The practice problem this student wishes to focus on is nursing turn-over in the psychiatric field. This leads to unsafe care to patients and a lack of continuity of care. In the psychiatric field, this especially takes a toll on the patients due to lack of trust and repore. The patients tend to pull back and not engage with nursing staff because the patients don’t trust that the nurse will be there for the duration of their treatment.
P-Population- The population is the group of psychiatric nurses. – please specify what setting this would be in, outpatient or inpatient? PICOT Statement
Nurses working in psychiatric settings have high rates of turnover because of unfavorable organizational factors. The problem arises due to low psychiatric nurse-to-patient staffing ratios, heavy workloads, and time constraints among others resulting in burnout and low job satisfaction (Hanrahan, Aiken, McClaine, & Hanlon, 2010).
I-Intervention-The intervention is minimizing burnout among the psychiatric nurses. – be specific as to what intervention you will implement – minimizing burnout is complicated and often multi-faceted
It is necessary to minimize burnout by improving organizational factors in psychiatric healthcare settings (Lukose, & Azeez, 2015). The psychiatric nurses become physically and emotionally exhausted since they deal with mentally ill patients. PICOT Statement
C-Comparison-The reference (comparison) would consist of psychiatric nurses who do not experience minimized burnout. What may have been meant here is that the comparison group would be the group who will not receive the intervention you will implement – make sure to clarify that intervention too.
Therefore, the effectiveness of using the intervention of minimizing burnout among the psychiatric nurses would be measured by comparing with the reference group.
O –Outcome-The outcome is the lowered turnover among psychiatric nurses. Reducing burnout should decrease the emotional and physical fatigue that psychiatric nurses experience (Chakraborty, Chatterjee, & Chaudhury, 2012). Consequently, their attitudes towards work would be positive and they would continue working in the psychiatric field thus reducing the staff turnover. PICOT Statement
T- Time-The outcome would be assessed for 2 months. – Please specify if two months is the time frame for measuring outcomes or will two months include the implementation of the intervention you are proposing?
Where is your PICOT statement/question?
Chakraborty, R., Chatterjee, A., & Chaudhury, S. (2012). Internal predictors of burnout in psychiatric nurses: An Indian study. Industrial Psychiatry Journal, 21(2), 119-124. doi:http://dx.doi.org/10.4103/0972-6748.119604
The study examined the psychological factors that could predict burnout among Indian psychiatric nurses. The study comprised of 101 psychiatric nurses from two hospitals. They gave their informed consent and provided socio-demographic data. The research then used the Pearson’s r (Spearman’s rho) method to determine the correlation existing between socio-demographic and clinical variables and burnout. The multiple linear regression analysis was useful in entering the dependent and independent variables. The findings indicated that various socio-demographic and clinical variables affected burnout. The study concluded that lower burnout was predicted by past military training, internal locus, emotional maturity, sense of general physical well-being and adjustability. PICOT Statement
Hanrahan, N. P., Aiken, L. H., McClaine, L., & Hanlon, A. L. (2010). Relationship between Psychiatric Nurse Work Environments and Nurse Burnout in Acute Care General Hospitals. Issues in Mental Health Nursing, 31(3), 198–207.
The abstract of this journal mentions that research was conducted to evaluate how organizational factors lead to burnout among psychiatric nurses. The research used robust clustered regression analysis to determine the relationship of the two variables (organizational factors and levels of burnout). A total of 353 psychiatric nurses from 67 hospitals were evaluated. The study also measured organizational factors using an instrument from the National Quality Forum. According to the research results, high quality psychiatric environments reduced the level of burnout faced by psychiatric nurses.
Holmberg, C., Caro, J., & Sobis, I. (2017). Job satisfaction among Swedish mental health nursing personnel: Revisiting the two-factor theory. International Journal of Mental Health Nursing, complete the publication information here 1-12. doi: 10.1111/inm.12339
The study explored the Herzberg’s theory and its relationship to job satisfaction among mental health staff offering inpatient psychiatric care in Sweden. The study was qualitative and it used semi-structured interviews among 25 mental health nurses. They described their perception of responsibilities, interactions with colleagues and management, as well as professional experiences in psychiatric nursing. The study concluded that the mental health nurses had lower job satisfaction because of inadequate monetary incentives and professional development opportunities. PICOT Statement
Lukose, S., & Azeez, A. E. P. (2015). Occupational stress, mental health and attitude towards mental illness of nursing staff working in general and psychiatric hospital: A comparative study. Journal of Organization and Human Behavior, 4(4) Retrieved from https://search.proquest.com/docview/1765137272?accountid=45049
The research was conducted to determine the occupational stress faced by psychiatric nursing staff. Therefore, the study was cross-sectional hospital-based in four centers. The participants included 50 female nurses working in psychiatric hospitals and 50 in general hospitals. Additionally, judgmental sampling method was utilized to collect 100 samples. The stress level, mental health, and the nurses’ attitudes towards mental conditions were evaluated using General Health Questionnaire and socio-demographic data sheet. The research revealed that compared to general nurses, the psychiatric nurses experience increased occupational stress and workload. They also faced more work conflict, ambiguity and political pressure. PICOT Statement
Tuvesson, H., Eklund, M., & Wann-Hansson, C. (2012). Stress of Conscience among psychiatric nursing staff in relation to environmental and individual factors. Nursing Ethics, 19(2), 208–219.
The research investigated how various factors (individual and environmental) affect the stress of conscience among nurses providing psychiatric healthcare services. The study was conducted in Sweden among 93 psychiatric nurses working in 12 psychiatric wards. They answered a questionnaire that had different instruments evaluating various factors. SPSS 17.0 was used to conduct statistical analyses. The logistic regression models involved using the Mann-Whitney U-test and Spearman rank correlations. Moreover, according to the study conclusions, the psychiatric nurses experienced high stress of conscience when they faced aggressive and angry behavior as well as a sense of moral burden. However, protective factors included mastery and control at work.
Yanchus, N., Periard, D., Moore, S., Carle, A., & Osatuke, K. (2015). Predictors of Job Satisfaction and Turnover Intention in VHA Mental Health Employees: A Comparison between Psychiatrists, Psychologists, Social Workers, and Mental Health Nurses. Human Service Organizations: Management, Leadership & Governance, 39(3), 219-244. PICOT Statement
The study explored job satisfaction and turnover intention among various healthcare professionals working in the Veterans Health Administration. The professionals included mental health nurses, psychiatrists, social workers as well as psychologists. Psychological safety, civility, autonomy and procedural justice were the predictors. Moreover, a total of 11, 726 VHA mental health staff participated in the study. The results of the study indicated that turnover intention among the mental health employees was predicted by autonomy, civility and procedural justice PICOT Statement
Also check: Cultural competence and diversity in healthcare