Decreasing Nurse Burnout: Implementing Workplace Stress-Reducing Interventions to Improve Nurse Health and Patient Outcomes

Nurse burnout and compassion fatigue is an epidemic of the United States healthcare system, (American Nurses Association [ANA], 2014). Burnout is the state of emotional exhaustion attributed to work stress, that leads to an individual “feeling fatigued, unable to face the demands of the job, and unable to engage with others,” (Bakhamis et al., 2019). In the 2019 study conducted by King and Bradley at 37 U.S. hospitals, 16 percent of all nurses reported feelings of burnout, while 41 percent of nurses were at risk for burnout with reports of being “unengaged”. The consequences of burnout syndrome are increased hospital expenses, implications on the physical health of nurses, and threats to patient safety, such as increased number of medical errors, higher infection rates, and higher mortality rates, (Bakhamis et al., 2019). However, workplace stress-reducing interventions, including providing adequate staff, team-building exercises, and strong leadership, have been proven to reduce the emotional distress of nurses, (Khamisa et al., 2013). Organizations that implement burnout interventions for nurses have experienced reduction in hospital expenses, improved nurse health, and better patient outcomes, (Henry, 2014). The purpose of this paper is to identify evidence-based practice, implementation strategies, and proponents of change to integrate stress-reducing workplace interventions aimed at decreasing the prevalence of nurse burnout.
The U.S. hospital system needs to adopt stress-reduction interventions for nurses at the organizational and managerial levels, (i.e. Hospital committees and unit managers), (ANA, 2014). These leaders in healthcare have the power to execute the changes that need to be implemented in order to improve the current workplace conditions affecting the mental health of nurses. The issue of nurse burnout has many vested stakeholders, including nurses, patients, physicians, unions, nursing organizations, researchers, employers (in particular, hospitals), and federal and state governments, (Tevington, 2011).
The authors of this work propose a concept for change that can first be approached by hospital employers and then by unit managers. Hospitals must establish a formal implementation team of clinical nurse leaders in order for change to be successful. These nurses can provide oversight of the changes being implemented, (Melnyk & Overholt, 2019, p. 280). EBP recommendations for employers include implementing policies allowing nurses to refuse work assignments due to fatigue, and lessening nurse work-loads by providing adequate staff, (ANA, 2014). At the microsystem level, nurse managers in hospitals should be encouraged to implement stress-reducing interventions, such as team-building exercises and stronger leadership, since these practices have been successful in decreasing the occurrence of burnout, (Duhoux et al., 2017). The last step, would be to identify the quality improvement outcomes, and sustain the practice change, (Melnyk & Overholt, 2019, p. 390). This practice change can theoretically be applied to any organization with employees. As development of interpersonal relationships, empowering leadership, and healthy workloads, are beneficial to any workplace environment.
Using the Iowa Model of Evidence-Based Practice, the implementation team can incorporate lasting change by ensuring participation, collecting baseline data of the current work environment, gathering resources for nurses, and lastly, evaluating the effectiveness of the changes. This model is superior because of its strengths in implementing quality improvement in hospital systems, and because the model has been proven effective in the past by managing career-related fatigue, (Melnyk & Overholt, 2019, p. 390-391).
Increasing nurse staffing levels in hospitals, and allowing more paid time off, will require short-term increases in hospital expenses. Currently, many hospitals are struggling with reduced levels of funding, which may make implementing these changes a difficult task. However, the cost reduction benefits of implementing these changes, such as improved employee health, reduction in medical errors, and better patient outcomes, have the potential to off-set these expenses after six months, (Khamisa et al., 2013). Another challenge that the authors anticipate are the heavy demands on nurse leadership. As the importance of hospital managers developing policies and practices to facilitate the successful integration of stress-reduction interventions is paramount. Nurse managers should be provided adequate resources by hospital funding committees in order to provide nurses with the level of support needed to implement these changes, (ANA, 2018).

References
American Nurses Association (2018). About the HNHN GC. Retrieved from https://www.healthynursehealthynation.org/en/about/about-the-hnhn-gc/
American Nurses Association (2014). Addressing nurse fatigue to promote safety and health: Joint responsibilities of registered nurses and employers to reduce risks. Retrieved from https://www.nursingworld.org/~49de63/globalassets/practiceandpolicy/health-and-safety/nurse-fatigue-position-statement-final.pdf
Bakhamis, P., David P., & Smith, H. (2019). Still an epidemic: The burnout syndrome in hospital registered nurses. The Health Care Manager, 38(1), 3-10. https://doi.org/10.1097/HCM.0000000000000243.
Duhoux, A., Menear, M., Charron, M., Lavoie-Tremblay, M., & Alderson, M. (2017). Interventions to promote or improve the mental health of primary care nurses: A systematic review. Journal of nursing management, 25(8), 597–607. https://doi.org/10.1111/jonm.12511
Henry, B.J. (2014). Nursing burnout interventions: What is being done? Oncology Nursing Society, 18(2), 211-214. https://doi.org/10.1188/14.CJON.211-214.
Khamisa, N., Peltzer, K., & Oldenburg, B. (2013). Burnout in relation to specific contributing factors and health outcomes among nurses: A systematic review. International Journal of Environmental Research and Public Health, 10(6), 2214–2240. https://doi.org/10.3390/ijerph10062214
King, C., & Bradley, L. A. (2019). Trends and implications with nursing engagement. PRC Custom Research. https://prccustomresearch.com/wp-

Published by Amanda Murray

Nurse, Student, Mentor, Mother, Artist, Cook

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