Evidence-Based Practice Proposal Section A: Organizational Culture and Readiness Assessment

Evidence-Based Practice Proposal Section A: Organizational Culture and Readiness Assessment

Evidence-Based Practice Proposal Section A: Organizational Culture and Readiness Assessment

 

Organizational Culture and Readiness Assessment

Healthcare organizations implement evidence-based practices in order to improve patient outcomes and deliver high-quality, patient-centered care (Schaefer & Welton, 2018). Effective EBP adoption occurs when an organization is prepared and capable of identifying potential hurdles and facilitators to the implementation process. To aid in the implementation of the current project, The Optimal Health Center conducted a readiness assessment using the “Organizational Culture and Readiness for System-Wide Integration of Evidence-based Practice Survey.” TOHC was found to be prepared to implement new EBP as a result of the assessment.

Evidence-Based Practice Proposal Section A: Organizational Culture and Readiness Assessment

Obstacles and Facilitators in a Project

Time constraints were a significant impediment to implementation. Staff reported being overburdened with work, leaving them with little time to analyze fresh evidence. Due to time restrictions, I had minimal expertise building EBP. Facilitators saw on-site providers who are willing to advocate for EBP despite time restrictions (Schaefer & Welton, 2018). Additionally, management stated that they will establish an effective structure for personal and professional development. Proposal for Evidence-Based Practice Section A: Assessment of Organizational Culture and Readiness

High Scores

The assessment tool had nineteen categories and TOHC performed well in five of them. The high scores are linked to the management and providers’ commitment to using EBP (Egeland, Ruud, Ogden, Lindstrøm & Heiervang, 2016). The staff pointed out that EBP improves patient care and were visiting online databases to learn more about best practice guidelines. Survey also revealed that the center was

tracking patient outcomes to evaluate if patients are receiving adequate care. The management has rolled out a clinical trial where diabetic patients are educated and offered removable subcutaneous meters. The device monitors patient sugar levels and the data collected will be used to enhance diabetic care within the center.

Low Scores

The center performed poorly in seven categories with the major contributor being lack of a tuition reimbursement program to help employees further their education (Egeland, Ruud, Ogden, Lindstrøm & Heiervang, 2016). TOHC also did not have a librarian to educate or guide staff on EBP matters.

Integration of Clinical Inquiry

To enhance integration, providers will be trained on EBP to improve their confidence and motivation. The training will help them outline areas that require improvement (Egeland, Ruud, Ogden, Lindstrøm & Heiervang, 2016). Research will then be executed on the identified weak areas and possible solutions tabled for approval. Policy to guide on implementation will then be created to help in adopting the approved solutions. Evidence-Based Practice Proposal Section A: Organizational Culture and Readiness Assessment

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References

Egeland, K. M., Ruud, T., Ogden, T., Lindstrøm, J. C., & Heiervang, K. S. (2016). Psychometric properties of the Norwegian version of the Evidence-Based Practice Attitude Scale (EBPAS): to measure implementation readiness. Health research policy and systems, 14(1), 47.

Schaefer, J. D., & Welton, J. M. (2018). Evidence-based practice readiness: A concept analysis. Journal of nursing management, 26(6), 621-629.

PICOT Statement And Literature Review

Problem Statement

Oncology nurses assess, plan, implement, monitor and evaluate plans of care to ensure that the needs of their patients are met. The nurses handle patients with dynamic needs which are stressing and induces burnout syndrome. Burnout syndrome refers to a situation where a nurse is emotionally exhausted and has a diminished sense of individual accomplishment (Gomez-Urquiza et al., 2016).  Research indicates that numerous oncology nurses report the burnout syndrome as they handle patients who succumb to cancer and has to come to term with the meaning of death (Cañadas‐De la Fuente et al., 2018). Additionally, the nurses have to promote recovery and help patients cope with pain, grief and accept the approaching death. Burnout syndrome makes nurses irritable, insomniac and abuse drugs which negatively impact their performance. The syndrome is linked to increased sick leave and absenteeism, increased medical errors and low attention and morale to help patients (Ko, 2014). A novel approach should be devised to address burnout and optimize oncology nurses’ performance. Mindfulness practice has been proven to reduce burnout among oncology nurses. This proposal, therefore, aims at finding out whether mindfulness practice is effective and the PICOT that will guide the research is: Evidence-Based Practice Proposal Section A: Organizational Culture and Readiness Assessment

Among oncology nurses working with patients at the end of life, will the use of mindfulness practice versus no intervention result in the reduction of reported burnout within 10 months?

Literature Review

Research executed indicated that mindfulness practice reduces burnout syndrome. Penque (2019) supported this notion with a quasi-experimental study that involved 61 nurses aged 21 years. The main aim of the study was to establish in mindfulness-based stress reduction programs reduced burnout and enhanced work satisfaction. The results indicated that not only did the program reduce burnout but also enhanced psychological factors like mindfulness, self-compassion, and serenity. Similar, a non-randomized controlled study executed by Duarte and Pinto-Gouvenia (2017) outlined that mindfulness mediated changes resulted in reduced compassion fatigue and better self-compassion which reduced anxiety, stress, burnout and increases satisfaction with life. The study had 96 oncology nurses and used self-reported measures to assess aspects like compassion fatigue, depression, burnout, self-compassion, and mindfulness.

A systematic review by Burton et al., (2017) reported that mindfulness-based interventions improve burnout among health professionals. The articles reviewed handled interventions like telephonic mindfulness-based stress reduction (MBSR) program, traditional MBSR, mindfulness-based cognitive attitude training and modified MBSR. Among all the article reviewed only one had negative results. A cross-sectional survey by Vivian et al. (2019) evaluated what caused stress among nurses. 340 nurses participated in the study and they indicated that lack of support, death and dying, workload and conflict with physicians were the major causes of stress. Nurses operating in critical care units reported least dispositional mindfulness creating a need to come up with interventions that address the weakness. Lastly, Flatt and Dabney (2019) executed a systematic review that revealed that mindfulness-based programs help in dealing with compassion fatigue, depression, distress, stress, and burnout.

A comparison of the articles reveals that they all support the use of mindfulness-based interventions. The articles indicate that MBIs make it easy for health professionals to execute their duties and they promote physical and psychological well-being (Penque, 2019). The authors point out that clinical work is stressful and it causes burnout. The articles align with the aim of the current proposal which is to find out the effectiveness of mindfulness practice on reducing burnout among oncology nurses.  A striking difference observed is the varying duration of interventions used in the various articles. Most of the interventions last between 6-8 weeks and cover varying participants (Flatt &Dabney, 2019). Although the articles involved health professionals, two articles dealt with general health practitioners while the rest specifically handled oncology nurses. A clear conclusion is that the articles generated results that were consistent with the existing literature.

For further review, the articles indicate that future programs should adopt mindfulness programs to redirect negative thinking among nurses and reframe difficult situations.  Oncology nurses need these programs to ensure that organizations have nurses who can promote companionship and support each other when stressful situations occur. Time-commitment is a major barrier to the implementation of mindfulness-intervention and researchers planning to implement them should be keen on this aspect (Vivian et al., 2019). To deal with time-constraints a brief and accessible intervention would facilitate a quicker adoption. Lastly, several assessment time points are crucial for any MBI to ensure that stronger conclusions are drawn and act as fidelity checks for the programs (Duarte & Pinto-Gouveia, 2017).

Conclusion.

Oncology nurses handle dynamic patients which induce stress and burnout. Burnout harms care offered because it makes nurses irritable and reliant on drugs. Burnout increases absenteeism, sick leaves, and medical errors. To avoid the negative impacts, mindfulness practice can be employed since reviewed literature indicate that it reduces burnout and promotes physical and psychological wellbeing. Programs adopted should be brief and accessible and should have several assessment time points to enhance the conclusions made.

References

Burton, A., Burgess, C., Dean, S., Koutsopoulou, G. Z., & Hugh‐Jones, S. (2017). How effective are mindfulness‐based interventions for reducing stress among healthcare professionals? A systematic review and meta‐analysis. Stress and Health, 33(1), 3-13.

Cañadas‐De la Fuente, G. A., Gómez‐Urquiza, J. L., Ortega‐Campos, E. M., Cañadas, G. R., Albendín‐García, L., & De la Fuente‐Solana, E. I. (2018). Prevalence of burnout syndrome in oncology nursing: A meta‐analytic study. Psycho‐oncology, 27(5), 1426-1433.

Duarte, J., & Pinto-Gouveia, J. (2017). Mindfulness, self-compassion, and psychological inflexibility mediate the effects of a mindfulness-based intervention in a sample of oncology nurses. Journal of Contextual Behavioral Science, 6(2), 125-133.

Flatt, T., & Dabney, B. W. (2019). Mindfulness-Based Stress Reduction and Workplace Burnout: A Literature Review. Sigma Theta Tau International.

Gomez-Urquiza, J. L., Aneas-López, A. B., la Fuente-Solana, D., Emilia, I., Albendín-García, L., & Díaz-Rodríguez, L. (2016). Prevalence, Risk Factors, and Levels of Burnout Among Oncology Nurses: A Systematic Review. In Oncology nursing forum, 43(3).

Gomez-Urquiza, J. L., Aneas-López, A. B., la Fuente-Solana, D., Emilia, I., Albendín-García, L., & Díaz-Rodríguez, L. (2016, May). Prevalence, Risk Factors, and Levels of Burnout Among Oncology Nurses: A Systematic Review. In Oncology nursing forum (Vol. 43, No. 3).

Ko, W. (2014). Stress levels of nurses in oncology outpatient units (Doctoral dissertation, North Dakota State University).

Penque, S. (2019). Mindfulness to promote nurses’ well-being. Nursing Management, 50(5), 38-44.

Vivian, E., Oduor, H., Arceneaux, S. R., Flores, J. A., Vo, A., & Madson Madden, B. (2019). A cross-sectional study of perceived stress, mindfulness, emotional self-regulation, and self-care habits in registered nurses at a tertiary care medical center. SAGE Open Nursing, 5, 2377960819827472.

NUR 590 Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness

Assessment Description