The relationship between nurse burnout, missed nursing care, and care quality following COVID-19 pandemic.

OBJECTIVES: To determine the relationship between nurse burnout, missed nursing care, and care quality following the COVID-19 pandemic. BACKGROUND: Quality of care and missed nursing care can be consequences of nurse burnout. Little is known about how these factors related to nurse burnout following the COVID-19 pandemic. DESIGN: This study used a cross-sectional correlational design and was conducted in 12 general hospitals across Thailand from August to October 2022. METHODS: 394 nurses providing direct nursing care to patients during the COVID-19 pandemic completed the survey. The Emotional Exhaustion (EE) subscale of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), MISSCARE survey, and quality of care reported by nurses were used to collect data. Descriptive statistics and logistic regression models were used to analyse the data. RESULTS: Approximately thirty-six percent of nurses had burnout following the COVID-19 pandemic. Missed nursing care was higher among nurses with burnout. Most participants reported illness/symptoms such as anxiety, fatigue, a lack of concentration, and sleeping problems. After adjusting for demographic characteristics, every additional unit of emotional exhaustion was associated with 1.61 times higher odds of missed nursing care, 3.37 times higher odds of poor quality of nurse care, and 2.62 times higher odds of poor quality of care for the overall unit. CONCLUSION: The study findings demonstrate that burnout is associated with missed nursing care and poor quality of care following the COVID-19 pandemic. RELEVANCE TO CLINICAL PRACTICE: Policymakers, hospital administrators, and nurse managers should invest in strategies to reduce nurse burnout, which can increase patient safety and quality of care.

Does a six-week online mindfulness intervention affect burnout in registered nurses working in an adult inpatient rehabilitation setting during the COVID-19 pandemic?

Burnout syndrome is a state of emotional, physical, and mental exhaustion that affects approximately 70% of nurses globally. Nurses are at higher risk for experiencing burnout due to work, home, and career demands. The COVID-19 pandemic has exacerbated the number of nurses experiencing burnout, as they continue to care for patients in highly stressful environments. Mindfulness meditation is a successful strategy for mitigating and managing burnout. Nursing leaders must raise awareness regarding burnout, lack of self-care, and wellbeing among nurses. The purpose of this quasi-experimental, pretest-posttest interventional study design was to examine if a six-week online mindfulness intervention decrease burnout levels related to emotional exhaustion, depersonalization, and feelings of personal accomplishment, as measured by Maslach Burnout Inventory (MBI) Toolkit, in registered nurses who cared for adults in a single, inpatient urban care setting located in Philadelphia, Pennsylvania, during the COVID-19 pandemic. Thirty-eight consenting registered nurses (RNs) participated in the study. The intervention group (n =25) participated in the mindfulness intervention only. The comparison group (n =13) did not participate in the intervention. Data findings supported statistically significant improvement in MBI subscale PA (p = 0.00006) and clinically significant change in MBI subscale EE (from 27.6 to 24.0) post-intervention. These results suggest that healthcare organizations should implement weekly mindfulness intervention activities to mitigate nurse burnout. Additionally, replication studies are warranted to identify and examine predictors related to burnout and study interventions to mitigate burnout and improve mental well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Does a six-week online mindfulness intervention affect burnout in registered nurses working in an adult inpatient rehabilitation setting during the COVID-19 pandemic?

Burnout syndrome is a state of emotional, physical, and mental exhaustion that affects approximately 70% of nurses globally. Nurses are at higher risk for experiencing burnout due to work, home, and career demands. The COVID-19 pandemic has exacerbated the number of nurses experiencing burnout, as they continue to care for patients in highly stressful environments. Mindfulness meditation is a successful strategy for mitigating and managing burnout. Nursing leaders must raise awareness regarding burnout, lack of self-care, and wellbeing among nurses. The purpose of this quasi-experimental, pretest-posttest interventional study design was to examine if a six-week online mindfulness intervention decrease burnout levels related to emotional exhaustion, depersonalization, and feelings of personal accomplishment, as measured by Maslach Burnout Inventory (MBI) Toolkit, in registered nurses who cared for adults in a single, inpatient urban care setting located in Philadelphia, Pennsylvania, during the COVID-19 pandemic. Thirty-eight consenting registered nurses (RNs) participated in the study. The intervention group (n =25) participated in the mindfulness intervention only. The comparison group (n =13) did not participate in the intervention. Data findings supported statistically significant improvement in MBI subscale PA (p = 0.00006) and clinically significant change in MBI subscale EE (from 27.6 to 24.0) post-intervention. These results suggest that healthcare organizations should implement weekly mindfulness intervention activities to mitigate nurse burnout. Additionally, replication studies are warranted to identify and examine predictors related to burnout and study interventions to mitigate burnout and improve mental well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Caring for COVID-19 infected patients admitted to redesignated coronavirus ICUs: Impact on nurse stress and burnout.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic globally impacted healthcare due to surges in infected patients and respiratory failure. The pandemic escalated nursing burnout syndrome (NBS) across the workforce, especially in critical care environments, potentially leading to long-term negative impact on nurse retention and patient care. To compare self-reported burnout scores of frontline nurses caring for COVID-19 infected patients with burnout scores captured before the pandemic and in non-COVID-19 units from two prior studies. METHODS: The descriptive study was conducted using frontline nurses working in eight critical care units based on exposure to COVID-19 infected patients. Nurses were surveyed in 2019 and in 2020 using Maslach Burnout Inventory (MBI), Well Being Instrument, and Stress-Arousal Adjective Checklist (SACL) instruments. Researchers explored relationships between survey scores and working in COVID-19 units. RESULTS: Nurses working in COVID-19 units experienced more emotional exhaustion (EE) and depersonalization (DP) than nurses working in non-COVID units (p= .0001). Pre-COVID nurse burnout scores across six critical care units (EE mean = 15.41; p= .59) were lower than burnout scores in the COVID-19 intensive care units (EE mean = 10.29; p= .74). Clinical significance (p= .08) was noted by an EE subscale increase from low prepandemic to moderate during the pandemic. CONCLUSION: Pinpointing associations between COVID-19 infection and nurse burnout may lead to innovative strategies to mitigate burnout in those caring for the most critically ill individuals during future pandemics. Further research is required to establish causal relationships between sociodemographic and work-related psychological predictors of NBS.

How Do We Reduce Burnout In Nursing?

Burnout syndrome has been defined as a state of chronic stress characterized by high levels of emotional exhaustion and depersonalization with low levels of professional efficacy. The effects of nurse burnout include poor job satisfaction and turnover. Nurses' physical and mental well-being are both essential to sustaining a healthy nursing workforce with factors such as an empowering work environment showing positive effects on reducing burnout. Formal and informal individual and organizational approaches to supporting novice nurses' transition and experienced nurses' sustained practice fulfillment are key to addressing burnout and fostering retention.

Cost Analysis of Providing Overtime to Current Nurses Versus Hiring a Dedicated Nurse for COVID-19 Management in a Processing Plant.

BACKGROUND: U.S. meat and poultry processing workers experienced a disproportionate burden of COVID-19 illness following the declaration of the COVID-19 pandemic. Managing prevention and surveillance activities for COVID-19 prevention required additional work for occupational health nurses. The purpose of this project was to conduct a cost analysis for two staffing options to address the increased workload for occupational health nurses. METHODS: An economic quality improvement design was used for this study. The project was performed at a meat and poultry processing plant with 1,800 employees and six occupational health nurses. Two staffing options were considered. Option 1 was to continue to pay current occupational health nurses overtime, and Option 2 was to hire a COVID-dedicated nurse to manage the increased workload. A cost analysis was conducted for wages per hour plus benefits at three time points: 3 months, 1 year, and 3 years. FINDINGS: Costs for Option 1 (continuing overtime) at 3 months, 1 year, and 3 years were estimated at US$27,370, US$109,517, and US$328,550, respectively. Costs for Option 2 (hiring a COVID-dedicated nurse) at 3 months, 1 year, and 3 years were estimated at US$44,279, US$94,979, and US$230,179, respectively. CONCLUSIONS/APPLICATION TO PRACTICE: Hiring a dedicated COVID nurse would save the processing plant extensive salary costs by Year 3. Reducing overtime had the potential to decrease the COVID-19-related workload and potential experiences of fatigue and burnout in occupational health nurses.

Heal the Healers: A pilot study evaluating the feasibility, acceptability, and exploratory efficacy of a Transcendental Meditation intervention for emergency clinicians during the coronavirus disease 2019 pandemic.

OBJECTIVE: Emergency clinicians face elevated rates of burnout that result in poor outcomes for clinicians, patients, and health systems. The objective of this single-arm pilot study was to evaluate the feasibility of a Transcendental Meditation (TM) intervention for emergency clinicians during the coronavirus disease 2019 (COVID-19) pandemic and to explore the potential effectiveness in improving burnout, sleep, and psychological health. METHODS: Emergency clinicians (physicians, nurses, and physician-assistants) from 2 urban hospitals were recruited to participate in TM instruction (8 individual or group in-person and remote sessions) for 3 months. Session attendance was the primary feasibility outcome (prespecified as attending 6/8 sessions), and burnout was the primary clinical outcome. Participant-reported measures of feasibility and validated measures of burnout, depression, anxiety, sleep disturbance, and stress were collected at baseline and the 1-month and 3-month follow-ups. Descriptive statistics and linear mixed-effects models were used. RESULTS: Of the 14 physicians (46%), 7 nurses (22%), and 10 physician-assistants (32%) who participated, 61% were female (n = 19/32). TM training and at-home meditation practice was feasible for clinicians as 90.6% (n = 29/32) attended 6/8 training sessions and 80.6% self-reported meditating at least once a day on average. Participants demonstrated significant reductions in burnout (P < .05; effect sizes, Cohen's d = 0.43-0.45) and in symptoms of depression, anxiety, stress, and sleep disturbance (P values < .001; Cohen's d = 0.70-0.87). CONCLUSION: TM training was feasible for emergency clinicians during the COVID-19 pandemic and led to significant reductions in burnout and psychological symptoms. TM is a safe and effective meditation tool to improve clinicians' well-being.

Cultivating joy: Improving nurse resilience through use of a practice playbook.

PURPOSE/AIMS: The purpose of this study was to determine whether resiliency activities, compiled into a practice playbook designed for implementation by nurse leaders and self-initiation by clinical nurses, improves resilience in both the nurse leaders and direct care nurses who implement them. BACKGROUND: Evidence indicates strengthening nurse resilience increases well-being, protects against burnout, improves retention and increases patient safety. METHODS: A resilience playbook was assembled to include stress-reduction activities. Resilience was measured at baseline and after two phases during which participants engaged in leader-led and self-initiated activities. The Connor-Davidson Resilience Scale (CD-RISC) was used to measure resilience. RESULTS: A total of 118 nurses completed both phases; 17 leaders and 101 clinical nurses. A significant increase in mean CD-RISC scores was detected among those who participated in self-initiated activities (p = 0.01). Initiating or participating in leader-led activities did not positively impact resilience scores. Further, clinical nurses who participated in leader-led activities were not more likely to participate in self-initiated activities. CONCLUSIONS: This study supports self-initiated resilience-strengthening activities as beneficial to nurses, but not leader-led initiatives. These results are especially important for nursing leaders as they strive to reduce burnout, improve nurse retention and achieve exceptional practice quality.

Voices of Nurses During the Covid-19 Pandemic: A Call to Action.

The Covid-19 pandemic is having a significant impact on the well-being of nurses and has exacerbated long-standing issues of stress and burnout. Expecting or hoping that nurses will recover quickly or bounce back from the stress and deep trauma of the pandemic is not realistic. Each nurse has a story, and while these stories may have similar themes, they are all different. It is important to reflect on our stories, identify the myriad of emotions we are experiencing, and find ways to work through our feelings. Ignoring, denying, or suppressing feelings does not serve us well in the long run. Stifling negative emotions does not make them go away. A Call to Action is needed to address the impact of the pandemic, clinician burnout, and systemic racism on health-care organizations and educational institutions. Strategies are identified that will support personal and organizational well-being.

Prevention Strategies to Cope with Nurse Burnout in Nephrology Settings.

Nurses in nephrology are susceptible to nurse burnout. This article discusses the causes, signs, and symptoms associated with burnout. Prevention strategies, as well as patient and nurse safety, are reviewed.