1.Present the nursing practice problem with the PICOT
question.
2.Discuss your appraisal of the literature that addresses the
problem.
3.Present the proposed practice changes from an integration
of the findings.
Introduction
High prevalence of nurse fatigue and its detrimental
effects have been documented,
Critical analysis of Chen et al., 2014; Martin, 2015;
Hunsaker, Maughan and Heaston, 2015; Barbara, 2014;
Domen, Connelly and Spence, 2015; Stewart and Terry,
2014 identifies six areas for potential nurse fatigue,
burnout and possible strategies
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Author(s)
Year
Dependent Variables
Independent
Variables
Research Design
Data Collection
Method
Conclusion
Martin, DM. (2015). Nurse fatigue and shift
length: A pilot study. Nursing economics 33:2;
81-90
2015
Nurse experience,
length of shift,
Age, gender, ethnic
group
Randomized
controlled study
Qualitative and
quantitative
Study concluded that one of the interventions that
can be used to address nurse fatigue is by reducing
the nursing shift to 8 hour.
Hunsaker, S., Chen, H., Maughan, D and
Heaston, S. (2015). Factors that influence the
development of compassion fatigue, burnout and
compassion satisfaction in emergency
department nurse. Journal of Nursing
Scholarship, 47:2, 186–194.
2015
Organization culture
of the hospital, length
of shift, nurse
experiences
Age, gender, ethnic
group
Descriptive
quantitative
research method
Quantitative
Study concluded that low levels of support from the
nurse managers and long working hours are the main
cause of nurse fatigue. Study suggests that
developing protocols that improve identification of
compassion fatigue will help prevent emotional
exhaustion and facilitate the identification of
interventions to reduce nurse fatigue
Domen, R., Connelly, C., and Spence, D. (2015).
Call shift fatigue and use of countermeasures
and avoidance strategies by certified Registered
Nurse Anesthetists: A National survey. AANA
Journal 83: 2, 123-133
2015
Organization culture
of the hospital, length
of shift, nurse
experiences
Age, gender, ethnic
group
Systematic
review
Qualitative and
quantitative
The study concluded that call shift fatigue is
common issue among the CRNAs and is closely
correlated with patient safety and negative health
outcomes. The study recommends the identification
of the CRNA call-shift frequency and length.
Chen J., Davis K.G., Daraiseh N.M., Pan W. &
Davis L.S. (2014). Fatigue and recovery in
12-hour dayshift hospital nurses Journal of
Nursing
Management 22, 593–603.
2014
Nurse experience,
length of shift,
Age, gender, ethnic
group
Integrated review
on cross sectional
survey
Qualitative and
quantitative
The paper concludes that despite the widespread
acceptance of the 12 hour shift, the study concludes
that the nurse experience more fatigue. Additionally,
lacks of regular exercises are associated with
unhealthy fatigue recovery process. The study
concludes that the administrations, the staff and unit
managers must collaborate to attain healthy fatigue
recovery for the 12-hour shift.
Stewart, W., and Terry, L. (2014). Reducing
burnout in nurses and care workers in secure in
settings. Nursing standard 28, 34, 37-45.
2014
Nurse experience,
length of shift,
Ethnic group, location,
age
Systematic
review
Qualitative and
quantitative
The study suggests that clinical supervision as well
as the psychological intervention nurse training are
effective in reduction of fatigue and nurse burnout.
The study also concluded by stating that supportive
relationship effectively facilitates reduction of
emotional stress and nurse fatigue.
Barbara, H. (2014). Nursing Burnout
interventions; What is being done? Clinical
Journal of Oncology Nursing • Volume 18,
Number 2
2014
Nurse experience,
length of shift
Ethnic group, location,
age
Systematic
review
Qualitative and
quantitative
The study concludes that nurse fatigue and burn out
can be reduced through employee assistance
programs, retreats, promote stress reduction
program, improving relaxation as well as family
relationships and support of effective
communication to help the nurses cope with difficult
emotions.
Work load
Total quantity of work completed in a day, rate of
participating on unexpected events. Causes nurses to
Feel drained physically and emotionally
Lonely and skip lunches and breaks
Interventions
Taking five minutes break walk outside at least
twice
daily
Increase teamwork
Introduction of technology to reduce workload
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Control
Control :Participating in decision making processes, type
of leadership which causes the nurses
Feel hopeless or powerless especially In case of
death
of a patient
Interventions
Offering staff support
Providing on-site counsellors
psychiatric advanced practice nurses
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Reward
Nurse fatigue has been associated with forgoing nurse
cost-of-living raise due to organizational cost cutting
This leads to nurses holding onto anger and resentment
Effective implementation of clinical ladder programs that
provide salary increases is recommended
Recognizing achievements as well as opportunities for
bonuses or raises empowers the employee
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Summary of the interventions
Increasing frequency of supportive work interactions
Introduce technology 8-hour shifts to reduce work load
Encouraging staff to air their voices and respecting other
staff feelings
Encourage management education
Provide an annual retreat for staff
Designating team leaders for projects
Include self-evaluations in annual performance reviews
Encouraging expressive patient and staff therapies
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References
Barbara, H. (2014). Nursing Burnout interventions; What
is being done? Clinical Journal of Oncology Nursing •
Volume 18, Number 2
Domen, R., Connelly, C., and Spence, D. (2015). Call
shift fatigue and use of countermeasures and avoidance
strategies by certified Registered Nurse Anesthetists: A
National survey. AANA Journal 83: 2, 123-133
Hunsaker, S., Chen, H., Maughan, D and Heaston, S.
(2015). Factors that influence the development of
compassion fatigue, burnout and compassion satisfaction
in emergency department nurse. Journal of Nursing
Scholarship, 47:2, 186–194.