courses in nursing education.
Appraisal and Study Quality

 

 

Describe the general worth of this research to practice.

 

What are the strengths and limitations of study?

The research has significant value to practice as it shows the relationship between job burnout and the quality of life among nurses. The main strength of the study is its use cross-sectional survey where nurses from different setting accepted to have online self-report questionnaire. However, a limitation of the study could be a possible bias from the self-reporting nurses. The study is significant as it shows the need to enhance knowledge on resilience among nurses. Therefore, it is worth for practice interventions in nursing care.

The strengths of the study include its design that allows collection of a wide-range of data with various outcomes, and better outcomes that can be applied in nursing care. However, bias is significant based on the application of different outcomes from the study.

The main strength of the study is its study design and the sample selected. The design allowed them to engage both academics and nursing students on ways to enhance resilience and fight job burnout. However, a limitation is its use of the sample since it does not involve the nurses who practically handle patients. The research is essential to practice because it demonstrates the need to incorporate resiliency education in nursing to prepare nursing students and even practitioners.

A primary strength of this study is the use of systematic review and meta-analysis that allows them to collect a wide-range of data on the issue at hand. The main limitation is that the data can lead to formulation and testing of research hypotheses based on false impressions.

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

 

What is the feasibility of use in your practice?

The risk may include bias leading to misguided interventions among nurses and healthcare facilities.

The feasibility of using the findings in my practice is high based on its outcomes.

The risk include misinterpretation due to possible bias.

The feasibility of using the article’s findings is significant due to its outcomes and recommendations.

The risk inherent to implementation is that it may not capture the real work-life experience of burnout based on its selected sample.

The study has no feasibility of being used in my practice due to its population sample as it does not capture practical nursing care situation.

The implementation of the recommended practices or processes does not have any risks except those associated with misinterpretation and possible false impression based on the multiple sources of data.

The study’s findings can be used in my practice with a high feasibility based on the level of knowledge among the practitioners.

Key findings The key findings suggest that job burnout has negative impact on the quality of nurse’s working life. The authors recommend consideration of work-associated factors to enhance nurses’ quality of life. Key findings include the need to assist nurses establish strategies to deal with adversity and understand the impacts of job demands and research to discover nurse resilience and develop consistent tools to enhance resilience. The findings show the need enhance endurance training for nursing students for their future career’s challenges as it will improve their ability to tackle job burnouts. The study is emphatic that a relationship exists between resilience and nurse burnout as it demonstrates that through education, nurses can have reduced levels of burnout.
Outcomes The outcomes suggest that a majority of nurses’ experience job burnouts that have negative effects on their working life. The outcomes include understanding that increased nurse resilience assists nurses to reduce emotional exhaustion and enhance work engagement and function when they encounter challenges in the workplace. The outcomes recommend feasibility of new knowledge concerning the importance of the suggested intervention to enhance resilience in dealing with nurse burnout. The outcomes emphasize the need to plan and develop interventional approaches that enhance the level of evidence and implementation of educational training to increase nurses’ knowledge on the burnout and resiliency.
General

Notes/Comments

The article is critical in enhancing understanding and the need for interventions to reduce job burnout among nurses and enhance use of evidence-based practice. The article’s findings are essential in development of effective understanding about the effects of burnout and should be used in practice to highlight the significance of evidence-based practice interventions. The study suggests effective use of endurance training to prepare nursing students to understand the nature of the nursing environment for better care provision. The need to reduce burnout among nurses is essential and the article is emphatic that increased nursing education can assist in such endeavors. Therefore, the findings are critical in improving overall application of evidence-based practice interventions in different areas in nursing practice.

 

These levels are from the Johns Hopkins Nursing Evidence-Based Practice: Evidence Level and Quality Guide

 

Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis

 

Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-

experimental studies only, with or without meta-analysis

 

Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative

systematic review with/without meta-synthesis

 

Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence

 

Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized

expert(s) opinion based on experiential evidence

 

 

**Note on Conceptual Framework

 

Part 3B: Critical Appraisal of Research

Nurse burnout is a leading cause of increasing rate of nurse turnover and nursing staff shortage in different care settings. The increasing demand for healthcare across the various demographics implores healthcare providers and organizations and their management to develop interventions based on evidence-based practice to address the issue of burnout. Nurse burnout leads to poor care delivery and outcomes for patients and low levels of satisfaction (The Joint Commission, 2019). As such, the best practice that emerges from the reviewed research is the need to enhance effective nurse training and education to help nursing professional deal with the issue and apply innovative ways in their care practice for better delivery and patient outcomes (Yılmaz, 2017). The research review demonstrates the need for stakeholders, especially leaders to invest in training programs to enhance resilience of nurses. The increased demand for health care across the demographics divide imply that nurses should understand the care environment and know that the possibility of burnout is significant but can be tackled using innovative approaches to lessen their emotional and psychological burden.

The best practice should focus in resiliency training as identified by different research studies highlighted in the first part of this paper. Resiliency has a positive interaction with nurse burnout as it allows nurses to adopt the best practices to lessen effects of burnout and remain focused on effective care interventions. As opined by Brook et al. (2021), both nursing students and professionals need effective resilience training to enhance their skills and have a positive attitude to solving rising demand and diversity in the healthcare environment. The training should incorporate cultural competence as an effective approach to improving overall understanding about the concept to tackle the adverse effects of burnout.

Conclusion

Nurse burnout remains a critical health issue and leads to nursing shortage and turnover that impact quality care among different patient populations. The critical appraisal exercise and paper illustrate the need to develop interventions that will enhance overall care delivery by training nurses and nursing students on resilience framework to prepare them better in handling stressful situation associated with increased demand for care. Again, resilience training will impact their perspective on different and innovative ways to engage patients and ensure that they tackle the issue of burnout.

Brook, J., Aitken, L. M., MacLaren, J. A., & Salmon, D. (2021). An intervention to decrease burnout and increase retention of early career nurses: A mixed methods study of acceptability and feasibility. BMC Nursing, 20(1), 1-12. https://doi.org/10.1186/s12912-020-00524-9

Deldar, K., Froutan, R., Dalvand, S., Gheshlagh, R. G., & Mazloum, S. R. (2018). The Relationship between Resiliency and Burnout in Iranian Nurses: A Systematic Review and Meta-Analysis. Open access Macedonian Journal of Medical Sciences, 6(11), 2250–2256. https://doi.org/10.3889/oamjms.2018.428

The Joint Commission (2019). Quick Safety: Developing resilience to combat nurse burnout. https://www.jointcommission.org/-

/media/tjc/newsletters/quick_safety_nurse_resilience_final_7_19_19pdf.pdf

Wang, Q. Q., Lv, W. J., Qian, R. L., & Zhang, Y. H. (2019). Job burnout and quality of working life among Chinese nurses: A cross‐sectional study. Journal of Nursing Management27(8), 1835-1844. https://doi.org/10.1111/jonm.12884

Yılmaz, E. B. (2017). Resilience as a strategy for struggling against challenges related to the nursing profession. Chinese Nursing Research, 4(1),

9-13. https://doi.org/10.1016/j.cnre.2017.03.004

Yu, F., Raphael, D., Mackay, L., Smith, M., & King, A. (2019). Personal and work-related factors associated with nurse resilience: A systematic review. International Journal of Nursing Studies, 93, 129-140. https://doi.org/10.1016/j.ijnurstu.2019.02.014

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