Assignment: Identifying a Clinical Question Essay

Assignment: Identifying a Clinical Question Essay

Assignment Identifying a Clinical Question Essay

The nursing profession has undergone immense evolution in the sense that evidence-based practice underpins all the facets of the profession. In order to make any decision, nursing professional depend on the evidence provided by researchers during their various projects. However, before the evidence is gathered, researchers have the obligation of formulating a researchable question. A researchable question that forms the basis of evidence-based research comprises an uncertainty regarding an issue that can be challenged, examined, and analyzed so as to offer useful information. In order to succeed in conducting a successful research, one would need to properly formulate a research question based on the issue that a clinical setting or practice faces on a daily basis. The present author has identified nurse burnout as an issue that afflicts their practice. As such, it becomes paramount for the paper to create a well-formulated research question with extreme specificity as well as preciseness that will form the foundation of addressing the matter. Therefore, in the present paper, nurse burnout will be identified as a clinical issue, the reasons why it is an issue and ways of improving it examined and a supporting nurse interventions article for the issue identified.

Identifying a Clinical Question

            In my clinical setting, nurse burnouts have been reported as an important factor in the provision of health care services. Nurse burnout has been defined as a chronic response to stress associates with work that consists of the depersonalization, personal accomplishment as well as emotional exhaustion (Adams, 2017). The existing nurse-to-patient ratio is an important facet of the issue and it points to the existence of the phenomenon. According to federal recommendations, the minimum nurse-to-patient ration has been placed at 1:6 in medico-surgical units while the ratio is 1:4, 1:2, and 1: 1 in non-critical emergency rooms/intermediate care units/telemetry/step-down, post-anesthesia/trauma patients/intensive care, and every patient under anesthesia respectively (Li, Pittman, Han, & Lowe, 2017). However, at the clinical setting of the present author, the nurse-to-patient ratio is 1: 9, which is more than the recommended numbers. As a consequence, several adverse events have occurred at the hospital such as increased mortality rate, decreased patient satisfaction and increased readmission rates have occurred, which leaves one to wonder whether then nurse to patient ration could be responsible for it. Therefore, the following PICOT Question will be formulated:

PICOT Question: In nurses working in high pressure environments compared to low pressure environments, does a lower nurse-to-patient ratio of 1:2 lead to improved psychological, emotional, and mental health and productivity of the nurses?

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            Nurse burnout syndrome that is caused by a high nurse-to-patient ration has been associated with severe impacts not only on the nurses but the patients as well. Literature reveals that an elevated nurse-to-patient ratio has adverse consequences such as high

Assignment Identifying a Clinical Question Essay
Assignment Identifying a Clinical Question Essay

stress levels as well as mental exhaustion among the nursing population (Adams, 2017). As a consequence, increased prevalence of accidents and mistakes have occurred. Moreover, nurse burnout syndrome in hospitals has led to a surge in malpractice lawsuits across the United States, which has strained the financial position of hospitals. In addition, high nurse-to-patient ration hence burnout have led to decreased patient satisfaction due to decreased quality of health care services offered by such nurses.

According to Wynendaele, Willems, and Trybou (2019), nurse burnout syndromes principally impacts the mental facet of such nurses. The burnout has in turn led to increased nurse turnout in hospitals, which has made them to struggle to handle the increasingly aged population in the United States. In addition, nurse burnout creates a cyclical problem in the sense that it offsets certain occurrences such as nurse shortage, patient and practitioner dissatisfaction, and negative patient outcomes.Assignment Identifying a Clinical Question Essay

In order to find appropriate articles regarding nursing burnout syndrome vis-à-vis the nurse-to-patient ration, a literature search was conducted based on the PICOT. The literature search was thus focused on finding information related to nurse burnouts and nurse-to-patient ration. The literature search occurred in CINAHL, Cochrane Databases, MEDLINE and NGC databases among others as highlighted by Melnyk and Finout-Overholt (2015). In order to get peer-reviewed, good quality articles, the search process deployed keywords such as “nurse burnout”, OR “burnout syndrome” AND “nurse-to-patient ratio” OR ‘workplace’ OR “mental and physical stress” AND ‘burnout outcomes’

The literature search revealed several articles that were relevant to the clinical issue of the present research vis-à-vis the formulated PICOT question. However, out of the plethora of articles that the research generated, the author chose five articles that met the criterion of peer-reviewed, evidence-based article. The article by Strachan-Hall (2017) revealed that mandated reduced nurse-to-patient ratio of 1: 4 in California has led to better overall mien in nurses lowered the prevalence of sickness as well as the economic factor of the staff turnover. Moreover, the article by Adams (2017) also revealed that backing for mandatory nurse-to-patient ration is generated from the belief that when a registered nurse is regulated, they will enhance positive patient outcomes as well as reduce the numbers for nursing shortage. The study by Liu et al. (2018) examined, among others, the impact of nurse burnout as a predictor of patient safety. Part of the results of the study encompassed the fact that lower workload due to lower nurse-to-patient ratio led to improved patient safety while nurse burnout was identified as a negative mediator of patient safety.

Wynendaele, Willems, and Trybou (2019) conducted a systematic review that intended to analyze and then summarize the association between the patient-nurse ratio vis-à-vis nursing personnel outcome. Their outcome revealed that the correlation between nurse-patient ratio as well as particular personnel-associated outcome was supported by multifarious studies. The study by S. Han, J. Han, and Kim (2018) focused on the effect of emotional labor by nursing personnel on various factors such as burnout and service delivery. The results of the study supported the assertion that addressing the emotional issues caused by increased nurse-patient ratio will lead to reduced adverse outcomes within the health care setting. This article is particularly relevant in the present clinical issues as it addressed the emotional aspect of burnout.

Article that Best Supports Intervention

            The article by Strathan-Hall (2017) best supports the recommendation to lower the nurse-patient ration in order to get better outcomes and improved quality of care due to improved well-being of nurses. The article is superior in the sense that it offers conclusive evidence since it focuses on a real situation wherein mandated lower nurse-patient ration is operational. As such, the results are not only valid but applicable. On the other hand, the article by S. Han, J. Han, and Kim (2018) did not focus on reducing nurse burnout. Instead, it provided a varied way of dealing with nurse burnout through addressing the emotional labor performed by nurses. According to the study, nurses have to handle their emotional states which will in turn enable them to handle the psychological impact of burnout syndrome. As regards Liu et al. (2018), the study focused on a multivariate analysis of factors affecting patient safety in hospital settings. Whereas nurse workload reduction as relates lowered nurse-patient ration was discussed, it did not form the basis of the study as opposed to the Stratchan-Hall (2017) study.

The article by Adams (2017) addresses the issue of nurse burnout in a superficial manner. It does not provide the methodologies that are associated with lower nurse-patient ration as relates to the improvement of patient safety and nurse satisfaction as opposed to Strathan-Hall (2017). Lastly, whereas Wynendaele, Willems, and Trybou (2019) supported the positive effect of lower nurse-to-patient ration on improving metrics such as patient safety, patient satisfaction, and nurse satisfaction, it still states that some of the articles therein disputed the effectiveness of the measure. As such, it diverges from the singular focus of the Strathan-Hall (2017) article. Therefore, from the comparisons, it is clear that the Strathan-Hall (2017) study supports the recommendation to increase the number of nurses so as to reduce burnouts amongst hospital staff.


In summary, nurse burnout syndrome is prevalent amongst nursing staff across the Unites States. The presence of nurse burnout syndrome has depersonalization, personal accomplishment as well as emotional exhaustion impacts. As a consequence, it negatively affects several aspects of nursing personnel such as their ability to improve the quality of services that they offer. However, literature search revealed that nurse burnout syndrome can be cured through the creation of policies and legislations that lower the nurse-patient ration. The lowering of the above ration will produce positive ramifications that will reverberate across the health care setting.

Write a 1000-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be three main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper.
Support your ideas with at least five (5) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount.

Identify a clinical question related to your work environment, write the question in PICOT format and perform a literature search on the identified topic.


To enable the student to identify a clinical question related to a specified area of practice and use medical and nursing databases to find research articles that will provide evidence to validate nursing interventions regarding a specific area of nursing practice.


Identify a clinical question related to your area of clinical practice and write the clinical foreground question in PICOT format utilizing the worksheet tool provided as a guide.

TOPIC = Nursing burnout & Nursing ratios(emergency room if possible)

Describe why this is a clinical problem or an opportunity for improving health outcomes in your area of clinical practice. Perform a literature search and select five research articles on your topic utilizing the databases highlighted in Chapter 3 of the textbook (Melnyk and Finout-Overholt, 2015).

Identify the article that best supports nursing interventions for your topic. Explain why this article best supports your topic as you compare the article to the other four found in the literature search.
Assignment Expectations:

Length: 1000 – 1500 words
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.

References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of five (5) scholarly sources are required for this assignment to support the topic.