Patient Safety And Nursing Satisfaction Project Sample Paper

Problem Conceptualization

When caregivers are not well, deterioration in the quality and quantity of patient care may occur. The research has indicated that nurses’ workloads and schedules can pose problems for addressing the issues mentioned above (Roberts & Grubb, 2014). This paper provides an intervention defining whether the implementation of stress reduction, time management strategies, and appropriate hour schedules, or leaving the profession, is a better choice to increment patient safety and nursing satisfaction.

Intervention

Population

The healthcare agencies will be chosen among large local hospitals to select at least one hundred nurses willing to participate. To be eligible for the study, nurses would have to be 21 years of age or older and work in oncology, general surgical, intensive care unit (ICU), and orthopedic wards. The participants would have to be knowledgeable about the phenomena under study, have at least six months of working experience, and be willing and able to transfer experience.

Intervention

The present study would use a quantitative approach through the pretest-posttest randomized controlled trial method. The web-based breath: Stress Management for Nurses program would be tested. As claimed, this program provides nurses with the tools and information they need to manage stressors influencing their work-life (Hersch et al., 2016). Given that the study will be aimed at health professionals, nursing interventions are irrelevant to the chosen topic.

The selected evidence-based solution, the BREATHE program, involves the use of web-based educational modules targeted at both nurses and managers. During this course, nurses study the basics of stress assessment, personal stressors, stress management tools, threats of negative coping, and seeking counseling services (Hersch et al., 2016). The comparative analysis of pre-and post-intervention stress scores in 104 people supports the program’s effectiveness (Hersch et al., 2016).

Long shifts negatively affect the care that patients receive, thus promoting their dissatisfaction (Khademi, Mohammadi, & Vanaki, 2015). Using the length of individual nurse shifts, the effects of different shift category proportions on each patient outcome will be studied. The participants would be randomly assigned to either a wait-list control group or the experimental group (receiving access to the BREATHE program). The experimental group would also be asked to arrive early to plan their work and prioritize their activities. Upon completion of the study, all participants would be given post-test questionnaires and access to the BREATHE program.

Comparison

Research indicates that nursing staff working in neonatal care has not been extensively studied (Tomazoni, Kuerten Rocha, de Souza, Anders, & Correia de Malfussi, 2014). In this connection, the results obtained from the present study would be compared to those assessing how stress reduction and time management strategies, as well as appropriate hour schedules, influence patient safety culture at neonatal intensive care units. It would allow hypothesizing if findings were generalizable and exclude potential bias, as well as determine potential strengths and limitations of the study.

Outcomes

The present study would hypothesize that participants receiving the BREATHE program would experience greater reductions in stress-related to nursing. The results are expected to be extremely relevant to both nursing practice and the quality of patient care. Nurses will be aware of stress reduction techniques to be used at the workplace, and this knowledge will enable them to minimize the frequency of mistakes in nursing practice. Upon this condition, fewer nursing errors will immediately increase patient satisfaction rates in the healthcare agency, indicating improvements in inpatient care (Nayak, 2018). The results obtained would allow further hypothesizing whether the implementation of the strategies mentioned above is a better choice than leaving the profession to increment patient safety and nursing satisfaction.

Time

The experimental group would be given individual access to the BREATHE program for a three-month test period. However, the experimental group would receive reminders to use the program both at work and at home. In contrast, the wait-list control group would only receive information about when the posttest questionnaire would be available.

References

Hersch, R.K., Cook, R.F., Deitz, D.K., Kaplan, S., Hughes, D., Friesen, M.A., & Vezina, M. (2016). Reducing nurses’ stress: A randomized controlled trial of a web-based stress management program for nurses. Applied Nursing Research, 32, 18-25.

Khademi, M., Mohammadi, E., & Vanaki, Z. (2015). Resources-tasks imbalance: Experiences of nurses from factors influencing workload to increase. Iranian Journal of Nursing and Midwifery Research, 20(4), 476-483.

Nayak, S.G. (20178). Time management in nursing – an hour of need. International Journal of Caring Sciences, 11(3), 1997-2000.

Roberts, R.K., & Grubb, P.L. (2014). The consequences of nursing stress and need for integrated solutions. Rehabilitation Nursing, 39(2), 62-69.

Tomazoni, A., Kuerten Rocha, P., de Souza, S., Anders, J.C., & Correia de Malfussi, H.F. (2014). Patient safety culture at neonatal intensive care units: Perspective of the nursing and medical team. Revista Latino-Americana de Enfermagem, 22(5), 755-763.

Mandatory Overtime For Nurses Should Be Eliminated

Nurses are consistently faced with mandatory overtime, which leads to high levels of distress and exhaustion. The realities of the healthcare sector require nurses to work long hours and dedicate extensive time to the profession. Mandatory overtime should be eliminated, as it affects nursing performance, creates dangers for patients and healthcare professionals, and incites issues with federal labor laws.

Context

Hospitals and medical facilities often struggle to meet staffing requirements to fulfill duties and remain compliant with regulations. It forces nursing staff, consisting of nursing assistants (CNAs) and nurses (RNs) to work extensive overtime. Nursing overtime is prevalent in the United States, with at least 60% of nurses surveyed work at least one type of overtime, and approximately 10% working unpaid hours (Wheatley, 2017). Mandatory overtime is when nurses are forced to work beyond the hours upon agreed upon contract, exceeding the legal working week of 40 hours per week. Although most nurses realize the need for them to work overtime and are glad to do so, utilizing this practice consistently is detrimental to the staff and non-sustainable, commonly leading to high levels of burnout and nurse turnover.

1st Pro-Point

While there are benefits to working overtime, there are also significant negative aspects of working for nurses which affect their performance and quality of life. A study by Lobo, Ploeg, Fisher, Peachey, and Akhtar-Danesh (2018) conducted a large survey of nurses which encompassed their attitudes and self-reflection regarding working overtime. The findings state that “reasons for not working overtime were (1) feeling tired and tired of being at work (50%); (2) having established plans (71%); and (3) not receiving enough notice (61%)” (p. 47). Furthermore, many only worked overtime to help colleagues rather than for personal benefit. This suggests that nurses often feel forced into the practice and it affects their attitude and approach to care.

2nd Pro-Point

Another reason to eliminate overtime is the dangers to patients and medical staff that it creates. A meta-analysis using nationwide panel data conducted by Lu and Lu (2016) focused on determining how mandatory overtime affected the quality of service. They found that “…mandatory overtime in healthcare reduces the quality of services provided to patients by healthcare workers” (p. 3578). A decreased quality of care can present risks to patients as nurses are fatigued and face too many tasks, which could lead to human error, and in turn, adverse effects on the patient. This has profound long-term effects on the well-being of nurses, patient health, and the overall effectiveness of the healthcare system.

3rd Pro-Point

Mandatory overtime for nurses, however, remains legal under federal law as long as appropriate breaks are given between 12-hour shifts. A study by Kunaviktikul et al. (2015) examined the legal and organizational ramifications of mandatory overtime. They found that “…during the 2000s, several US states passed laws that are against mandatory overtime for nurses” (p. 3581). At least 19 states have made mandatory overtime illegal for nurses, with calls to apply this aspect to federal law. The concept of mandatory overtime was a temporary solution to a longstanding problem, but no significant changes have been made to the practice over the last decades.

Conclusion

It becomes evident that nursing overtime has significant negative effects on nursing performance and practice, thus suggesting that this approach should be eliminated in the healthcare sector. Consistent mandatory overtime leads to risks and dangers to both nurses and patients, while potentially violating labor regulations. Steps should be taken to address this issue to determine a sustainable solution.

References

Kunaviktikul, W., Wichaikhum, O., Nantsupawat, A., Nantsupawat, R., Chontawan, R., Klunklin, A., … Sirakamon, S. (2015). Nurses’ extended work hours: Patient, nurse, and organizational outcomes. International Nursing Review, 62(3), 386-393. Web.

Lobo, V. M., Ploeg, J., Fisher, A., Peachey, G., & Akhtar-Danesh, N. (2018). Critical care nurses’ reasons for working or not working overtime. Critical Care Nurse, 38(6), 47-57. Web.

Lu, S. F., & Lu, L. X. (2017). Do mandatory overtime laws improve quality? Staffing decisions and operational flexibility of nursing homes. Management Science, 63(11), 3566-3585. Web.

Wheatley, C. (2017). Nursing overtime: Should it be regulated? Nursing Economics, 35(4), 213-217. Web.

Meditation-Based Chronic Pain Management Study

Chronic pain can be a significant burden on patients having various health disparities, including cancer and neurological disorders. In this paper, chronic pain will be defined as the symptoms that last for longer than three months or exceed the standard period for tissue healing (Hilton et al., 2016). The problem of this study is the feasibility of using mindfulness meditation-based interventions in controlling the symptoms of chronic pain. Within the research, the feasibility of this approach will be compared to the outcomes of traditional treatment methods, such as opioids. The purpose of this review is to analyze the following question: In patients experiencing chronic pain (P), how feasible is the use of mindfulness meditation-based interventions (I), compared to traditional treatment methods (C) in controlling the symptoms of pain?

The topic study is significant because it is vital to find additional ways of reducing chronic pain in patients. The background of the problem is that currently, strong opioids are primarily used to minimize the symptoms of chronic conditions. However, they can have adverse effects on individuals’ health and are costly (Ngamkham, Holden, & Smith, 2019). One of the alternative methods of pain relief is mindfulness meditation. Such an approach has been used for treating chronic pain for several decades, often as a supporting measure along with opioids (Zgierska, Ircink, Burzinski, & Mundt, 2017). During meditation, patients can pay attention to their breath, relax their muscles, and enhance their awareness of mind and body. This paper argues that the mindfulness meditation-based approach can be effective in reducing chronic pain.

Methods

The sources for this literature review were selected from peer-reviewed journals. They include Annals of Behavioral Medicine, Pain Medicine, Journal of Holistic Nursing, Journal of Opioid Management, Japan Journal of Nursing Science, and Asia-Pacific Journal of Oncology Nursing. The databases that were used for the research include PubMed, JSTOR, BioMed Central, and ScienceDirect. The keywords included mindfulness meditation, chronic pain, mindfulness meditation-based analgesia, effects of mindfulness meditation, meditation interventions. The inclusion criteria for the articles were: peer-reviewed, published within the past five years, and feature information about mindfulness meditation-based approaches to treating chronic pain. In addition, some materials were selected from nursing journals specifically to ensure the relevance of the question to the nursing practice. The exclusion criteria included being published in a non-peer-reviewed journal or being published more than five years ago. Two of the selected works present the first level of evidence, while the rest of them are systematic reviews. Seven peer-reviewed articles were selected; four of them were obtained from nursing journals.

Results

The first article selected for the literature review is the one by Chan and Larson (2015). In their work, the authors discuss the impact of meditation on chronic disease symptoms. The purpose of this study is to identify the most effective combination of meditation interventions to treat chronic pain and other conditions associated with chronic diseases, including anxiety and depression (Chan & Larson, 2015). The method of data collection used for research is the systematic review of 45 research studies. The primary findings of the study are that meditations can reduce chronic pain in patients with various conditions, including peripheral neuropathy, fibromyalgia, and headache (Chan & Larson, 2015). The primary strength of this study is that analyzes how mindfulness interventions can be applied for managing pain associated with conditions caused by different reasons. The main disadvantage is that it is not an original study but a summary of the existing body of literature on the topic.

The second article is by Hilton et al. (2016); the authors use the methods of a systematic review and a meta-analysis. The purpose of the study is to synthesize the evidence on the effectiveness of mindfulness meditation interventions used as treatment methods for chronic pain. The data for the analysis are collected through the systematic review of 38 randomized controlled trials and evaluated using the Hartung-Knapp-Sidik-Jonkman method for random-effects models (Hilton et al., 2016). The most significant finding of the paper is that mindfulness meditations can have a positive effect on improving pain symptoms; however, their impact compared to traditional treatment is small. At the same time, mindfulness interventions can reduce other symptoms of chronic conditions dramatically, including depression. The main strengths of the study are duplicate study selection and bias assessment. Its main disadvantage is the high percentage of poor-quality studies reviewed.

The third selected study is the one by La Cour and Petersen (2015); it represents a randomized controlled clinical trial. The purpose of the research is to evaluate the impact of mindfulness meditation on chronic pain. The findings reveal that mindfulness interventions had a significant positive impact on patients with long-lasting pain, showing a medium effect size immediately after treatment (La Cour & Petersen, 2015). The effect is still present with a non-significant decrease after six months. The primary strength of the study is that it provides the first level of evidence. Its potential weakness is that the authors do not consider the natural nonspecific improvements in patients’ conditions.

The fourth work is by Ngamkham et al. (2019); it uses the method of the integrative literature review. The study’s purpose is to analyze the effectiveness of mindfulness interventions on pain management and describe the underlying pathophysiologic mechanisms. The authors show that such an approach is useful because it moderates individuals’ emotional appraisal of their symptoms and withdraws their attention from pain (Ngamkham et al., 2019). The study’s primary strength is that it evaluates the level of bias in selected studies; its weakness is that it analyzes a small number of works.

The next study is by Takai, Yamamoto‐Mitani, Abe, and Suzuki (2015). Its purpose is to analyze possible nursing strategies aimed at reducing chronic pain, including those associated with meditation, by using the systematic review method. The findings of the research show that non-medications-based multidisciplinary pain management interventions decrease pain intensity significantly; however, they do not show long-term effectiveness (Takai et al., 2015). The study’s primary strength is that it provides implications for nursing practice; its limitation is that it does not consider long-term trends in pain management using mindfulness approaches.

The sixth work is by Williams, Simmons, and Tanabe (2015). The authors use a systematic review to identify how nurses can incorporate mindfulness interventions and the effectiveness of such an approach. The study reveals that can reduce chronic pain by more than 30%, minimizing its intensity, and improve patients’ acceptance of their symptoms (Williams et al., 2015). The primary strength of the study is that it provides information on how mindfulness meditation can be used in clinical practice. Its limitation is that the authors do not compare such an approach to traditional treatment methods.

The last selected study is by Zgierska et al. (2017). It presents the randomized controlled trial and aims at comparing the outcomes of mindfulness meditation used alone or as a support measure to traditional treatment to the results of usual care only. The findings show that meditation can reduce the severity of pain and pain sensitivity in patients while being a cost-effective approach (Zgierska et al., 2017). The work’s strength is that it provides the first level of evidence; its potential limitation is that the follow-up duration is short and the sample size is relatively small.

Discussion

The findings of the literature review show that mindfulness meditation-based methods can have a significant positive effect on managing chronic pain in patients. Selected works reveal consensus on the topic, confirming that such interventions can relieve pain immediately regardless of the condition an individual has (La Cour & Petersen, 2015; Chan & Larson, 2015). In addition, studies reveal that such an approach can change individuals’ attitudes towards their symptoms, withdraw patients’ attention from pain, and help them to accept it (Williams et al., 2015; Ngamkham et al., 2019). However, the authors disagree on the longevity of the positive impact of meditation; some of them note that its effectiveness compared to traditional methods is small (Hilton et al., 2016). The primary strength of the research area is that much evidence on the topic is available. The evidence includes the findings of randomized control trials, which shows that the results are reliable. The potential weakness of the research area is that few studies are comparing the effects of mindfulness meditation-based interventions and traditional pain relief methods.

Conclusion

The literature review answers the research question and shows that the implementation of mindfulness meditation-based intervention is feasible for reducing chronic pain. The findings of the studies show that such an approach can minimize the symptoms and change patients’ perspectives towards them significantly. The recommendation that can be drawn from the literature review is that nurses should use holistic approaches, including meditation, in addition to traditional ones to manage individuals’ symptoms.

References

Chan, R. R., & Larson, J. L. (2015). Meditation interventions for chronic disease populations: A systematic review. Journal of Holistic Nursing, 33(4), 351-365.

Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S.,… Maglione, M. A. (2016). Mindfulness meditation for chronic pain: Systematic review and meta-analysis. Annals of Behavioral Medicine, 51(2), 199-213.

La Cour, P., & Petersen, M. (2015). Effects of mindfulness meditation on chronic pain: A randomized controlled trial. Pain Medicine, 16(4), 641-652.

Ngamkham, S., Holden, J. E., & Smith, E. L. (2019). A systematic review: Mindfulness intervention for cancer-related pain. Asia-Pacific Journal of Oncology Nursing, 6(2), 161-169.

Takai, Y., Yamamoto‐Mitani, N., Abe, Y., & Suzuki, M. (2015). Literature review of pain management for people with chronic pain. Japan Journal of Nursing Science, 12(3), 167-183.

Williams, H., Simmons, L. A., & Tanabe, P. (2015). Mindfulness-based stress reduction in advanced nursing practice: A nonpharmacologic approach to health promotion, chronic disease management, and symptom control. Journal of Holistic Nursing, 33(3), 247-259.

Zgierska, A. E., Ircink, J., Burzinski, C. A., & Mundt, M. P. (2017). Cost of opioid-treated chronic low back pain: Findings from a pilot randomized controlled trial of mindfulness meditation-based intervention. Journal of Opioid Management, 13(3), 169-181.

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