Advanced Levels of Clinical Inquiry

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
• Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
• Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
• Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

Job burnout is a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity (Mayo Clinic Staff, 2018). Nursing burnout/turnover is negatively impacting healthcare at a national level. With recent reports of pervasive “burnout” and depression among healthcare professionals and the pressure that many influential healthcare organizations exert on clinicians to deliver high-quality, safe care under increasingly heavy patient loads, the use and teaching of EBP may be key not only to providing outstanding care to patients and saving healthcare dollars, but also to reducing the escalating turnover rate in certain healthcare professions (Melnyk & Fineout-Overholt, 2018). This is devastating, yet important, due to the impact this has on patient care and safety. This being said, my topic of nurse burnout/turnover formed into a PICO(T) question is:

P: Registered Nurse’s in the ED

I: Nurse burnout and turnover rate

C: Other areas of nursing

O: Patient safety and satisfaction

Question: Does Registered Nurse burnout/turnover in the ED impact patient safety and satisfaction?

Databases and Results

When searching for this topic the databases used were MEDLINE, PubMed, and EBSCO through the Walden Library. The search terms used for MEDLINE and PubMed were nurse burnout narrowing the search to 5 years, humans, journal article, English, and full text. That generated approximately 813 articles. After incorporating the Boolean terms AND nurse turnover, it then narrowed the search articles to 402. Through the Walden Library, the search terms nurse burnout in the ED were used, narrowing to peer-reviewed only and full text. This generated 8 articles. To improve these results strategies such as incorporating more Boolean terms, using more specific search terms, and trialing more databases could benefit in a more efficient and effective search.

Conclusion

Clinicians with burnout may have impaired attention, memory, and executive function that decrease their recall and attention to detail placing them and their patients at higher risk for errors and safety (Heath, 2018). Happy and healthy employees promote happy and healthy patients. This topic is in need of clinical inquiry at a national level, but also where this nurse is employed. The turnover rate has been significantly increased where this nurse is employed, leading to short staffing, thus increased workload and unhappy patients. This kind of work environment is unsafe and warrants change not only for the healthcare professionals sake, but more importantly the patients sake.

References

Heath,S. (2018, September 5). How does provider burnout impact patient care quality, care access? Retrieved from https://patientengagementhit.com/news/how-does-provider-burnout-impact-patient-care-quality-care-access

Mayo Clinic Staff. (2018, November 21). Know the signs of job burnout. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642

Melnyk,B., & Fineout-Overholt,E. (2018). Evidence-based practice in nursing & healthcare (4thed.). Philadelphia, PA: Wolters Kluwer.