PICOT Question on Nursing Research

PICOT Question On Nursing Research

The first step of the evidence‐based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question known as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer‐reviewed research articles, as indicated below. The PICOT question and six peer‐reviewed research articles you choose will be utilized for subsequent assignments.

Use the “Literature Evaluation Table” to complete this PICOT Question on Nursing

Research assignment.

• Select a nursing practice problem of interest to use as the focus of your research (use hypertension as a topic/problem). Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
• Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN‐BSN program of study).
• The PICOT question will provide a framework for your capstone project.
• Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer‐reviewed research articles to support your nursing practice problem.

Assignment Requirements for PICOT Question on Nursing Research

Before finalizing your work, you should:

• Minimum requirement of at least 5 sources of support be sure to read the Assignment description carefully (as displayed above);
• consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and utilize spelling and grammar checks to minimize errors.

Research Critiques And PICOT Question Final Draft: Nurse Burnout Sample Paper

Introduction

Burnout for nurses and other clinicians is a consequence of persistent emotional and workplace stressors, especially due to workload and institutional environments. Often, nurses in different clinical departments have high-level responsibilities and demands that expose them to work-related stress and burnout burdens. The effects of burnout present a concern to the mainstream healthcare systems because professional workloads may lead to hypertension, depression, and anxiety (Friganović et al., 2020). 

Although, overloading nurses with long operational hours and many patients affects their professional empathy, esteem, and overall productivity. In this sense, they operate in unpredictable work environments and conditions, leading to depression, absenteeism, medication errors, and unsustainable interpersonal relationships. Due to the concern emanating from nursing burnout, healthcare institutions should develop interventions to address causal factors and improve working conditions. Some of these measures include scheduling relaxation break time for nurses, rewarding clinicians, emotional intelligence training, and establishing a favorable patient-nurse ratio to prevent workplace overloading.

Background Of The Study

Often, surgical-medical units have high-level responsibilities and standards for nurses because of the complexities surrounding care delivery cultures in such an essential department. Nurses in the surgical-medical units should provide patient-oriented care, individualized attention, and participate in testing, clinical reporting, and other significant roles (Amiri et al., 2019). As a result, nursing burnout is a common phenomenon if nurses deal with unfavorable patient-nurse ratios, unsustainable interpersonal relationships with other professionals, and other workplace stressors. 

Therefore, steadfast and practical interventions such as providing relaxation breaks, patient acuity scores, stress management approaches, and establishing a favorable patient-nurse ratio are fundamental in preventing burnout and its subsequent effects on professionalism.

PICOT Question/Statement

Among the registered nurses working in the surgical-medical units (P), does implement patient acuity score, break time for nurses, and establishing favorable patient-nurse ratio (I) help increase patient satisfaction and reduce burnout for nurses (O) compared to nurses in operating in absence of these interventions (C) in three months (T)?

PICOT Question On Nursing Research – Quantitative Study 1

The patient-nurse ratio is related to nurses’ intention to leave their job through mediating factors of burnout and job dissatisfaction (Chen et al., 2019).

Background Of The Study

Nurses’ workload, burnout, and job satisfaction rely massively on the patient-nurse ratio because it determines the effectiveness of healthcare services. When the ratio is unfavorable to nurses, they face challenges in delivering patient-oriented care due to the underlying stress, complexities, and limitations. As a result, this study aimed at investigating the effects of the patient-nurse ratio and its influence on nurse’s intention to leave clinical responsibilities. The researchers sought to mediate the role of burnout and job satisfaction to evaluate how the two concepts relate.

Methods And Critique

The study took place in medical and surgical wards of 24 secondary or tertiary hospitals in Taiwan, where the researchers conducted two cross-sectional investigations in 2013 and 2014. The primary data collection strategies for this study were structured and self-administered questionnaires. The researchers requested nurses to answer a question, “how many patients do you take care of in a day, evening, and night shift, respectively? 

Arguably, this question provided investigators with an idea about a practical formula to calculate the average daily patient-nurse ratio (ADPNR). Also, self-administered and structured questionnaires allowed researchers to obtain reliable feedback from participants to test study hypotheses.

Results And Critique

Notably, the study included a review of 1409 questionnaires that met the eligibility criteria. Out of 1409 respondents, 1369 were female (97.2%). The researchers considered age, marital status, educational achievements, and work tenure when analyzing data. Essentially, they ran adjusted odds ratios (AOR) of average daily patient-nurse ratio (ADPNR) to analyze potential confounders. After controlling the covariates, the researchers revealed that standardized ADPNR was related to personal burnout (estimate for a1=15.06, p<0.001).

Also, the study revealed that personal burnout correlated to leave (estimate for b¹ =0.33, p<0.001) (Chen et al., 2019). In summary, the results validated the argument that personal burnout, client-related burnout, and job dissatisfaction mediated the effects of standardized ADPNR on nurses’ intention to leave. Therefore, the researchers proposed that policymakers and researchers should establish a favorable patient-nurse ratio that would promote Job satisfaction and reduce personal burnout.

Ethical Considerations

The researchers observed ethical principles when conducting nursing research because they provided informed consent to potential participants via emails. Also, they cooperated with the Research Ethics Committee (REC) of National Taiwan University Hospital for study approval (Chen et al., 2019, p. 4). Arguably, these ethical considerations enabled the investigators to prevent conflicting interests and claims from the respondents.

PICOT Question On Nursing Research – Quantitative Study 2

Impact of nurses taking daily work breaks in a hospital garden on burnout (Cordoza et al., 2018)

Background Of The Study

Nurses operate in complex clinical contexts because of the high demand and responsibilities to deliver quality care to patients with various health concerns. Therefore, exposing them to nature has multiple psychological benefits. However, the effects of hospital gardens in reducing burnout for nurses remain unclear because of limited research. As a result, this study aimed at comparing the effect of taking daily work breaks in a hospital-integrated garden with the impact of indoor-only breaks on nurse burnout.

Methods And Critique

The study took place at Legacy Emanuel Medical Center in Portland, Oregon, for two summers to capture favorable weather for outdoor breaks (Cordoza et al., 2018). The researchers adopted a prospective crossover trial to collect data for nurses assigned to either 6 weeks of work break in an outdoor hospital garden or indoor-only breaks. When comparing the effects of two work breaks, investigators utilized the scores on the Maslach Burnout Inventory (MBI) subscales for emotional exhaustion (4.5 vs -0.2; p<.001) and depersonalization (1.8 vs 0.0; p=.02) (Cordoza et al., 2018, p. 508).

Results And Critique

Out of the 29 nurse participants, 21 completed the MBI scores, leading to the development of VAS scores for all nurses. The research revealed a significant improvement in the mean MBI scores for garden breaks compared with indoor-only breaks for emotional exhaustion (4.5 vs-0.2; p<.001) and depersonalization (1.8 vs 0.0; p=.02). Arguably, this research validated the importance of taking daily work breaks in an outdoor garden in mitigating burnout among nurses operating in different clinical settings. Essentially, the study revealed that exposing nurses to nature may play a significant role in alleviating psychological exhaustion.

Ethical Considerations

Researchers complied with various ethical principles of nursing research because they sought approval from the hospital’s institutional review board. Also, they excluded participants with severe allergic reactions to avoid potential exposure to triggers when conducting a field study in an outdoor garden. Finally, the investigators provided written consent forms to the participants and requested their participation via email communication. Arguably, these ethical principles helped the researchers in avoiding conflicting interests and preserving the participants’ autonomy.

Qualitative Study 1

The role of organizational factors in nurse burnout: Experiences from Iranian nurses working in psychiatric wards (Fallahi-Khoshknab et al., 2019).

Background Of The Study

Organizational management plays a significant role in promoting optimal performance for healthcare professionals. Also, institutional top leadership is crucial in enhancing process efficiency, productivity, and addressing workplace stressors. Therefore, the objective of this study was to investigate the role of organizational management/leadership in reducing nurse burnout for nurses working in Iranian psychiatric wards.

Methods And Critique

When serving the study’s objectives of establishing the role of organizational management in preventing nurse burnout among psychiatric-mental nurses, the researchers used a qualitative approach alongside an inductive conventional content analysis technique. Also, investigators used in-depth semi-structured interviews and purposeful sampling to obtain reliable data from participants. After data collection, researchers transcribed responses in MS Word succeeded by assigning primary code to the data for effective analysis.

Results And Critique

The study took place at the Ahvaz Golestan Hospital affiliated with Ahvaz Jundishapur University of Medical Sciences and Besat General Hospital. The researchers included 15 participants, 7 males, and 8 females from the specialist center and two general psychiatric hospitals (Fallahi-Khoshknab et al., 2019). Notably, the respondents portrayed varied traits, including age, gender, work experience (years), qualifications, and place of employment. Essentially, the study revealed that ineffective organization management is an essential factor for nursing burnout, leading to job dissatisfaction, reduced autonomy, absenteeism, and disloyalty to the health institution. Although the research had a limitation because of a small sample, its subsequent findings presented a general picture of negative and positive factors that affect the quality of nursing.

Ethical Considerations

Undoubtedly, the researchers observed various ethical principles of nursing research, including seeking approval from the Ahvaz Jundishapur University of Medical Sciences and providing written consent to the participants. Also, the investigators explained the study’s purpose to potential respondents to eliminate doubts (Fallahi-Khoshknab et al., 2019). Essentially, they requested permission to record interviews and handle transcripts across all research stages. Finally, researchers upheld participants’ autonomy by allowing them to withdraw from the research without any limitation.

PICOT Question On Nursing Research – Qualitative Study 2

A cross-sectional multicenter qualitative study exploring attitudes and burnout knowledge in intensive care nurses with burnout (Friganović et al., 2020).

Background Of The Study

Often, interventions to address nursing burnout require robust policy backings from organization leaders and other stakeholders. Unfortunately, institutions have not yet established consistent and practical policies to prevent personal burnout. As a result, this study aimed at determining the attitudes and the existing knowledge of burnout among nurses who have not yet experienced burnout, especially in intensive care units (ICUs).

Methods And Critique

The researchers applied a qualitative phenomenological design, involving semi-structured interviews and an inductive approach. When determining the burnout score for nurses in ICUs, the investigators used the Maslach Burnout Inventory (MBI) to develop emergent themes. Also, researchers auto-recorded interviews and verbatim transcription to derive meanings from responses. Arguably, the inductive approach enabled investigators to develop research themes, leading to an understanding of participants’ experiences, beliefs, and views.

Results And Critique

The study took place in Croatia, involving nurses from five Zagreb university hospitals. The researchers recruited 620 ICU nurses working in various specialties, including neurosurgery, pediatric and neonatal ICUs, general surgery, and coronary ICUs. The researchers grouped data in thematic categories, including compromised private life, stressful work demands, stress reduction options, and the sense of knowledge for personal burnout among ICU nurses.

Essentially, the study revealed that hospital departments, especially in the ICU environment should implement education programs on burnout due to the poor sense of knowledge about this syndrome among nurses. Although quantitative data is necessary to establish the effectiveness of education programs on burnout for ICU nurses, this study presents a practical intervention of imparting knowledge to nurses regarding personal burnout and its subsequent effects.

Ethical Considerations

The researchers adhered to various ethical considerations when conducting this research. For instance, they did not hold any bias towards the participants because they recruited nurses of diversities. Secondly, they provided informed consent alongside in-depth explanations of the research purpose to the participants. Thirdly, investigators and respondents agreed on the time and place for interviews, eliminating inconveniences and contradictions. Arguably, researchers promoted individual autonomy by allowing respondents to decide the research trajectories.

Summary Of Articles And The PICOT Question

Arguably, each article validates the importance of addressing personal burnout among nurses in various specialties. In this sense, researchers are aware of the burnout effects on professionalism, individual performance, quality services, and job satisfaction. While relating research findings to my PICOT question, it is essential to consider that qualitative and quantitative studies vary in testing the effectiveness of organizational interventions to address burnout. Regardless of the existing variations in different research methods, it is valid to argue that each of the notable articles supports my PICOT question about the effectiveness of work breaks, patient acuity score, and patient-nurse ratio in reducing burnout.

Notably, Fallahi-Khoshknab et al. (2019) present the importance of organizational management in developing approaches to prevent workload, job dissatisfaction, and burnout among nurses. On the other hand, Cordoza et al. (2018) validate the importance of the outdoor garden in mitigating psychological exhaustion for nurses. Other articles propose educational training and policy measures to impart knowledge about burnout among nurses. Essentially, Chen et al. (2019) challenge healthcare institutions and departments to develop interventions to establish a favorable patient-nurse ratio for preventing overloads, job dissatisfaction, and nurses’ intention to leave. Undoubtedly, these articles support my PICOT question by expounding on the topic and providing reliable explanations.

Conclusion

Burnout among nurses is a global public health concern because it leads to depression, absenteeism, medication errors, low productivity, and personal intentions to abandon professional duties. Arguably, these consequences prompt researchers and policymakers to develop practical interventions for preventing burnout. In this sense, favorable patient-nurse ratio, emotional support, teamwork, work breaks, and knowledge enhancement are among interventions to reduce personal burnout. Notably, this research consolidates findings and inputs from qualitative and quantitative studies regarding approaches to prevent work stressors live overloading nurses.

References

• Amiri, A., Solankallio-Vahteri, T., & Tuomi, S. (2019). Role of nurses in improving patient safety: Evidence from surgical complications in 21 countries. International Journal of Nursing Sciences, 6(3), 239-246. https://doi.org/10.1016/j.ijnss.2019.05.003
• Chen, Y.-C., Guo, Y.-L. L., Chin, W.-S., Cheng, N.-Y., Ho, J.-J., & Shiao, J. S.-C. (2019). The patient-nurse ratio is related to nurses’ intention to leave their job through mediating factors of burnout and job dissatisfaction. International Journal of Environmental Research and Public Health, 16(23), 4801. https://doi.org/10.3390/ijerph16234801
• Cordoza, M., Ulrich, R. S., Manulik, B. J., Gardiner, S. K., Fitzpatrick, P. S., Hazen, T. M., Mirka, A., & Perkins, R. S. (2018). Impact of nurses taking daily work breaks in a hospital garden on burnout. American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses, 27(6), 508–512. https://doi.org/10.4037/ajcc2018131
• Fallahi-Khoshknab, M., Ghavidel, F., Molavynejad, S., & Zarea, K. (2019). The role of organizational factors in nurse burnout: Experiences from Iranian nurses working in psychiatric wards. Journal Of Family Medicine and Primary Care, 8(12), 3893-3898. https://doi.org/10.4103/jfmpc.jfmpc_615_19
• Friganović, A., Kurtović, B., & Selič, P. (2020). A cross-sectional multicenter qualitative study exploring attitudes and burnout knowledge in intensive care nurses with burnout. Slovenian Journal of Public Health, 60(1), 46-54. https://doi.org/10.2478/sjph-2021-0008