PICOT Question And Literature Search assignment

Summary of Clinical Issue

Nurse burnout is a serious challenge to the healthcare system because of its adverse effects on patient delivery, quality of care and the welfare of nurses. Studies show that nurses face a high level of burnout alongside other psychological issues like stress because of increased workload that leads to strain on their performance (Van Bogaert et al., 2021). Different sources of burnout impede the ability of nurses to perform and be productive in their workplace environment. Nurses in different areas and specialties, especially those in critical care settings like the emergency room and department and intensive care units (ICUs) have the greatest exposure to burnout incidences because of their demanding and complex nature of these environment (Dall’Ora et al., 2020). Burnout leads to a host of poor health outcomes for patients, increase the level of stress and anxiety in nurses, occasions high turnover rates, and is a danger to the overall effectiveness of the healthcare system. With increased roles and specialties compounded by a rise in care demand and a nursing shortage, burnout will impact the ability of these providers to meet diverse patient needs and quality care delivery. Developing strategies to address burnout effects; including stress management, is essential to helping nurses offer quality care and remain in the profession (Friganović et al., 2021). As such, this literature evaluation table focuses on the identification of research articles; both qualitative and quantitative, on the issue of burnout among nurses. These articles demonstrate a relationship with the developed PICOT question for the proposed capstone project.

PICOT Question: Among nurses (P) who practice stress management (I) compared to those who do not (C) have reduced burnout (O) within six months (T)?


Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink Uchmanowicz, I., Kubielas, G., Serzysko, B., Kołcz, A., Gurowiec, P., & Kolarczyk, E. (2021). Rationing of Nursing Care and Professional Burnout Among Nurses Working in Cardiovascular Settings. Frontiers in Psychology, 12.


Dos Santos, L. M. (2020, December). Stress, burnout, and low self-efficacy of nursing professionals: A qualitative inquiry. Healthcare, 8(4): 424. https://doi.org/10.3390/healthcare8040424 Rozo, J. A., Olson, D. M., Thu, H., & Stutzman, S. E. (2017). Situational factors associated with burnout among emergency department nurses. Workplace Health & Safety, 65(6), 262-265. DOI: 10.1177/2165079917705669.
How Does the Article Relate to the PICOT Question? The article relates to the PICOT question as it shows that nurse burnout is a phenomenon that impacts different aspects of care delivery. The article is categorical that increased workload among nurses leads to burnout. The article relates to the PICOT question as it demonstrates the relationship between stress, burnout and reduced or low-levels of self-efficacy among nurses in healthcare facilities. The article also examines the sources of stress and burnout among nursing professionals. The article relates to the PICOT question as it shows the contributory factors and effects of nurse burnout. The article stresses the need effective understanding of different ways that burnout manifests in emergency department (ED) nurses.
Quantitative, Qualitative (How do you know?) The article is qualitative since the researchers employ a cross-sectional design and investigates the relationship between care rationing factors and professional burnout The article is qualitative as demonstrated by its heading and the use of cross-sectional survey. The study is qualitative based on the use of a phenomenological approach to enhance understanding of the issue among nurses.
Purpose Statement To assess the relationship between the rationing of nursing care and professional burnout in nursing staff Based on the perspective of nurses, the aims of the study included understanding the sources of stress and burnout that reduce self-efficacy and the unbalanced patient ratio as well as a description of nurses’ experiences. The purpose of the study was to increase understanding of factors related to burnout among nurses in the emergency department.
Research Question Does rationing of nursing care lead to professional burnout in nursing staff? What are the sources of burnout and stress which lower self-efficacy, and lead to unbalanced patient ratio? What factors are associate with burnout among nurses in the emergency department?
Outcome The article asserts that the level of nurse rationing care in cardiovascular facilities rises leading to emotional exhaustion, depersonalization and high levels of job dissatisfaction among nurses The outcomes of the study included a discovery of social status and discrimination towards nurses. The researchers opine that burnout is evident in multiple modes and can impact nurses’ ability to make decisions about leaving the profession.

(Where did the study take place?)

The study was set in cardiovascular facilities The study occurred in diverse settings as nurses were invited to offer data and information about their experiences with burnout and stress in their facilities. The study’s setting was the emergency department as all participants were required to have had an experience working in the department.
Sample The sample comprised of 219 nurses in the cardiovascular facilities The sample comprised of 60 nursing professionals who were recruited through snowball sampling design or strategy. The study does not provide the sample size of the participants that took part in the research. However, the researcher observe that five interviews were carried out, transcribed, coded, and analyzed.
Method Cross-sectional design aimed at investigating the link between rationing and professional burnout. Snowball sampling was used in the study The researchers used a phenomenological approach based on purposive sampling.
Key Findings of the Study The key findings from the study include the existence of a positive relationship between rationing and burnout, occurrence of emotional exhaustion and significant levels of depersonalization. The results from the study show that factors within the nurses’ environment that include family stress, workplace incivility, and personal development play a significant role in increasing stress and burning which reduce self-efficacy of the nurses. The findings of the study illuminated four critical areas as leading to burnout among nurses. These include work environment, perception, workplace violence and moral distress. However, the most coded theme was workplace environment.
Recommendations of the Researcher The researchers recommend the need for effective rational schedules and sufficient nurse levels to reduce incidences of professional burnout among the providers in different care settings. The researchers recommend leaders in government, policymakers and researchers to use the findings as a chance to reform human resource management policies and awareness for the public to have recognition and respect for the medical and nursing professionals. The article recommends the need for better understanding of the factors that lead to burnout in emergency department for effective interventions. The researchers emphasize better strategies to mitigate burnout in these settings.
Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink Bryan-Rose, C., & Bourne, P. A. (2018). Factors Determining ‘Burnout’ Among Nursing Staffers at a National Hospital in Jamaica. Juniper Online Journal of Public Health, 3(2): 555608. DOI: 10.19080/JOJPH.2018.03.555608. Elkady, A. A. M. (2019). Mindfulness and Resilience as Predictors of Job Burnout among Nurses in Public Hospitals. International Journal of Psycho-Educational Sciences, 8, 14-21. https://perrjournal.com/index.

php/per journal/article/view/167

Diehl, E., Rieger, S., Letzel, S., Schablon, A., Nienhaus, A., Escobar Pinzon, L. C., & Dietz, P. (2021). The relationship between workload and burnout among nurses: the buffering role of personal, social and organizational resources. PloS one, 16(1), e0245798. https://doi.org/10.1371/journal.


How Does the Article Relate to the PICOT Question? The article relates to the PICOT question as it illustrates that burnout is a prevalent issue not just in developed countries’ healthcare systems but also in developing ones like Jamaica. The article relates to the PICOT question as it shows different interventions that nurses can use to mitigate burnout and manage stress. Mindfulness and resilience are important interventions that can help nurses manage burnout and enhance their overall performance. The article relates to the PICOT question as it shows that effective interventions based on social, personal and organizational resources can protect nurses from burnout. The article is important as it offers interventions to address nurse burnout in palliative care settings.
Quantitative, Qualitative (How do you know?) The article is quantitative as it uses different approaches of quantitative research. The article is quantitative based on its use of different elements of quantitative research approaches. The independent variables in the study were resilience and mindfulness while the dependent variable was job burnout. The article is quantitative as it uses an exploratory cross-sectional survey on rates of nurse burnout among nurses in Germany.
Purpose Statement To evaluate if burnout has an influence on the attitude to work among nurses at the National Hospital in Jamaica The purpose of the study was to inquire the effects of resilience and mindfulness on nurse burnout. The study also investigates the contribution of these two phenomena to job burnout among nurses in public health facilities. The purpose of the study was to examine the protective role of resources on the association between workload and burnout.
Research Question What is the effects of burnout on nurses’ attitude to work at the national hospital in Jamaica? What is the impact of mindfulness and resilience on nurse burnout?

What is the relative contribution of mindfulness

and resilience to job burnout among nurses in

public hospital?

What is the relationship between workload and burnout among nurses and the role of personal, social and organizational resources in protecting these providers?
Outcome The outcomes from the study show high levels of burnout that impact personal fulfillment and lead to emotional exhaustion. The outcomes show a positive correlation between the two sets of variables. However, the study advances that job burnout had a negative relationship with resilience. Good workplace environment and effective working teams mediated the severity of burnout as well as the quantitative demands from work. The authors also assert that more time spent in healthcare facilities by nurses increases their susceptibility to burnout.

(Where did the study take place?)

The setting for the study was the national hospital of Jamaica. The setting for the study entailed different departments in various public health facilities. The setting for the study was palliative care units in different hospitals in Germany.
Sample The sample involved 327 nursing personnel working in the facility at the time of the research study. The study sample comprised of 130 female nurses with a mean age of 26.4 years. A total sample of 497 nurses participated in the study
Method The study uses cross-sectional probability sample to get nurses who participated in the research. The researcher used a quantitative survey design with both dependent and independent variables The study used a quantitative stratified technique to get its sample.
Key Findings of the Study The key findings of the study ire that burnout is prevalent than previously understood at the national hospital. The nursing personnel feel that they are experiencing increased levels of depersonalization and a rift between them and management. The findings show that mindfulness can facilitate wellbeing of nurses and protect them from stress and burnout. Nurses can also overcome burnout in different departments when they exercise resilience and focus on the different aspects of their job from an innovative perspective. The findings show the different personal, organizational and social resources provide protection for nurses to buffer them from burnout in different care settings. The findings also demonstrate that high levels and demands of palliative care have negative effects on nurse burnout.
Recommendations of the Researcher The researchers recommend the creation of effective strategies by the management at the facility to address the issue in an effective manner and reduce the challenges that it poses to providers and the general population. The author recommends the need for policymakers to address the issue of nurse burnout in public health facilities as a matter of urgency due to its negative effects. The policymakers can teach nurses mindfulness and resilience as ways to mitigate stress associated with burnout emanating from increased workload. The researchers recommend more future studies on the role of buffering resources to protect nurses from burnout in their workplace environment. The researchers also recommend increased involvement of nurses in decision making to mitigate these issues.


Nurse burnout is a serious concern that affects the nursing profession and threatens to lower the quality of care and patient safety. Burnout among nurses increases the susceptibility to adverse patient events that include medication errors. Therefore, the literature evaluation table offers a host of resources; both qualitative and quantitative on how to deal with the issue and attain quality care outcomes. Interventions to address burnout require the participation of policymakers and other stakeholders across different health systems.

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Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: a theoretical review. Human resources for health, 18(1), 1-17. DOI: https://doi.org/10.1186/s12960-020-00469-9

Friganović, A., Kurtović, B., & Selič, P. (2021). A cross-sectional multicentre qualitative study exploring attitudes and burnout knowledge in intensive care nurses with burnout. Slovenian Journal of Public Health, 60(1), 46-54. DOI: 10.2478/sjph-2021-0008

Van Bogaert, P., Peremans, L., Van Heusden, D., Verspuy, M., Kureckova, V., Van de Cruys, Z., & Franck, E. (2017). Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: a mixed method study. BMC nursing, 16(1), 1-14. DOI: https://doi.org/10.1186/s12912-016-0200-4

PICOT Question And Literature Search

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 know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer‐revised 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 assignment.

  1. 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.
  2. 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).
  3. The PICOT question will provide a framework for your capstone project.
  4. 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.

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