C361: Evidence-Based Practice and Applied Nursing Research
C361 - MLM1 – Performance Assessment 1
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College of Health Professions, Western Governors University
C361: Evidence-Based Practice and Applied Nursing Research
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C361 - MLM1 – Performance Assessment 1
Impact of the Problem on the Patient
Bedside nursing in the healthcare setting needs physical exertion to be able to give quality care to patients. The nurses should be able to lift, carry, push, and pull equipment around the facility. They must also stand and walk for long periods, sometimes in uncomfortable positions. Such physical demands can result in acute or chronic pain or injury among the nursing teams in the facility (Chang & Cho, 2022). As a result, the nurses may be unable to perform certain tasks needed to provide safe and quality care. In addition, when the nurses are in pain, they may be exposed to errors that can result in further complications for the patient. Therefore, nurses must reduce the risk of injury or pain to provide the best care for their clients.
The physical demands can also cause fatigue that significantly affects the care provided to the patients. It can reduce the nurses' focus, concentration, and alertness. Hence, it becomes difficult for the nurses to provide safe and effective care. Fatigue can also affect the ability of the nurse to focus at work and expose their patients to immense risks. Therefore, it is critical to have nurses take adequate breaks throughout the day and have enough sleep. They also need to engage in healthy eating habits and ensure they consume a lot of water throughout their shift. Generally, nurses must practice proper body mechanics and ergonomics when performing tasks. Experts also recommend that nurses take regular breaks to participate in stretching and strengthening exercises when possible.
Impact of the Problem on the Organization
The physical demands also have critical impacts on the organization. The physical demands of bedside nursing can have a significant impact on an organization’s bottom line. Injuries due to the physical demands can lead to increased workers’ compensation costs, and increased staff turnover can lead to higher recruitment and training costs. The nurses are injured following the physical demands of their employment. As a result, they may be unable to work, and the facility is forced to pay for their medical expenses. The injuries also result in low productivity, pushing the organization into financial strains. When nurses are fatigued or are in a lot of pain, they cannot provide the best quality care and hence, poor health outcomes and low patient satisfaction. Health organizations are recommended to ensure nurses take the necessary steps to protect their health and reduce the risk of injury.
The nurses' morale is also at risk following the physical demands of bedside nursing. When the staff is in pain or tired due to these physical demands, they become frustrated and lose motivation to work. As a result, they experience low job satisfaction, high absenteeism, and high turnover rates. They are also unable to provide safe and quality care, resulting in low satisfaction among the patients and their families (Zakerian, Afzalinejhad, Mahmodi & Sheibani, 2021). The organization's reputation is also at risk due to these issues and risks losing loyal clients and possibly new clients. Mistakes due to fatigue and stress can lead to negative press coverage and complaints from patients and their families. If an organization is not taking steps to reduce the physical demands of bedside nursing, they may be perceived as not caring about the wellbeing of their staff or the quality of care they are providing. This can lead to a loss of trust and loyalty from patients and their families. Eventually, the organization experiences a staff shortage, low financial income, and lack of adequate resources due to limited finances. The organization is forced to recruit nurses every time, which is expensive and time-consuming. It also spends more time and money training and orienting the new staff each time.
Identify the PICO components
P – Nurses in the healthcare
I – Bedside nursing
C – Community nurses
O – Acute/chronic pain and/or injury
Evidence Based Practice Question
In the healthcare setting, what are the physical demands of bedside nursing and how do they contribute to acute/chronic and/or injury in nurses compared to community nursing?
Research Article: Job demands at the patient's bedside and their effects on stress and satisfaction of nurses.
Background Introduction
The article explores the demands nurses endure at bedside and how these affects the stress and satisfaction of nurses. According to the authors, the COVID-19 period reveals the importance and relevance of the nursing profession after they exhibited appropriate functioning of the health systems. The author further notes that the profession is characterized by physical and mental burden. The job demands while working at the bedside correlates with strain and satisfaction or nurses. These demands result in burnout of nurses (Wenderott, Franz, Friedrich & Boos, 2023). As a result, health facilities experience low patient satisfaction, low quality of care and safety issues. Hence, it is essential to ensure nurses are satisfied with their job as this influences the safety and quality of care they provide to their patients. The dissatisfaction of nurses generally results in absenteeism and eventually change of careers among nurses.
Methodology
The authors carried out a cross sectional survey study to be able to get high response and compare with large projects. The cross-sectional study adopts a consensus-based checklist for reporting survey studies. The data is collected through a pretest questionnaire that focuses on readability, structure and acceptance. The nurses were randomly selected to fill the questionnaires. The data analysis was through a statistical evaluation using Rstudio. An inclusion and exclusion strategy were adopted to ensure the data collected from the sample gave more accurate and desirable results. The participation was voluntary and nurses engaging in the study were all licensed practitioners working at the bedside or who have worked at the bedside before.
Level of Evidence
The research is level VIII evidence considering it represents a cohort studies.
Data Analysis
Data analysis in this article uses the Rstudio (V.1.2.5033, 2016, Boston Massachusetts, USA). The inverted items were recoded and those with missing values were eliminated using a row-by-row exclusion. Only the sales that were relevant to the respective analyses were filtered using the line-by-line exclusion. The researchers recalculated the internal consistency of scales to ensure the quality of the questionnaires.
Ethical Considerations
The study involves human participation and hence, the ethics committee of the University clinic of Gottingen reviewed the questionnaires and approved the project. It is essential to note that this exercise happened in the healthcare setting. hence, there are various issues to be considered. The time used to conduct the survey should not be parallel to the working hours of the nurses as this would compromise the safety and quality of care. The identity of the nurses also needs to be anonymous to prevent the nurses from attracting any attention from the management or administrators in their facilities. The participants voluntarily wish to engage in the study; hence, a consent form need to be signed to affirm that their engagement is voluntary and that they would not expect any compensation for taking part in the study.
Quality Rating
While the article is peer-reviewed and considered credible, it has not been cited in other research studies as it is only a few months old. hence, the quality rating results cannot be ascertained at the moment.
Analysis of the Results / Conclusions
The results identifies that there are issues associated with stress, burnout and satisfaction of the nurses at bedside. The study gives evidence that the rate of burn-out and stress do not differ on the work area for nurses. The job demands at the bedside correlate with the outcomes. Hence, there needs to be measures to improve the workspace at the bedside. Administrators in the healthcare area also need to be educated on how they can influence their organizations to support the nurses better.
Non-Research Article: The Effects of Nurse Burnout on Patient Experiences.
Background Introduction
The article acknowledges that healthcare providers face a high risk for burnout where they suffer emotional and physical exhaustion following exposure to demanding work. The burnout eventually affects the performance, interpersonal skills and psychological health as well as job satisfaction. The authors note that the nursing profession is highly demanding and stressful due to a high intensity and variety of underlying risk factors, work environment and different nurses’ experiences (Richemond, Needham, & Jean, 2022). the nurses are expected to offer patient care with empathy and maintain a high focus in a stressful environment. the stressful experiences are mostly due to the excessive workloads such as the nature of the department. Eventually, nurses experience a decline in physical, psychological and emotional energy. They become cynical about the patients and colleagues.
Type of Evidence
The evidence from this article is a mostly a literature review.
Level of Evidence
The research is level VI evidence as it comprises evidence summaries from individual studies.
Quality Rating
The article presents evidence from various studies. It is a literature review of studies on the topic and gives adequate recommendation on how nurses can reduce burnout to effectively manage a safety and quality care experience for their patients.
Author’s Recommendations
The authors recommend that nurses should be afforded an opportunity to engage in the decision-making processes so they can share their views and opinions. In this view, the nurses can share their experiences at bedside and the challenges they face. They can also provide possible solution to these issues and guide the management on how they can implement the changes to sustain a productive and highly active nurses team at the department. Innovation is also recommended where the management at facilities encourage the establishment of wellness clubs where the nurses need to share experiences to cope with the stressors that lead to burnout among nurses. These clubs are critical as they foster strong relationships in the workplace. They also help reduce nurse burnouts as they can reduce the shifts, recommend innovative measures to reduce the physical strain at bedside and ways of handy the medical equipment.
Recommended Practice Change
Bedside nursing is demanding, and its physical aspects can result in acute or chronic pain. Taking precautions and using ergonomic solutions can help nurses reduce the risk of pain and injury while providing quality patient care. It is recommended that nurses practice good body mechanics when lifting and moving patients and medical equipment (Sagherian, Clinton, Huijer & Geiger-Brown 2017). They must also take breaks and practice stress-reducing techniques such as deep breathing and stretching. In addition, there is a need to use ergonomically designed workstations and equipment to help nurses reduce the physical strain endured in their bedside nursing care. They must also be aware of their physical limitations and seek medical attention if they experience pain or injury.
Key Stakeholders
The stakeholders in this initiative are the nurses, healthcare administrators, providers, and patients. The nurses are responsible for providing safe and quality care while managing the physical demands associated with bedside nursing. Healthcare administrators must ensure that nurses are afforded the necessary tools and equipment to facilitate safe and efficient care. The providers are expected to be aware of the possible risks associated with bedside nursing and ensure safety protocols are in place to counter these issues. Finally, the patients should be educated on the risks of bedside nursing and how to reduce the risks of pain and injury.
Barrier to Implementation
There are possible barriers to the implementation of safety protocols for bedside nursing. Cost is one of the notable barriers considering the ergonomic solutions and equipment are expensive. It will need the finance department of the facility to allocate more funds to this course, which might strain the financial reach of the organization. There is also an aspect of limited resources, as most healthcare facilities do not have the budget or personnel to implement new safety measures. In addition, patient workloads might be too high for the nurses to take frequent breaks or for the facility to offer adequate training. There is also a lack of understanding or awareness of the possible risks associated with bedside nursing and hence, inadequate safety protocols.
Strategy to Overcome the Implementation Barrier
There are various strategies to overcome these barriers.
- Healthcare facilities need to include a budget allocated towards the ergonomics solution for the bedside nurses. The budget needs to be allocated every financial year to ensure the nurses have the best ergonomic solution every year to facilitate their safe and quality provision of care.
- Recruiting more nurses can help reduce the impacts of the physical demands of bedside nursing. More nurses implies that nurses can take breaks and shorter shifts to help them have adequate rest and avoid strains. It will reduce fatigue and burnout among nurses and lowers the changes for pain and injuries.
- Reducing patient workloads allows nurses to take frequent breaks and receive adequate training. The patient-nurse ratio should be considerate to ensure nurses do not have to care for more patients which can strain them and cause fatigue and burnout. The low workloads also allow room for patients to attend training and workshop sessions where they can be educated on the best ergonomic solution to prevent pain and injury while engaging in the bedside nursing.
- It is critical to encourage the healthcare administrators to appreciate the physical demands of bedside nursing and provide appropriate compensation for their work. The administrators can also develop protocols to ensure nurses adhere to proper body mechanisms when lifting and moving patients and the medical equipment.
Indicator to Measure the Outcome
The implementation of safety protocols for bedside nursing is critical to reduce the risk for pain and injury. Providing nurses with resources can ensure they are able to safely and efficiently provide care for patients. Various indicators can be used to determine the outcome of the implemented solutions.
- Low cases of injuries and illnesses related to bedside nursing
- High number of nurses adhering to proper body mechanics when lifting and moving patients
- High number of nurses taking regular breaks to reduce fatigue and stress
Conclusion
The physical demands of bedside nursing can take their toll on nurses, leading to fatigue, stress, and burnout. This can harm the quality of care they can provide and can lead to physical injuries, such as back and shoulder strain. Additionally, the long hours and physical demands can lead to mental exhaustion, making it difficult to concentrate and focus on patient care. The physical demands of bedside nursing can affect the quality and safety of patient care. Fatigue and stress can lead to mistakes, such as overlooking vital signs or not following safety protocols. When nurses are too tired to provide the necessary care, patients may not receive the care they need and deserve. This can lead to complications and prolonged hospital stays. To reduce the physical demands of bedside nursing and the impact on the quality and safety of patient care, nurses should take steps to manage fatigue, stress, and burnout. This includes taking regular breaks, engaging in stress-relieving activities, and ensuring adequate sleep. Additionally, nurses should ensure they are properly trained and adequately staffed to handle the physical demands of bedside nursing. Finally, nurses should ensure they are using correct body mechanics when lifting and transferring patients and other tasks.
References
Chang, H. E., & Cho, S. H. (2022). Nurses' steps, distance traveled, and perceived physical demands in a three-shift schedule. Human resources for health, 20(1), 72. https://doi.org/10.1186/s12960-022-00768-3
Donel Richemond, Maria Needham, Kerline Jean. (2022). "The Effects of Nurse Burnout on Patient Experiences." Open Journal of Business and Management, Vol.10(5). Doi: 10.4236/ojbm.2022.105139
Sagherian K, Clinton ME, Abu-Saad Huijer H, Geiger-Brown J. (2017). Fatigue, Work Schedules, and Perceived Performance in Bedside Care Nurses. Workplace Health & Safety. 2017;65(7):304-312. doi:10.1177/2165079916665398
Wenderott, K., Franz, S., Friedrich, M. G., & Boos, M. (2023). Job demands at the patient's bedside and their effects on stress and satisfaction of nurses. BMJ open quality, 12(1), e002025. https://doi.org/10.1136/bmjoq-2022-002025
Zakerian, S. A., Afzalinejhad, M., Mahmodi, M., & Sheibani, N. (2021). Determining the Efficiency of Ergonomic Belt During Patient Handling and its Effect on Reducing Musculoskeletal Disorders in Nurses. SAGE open nursing, 7, 23779608211057939. https://doi.org/10.1177/23779608211057939
