Capstone Nursing Project Paper Help
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Capstone Nursing Project Paper Help
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In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.
Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:
- Background
- Problem statement
- Purpose of the change proposal
- PICOT
- Literature search strategy employed
- Evaluation of the literature
- Applicable change or nursing theory utilized
- Proposed implementation plan with outcome measures
- Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
- Appendix section, if tables, graphs, surveys, educational materials, etc. are created
Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
Below are papers to REFERENCE only. No plaragism please.
Literature Evaluation Table
Student Name:
Change Topic (2-3 sentences): How does nursing burnout related to long shift hours effect patient satisfaction and join satisfaction?
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article |
Chiara Dall’Ora1, Peter Griffiths, Jane Ball, Michael Simon, Linda H Aiken
BMJ Journal
|
Amy Witkoski Stimpfel1, Douglas M. Sloan and Linda H. Aiken
Health Affairs
|
Doris C. Vahey, PhD, RN, Linda H. Aiken, PhD, RN, Douglas M. Sloane, PhD, Sean P. Clarke, PhD, RN, and Delf no Vargas, PhD
NCBI
|
Amy Witkoski Stimpfel, PhD, RN and Linda H. Aiken, PhD, RN, FAAN
NCBI
|
| Article Title and Year Published | Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. Capstone Nursing Project Paper Help
10 September 2015 |
The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction
November 2012 |
Nurse Burnout and Patient Satisfaction
15 July 2010 |
Hospital Staff Nurses’ Shift Length Associated With Safety and Quality of Care
1 April 2014 |
| Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study | The aim of this study is to examine the association between working long shifts and burnout, job dissatisfaction, dissatisfaction with work schedule flexibility and intention to leave current job among hospital nurses. | In this study we investigated the relationship between hospital nurses’ shift length and three nurse outcomes: burnout, job dissatisfaction, and intention to leave the job. Burnout is characterized by emotional exhaustion, depersonalization of patients, and feelings of lack of personal accomplishment by caregivers, which could negatively affect nurse job satisfaction and voluntary turnover. | This study examines the effect of the nurse work environment on nurse burnout, and the effects of the nurse work environment and nurse burnout on patients’ satisfaction with their nursing care. | The objective of this study was to analyze hospital staff nurses’ shift length, scheduling characteristics, and nurse reported safety and quality |
| Design (Type of Quantitative, or Type of Qualitative) | Both | Quantitative | Both | Qualitative |
| Setting/Sample | 12 General Med-surg European Hospitals | The nurses in our study worked in 577 hospitals in California, New Jersey, Pennsylvania, and Florida. | 40 units in 20 urban hospitals across the United States. | 577 nonfederal acute care hospitals in 4 states (California, New Jersey, Pennsylvania, and Florida). |
| Methods: Intervention/Instruments | Cross-sectional survey of 31 627 registered nurses in 2170 general medical/surgical units within 488 hospitals across 12 European countries. | All analyses were completed using the statistical analysis software SAS, version 9.3. The significance level was Formula for a two-tailed test. | We conducted cross-sectional surveys of nurses (N = 820) and patients (N = 621) from 40 units in 20 urban hospitals across the United States | The analytic sample included 22 275 hospital staff RNs from 577 nonfederal acute care hospitals in 4 states (California, New Jersey, Pennsylvania, and Florida). There were at least 10 nurses per hospital, ranging from 10 to 205, with an average of 39 nurse respondents per hospital. The nurses included in this sample reported working between 1 and 24 hours on their last shift and caring for 1 to 19 patients from a variety of inpatient medical-surgical units, excluding long-term care and operating room settings. Only direct care nurses were studied. |
| Analysis | Nurses working shifts of ≥12 h were more likely than nurses working shorter hours (≤8) to experience burnout, in terms of emotional exhaustion, depersonalization and low personal accomplishment. Nurses working shifts of ≥12 h were more likely to experience job dissatisfaction, dissatisfaction with work schedule flexibility and report intention to leave their job due to dissatisfaction. Capstone Nursing Project Paper Help | Descriptive statistics were used to examine the major outcomes of interest and characteristics of nurses and hospitals by shift length category. First, we examined the bivariate relationship between nurses’ shift length and the nurse outcomes (burnout, job dissatisfaction, and intent to leave), using separate generalized estimating equation models. All comparisons between shift length categories were made using the category of 8–9 hours as the reference group.
Next, we added controls to the three nurse outcome models. All of the models used generalized estimating equations to take account of the clustering of nurses within hospitals.
Then we used the measures from the Hospital Consumer Assessment of Healthcare Providers and Systems survey to examine the relationship between the proportion of nurses in each hospital working each type of shift and patient satisfaction, using hospital-level data and estimating ordinary least squares regression models. After first estimating bivariate models, we added hospital-level controls to the models |
Nurse surveys included measures of nurses’ practice environments derived from the revised Nursing Work Index (NWI-R) and nurse outcomes measured by the Maslach Burnout Inventory (MBI) and intentions to leave. Patients were interviewed about their satisfaction with nursing care using the La Monica-Oberst Patient Satisfaction Scale (LOPSS). | Descriptive and inferential statistics were calculated, examining shift length in detail by individual nurse and then by hospital specialty unit and state. Differences were assessed using analysis of variance for continuous variables accounting for multiple comparisons, and χ2 tests for categorical variables. Generalized estimating equation models were used to assess the relationship between shift length and nurse-reported safety and quality measures, which accounted for the non independence of the nurses within hospitals. Bivariate generalized estimating equation models were constructed prior to multivariate generalized estimating equation models, which accounted for nurse, nursing organizational, and hospital structural characteristics (as described earlier). The 8- to 9-hour shift length was the reference group for all of the predictive models. All statistical analyses were conducted using SAS version 9.2 (SAS Institute, Cary, North Carolina), and significance was set at the P < .05 level. |
| Key Findings | Longer working hours for hospital nurses are associated with adverse outcomes for nurses. Some of these adverse outcomes, such as high burnout, may pose safety risks for patients as well as nurses. | Our findings contribute to a growing body of research associating nurses’ shift length with patient safety issues. The results also highlight an area of health care ripe for policy development at both national and institutional levels. | Patients cared for on units that nurses characterized as having adequate staff, good administrative support for nursing care, and good relations between doctors and nurses were more than twice likely as other patients to report high satisfaction with their care, and their nurses reported significantly lower burnout. The overall level of nurse burnout on hospital units also affected patient satisfaction. | This study found that found that nurses working shifts of 10 hours or longer were associated with worse reports of patient care quality and overall safety grade compared with nurses working 8 to 9 hours. |
| Recommendations | Shorten nursing shift hours. | At a minimum, hospital administrators should establish practices designed to comply with the Institute of Medicine’s recommendations to limit nurses’ work hours to twelve hours in a twenty-four-hour period and to sixty hours in a week. | Improvements in nurses’ work environments in hospitals have the potential to simultaneously reduce nurses’ high levels of job burnout and risk of turnover and increase patients’ satisfaction with their care. | These findings add to a growing body of research, which suggests that a reevaluation of widespread extended nurse shift length may be warranted. |
| Explanation of How the Article Supports EBP/Capstone Project | Explains the effects of 12 hour shifts. | Give a solutions on how to shorten nursing staff hours. | Includes way to reduce nursing burnout in the work environment. | Explains the effect that long shift hours have on patients. |
| Criteria | Article 5 | Article 6 | Article 7 | Article 8 |
| Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article |
A. Wisetborisut C. Angkurawaranon W. Jiraporncharoen R. Uaphanthasath P. Wiwatanadate
Occupational Medicinr
|
Claire C. Caruso, PhD, RN
NCBI
|
Steven W. Lockley, Ph.D. Laura K. Barger, Ph.D. Najib T. Ayas, M.D., M.P.H. Jeffrey M. Rothschild, M.D., M.P.H. Charles A. Czeisler, Ph.D., M.D. Christopher P. Landrigan, M.D., M.P.H. For the Harvard Work Hours, Health and Safety Group
The joint Commission Journal
|
,
, , , Gustavo R. Cañadas,
NJNS
|
| Article Title and Year Published |
Shift work and burnout among health care workers
18 February 2014 Capstone Nursing Project Paper Help |
Negative Impacts of Shiftwork and Long Work Hours
18 June 2013 |
Effects of Health Care Provider Work Hours and Sleep Deprivation on Safety and Performance
November 2007 |
Risk factors and prevalence of burnout syndrome in the nursing profession
10 July 2014 |
| Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study | To identify and describe the association between shift work and burnout among health care workers. | The purpose of the article is to give an overview of the wide range of risks to nurses, patients, and employers that are linked to shift work, long work hours, and poor sleep from other sources. | Nurses working shifts greater than 12.5 hours are at signif- icantly increased risk of experiencing decreased vigilance on the job, suffering an occupational injury, or making a medical error. | Burnout levels were evaluated in a group of nurses. The objectives of this study were to estimate the prevalence of burnout, to identify the variables related to burnout and to propose a risk profile for this syndrome among the nursing personnel. |
| Design (Type of Quantitative, or Type of Qualitative) | Quantitative | Quantitative | Both | Both |
| Setting/Sample | Chiang Mai University Hospital, Thailand. | Midwest | Several different hospital studies across US | The study was carried out in public health centers in Andalusia (Spain). |
| Methods: Intervention/Instruments | A cross-sectional study of health care workers in Chiang Mai University Hospital, Thailand. Data were collected via an online self-answered questionnaire and included details of shift work and burnout. Burnout was measured by the Maslach Burnout Inventory (MBI) | A cross-sectional study | Cross-Sectional study | The sample consisted of 676 nursing professionals from public health centers. Dependent variables were the three Burnout dimensions: emotional exhaustion, depersonalization and personal accomplishment. Independent variables were socio-demographic, organizational, personality-related variables. |
| Analysis | Two thousand seven hundred and seventy two health care workers participated, a 52% response rate. Burnout was found more frequently among shift workers than those who did not work shifts (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI]: 1.0–1.9). Among shift workers, over 10 years of being a shift worker was associated with increasing burnout (aOR 1.7, 95% CI: 1.2–2.6) and having 6–8 sleeping hours per day was associated with having less burnout (aOR 0.7, 95% CI: 0.5–0.9). Nurses who had at least 8 days off per month had lower odds of burnout compared with those with fewer than 8 days off (aOR 0.6, 95% CI: 0.5–0.8). | Sleep duration of 7–8 hours a night is associated with a lower risk of obesity, diabetes, high blood pressure, myocardial infarction, and cerebral vascular accidents as well as reduced risk for injuries and errors (Colten & Altevogt, 2006). Recent studies warn that a growing number of Americans are not getting enough sleep (CDC, 2008, 2011). Between the periods of 1985–1990 and 2004–2007, the percentage of healthcare workers reporting 6 or less hours sleep each day (a level considered too short by sleep experts) increased from 28% to 32% (Luckhaupt, Tak, & Calvert, 2010).
This trend for shorter sleep is likely linked to several factors. Nursing staff in facilities that operate around the clock are commonly exposed to shift work and long work hours. These demanding schedules can lead to difficulties with sleep because of the need to sleep at irregular times and at times that are out of phase with circadian rhythms. Misalignment of sleep with circadian rhythms leads to difficulties with falling asleep, more arousals during sleep, and early awakenings leading to poorer sleep quality and shorter sleep duration. Also, sleep duration may be shortened by insufficient time between work shifts and the competing demands of work and personal life. In addition, economic pressures could push healthcare workers to take on second jobs or work longer hours. Another factor is lack of knowledge about the importance of sleep which can lead people to cut their sleep time for other activities (). Of all industrial sectors, health care is the second highest sector for the number of workers reporting short sleep duration (5 million workers which is 32% of the total healthcare and social assistance workforce of 16 million Americans) (). The purpose of this article is to give an overview of the wide range of risks to nurses, their patients, and employers that are linked to shift work, long work hours, and poor sleep from other sources.
|
Collectively, the weight of current evidence strongly sug- gests that extended-duration work shifts significantly increase fatigue and impair performance. Residents’ tradi- tional work shifts of 24–30 consecutive hours unquestion- ably increase the risk of serious medical errors and diagnostic mistakes and have been shown in a national cohort study to increase the risk of harmful and fatal med- ical errors. Nursing shifts of more than 12.5 hours are common and similarly appear to greatly increase the risk of medical error. Likewise, long work hours increase the risk that nurses and doctors will suffer an occupational injury with potentially devastating long-term consequences and increase the risk of motor vehicle crashes, a leading cause of mortality among young adults. Thus, both from the standpoint of providers and patients, the hours routinely worked by health care providers in the United States are unsafe. | Student’s t test and an analysis of variance were used to analyze the differences between averages after checking the assumptions required for applying these tools. In the cases in which equal population variances could not be assumed, the Welch or Brown–Forsythe approaches were applied, and the Games–Howell test was used to assess post hoc differences. Effect sizes were calculated using Cohen’s d and η2.
Multiple linear regression models constructed with backward stepwise regression were used because of the lack of theoretical and empirical agreement on the significance of these variables in explaining the dimensions of burnout. When the assumptions were checked, heteroscedasticity was observed. For this reason, a heteroscedasticity consistent covariance matrix was estimated following Mackinnon and White’s procedure. The analyses were performed using SPSS version 20.0 and R 2.15.2 software. |
| Key Findings | Shift work was associated with burnout in this sample. Increased years of work as a shift worker were associated with more frequent burnout. Adequate sleeping hours and days off were found to be possible protective factors. | Shift work and long work hours increase the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases. In addition, fatigue-related errors could harm patients. Fatigued nurses also endanger others during their commute to and from work. | The weight of evidence strongly suggests that extended-duration work shifts significantly increase fatigue and impair performance and safety. From the standpoint of both providers and patients, the hours rou- tinely worked by health care providers in the United States are unsafe. To reduce the unacceptably high rate of pre- ventable fatigue-related medical error and injuries among health care workers, the United States must establish and enforce safe work-hour limits. | The nurses manifested average to high burnout levels. There were statistically significant differences in burnout levels associated with the following variables: age, gender, marital status, having children, level of healthcare, type of work shift, healthcare service areas and conducting administrative tasks. Burnout was also associated with personality-related variables. |
| Recommendations | Policies on shift work should take into account the potential of such work for contributing towards increasing burnout. | Education and training programs for managers and staff nurses would help increase their appreciation and knowledge about the demands of shift work and long work hours and provide them with strategies to reduce these risks. | To reduce the unacceptably high rate of preventable fatigue-related medical error and injury among health care workers, the United States must establish and enforce safe work-hour limits for healthcare providers. | Personality factors should be considered in any theory of risk profiles for developing burnout syndrome in the nursing profession. |
| Explanation of How the Article Supports EBP/Capstone | What polices should be in effect to reduce nurse burnout. Capstone Nursing Project Paper Help | Give examples on ways to correct nursing burnout. | Effects of working long shifts hours on patients and nurses. | Risk factors that are related to nurse burnout. |
Capstone Nursing Project Paper Help
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