Evidence-Based Practice: Search Strategy Paper

Evidence-Based Practice: Search Strategy Paper

Evidence-Based Practice: Search Strategy Paper

            Evidence-based practice requires nurses to utilize effective search strategies to be able to locate reliable and relevant sources to guide practice change. Staff development professionals and continuing education can help nurses carry out effective literature searches from medical databases (Eriksen & Frandsen, 2018). However, the clinician must identify a clinical problem or topic of interest before deciding on which search strategy to utilize. The purpose of this paper is to demonstrate the use of a search strategy in identifying two relevant and credible articles to promote evidence-based practice in managing and preventing nurse burnout during the COVID-19 pandemic. 

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Clinical Question

            Nurse burnout is one of the main significant concerns in healthcare that can be described as work-related stress syndrome that is characterized by depersonalization, emotional exhaustion, and reduced personal accomplishment. Even before the COVID-19 pandemic, nurse burnout had already been considered a healthcare epidemic, but has worsened due to the massive spread of the virus (Armstrong & Turne, 2022). According to the Medscape Nurse Career Satisfaction Report which was based on online replies from a total of 10,424 registered nurses and APRNs in America, the rates of nurse burnout are way higher as compared to the pre-epidemic period (Wang et al., 2021). The American Nurses Association (ANA) also conducted two surveys that revealed an increased feeling of being overwhelmed, sad, anxious, depressed, lonely, irritable, and numb among nurses, during this period, among other frontline healthcare workers (Serrano‐Ripoll et al., 2021). Nurse burnout is associated with the deteriorated mental health of nurses, which undermines patient safety and the quality of care provided. However, with the utilization of evidence-based practice, the rates of burnout can be significantly reduced to uphold patient safety and care outcomes. As such, this literature search will be guided by the following PICOT question: “Among nurses working in both outpatient and inpatient hospital settings, does the implementation of mindfulness-based interventions reduce the rates of burnout as compared to routine practice during the COVID-19 pandemic?”

Level of Evidence

            The literature search mainly focuses on the effectiveness of mindfulness-based intervention in preventing burnout among nurses during the COVID-19 pandemic. The clinical question can be categorized under the prevention domain, which means that evaluating the potential harm and benefits of the intervention is crucial (Eriksen & Frandsen, 2018). As such, the type of evidence required to answer this question can either be from randomized controlled trials or prospective studies. RCTs are the best type of evidence for this study as they eliminate biases via the utilization of double blinding in addition to minimizing or eliminating confounding factors via randomizations. Prospective studies on the other hand are tailored to gather specific exposure data from the present time into the future and hence may be more complete.

Search Strategy

            To identify the literature sources utilized in answering the clinical question, the Chamberlain University Library was utilized. The search process was initiated using search terms like “nurse burnout” “COVID-19” “patient safety” and “mindfulness-based interventions.” The advanced search option was utilized to ensure that all the search terms were considered. A total of 139 articles were arrived at from several databases including PubMed, EBSCO host, and MEDLINE. To narrow down to only the relevant and reliable sources, it was necessary to apply filters such as peer-reviewed journals, publications from 2017-2022, and in the English Language. This reduced the number of search results to 93, which was still huge. It was necessary to add more filters of full publications and restrict the search to only medical databases that led to 3 articles, of which the following two met the inclusion criteria for this study. 

            The first article by Wang et al. (2021) was aimed at evaluating the mediated moderation of the impact of psychological detachment and micro-break activity on the relationship between work engagement and job stress among hospital nurses during the COVID-19 pandemic. The researchers reported that the two interventions played a joint significant role in reducing nurse burnout during this involving times. The second article by Armstrong & Turne (2022) aimed at examining the significance of mindfulness-based interventions in reducing stress levels and burnout among nurses working in acute hospital settings among other frontline healthcare during the COVID-19 pandemic. The researchers found that the implementation of standardized mindfulness-based interventions was beneficial in reducing stress levels and rates of burnout among nurses and other frontline healthcare workers in acute care settings during the covid-19 pandemic period. Both articles provide evidence supporting mindfulness-based interventions as the most effective and appropriate in managing and preventing nurse burnout hence relevant to the clinical question.

Conclusion

            The welfare of nurses has always been directly associated with the quality of care provided and patient safety. As a result, any form of stress or nurse burnout can greatly undermine patient outcomes. The COVID-19 pandemic has made it worse, as nurses among other frontline healthcare workers have reported significantly increased rates of burnout. However, as demonstrated in the reviewed literature sources, mindfulness-based interventions have displayed potential effectiveness in reducing stress levels among nurses and promoting the quality and safety of care provided.

References

Armstrong, J. W., & Turne, L. N. (2022). Mindfulness-based interventions to reduce stress and burnout in nurses: an integrative review. British Journal of Mental Health Nursing, 11(1), 1–11. https://doi.org/10.12968/bjmh.2020.0036

Eriksen, M. B., & Frandsen, T. F. (2018). The Impact of patient, intervention, comparison, Outcome (PICO) as a Search Strategy Tool on Literature Search quality: A Systematic Review. Journal of the Medical Library Association, 106(4). https://doi.org/10.5195/jmla.2018.345

Serrano‐Ripoll, M. J., Ricci‐Cabello, I., Jiménez, R., Zamanillo‐Campos, R., Yañez‐Juan, A. M., Bennasar‐Veny, M., Sitges, C., Gervilla, E., Leiva, A., García‐Campayo, J., García‐Buades, M. E., García‐Toro, M., Pastor‐Moreno, G., Ruiz‐Perez, I., Alonso‐Coello, P., Llobera, J., & Fiol‐deRoque, M. A. (2021). Effect of a mobile‐based intervention on mental health in frontline healthcare workers against COVID‐19: Protocol for a randomized controlled trial. Journal of Advanced Nursing, 77(6), 2898–2907. https://doi.org/10.1111/jan.14813

Wang, H., Xu, G., Liang, C., & Li, Z. (2021). Coping with job stress for hospital nurses during the COVID‐19 crisis: The joint roles of micro‐breaks and psychological detachment. Journal of Nursing Management. https://doi.org/10.1111/jonm.13431

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The term dissemination means to spread knowledge and the associated evidence-based interventions. The targeted audience to a specific public health or clinical practice audience. The main goals of dissemination is to increase the reach of evidence, to increase motivation of nurses and patients in using evidence-based practice. (AHRQ, 2012) The strategies facilitate the use of health related evidence. As a health care member your evidence of information will have to be that of a systematic review, the highest level of evidence. Persuating a targeted group in a entertaining way, delivering tailored infoirmation based on the stakeholder.

A strategy I would be inclined to use is the unil level presentaiton. This is a type of EBP dissemination that will reach the audience closer to you therefore having a better understanding of their needs and issues within your unit and organization. One of the benefits of using EBP in unit bases presentation is to boost confidence in stakeholders for a certain clinical implementation. (Brownson et al, 2018).

Another dissemination strategy I would use iof social media at a organizational level. Proactive dissemination methods such as invitation to your social media platform or the organization. You can quickly communicate with your audience and easily engage among them. Also you may use your experiece in networking to spread the word about your guidelines and inviting advocacy groups to participate in your dissemination. (NHMRC, n.d.)

One of the disemination strategies I would be less inclined the use of podium presentaiton and professional journals. Presentaiton in your facility run the risk of low turnout of members, since you will have to work around everybody schedules and this could take a long time. Also in person presentation requires a constant attention from the audience and inability to control distractions. Professional journals are sometimes retrieved from a database that requires fees and subscriptions and most people often opt out of them.

The barriers that can I can encounter with my preferred disemination strategy at a unit level presentation are distractions from other members of healtcare at the nursing station. Such as RT or doctors interrupting, while having a unit based meeting. A potential barrier to using social media platforms is that not all nurses follow the organization page and connectivity problems. The barriers can be overcomed by selecting a time when its least busy in the unit and incentivising stakeholders attending the platform and benefits from following the organization page.
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