-
QUESTION
Week5-Benchmark Assignment: Practicum Project Proposal
Needs Assignment and Gap Analysis
Gap Analysis
Project:
Organization:
Student name:
Best Practice #1: Embed self-care training in the teaching curriculum to help students learn how to manage stress and burnout.
Best Practice Strategies
How Your Practices Differ from Best Practice
Barriers to Best Practice Implementation
Will Implement Best Practice
Proper diet: allow students to bring a healthy snack and eat during short break. This will enable them maintain healthy eating habits both as students and as practicing nurses
Classroom policies of the current curriculum forbid students from eating during class sessions.
Some students might not afford healthy snacks due to financial challenges
Yes
Physical exercise: Teach students how to practice aerobic exercises and other physical exercises aimed at reducing stress levels
The current curriculum does not teach students self-care techniques and skills they to manage/reduce stress and burnout or avoid it altogether.
Lack of adequate time to teach students self-care skills due to overemphasis on academic achievement (high grades)
Breathing techniques and other stress-reduction techniques
Mindfulness: Prepare students to understand the nature as well as frequency of thoughts that come from a given behavior or feeling, and attain a more contented and balanced emotional state to reduce stressors.
The current curriculum does not equip students with skills and techniques needed to attain a more balanced and contented emotional state.
Some mindfulness techniques might be appropriate for certain religious groups, to which different students ascribe. For instance, meditation – one of the widely known meditation technique – is largely inspired by Buddhist teachings (Buddhism) from the Eastern World. However, certain religions, such as Islam, emphasize prayers, chants, songs and reading of spiritual books, as a way of attaining a contented emotional state (John Paul Caponigro, 2015).
Best Practice #2: Teach students how to practice healthy sleeping habits
Best Practice Strategies
How Your Practices Differ from Best Practice
Barriers to Best Practice Implementation
Will Implement Best Practice
Teach students how to achieve quality sleep by maintaining fixed sleeping schedules as well as keeping off hand-held devices and social media at least two hours before going to bed
The current nursing curriculum does not reinforce attainment of behavior change skills, particularly those that can help students practice healthy sleeping habits and avoid sleep deprivation, which is one of the major predictors of elevated stress levels.
Some students are social media addicts, which not only makes them sleep in the late night, and accordingly sleep for lesser hours than the recommended, also affects the quality of their sleep due to stress caused by comparing themselves to social media friends
Yes
Best Practice #3: Incorporate staff and peer mentorships and modelling in the teaching program
Best Practice Strategies
How Your Practices Differ from Best Practice
Barriers to Best Practice Implementation
Will Implement Best Practice
Provide a non-threatening and supportive learning environment by encouraging teaching staff and senior nursing students to mentor new students to help them acquire effective communication effective skills as well as self-esteem and self-efficacy
The current curriculum lacks a peer mentoring program where senior students can coach new students
Language differences/barrier will be a major hurdle to effective mentoring as students come from diverse backgrounds
Yes
References
Belnavis, C. S. (2019). Addressing Students Stress Levels in Nursing Education Programs.
Blum, C. (2014). Practicing self-care for nurses: A nursing program initiative. OJIN: The Online Journal of Issues in Nursing, 19(3), 3.
John Paul Caponigro. (2015, August 27). All religions practice forms of meditation. Retrieved October 23, 2020, from https://www.johnpaulcaponigro.com/blog/9419/all-religions-practice- forms-of-meditation-meditation-is-a-universal-practice/
Lewis, M. L., & King, D. M. (2019). Teaching self-care: The utilization of self- care in social work practicum to prevent compassion fatigue, burnout, and vicarious trauma. Journal of Human Behavior in the Social Environment, 29(1), 96-106.
Moulzolf, H. (2015). Embedding Self Care Strategies into the Nursing Curriculum: The Students’ Lived Experience.
Workflow Diagrams
Figure 1: Flowchart depicting the current nursing curriculum and related educational needs and knowledge gaps
Figure 2: Workflow diagram depicting the future nursing curriculum with best practices
Summary
Gap analysis revealed various differences between current practices in the Texarkana’s nursing curriculum and the best practices or the ideal state. Notable among the differences is overemphasis on the acquisition of hard skills in the current curriculum vs. focus on both hard and soft skills in the best practice curriculum. The fact that the current curriculum places more emphasis on academic qualification and high grades by mandating students to maintain an average of 75% or higher in vocational nurse training courses, or risk dismissal from the program means that the current is less concerned about the acquisition of non-academic (soft) skills. Indeed, certain non-academic skills, such as emotional intelligence, self-care care skills and mindfulness techniques are strong predictors of low stress and burnout levels, as well as effective management of stressors in the work environment. Maintaining a healthy diet, which the best practices seek to instill by allowing students to bring healthy snacks and eat during short breaks, is also known to reduce stress levels among both student and practicing nurses.
The current and best practices also differ in the sense, unlike the current practice that best practices teach students how to improve their sleep quality by maintaining a regular sleep schedule and avoiding social media at least two hours before bedtime. In fact, the current practices seem to encourage students to stay until late night, juggling assignments, lab reports and discussion forums. Another best practice, as identified by the gap analysis, is bordered around creating a supportive and non-threatening environment through peer and staff mentorships, coaching and modeling. This equips students with vital skills necessary for not only communicating effectively, but also attaining a higher sense of self-efficacy and self-esteem. Combined, these best practices produce nurses who are more resilient to environmental stressors, such as role conflict and workplace incivility, which ultimately enhances their retention in a given healthcare facility due to increased compassion and reduced levels of stress and burnout.
Certain barriers need to be addressed if the aforementioned best practices have to successfully implemented. Nursing courses, by nature, are characterized by high academic workload, ranging from long hours of theoretical studying to simulation labs, regular exams/ assessments, and clinical assignments. This implies that there will be the issue of time constraint when trying to incorporate these best practices in the nursing curriculum, particularly self-care and mindfulness techniques. Second, due to financial challenges, not all students can afford bring healthy food to class/school so they can eat during short breaks. This will breed another problem in that those who cannot afford healthy snacks will feel inadequate, disadvantaged, less confident and even isolated. Additionally, the fact that the learning environment at the college is socially and culturally diverse means that some self-care and mindfulness techniques taught during the program, under the new integrated curriculum, might not work for some student groups. For instance, some forms of mindfulness techniques, such as meditation that work for Buddhism and Hinduism might not be suitable for Islam and other religious groups (John Paul Caponigro, 2015).
| Subject | Nursing | Pages | 47 | Style | APA |
|---|
Answer
Enhancing Compassion, Addressing Fatigue, and Burnout to Improve Nurse Retention: Practicum Project Proposal
Table of Contents
3.0 GAP ANALYSIS/ NEEDS ASSESSMENT 10
4.0 PROJECT CHARTER, SCOPE, AND OBJECTIVES 15
Potential Benefits and Savings 20
Burnout and occupational stress have been highlighted in a number of studies as most important impediments to “patient safety and care quality” (White, Aiken, Sloane & McHugh, 2020). Fatigue and burnout essentially aggregate a number of syndromes including emotional fatigue and skepticism and are believed to be a critical prognosticator of negative healthcare outcomes. To enhance compassion, and to address fatigue, and burnout and to improve nurse retention Mission Healthcare Facility will concentrate on the provision of a spectrum of high-grade, competitively priced services to deliver quality health outcomes to clients, while maintaining high standards of personal and corporate integrity. Greater health outcomes should be pursued to expand access to excellent health services for rural communities and marginalized populations within the community. Positive health outcomes will be achieved by addressing fatigue, burnout, and negative health outcomes through a supportive multidisciplinary team to cater for the comprehensive academic and educational relationships. Specifically, this project seeks to improve performance outcomes among nurses by increasing compassion, reducing fatigue and burnout by 30% and to improve nurse retention by an average of 5 years. This will be achieved by reviewing training programs for the next generation of nurses to include best practices by including self-care training in the training curriculum to inculcate stress and burnout management skills to the trainee nurse, teaching students how to practice healthy sleeping habits, and integrate staff, and peer mentorships in the teaching program. This section is structured as follows: the second section is the literature review, a concise summary of key findings from respected authors on nurse retention, burn out, and fatigue. The third part presents the Gap Analysis/ Needs Assessment, followed by project charter, scope, and objectives. The fifth part discusses the implementation plan, followed by the timeline and scheduling, budget, and risk management plan in that order.
This section draws from numerous studies to provide perspective on compassion, fatigue, and burnout, their reduction, and their impact on nurse retention. Studies by Adams, Hollingsworth and Osman (2019) propose a cultural change toolkit outlining certain components critical for reduction of burnout and exit. Paired t-test results delineate these components such as “meaningful recognition, shared decision making, and even the enhanced leadership involvement” expected exit and burnout numbers caused a quantifiable decline in general burnout tallies (Adams, Hollingsworth and Osman, 2019).
Research by Boamah, Read and Spence Laschinger (2017) has established positive correlation between leadership style and severity of “burnout, job satisfaction, and equality of patient care” in nurses. The authors demarcate “short-staffing and work-life interference” as critical antecedents to burnout new graduate nurses. Subsequently, the study idealizes the application of authentic leadership tendencies for the realization of enabling occupational settings critical for elimination of burnout, enhanced satisfaction, and superior nursing outcomes. The proposed leadership trajectory is projected to cure insufficient recruitment and “work-life imbalance” which result in burnout, poor occupational fulfillment and poor healthcare outcomes.
Similarly, Cheung, Hernandez, Herold and Moskowitz (2020) recommend constructive sentiments towards work as panacea for reduction of burnout and enhancement of positive health outcomes. Consequently, most nursing and fatigue prevention strategies are heavily weighted in favor of decreasing destructive sentiments related to the nursing environment. These include psychosomatic strain, anxiety, and despair. Indeed, modern scholarship outlines growing focus on healthy occupational outlook as critical for management of work-related anxiety, and could yet be the basis of more sophisticated interventions.
A quasi-experimental study by Copeland (2020) highlights the criticality of ephemeral mediations by which nurses can minimize impacts of compassion fatigue and burnout. As collaboration and burnout are negatively correlated, the findings suggest that brief interludes involving “meditation, journaling, gratitude, outside, and control” are essential for attenuating the impacts of burnout.
A comprehensive review by Dyrbye, et al., (2019) associates burnout with elevated risk of absenteeism at least once a month and reduced output. All things considered, and taking patient-specific factors such as “age, sex, relationship and parental status, highest academic degree, practice setting, burnout, depression, and satisfaction with work-life integration”, into considerations, nurses who had a history of burnout exhibited increased absenteeism as peers with less exposure had fewer truancies.
Moreover, recent studies by Haizlip, McCluney and Hernandez (2020) have established positive associations between affirmative recognition and burnout. Consequently, the study associates positive sentiments around “mattering at work” reduces the probability of burnout (Haizlip, McCluney & Hernandez, 2020). In essence, the study delimited reduced burnout, and greater participation at work as significant precursor to positive perceptions of work. Additionally, research evidence shows that the positive sentiments are strongly related to social capital in clinical settings as provided by seniors, juniors and peers (Haizlip, McCluney and Hernandez, 2020).
Modern research has confirmed strong correlations between resilience and burnout in the case of nurses in intensive care settings (Jackson, et al., 2018). In other words, empirical evidence have routed for resilience as an intervention mechanism for minimizing occupational challenges which exacerbate burnout.
In clinical settings, occupational challenges have generally been traced to a number of conditions that adversely impact nurses of which burnout and empathy fatigue are part (Jackson, et al., 2018). In this regard, “workplace adversity” should be addressed through a raft of measures including “protecting, processing, decontaminating, and distancing” (Jackson, et al., 2018).
A cross-sectional research by Liu et al. (2018) on the significance of healthcare occupational settings in healthcare delineates three antecedents to improved patient outcomes: assigned tasks, extended deployment of nurses to non-clinical functions and burnout. The aforestated factors also lead to poor patient outcomes. The study proposes improvements to clinical working environment, such as adequate staffing of nurses, expanding provisions aimed at engaging nurses with core clinical functions as critical for better patient outcomes. The findings generally validates the hypothesis that improvements to work environment will encourage greater “patient safety both directly and indirectly” (Liu, et al., 2018). The study found that reduced workload was negatively correlated to better patient outcomes as “nursing care left undone and nurse burnout” negatively impacted patient safety (Liu, et al., 2018).
Correspondingly, studies by Nantsupawat et al (2020) on nursing turnover in Thai hospitals have positively correlated nurse burnout with increased frequency of “negative patient outcomes”. These findings underscore the importance of reducing nurse burnout as a critical step towards cultivating positive care outcomes. in addition, Additionally, the studies revealed a strong positive relationship between “emotional exhaustion” and 2.63 times increase in suboptimal care, a 47% rise in clinical mistakes, and a 32% risk of infection (Nantsupawat et al, 2020).
Registered nurses have recently showed disproportionately higher propensity for burnout, a phenomenon associated with personal engagement with patients, large volumes of work, and long durations of work. These outcomes highlight the need for urgent intervention (Naves, 2016). Specifically, the findings associate a number of “personal and organizational determinants and interventions” could preclude and diminish possibilities of burnout. However, theoretical evidence from extant literature recommends that nursing students should be equipped with suitable approaches to combat burnout, and to reduce employee burnout (Naves, 2016).
Studies by nurse managers in recent times have identified elevated “job demands” for high incidences of work-related stressors. Nelson (2017) contends that the situation is further compounded by the fact that some nurse managers are structurally bereft of power to make certain critical decisions in the line of duty, leading to further violence (Nelson, 2017). Elevated amounts of stress have been blamed for the increased possibility of “disengagement, burnout, and ultimately, to nurse manager turnover”. Some of the most energy sapping roles includes patient care, cross-team leadership and cooperation (Nelson, 2017).
While several studies have mainly zeroed in on individual nurse characteristics as the most important contributor to burnout and nurse turnover, a study by Virkstis, Herleth and Langr (2018) a study by Virkstis, Herleth and Langr (2018) have established linkages between individual attributes and factors in the immediate care environment. This essentially calls for greater focus on the “care environment rather than individual resilience building” (Virkstis, Herleth and Langr, 2018). In modern nursing literature, there has been increased appreciation of factors in the care environment, also known as “cracks” in the care environment. These include, safety concerns; concessions in healthcare value chain, distressing episodes during practice; new equipment, added duties, and poorly designed policies that inhibit cross-team sharing among nurses (Virkstis, Herleth, & Langr, 2018).
Still on the healthcare environment, a study by Wampole and Bressi (2020) argues that nurses in strict “psychiatric nurses” exposed to “workplace stressors” which include “staffing shortages, along with interpersonal conflict with patients and colleagues” (Wampole and Dance, 2020). The findings show that nurses who have been exposed “emotional exhaustion” experienced high levels of burnout, and a more satisfaction with work. As a result, the study proposes that intervention should focus on programs that encourage effective “emotional regulation”. In clinical settings, it is essential to structure social worker education programs to attain “mindfulness techniques may represent an untapped resource for improving the emotional wellness and effective patient care” (Wampole & Bressi, 2018).
White, Aiken and McHugh (2019) argue that gaps in healthcare provision attributed to insufficient time and resources for the management of nursing homes has been blamed for increased burnout and job fulfilment. It follows that a sufficiently staffed facility with the optimal working conditions could forestall exits and improves healthcare qualities. In particular, the study found that some 30% of registered nurses exhibited extraordinary degrees of burnout, 31% had unfavourable outlooks in regard to their jobs, and 72% reportedly had tasks rescheduled as a result of inadequate and resources (White, Aiken and McHugh (2019). The study further suggests that RNs suffering from burnout were up to 5 times more predisposed to vacate critical care duties (White, Aiken & McHugh, 2019).
By the same token, a cross-sectional study by White, Aiken, Sloane and McHugh (2020) has revealed a strong relationship between “work environment, care quality, registered nurse (RN) burnout, and job dissatisfaction in nursing homes”. These findings recommend a healthy work environment for removal of barriers to healthcare by focusing on measures to improve standards of healthcare and “nurse retention in nursing homes” (White, Aiken, Sloane and McHugh, 2020).
3.0 GAP ANALYSIS/ NEEDS ASSESSMENT
Gap Analysis
Project: Enhancing Compassion, Addressing Fatigue, and Burnout to Improve Nurse Retention
Organization: Mission Healthcare Facility
Student name:
Best Practice 1: include self-care training in the training curriculum to inculcate stress and burnout management skills to the trainee nurse.
|
Best Practice Approach |
How Your Practices Differ from Best Practice |
Barriers to Best Practice Implementation |
Will Implement Best Practice |
|
Healthy diet: Allow trainee nurses to have healthy snacks during short breaks to entrench healthy eating habits as students and as prospective nurses |
Current curriculum forbids eating during learning. |
Healthy snacks are unaffordable to some students
|
Yes
|
|
Physical fitness: Train students on both aerobic and anaerobic exercises to reduce stress levels |
Current curriculum lacks self-care training techniques essential for management of stress and burnout. |
Current curriculum too congested with academic achievement leaving inadequate time for self-care skills. |
|
|
Breathing techniques and other stress-reduction techniques |
|||
|
Mindfulness: Train students to harness the power of positive thought patterns to attain contentment and emotional balance to minimize the impacts of stressors. |
Current curriculum does not address emotional wellbeing. |
Meditation techniques vary and are dependent on different religious groupings to which students belong. For instance, medication means different things tis attained through prayer to Christians, but may be different for Muslims, and Buddhists. (John Paul Caponigro, 2015). |
Best Practice 2: Teach students how to practice healthy sleeping habits
|
Best Practice Strategies |
How Your Practices Differ from Best Practice |
Barriers to Best Practice Implementation |
Will Implement Best Practice |
|
Train students how to attain sufficient sleep through static sleeping plans and the importance of avoiding mobile devices and social media a few hours before bed time. |
Current curriculum does emphasize behavior change skills, especially those focusing on healthy sleeping patterns and avoid sleep deprivation, key antecedents of elevated stress levels. |
Some students are addicted to social media leading to erratic sleep patterns. |
Yes |
Best Practice 3: Integrate staff and peer mentorships and modelling in the teaching program
|
Best Practice Strategies |
How Your Practices Differ from Best Practice |
Barriers to Best Practice Implementation |
Will Implement Best Practice |
|
Provide tension-free and facilitative settings for mentorship of students by staff and senior nursing students. This will accelerate acquisition of effective communication skills, self-esteem and self-efficacy. |
The current curriculum does not have peer mentorship programs. |
Language barrier presents significant challenge to mentorship as faculty staff and students are from diverse linguistic backgrounds. |
Yes |
Workflow Diagrams
Flowchart depicting the current nursing curriculum and related educational needs and knowledge gaps and workflow diagram depicting the future nursing curriculum with best practices are attached in Appendix A and B respectively.
Summary
Gap analysis outlines variances in current practices in the Texarkana’s nursing curriculum and industry best practices. The most outstanding gap is heavy focus on hard skills in the current curriculum which precludes soft skills recommended in new curricula. This anomaly is highlighted and accentuated by requirement that students must clock upwards of 75% of theoretical lecture hours or risk discontinuation from the program. Effectively, the foregoing situation inhibits attainment of important non-academic skillsets, such as emotional intelligence, self-care care skills and mindfulness techniques which are critical predictors of low stress and burnout levels, as well as effective management of stressors in the work environment. Embedding healthy dietary practices by permitting students to carry healthy snacks could potentially minimize stress among student and practicing nurses.
Best practice curricula also differ from current curricula through emphasis on sleep quality and regular sleep patterns achievable by avoidance of mobile devices at least two hours before bedtime. Indeed, best practices paradigms appear to recommend that the two hours prior to bedtime should be dedicated to assignments, laboratory reports and group discussions.
This analysis also recommends supportive and free learning atmospheres which promote career guidance by peers and staff. This is essential for imparting vital communication skills as well as greater self-efficacy and self-esteem. Cumulatively, these practices are ideal for cultivating resilience against environmental stressors, such as role conflict and workplace incivility, which ultimately enhances their retention in a given healthcare facility due to increased compassion and reduced levels of stress and burnout.
Bridging the aforestated gaps will inevitably be mediated by barriers which must be overcome. For instance, large academic workloads and extended periods of theoretical learning will present new constraints as insufficient time will be dedicated for best practices recommended in the new curricula. Additionally, prevailing financial limitations will limit access to healthy food and snacks. Further, sociocultural diversity means that certain self-care and mindfulness programs will not avail uniform outcomes for all students. Students from different faiths will respond differently to various meditation techniques. For instance, meditation techniques for Buddhists and Hindus are mostly different from Islam and other religious groups (John Paul Caponigro, 2015).
4.0 PROJECT CHARTER, SCOPE, AND OBJECTIVES
This section covers programmatic student learning outcomes (PSLOs) by means of which project charter, scope, and objectives are defined. Consequently, the PSLOs provide a basis for development of the program specifically suited for the stated objectives. Detailed description of the project charter, scope, and objectives, are contained in Appendix D.
Project: Curriculum Lesson Plan on Strategies for Enhancing Compassion, Addressing Fatigue, and Burnout to Improve Nurse Retention
Organization: Mission Healthcare Facility
Student name:
Selected Best Practice 1 Identified in Gap Analysis: [Develop Initiatives to promote support and self-efficacy]
|
Detailed Tasks/Actions Associated With Implementation of Best Practice |
Team Members Assigned to Each Task |
Target Implementation Start Date |
Communication and/or Training Required? |
Communication and/or Training Scheduled Dates |
Actual Implementation Start Date |
|
Establish support systems (Cheung et al., 2020) |
5 |
[25/10/2020] |
Yes. |
[26/10/2020] |
[26/11/2020] |
|
Develop assessment strategies |
5 |
[27/11/2020] |
Yes. |
[27/11/2020] |
[28/11/2020] |
Selected Best Practice 2 Identified in Gap Analysis: [Incorporating stress management training]
|
Detailed Tasks/Actions Associated With Implementation of Best Practice |
Team Members Assigned to Each Task |
Target Implementation Start Date |
Communication and/or Training Required? |
Communication and/or Training Scheduled Dates |
Actual Implementation Start Date |
|
Identify various stress management tools (Boamah et al., 2017) |
10 |
[10/11/2020] |
Yes. |
[11/11/2020] |
[15/11/2020] |
|
Teach students how to use the stress management tools to deal with stress (Haizlip et al., 2020) |
5 |
[10/11/2020] |
Yes. |
[11/11/2020] |
[15/11/2020] |
Selected Best Practice 3 Identified in Gap Analysis: [Identify Stressors and the relevant coping mechanisms]
|
Detailed Tasks/Actions Associated With Implementation of Best Practice |
Team Members Assigned to Each Task |
Target Implementation Start Date |
Communication and/or Training Required? |
Communication and/or Training Scheduled Dates |
Actual Implementation Start Date |
|
Encourage students to list their stressors (Copeland,2020) |
5 |
[16/11/2020] |
No. |
[n/a] |
[16/11/2020] |
|
Consider alternatives for coping with the stressors (Adams et al., 2019) |
5 |
[20/11/2020] |
Yes. |
[22/11/2020] |
[25/11/2020] |
|
Apply the top three coping mechanisms identified |
5 |
[26/11/2020] |
Yes. |
[27/11/2020] |
[30/11/2020] |
Define processes and procedures involved
Work units, tasks/ activities
Define project deliverables
Define metrics that determine success (how will you measure that change is an improvement)
The project is planned and scheduled using Gantt chart, attached on an excel sheet.
Table 1: Budget/Costs
|
Category |
Details |
Cost in First year |
|
Training |
Train the current nursing teachers, through workshops and seminars, on how to incorporate self-care and mindfulness training in their lesson plans. |
$2,000 |
|
Hire two counselors; four student enablers and three physical exercise trainers |
Recruitment and onboarding costs Salaries and benefits |
$900 $120,000 |
|
Guest speakers |
Invite motivational speakers to talk to students at least twice every semester |
$3,000 |
|
Introduce staff and peer mentorship program |
Provide mentors with airtime and other resources required to support the mentorship program |
$1,000 |
|
Stipend to students with financial challenges |
Stipend to students from economically disadvantaged families to enable them buy healthy food |
$150,000 |
|
Educational brochures |
Print educational brochures on stress management, healthy sleeping and eating habits and important topics to be issued to each student at the beginning of every semester |
$600 |
|
Total |
|
$278,400 |
Potential Benefits and Savings
Table 2: Potential Benefits and Savings
|
Benefit |
Benefit within 12 months |
|
15% increase in pass rate, minimizing the need for re-sits/ retakes and at-risk assessment panels |
$2,500 |
|
60% increase in revenue due to increased student population |
$150,000 |
|
20% increase in cost savings due to reduced rate of withdrawal/ dismissal from the course |
$6,000 |
|
Increased recognition and recommendation by accrediting agencies and hospitals within the state. |
- |
|
20% increase in funding from the Texas Board of nursing |
$100,000 |
|
50% increase in philanthropic contributions and support from alumni students who succeeded in their nursing career. |
$80,000 |
|
Total |
$338,500 |
Table 3: Cost Benefit Analysis
|
Total Cost |
Potential Benefits and Savings |
|
$278,400 |
$338,500 |
Total Savings = $(338,500 – 278,400) = $60,100.
Payback time =
=
= 0.85 of a year or approximately 10.2 months
Identify all resources needed (tangible and intangible)
Project: Enhancing Compassion, Addressing Fatigue, and Burnout to Improve Nurse Retention
Organization: Mission Healthcare Facility
Student name:
|
Description |
Rank |
Trigger |
Mitigation |
Contingency |
Status |
|
Ex.: Understaffing |
2 |
Flu Season |
Rescheduling of shifts to mitigate interruptions when employees fall sick. |
Schedule experienced employees as substitutes. |
Ongoing |
|
Nursing unit is understaffed and nurses are unable to afford an interview. |
1 |
Admission of more patients relative to available staff per shift. |
Strengthen internal communications using tech applications such as survey monkey and email. |
Referral of patients to other facilities when the bed capacity is overstretched. |
Ongoing |
|
New electronic medical record system implementation causing stress as nurses cannot afford time interviews. |
2 |
Increased workload due to added responsibilities |
Schedule interview times in consultation with nurses |
Educating nurses on how to use the new electronic health record system. |
Ongoing |
|
Lack of face to face contact with nursing students due to Covid-19 pandemic and flu season restrictions. |
1 |
Covid-19 pandemic |
Schedule zoom meetings with students to discuss reduction of stress, burnout, and fatigue among nurses. |
Install tech innovations to facilitate interaction. |
Ongoing |
|
Data collection, analysis, and reporting time consuming. |
3 |
Investigator singlehandedly running all project activities. |
Hire a research assistant |
Seek expert opinion, counsel and help whenever necessary. |
Ongoing |
|
Language barrier |
2 |
Multilingual and multicultural workforce |
Hire a language translator |
Language interpreters are integral for mitigating language barrier problems in research (Squires, Sadarangani, & Jones, 2020). |
Ongoing |
|
Financial Limitations |
5 |
Inadequate funding for the project |
Application for research grant. |
Pursue a personal-sponsored to mitigate against project funding disappointment. |
Ongoing |
|
Failure to obtain ethical approval for the project |
4 |
Poorly developed research proposal. |
Review the research design of proposal. |
Awareness of ethical research policies and regulations |
Ongoing |
|
Congested personal work schedule |
4 |
Competing tasks (activities of daily living) eating into project time |
Obtain a study leave from regular work. |
Effective planning and time management |
Ongoing |
|
Inadequate statistical knowledge, skills data analysis such a s Statistical Program for Social Sciences (SPSS) (Puteh, & Ong, 2017). |
5 |
Lack of prior statistical learning and exposure. |
Hire data analysts and statisticians. |
Acquisition of relevant knowledge and experience |
Ongoing |
|
Low response rate from research participants. |
3 |
Lack of enthusiasm from research participants |
Recruitment a large number of research participants |
Acquaint research participants on project goals and objectives |
Ongoing |
SUMMARY OF PROJECT IMPLEMENTATION STAGE AND BARRIERS
The project broadly aims at enhancing compassion by addressing fatigue, and burnout to improve nurse retention. The project is already planned out as the problem has been identified, the beneficiaries, as well as what needs to be done. In addition, project stakeholders have been identified, as students, academic institutions, clinicians, community health care services, nursing bodies, nursing managers, non-nurse representatives from academia, and government agencies. Moreover, the budget has been prepared, project objectives defined as well as the scope, resources and major tasks. However, there is need to fine-tune the membership of the project team before actual implementation, and progress reporting can follow. As the project is in the pre-implementation stage, it is expected that its execution will be moderated by barriers both intrinsic and external to the student. Three barriers feature prominently: First, challenges are expected in the implementation of self-care training curriculum as it seeks to inculcate stress and burnout management skills to the trainee nurse. The preceding challenge will be accentuated by factors such as inability of some students to assess healthy snacks, congestion in the current curriculum with heavy focus on academic achievement at the expense of self-care skills, and variances in meditation techniques which are also dependent on religious groupings to which students belong. For instance, meditation as a remedy for burnout and stress will be have different meanings to various groups: For Christians, it may be attained through prayer, but may be different for Muslims, and Buddhists. Secondly, barriers will be anticipated during course instruction in matters pertaining to healthy sleeping habits. This will emanate from inability by some students to maintain healthy routines as addiction to social media contributes to erratic sleep patterns. Finally, barriers to integration of staff and peer mentorship programs in the teaching program will be hindered by language limitations as faculty staff and students are from diverse linguistic backgrounds.
References
Adams, A., Hollingsworth, A., & Osman, A. (2019). The implementation of a cultural change toolkit to reduce nursing burnout and mitigate nurse turnover in the emergency department. Journal of Emergency Nursing, 45(4), 452-456. https://doi.org/10.1016/j.jen.2019.03.004
Boamah, S., A., Read, E., A., & Spence Laschinger, H., K. (2017). Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: A time‐lagged study. Journal of Advanced Nursing 73(5), 1182– 1195. https://doi.org/10.1111/jan.13215
Cheung, E., Hernandez, A., Herold, E., Moskowitz, J. (2020). Positive Emotion Skills Intervention to Address Burnout in Critical Care Nurses. AACN Adv Crit Care. 31 (2), 167–178. https://doi.org/10.4037/aacnacc2020287
Copeland, D. (2020). Brief Workplace Interventions Addressing Burnout, Compassion Fatigue, and Teamwork: A Pilot Study. Western Journal of Nursing Research. https://doi.org/10.1177/0193945920938048.
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APPENDIX A
Flowchart depicting the current nursing curriculum and related educational needs and knowledge gaps
APPENDIX B
Workflow diagram depicting the future nursing curriculum with best practices
APPENDIX C:
GANTT CHART: MISSIONS HEALTHCARE FACILITY
The supplementary file [gantt_chart_missions_healthcare_facility.xlsx] includes a list of project tasks completed against time.
APPENDIX D: PROJECT CHARTER, SCOPE, AND OBJECTIVES
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PSLO1: Apply organizational and systems leadership concepts to the management of human, fiscal, and physical health care resources for diverse populations in a variety of settings. |
Evaluation of strengths and weaknesses of employees through performance management. |
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The working environment is influenced and based on leadership and management. |
The organizational system and leadership is responsible for evaluating and monitoring the employee turnover rate. |
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PSLO2: Evaluate processes, systems, and utilization of current technologies to support continuous quality improvement and promote safety in order to elevate patient outcomes in various settings across the care continuum. |
The learning needs are evaluated through technology systems. These include the collection, analysis, and storage of data. |
The curriculum is developed and implemented through online platforms. The curriculum content involves simulation. |
Simulations will be used to evaluate the nurses’ capabilities to cope with the stressful environment. |
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PSLO3: Synthesize scholarship from a variety of sources to promote the implementation of evidence-based practice. |
Relate the evaluated learning needs with the literature. |
Use literature on the best practices for nurses on compassion, fatigue, and burnout to develop a training curriculum. |
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Use scholarly information to determine how the retention rates can be evaluated. |
The literature and scholarly sources inform the assessment and evaluation criteria. |
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PSLO4: Evaluate healthcare policy, regulatory, legal, economic, ethical, and sociocultural environments to advocate for patients and effect change in the health care system based on their role. |
The learning needs are socioeconomic factors as well as compassion, fatigue, and burnout. |
Nurses are directed by their standards of practice to provide quality care that is compassionate and engage in lifelong learning. |
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PSLO5: Critique evidence-based delivery within an interdisciplinary team to serve diverse populations in various local, national, and global settings. |
Use the literature to establish the best evidence-based practice on compassion, fatigue, and burnout. |
Develop a curriculum that is informed by evidence-based practices. |
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PSLO6: Justify teaching methodologies that support adult learning. |
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Use simulations in the education curriculum. The information and training programs can also be shared using technological platforms. |
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PSLO7: Design engaging learning activities. |
Using the learning needs assessment and evidence-based practice to develop an engaging training program. |
The curriculum involves technology, such as simulation, to enhance its quality and engagement. |
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PSLO8: Plan curriculum to meet the current regulatory requirements, accreditation standards, and industry standards. |
The curriculum is developed in line with the training needs and literature on various aspects, including the standards. |
The curriculum borrows concepts from the existing education programs and standards. |
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PSLO9: Design tools that evaluate formative and summative student learning. |
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The evaluation tool is tailored to evaluate the student nurse’s grasping of various concepts. |
The evaluation tool examines the student’s coping mechanism within a stressful working environment. |
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The evaluation tool evaluates the student’s competence and ability to provide compassionate care, managing burnout and fatigue. |