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PLEASE SEE ATTACHED DOCUMENT FOR INSTRUCTIONS AND RUBRIC
2 PAGES
DUE DATE APRIL 10, 2025
NO PLAGIARISM MORE THAN 10 %
SOURCES NO OLDER THAN 5 YEARS WITH IN-TEXT CITATIONS
PLEASE NOTE THAT THIS ASSIGNMENT IS THE FINAL PART OF A PREVIOUS PROJECT, I HAVE UPLOAD HERE PART 1 TO 5 , AND THEN THIS NEW ASSIGNMENT GOING TO BE PART 6 AS A CONTINUATION, AS A SEQUENCE OF THE ASSIGNMENT ATTACHED.
PLEASE CHECK THE RUBRIC PROFESSOR IS VERY EXIGENT ADN WILL GO POINT BY POINT FOR GRADE THIS ASSIGNMENT. NOTE BOLD LETTER OF THE MANDATORY SECTION THAT NEED TO BE COVER IN THIS SECTION VI.
NR 662: ADVANCED NURSING ROLE SYNTHESIS
Module 7 Assignment:
MSN Project
Manuscript
Completion:
Executive Summary
& Section VI
Guidelines and
Rubric
TOTAL POINTS POSSIBLE: 160
ASSIGNMENT OVERVIEW
This assignment will assist you with the informa3on needed to complete the MSN project manuscript for
dissemina3on. In this assignment you will complete the final sec3on of your MSN project manuscript,
Transla3on to Prac3ce and Evalua3on, as well as the Execu3ve Summary. In the final sec3on of the MSN
Project Manuscript the student will include informa3on on:
1. Data Collec>on Methods,
2. Evalua>on
3. Dissemina>on, and
4. Conclusion of Project.
NR528 6/11/19
NR 662: ADVANCED NURSING ROLE SYNTHESIS
Please make sure to include all previous sec3ons of your MSN-Project Manuscript so that this document is
complete.
ASSIGNMENT INSTRUCTIONS
1. Abide by the Chamberlain College of Nursing Academic Integrity Policy. NO MORE THAN 10%
PLAGIARISM ALLOWED.
2. Complete sec3ons VI as well as the Execu3ve Summary of the MSN project template.
3. Sources older than five years may not be used without the permission of the class professor.
4. Title page, pagina3on, subheadings, body of paper, cita3on of sources, and reference page must
follow APA guidelines as found in the current edi3on of the manual.
5. Rules of grammar, spelling, word usage, punctua3on, sentence and paragraph structure are followed
and consistent with formal, scholarly wri3ng as noted in the APA Manual (current edi3on).
6. SEE RUBRIC TO KNOW HOW YOU WILL BE GRADED
ASSIGNMENT CRITERIA
Assessment
Criteria
Points % Descrip>on
Sec>on VI of the
MSN-Project
Manuscript:
Data Collec>on
40 25% Complete the MSN Project template Sec3on VI
Transla3on to Prac3ce and Evalua3on:
Data Collec3on to Support Outcomes
All areas are addressed:
• Include informa3on regarding what types of data
was collected.
• Include how the data was collected and if there
are any restric3ons to sharing the data
• Include how the data was used to determine
outcome measurement
• Include scholarly literature
NR528 6/11/19
NR 662: ADVANCED NURSING ROLE SYNTHESIS
Sec>on VI areas
of the MSN-
Project
Manuscript
Evalua>on
40 25% Complete the MSN-project Template Sec3on VI
Translate to Prac3ce and Evalua3on:
Evalua3on
All areas are addressed:
• How effec3ve was the interven3on in
improving outcomes?
• Stakeholder input in regards to effec3veness
of interven3on
• Recommenda3ons for improvement based on
feedback?
• Discussion on how this change project impacts
nursing and future research
• Brief cost/benefit analysis
• Scholarly literature is used
Sec>on VI areas
of the MSN-
Project
Manuscript:
Dissemina>on
25 16% Complete the MSN-Project Template Sec3on VI
Translate to Prac3ce and Evalua3on:
Dissemina3on
All areas are addressed:
• Discuss how the results of the project will be
shared with the stakeholders and
• Discuss the plan for sustainability of the
project
Sec>on VI areas
of the MSN-
Project
Manuscript:
Conclusion and
Contribu>ons to
the Nursing
Profession
25 16% Complete the MSN-Project Template Sec3on VI
Translate to Prac3ce and Evalua3on: Conclusion and
Contribu3ons to the Nursing Profession
All areas are addressed:
• Discussion conclusions about your project that
can be looped back to literature.
• For each conclusion you make, cite the
sources that support or contradict your
findings
• Contribu3ons your prac3ce project has made
to the body of exis3ng scien3fic knowledge on
this topic
Execu>ve
Summary
20 13% Each sec3on of the Execu3ve Summary is filled out
and complete and is placed properly in the
Manuscript aber the 3tle page.
All Areas Completed:
• Title and purpose of the project
• Loca3on of the project
• Literature Synthesis
• Summary of Implementa3on
• Dissemina3on
• Placed properly in Manuscript aber 3tle page
NR528 6/11/19
NR 662: ADVANCED NURSING ROLE SYNTHESIS
Graduate-level
Wri>ng Style
10
5
% • Correct use of spelling, grammar, punctua3on,
sentence and paragraph structure
• Clarity, organiza3on, and logical flow of ideas
within wri3ng
• Scholarly, professional wri3ng tone with no use of
first person
• Synthesis of informa3on is present with no more
than one short direct quote (15 words or less)
• Correct APA format for the following:
o Font style and size
o Margins and
spacing
o Cita3on and referencing sources
o Mechanics of style (abbrevia3ons,
capitaliza3on, italics, numbers)
Total 160 100% A quality assignment will meet or exceed the above
requirements.
NR528 6/11/19
GRADING RUBRIC
Assessme
nt Criteria
Dis>nguished
(100%)
Exceeds
(92%)
Proficient
(84%)
Needs
Improvement
(0)
Sec>on
VI of the
MSN-
Project
Manuscri
pt: Data
Collec>o
n
40 Points 36 Points 34 Points 0 Points
Dis3nguished
presenta3on of
informa3on evidenced
by all of the following
content areas covered
in a comprehensive
and concise manner:
Data Collec3on to
Support Outcomes
All areas are
addressed:
• Include
informa3on
regarding what
types of data was
collected.
• Include how the
data was
collected and if
there are any
restric3ons to
sharing the data
• Include how the
data was used to
Presenta3on of
informa3on
exceeds
expecta3ons
evidenced by
most content
covered in a
comprehensive
and concise
manner, but with
one area where
coverage is
superficial:
Data Collec3on to
Support Outcomes
All areas are
addressed:
• Include
informa3on
regarding what
types of data was
collected.
• Include how the
data was collected
Proficient presenta3on
of informa3on evidenced
by content covered in a
limited or superficial
manner in two or more
of the content areas:
Data Collec3on to
Support Outcomes
All areas are addressed:
• Include informa3on
regarding what
types of data was
collected.
• Include how the
data was collected
and if there are any
restric3ons to
sharing the data
• Include how the
data was used to
determine
outcome
measurement
• Include scholarly
Presenta3on of
informa3on
needs
improvement as
evidenced by
content that is
missing or
unsa>sfactory in
one or more of
the content
areas:
Data Collec3on
to Support
Outcomes
All areas are
addressed:
• Include
informa3on
regarding
what types
of data was
collected.
• Include how
the data Sec>on VI
areas of
40 Points 36 Points 34 Points 0 Points
5
Sec>on VI
areas of
the MSN-
Project
Manuscrip
t
Evalua>on
Dis3nguished
presenta3on of
informa3on evidenced
by all of the following
content areas covered
in a comprehensive
and concise manner:
Evalua3on
All areas are
addressed:
• How effec3ve
was the
interven3on in
improving
outcomes?
• Stakeholder
input in
regards to
effec3veness
of interven3on
• Recommenda3
ons for
improvement
based on
feedback?
• Discussion on
how this
change project
impacts
nursing and
future
research
• Brief cost/
Presenta3on of
informa3on
exceeds
expecta3ons
evidenced by
most content
covered in a
comprehensive
and concise
manner, but with
one area where
coverage is
superficial:
Evalua3on
All areas are addressed:
• How effec3ve
was the
interven3on in
improving
outcomes?
• Stakeholder
input in regards
to effec3veness
of interven3on
• Recommenda3
ons for
improvement
based on
feedback?
• Discussion on
how this
change project
impacts nursing
Proficient presenta3on
of informa3on evidenced
by content covered in a
limited or superficial
manner in two or more
of the content areas:
Evalua3on
All areas are addressed:
• How effec3ve
was the
interven3on in
improving
outcomes?
• Stakeholder
input in regards
to effec3veness
of interven3on
• Recommenda3o
ns for
improvement
based on
feedback?
• Discussion on
how this change
project impacts
nursing and
future research
• Brief cost/
benefit analysis
• Scholarly
literature is used
Presenta3on of
informa3on
needs
improvement as
evidenced by
content that is
missing or
unsa>sfactory in
one or more of
the content
areas:
Evalua3on
All areas are
addressed:
• How
effec3ve
was the
interven3
on in
improvin
g
outcomes
?
• Stakehold
er input
in regards
to
effec3ven
ess of
interven3
on
• Recomme
nda3ons Sec>on
VI areas
25 Points 23 Points 21 Points 0 Points
6
Sec>on
VI areas
of the
MSN-
Project
Manuscri
pt:
Dissemin
a>on
Dis3nguished
presenta3on of
informa3on evidenced
by all of the following
content areas covered
in a comprehensive
and concise manner:
Dissemina3on
All areas are
addressed:
• Discuss how
the results of
the project will
be shared with
the
stakeholders
and
• Discuss the
plan for
Presenta3on of
informa3on
exceeds
expecta3ons
evidenced by
most content
covered in a
comprehensive
and concise
manner, but with
one area where
coverage is
superficial:
Dissemina3on
All areas are addressed:
• Discuss how
the results of
the project will
be shared with
Proficient presenta3on
of informa3on evidenced
by content covered in a
limited or superficial
manner in two or more
of the content areas:
Dissemina3on
All areas are addressed:
• Discuss how the
results of the
project will be
shared with the
stakeholders and
• Discuss the plan
for sustainability
of the project
Presenta3on of
informa3on
needs
improvement as
evidenced by
content that is
missing or
unsa>sfactory in
one or more of
the content
areas:
Dissemina3on
All areas are
addressed:
• Discuss
how the
results of
the
project 25 Points 23 Points 21 Points 0 Points
7
Sec>on VI
areas of
the MSN-
Project
Manuscrip
t:
Conclusio
n and
Contribu>
ons to the
Nursing
Profession
Dis3nguished
presenta3on of
informa3on evidenced
by all of the following
content areas covered
in a comprehensive
and concise manner:
Conclusion and
Contribu3ons to the
Nursing Profession
All areas are
addressed:
• Discussion
conclusions
about your
project that
can be looped
back to
literature.
• For each
conclusion you
make, cite the
sources that
support or
contradict your
findings
• Contribu3ons
your prac3ce
project has
made to the
body of
exis3ng
Presenta3on of
informa3on
exceeds
expecta3ons
evidenced by
most content
covered in a
comprehensive
and concise
manner, but with
one area where
coverage is
superficial:
Conclusion and
Contribu3ons to the
Nursing Profession
All areas are addressed:
• Discussion
conclusions
about your
project that can
be looped back
to literature.
• For each
conclusion you
make, cite the
sources that
support or
contradict your
findings
• Contribu3ons
your prac3ce
Proficient presenta3on
of informa3on evidenced
by content covered in a
limited or superficial
manner in two or more
of the content areas:
Conclusion and
Contribu3ons to the
Nursing Profession
All areas are addressed:
• Discussion
conclusions
about your
project that can
be looped back
to literature.
• For each
conclusion you
make, cite the
sources that
support or
contradict your
findings
• Contribu3ons
your prac3ce
project has made
to the body of
exis3ng scien3fic
knowledge on
this topic
Presenta3on of
informa3on
needs
improvement as
evidenced by
content that is
missing or
unsa>sfactory in
one or more of
the content
areas:
Conclusion and
Contribu3ons to
the Nursing
Profession
All areas are
addressed:
• Discussio
n
conclusio
ns about
your
project
that can
be
looped
back to
literature.
• For each
conclusio
n you
make, 20 Points 18 Points 16 Points 0 Points
8
Execu>ve
Summary
Dis3nguished
presenta3on of
informa3on evidenced
by all of the following
content areas covered
in a comprehensive
and concise manner:
Each sec3on of the
Execu3ve Summary is
filled out and complete
and is placed properly
in the Manuscript aber
the 3tle page.
All Areas Completed:
• Title and
purpose of the
project
• Loca3on of the
project
• Literature
Synthesis
• Summary of
Implementa3o
n
• Dissemina3on
• Placed
properly in
Presenta3on of
informa3on
exceeds
expecta3ons
evidenced by
most content
covered in a
comprehensive
and concise
manner, but with
one area where
coverage is
superficial:
Each sec3on of the
Execu3ve Summary is
filled out and complete
and is placed properly
in the Manuscript aber
the 3tle page.
All Areas Completed:
• Title and
purpose of the
project
• Loca3on of the
project
• Literature
Synthesis
Proficient presenta3on
of informa3on evidenced
by content covered in a
limited or superficial
manner in two or more
of the content areas:
Each sec3on of the
Execu3ve Summary is
filled out and complete
and is placed properly in
the Manuscript aber the
3tle page.
All Areas Completed:
• Title and
purpose of the
project
• Loca3on of the
project
• Literature
Synthesis
• Summary of
Implementa3on
• Dissemina3on
• Placed properly
in Manuscript
aber 3tle page
Presenta3on of
informa3on
needs
improvement as
evidenced by
content that is
missing or
unsa>sfactory in
one or more of
the content
areas:
Each sec3on of
the Execu3ve
Summary is filled
out and complete
and is placed
properly in the
Manuscript aber
the 3tle page.
All Areas
Completed:
• Title and
purpose
of the
project
• Loca3on
of the 10 Points
9
Points 8 Points 0 Points
9
Graduate
Level
Wri>ng
Style
Dis3nguished
graduate-level wri3ng
style is evidenced by
mee3ng all of the
following criteria with
0-1 errors total:
• Correct use of
spelling, grammar,
punctua3on,
sentence and
paragraph
structure
• Clarity,
organiza3on, and
logical flow of
ideas within
wri3ng
• Scholarly,
professional
wri3ng tone with
no use of first
person
• Synthesis of
informa3on is
present with no
more than one
short direct quote
(15 words or less)
• Correct APA format
for the following:
o Font style and
size
o Margins and
spacing
Graduate-level
wri3ng style exceeds
expecta3ons as
evidenced by
mee3ng the
following criteria
with 2-4 errors total:
• Correct use of
spelling, grammar,
punctua3on,
sentence and
paragraph structure
• Clarity,
organiza3on, and
logical flow of ideas
within wri3ng
• Scholarly,
professional wri3ng
tone with no use of
first person
• Synthesis of
informa3on is
present with no
more than one
short direct quote
(15 words or less)
• Correct APA format
for the following:
o Font style and
size
o Margins and
spacing
o Cita3on and
referencing
Proficient graduate-
level wri3ng style is
evidenced by mee3ng
the following criteria
with 5-7 errors, total:
• Correct use of
spelling, grammar,
punctua3on,
sentence and
paragraph structure
• Clarity, organiza3on,
and logical flow of
ideas within wri3ng
• Scholarly,
professional wri3ng
tone with no use of
first person
• Synthesis of
informa3on is
present with no
more than one short
direct quote (15
words or less)
• Correct APA format
for the following:
o Font style and
size
o Margins and
spacing
o Cita3on and
referencing
sources
o Mechanics of
style
Graduate-level
wri3ng style
needs
improvement as
evidenced by
mee3ng the
following
criteria with 8 or
more errors,
total:
• Correct use
of spelling,
grammar,
punctua3on,
sentence and
paragraph
structure
• Clarity,
organiza3on,
and logical
flow of ideas
within wri3ng
• Scholarly,
professional
wri3ng tone
with no use
of first person
• Synthesis of
informa3on is
present with
no more than
one short
direct quote
10
- Total Points Possible: 160
- Assignment Overview
- Assignment Instructions
- Assignment Criteria
- Grading Rubric
Nurse Burnout
Student: Byron Gonzalez
Institution: Chamberlain College of Nursing
Course: Advanced Nursing Role Synthesis
Instructor: Dr. Mary Naccarato
Date: March 26, 2025
Executive Summary
Purpose: The purpose of the Nurse Burnout improvement project was to implement a 30 minute uninterrupted lunch break reduce in nurse burnout and fatigue.
Project Location: The Nurse Burnout project was completed on the hematology and transplant clinic at a medical center.
Synthesis of Literature and Evidence: Nurses who do not take a 30-minute uninterrupted lunch break, nurse staff satisfaction has deceased, and patient outcomes have shown a negative decline. Further, interventions to reduce nurse burnout have been implemented at the microsystem and macrosystem levels to ensure nursing staff take appropriate breaks.
Implementation: A nurse burnout in-service education was completed to explain the nurse burnout intervention of an uninterrupted lunch break to the hematology and transplant clinic nursing staff. Nursing staff utilized team nursing to take a 30 minute uninterrupted lunch break during each shift. Weekly timesheets were used to record the 30 minute lunch breaks. A pre/post intervention survey was completed to measure the incidence of nurse burnout, fatigue, and nurse staff satisfaction. 35 hematology and transplant clinic nurses participated in the nurse burnout project.
Dissemination: The nurse burnout project results were disseminated internally and externally. Internally, the nurse burnout project results were presented to the hematology and transplant clinic nursing staff, at shared governance meetings. Externally, the nurse burnout project results were presented to nursing students for the purpose of teaching the nursing g students the value of taking lunch breaks.
Nurse Burnout Prevention Project
Nurse burnout continues to be problematic for many healthcare organizations. As a caregiver, nurses usually place the needs of patients before the needs of the nurse caregiver (Roth, 2019). Also, the literature has suggested, nurses do not routinely take appropriate breaks, including lunch breaks; because nurses decide to provide patient care, rather than take a break (Roth, 2019). Further, not taking appropriate breaks throughout a scheduled shift can lead to nurse fatigue and burnout, and a decrease in nurse satisfaction and patient care (Barrientos-Trigo et al., 2018). The nurse burnout project was completed on a hematology and transplant clinic unit of a medical center to implement a 30-minute uninterrupted meal break. The purpose of the nurse burnout project was to reduce nurse burnout and fatigue.
Problem Statement
Many nurses would agree that break time is frequently missed (Gifkins, et al., 2020). Nurses not taking a break during the work shift was the identified problem in a hematology and transplant clinic unit. The purpose of the nurse burnout project was to reduce nurse burnout and fatigue by providing staff with a 30-minute uninterrupted lunch break (Appendix A). Currently, many nurses indicate not taking the 30 minute uninterrupted lunch break; which means a high occurrence of nurses do not receive a lunch break. Literature has shown the inability to take adequate breaks can lead to nurse burnout and fatigue (Gifkins et al., 2020). Further, Gifkins and colleagues (2020) has shown a correlation between missing patient care and compromising patient safety when nurses are unable to take breaks.
Problem Background
Nurses who do not take an adequate lunch break has been linked to patient errors, high nurse turnover rates, and nurse burnout or fatigue (Youssef & Senbel, 2018). In contrast,Adequate rest breaks has been shown to improve nurse wellbeing and positive behaviors (Youssef & Senbel, 2018). Also, the positive nurse outcomes when taking adequate rest breaks, has been linked to a reduction of medical errors and missed patient care. Huang and colleagues (2017) reported similar results from inadequate rest breaks; which indicated occurrence of depersonalization that can lead to nurse burnout and fatigue. Further, the missed rest breaks can reduce or eliminate the time to decompress during an assigned shift.
The literature indicated many factors that influence a nurse not taking a rest break. The most common factors are: inadequate staff coverage, patient-care priority over self-care, and consuming food quickly or while working (Johannes Wendsche, 2017). In addition, social norm or workplace culture can alter a nurse’s decision to take a rest break (Johannes Wendsche, 2017).
.
Stakeholders
The nurse burnout project identified four major stakeholders, the hematology and transplant clinic nursing staff, float pool nursing staff, unit manager and administration are the major stakeholders. Thus, engagement of the nursing staff can influence the success of the nurse burnout project implementation. The float pool nursing staff, who frequently supplement the core nursing staff, will also be included in the nurse burnout project participation. Additionally, the unit manager involvement can expedite project approval and serve as a role model for practice change. Administration, specifically, the director of evidenced-based practice will provide access to base line data about the current nursing staff not using rest breaks
.
PICOT Question
The PICOT Model was used to formulate an improvement project PICOT question that guided the literature search and development of an improvement project (Dang & Dearholt, 2017). The PICOT question was: Among nurses in the hematology and transplant clinic, will a 30-minute uninterrupted lunch breaks, decrease nurse fatigue and burnout, in four weeks? The identified nurse burnout project population were nurses working on the hematology and transplant clinic unit. The proposed intervention was a 30-minute uninterrupted lunch break. The outcome was a measurement of nurse fatigue and burnout signs/symptoms, using a pre/post intervention questionnaire.
Review of Literature
The literature review that follows discusses evidence-based practices to minimize burnout in nursing staff. A systematic search was conducted on databases such as PubMed, CINAHL, and PsycINFO using keywords such as “nursing burnout,” “relaxation techniques,” and “educational interventions.” The search was filtered for peer-reviewed articles from 2021 to 2025.
Burnout Prevalence
Current studies have reconfirmed that burnout remains a critical issue among nursing professionals. Han & Yeun’s (2023) systematic review identifies nurses’ burnout levels as 35% to 55%, depending on healthcare settings and work pressure. The study observes that stress extends emotional exhaustion, depersonalization, and decreased personal accomplishment, finally impacting patient care outcomes.
Educational Interventions
Education programs and training sessions have been shown to enhance nurses’ coping strategies and awareness. Burleson et al. (2023) reviewed a scoping study that identified cognitive-behavioral training and education through peer support as effective interventions. The review revealed that formal education sessions not only enhanced nurses’ knowledge regarding burnout but also helped reduce symptoms of stress.
Relaxation Techniques
Meditation, mindfulness-based stress reduction (MBSR), and progressive muscle relaxation (PMR) have effectively reduced burnout symptoms in healthcare workers. Wong et al. (2024), conducting a systematic review of randomized controlled trials, identified that nurses undergoing relaxation training experiences showed significant psychological well-being and job satisfaction improvement. The interventions also positively affected cortisol levels as well as sleeping habits.
Outcome Measurement
Quantifying the performance of burnout interventions is necessary for validation and further development. A systematic review by Lee & Cha (2023) assessed various intervention results based on pre- and post-intervention questionnaire surveys. Their findings showed evidence of intervention impacts through programs that measured self-reported stress levels, heart rate variability, and burnout scales. The review emphasizes the need for long-term follow-ups so benefits will be maintained.
Synthesis of Evidence
The evidence from the literature is overwhelmingly in favor of using educational interventions and relaxation strategies to minimize burnout in nurses. Cognitive-behavioral training and peer education efficiently increase awareness and knowledge, while mindfulness-based approaches such as guided meditation and progressive muscle relaxation reduce stress levels and improve well-being. Based on available evidence, using these interventions to inform nursing practice will likely yield beneficial effects in workforce maintenance and patient care quality.
Proposed Intervention
The nurse burnout project intervention was a 30 minute-uninterrupted meal break (Appendix C and Appendix D). According to Ohio law (citation) and Ohio Nurses Association (citation) nurses must be able to take a 30-minute meal break during the assigned work shift. When staff are unable to take a meal break nurse burnout and fatigue can occur. Research has shown nurse burnout and fatigue lead to patient errors and a high nurse staff turnover rate (citation). Thus, the nurse burnout project goal was to decrease nurse fatigue and burnout by implementing a 30-minute uninterrupted lunch break
Setting
The nurse burnout project was conducted in a hematology and transplant clinic. The current workplace culture did not intervene to support nurses taking a 30-minute uninterrupted meal break. Rather, the workplace culture fostered the nurse behavior of “eat on the go” instead of a 30-minute meal break. Nurse turnover in the hematology and transplant clinic remained high. Informally, nurses would describe the hematology and transplant clinic as a difficult unit because nurses do not have the opportunity or support to take a break. The hematology and transplant clinic manager were open to finding ways to support nursing staff, increase nurse staff retention and nurse staff satisfaction. The hematology and transplant clinic unit council had an objective to improve nurse staff satisfaction for the last 3 years. Therefore, readiness to change the work culture appeared high. The nursing staff and the unit manager discussions were positive and supportive of the 30-minute meal break
Barriers
The nurse burnout project identified four barriers to implementation of the 30-minuites meal break. The first barrier was the inability to find patient coverage for a nurse taking a meal break. Patient coverage is important to ensure the meal break time would be uninterrupted. Another potential barrier was time management to ensure all nurses take a full 30-minute meal break. One strategy for overcoming the patient coverage and time management barriers was the use of team nursing care delivery model. Team nursing care delivery would provide adequate patient coverage and the management of time to achieve a 30-minute, uninterrupted meal break for all nurses.
The third barrier was staffing shortages. The utilization of a float pool staff to cover lunch breaks could overcome the staffing shortage barrier. The fourth barrier was nurses unwilling to take a 30-minute uninterrupted meal break. A strategy to overcome the nurse unwillingness barrier was an in-service education about the nurse burnout project and the importance of a 30-minute uninterrupted meal break. The goal of the in-service education was to assist staff in recognizing the link between not taking a meal break and nurse fatigue and burnout.
Outcomes
The nurse burnout project outcome was a decrease in nurse fatigue and burnout
. The nurse burnout project outcome was measured by comparing a pre/post intervention survey score. The pre survey was completed prior to project implementation and a post survey was completed 3 weeks after project implementation. The survey questions related to the nurse burnout project outcome, which measured nurse burnout and fatigue. The expected outcome was a decrease in the incidence of burnout and fatigue by participating in a 30-minute uninterrupted lunch break. Also, the nurse timesheets were reviewed to validate nurses participated in the 30-minute lunch break.
Action Plan
The nurse burnout project action plan utilized critical project milestones (Appendix C) to achieve a successful completion of the nurse burnout quality improvement project. The first milestone involved the pre-survey by 30 nurses in the hematology and transplant clinic. The pre-survey was 10 questions asked the nursing staff to rate burnout, fatigue, and staff satisfaction on a scale of 1-5. The survey data for each question was analyzed, comparing the pre and post intervention survey results. The nurse burnout project results were shared with the director of evidence-based practice and the hematology and transplant clinic manager.
The second critical milestone was an in-service to the hematology and transplant clinic nurses about the nurse burnout project goals, intervention and outcome. The in- service included evidence about the importance of staff taking 30-minute uninterrupted breaks and the effects of a meal break on fatigue, burnout, and nurse satisfaction. Team nursing was explained as a strategy to allow nurses to take appropriate lunch breaks. A meeting with the float pool manager explained the nurse burnout quality improvement project and how the float pool staff would provide support lunch breaks for the nursing staff.
Data collection was the third milestone which involved documentation of the nurses taking or not taking the 30-minute uninterrupted lunch break. Weekly meetings were conducted with the hematology and transplant clinic manager to collect the nurse timesheets. Meal break findings from the nurse timesheets were disseminated to the nursing staff.
The fourth and final milestone was the completion of the post-survey by the 30 nurses in the hematology and transplant clinic. The post-survey was completed week 3 of implementation of the project. Both, the pre and post survey questions were identical. Findings of the post-survey were discussed with the director of evidence-based practice and the manager of the hematology and transplant clinic to support further collaboration.
Introduction to Model
“The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) is the guiding model for the practicum project and practice change. The model provides high-quality patient care through a systematic process of integrating evidence-based practice in clinical decision making (Dang et al., 2021). It works best in addressing problems in healthcare institutions by enabling nurses to go through a guided process of finding, evaluating, and implementing evidence-based solutions.
“The three elements of the JHNEBP Model are practice, evidence, and translation.” The practice element is drawn from solving a problem or a clinical question that requires a solution. The evidence element deals with the collection, critique, and synthesis of best available research and non-research evidence (Brunt & Morris, 2023). The translation element implements the evidence and evaluates the outcomes of the change.
It has a methodical nineteen-step process that evolves in three stages. The practice question stage begins with organizing an interprofessional team, developing the practice question, and making a search plan. The evidence stage involves searching for the relevant literature, “its strength and quality critique, summarizing findings, and establishing evidence-based recommendations” (Dang et al., 2021). The translation stage determines whether the change is ready to be implemented, complete an action plan, secure organizational endorsement, implement the change, evaluate outcomes, report outcomes, establish next steps, disseminate findings, implement the practice change, sustain it in the long term, and conduct periodic re-assessments.
Use of Model to Support Project
The “JHNEBP Model” was the model used for the nurse burnout project that aimed to reduce fatigue and enhance nurse satisfaction through the implementation of a 30-minute unbreakable lunch break. “In the practice phase, the project team set the issue of nurse burnout in the hematology and transplant clinic and formulated the PICOT question, where the question was whether an unbreakable lunch break would decrease nurse burnout and fatigue for four weeks.”
The process of translation involved the use of evidence-based change. The action plan included staff education, utilization of team nursing practices, and collection of data using pre- and post-surveys. Support was received from “unit managers and the director of evidence-based practice to ensure easy implementation.” The efficacy of the project was measured using nurse fatigue and burnout levels before and after the intervention. Results were internally reported to clinic staff and externally to nursing students to emphasize the importance of organized breaks in avoiding burnout.
Implementation
Implementation of the project is a significant process to achieve evidence-based practice to clinical change. As per the evaluation of the evidence, the practice recommendation of the project is implementing a “30-minute uninterrupted lunch break for nurses in the hematology and transplant clinic to reduce burnout and fatigue.” Implementation process is directed through “the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model” and is made up of a series of organized steps (Brunt & Morris, 2023).
Phase one involves the formation of an interprofessional team that includes nursing staff, the unit manager, and a float pool representative. Once the team is formed, an in-service educational session will be conducted to introduce the project, highlight break periods’ importance, and present the benefits to staff health and patient care (Liu et al., 2021). Following training, the intervention will be implemented by booking uninterrupted lunch breaks through the use of a team nursing approach. Rotating responsibility for coverage will be assigned to staff to allow all nurses to have their allotted break without compromising patient care. Weekly Nurse Timesheets will be checked to ensure compliance.
Feasibility and organizational appropriateness are facilitated through matching the intervention with existing staffing models and securing leadership support. Resources include educational materials, time-tracking software, and administrative resources. The project will be piloted over a four-week duration with pre- and post-survey assessments of burnout levels. Continuous feedback will be obtained to overcome challenges and customize the approach.
References
Brunt, B. A., & Morris, M. M. (2023). Nursing professional development evidence-based practice. In
StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK589676/
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021).
Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. Sigma Theta Tau.
https://books.google.com/books?hl=en&lr=&id=m4k4EAAAQBAJ&oi=fnd&pg=PP1&dq=Johns+Hopkins+Nursing+Evidence-Based+Practice+(JHNEBP)+Model&ots=pVMsCJwdB8&sig=lTz2VpF081o1Qu7Mv1HQLmljMoI
Burleson, S., Thomas, L., & DeBoor, S. (2023). Effective interventions for nursing student burnout: a scoping review.
Nurse Educator,
48(3), E85-E89.
https://journals.lww.com/nurseeducatoronline/fulltext/2023/05000/effective_interventions_for_nursing_student.25.aspx
Han, S. J., & Yeun, Y. R. (2023, December). Psychological intervention to promote resilience in nurses: A systematic review and meta-analysis. In
Healthcare (Vol. 12, No. 1, p. 73). MDPI.
https://www.mdpi.com/2227-9032/12/1/73
Lee, M., & Cha, C. (2023). Interventions to reduce burnout among clinical nurses: systematic review and meta-analysis.
Scientific Reports,
13(1), 10971. https://www.nature.com/articles/s41598-023-38169-8
Liu, M., Lin, Y., Dai, Y., Deng, Y., Chun, X., Lv, Y., … & He, F. (2021). A multi-dimensional EBP educational program to improve evidence-based practice and critical thinking of hospital-based nurses: development, implementation, and preliminary outcomes.
Nurse Education in Practice,
52, 102964. https://www.sciencedirect.com/science/article/pii/S1471595320310507
Wong, K. W., Wu, X., & Dong, Y. (2024). Interventions to reduce burnout and improve the mental health of nurses during the COVID‐19 pandemic: A systematic review of randomized controlled trials with meta‐analysis.
International journal of mental health nursing,
33(2), 324-343. https://onlinelibrary.wiley.com/doi/abs/10.1111/inm.13251
Appendices, Tables, and Figures
Appendix A: John Hopkins Action Planning Tool
Action Step
Person Responsible
Timeline
Resources Needed
Potential Barriers
Strategies to Overcome Barriers
Recruitment of participants
Project Lead
Week 1
Clinic staff roster
Low staff interest
Communicate the benefits of the program
Baseline data collection
Research Assistant
Week 1
Surveys, consent forms
Time constraints
Schedule during staff downtime
Small group discussions
Facilitator
Weeks 2-4
Meeting space, materials
Staff availability
Offer multiple session times
Post-intervention data collection
Research Assistant
Week 5
Surveys
Low response rate
Remind staff of the importance
Data analysis
Project Lead
Week 5
Statistical software
Limited expertise
Consult with statistician
Dissemination of results
Project Lead
Week 6
Presentation tools
Stakeholder engagement
Tailor results to audience needs
Appendix B: Financial Table
EXPENSES
Cost
REVENUE
Amount
Direct Costs
Billing
$0
– Facilitator fees
$1,000
Grants
$0
– Educational materials
$200
Institutional budget support
$1,500
– Survey printing
$50
Indirect Costs
– Overhead (meeting space)
$300
Total Expenses
$1,550
Total Revenue
$1,500
Net Balance
-$50
Pre-Intervention Survey
1.
How familiar are you with the signs and symptoms of burnout?
· Very familiar
· Somewhat familiar
· Not familiar
1.
How often do you feel emotionally exhausted at work?
· Always
· Often
· Sometimes
· Rarely
· Never
1.
Have you ever used relaxation techniques to manage stress?
· Yes
· No
1.
How effective do you believe relaxation techniques are in reducing burnout?
· Very effective
· Somewhat effective
· Not effective
1.
What is your current level of job satisfaction?
· Very satisfied
· Satisfied
· Neutral
· Dissatisfied
· Very dissatisfied
Post-Intervention Survey
1.
After the training, how familiar are you with the signs and symptoms of burnout?
· Very familiar
· Somewhat familiar
· Not familiar
1.
How often do you feel emotionally exhausted at work after the training?
· Always
· Often
· Sometimes
· Rarely
· Never
1.
Have you used relaxation techniques since the training?
· Yes
· No
1.
How effective do you believe relaxation techniques reduce burnout after the training?
· Very effective
· Somewhat effective
· Not effective
5.
What is your current level of job satisfaction after the training?
· Very satisfied
· Satisfied
· Neutral
· Dissatisfied
· Very dissatisfied
Appendix C: Pre- and Post-Intervention Survey
Appendix D: Consent Form
Consent to Participate in Research Study
Title of Study: Addressing Burnout Among Clinic Nursing Staff Through Education and Relaxation Techniques
Principal Investigator: [Your Name]
Purpose of the Study:
This study aims to evaluate the effectiveness of an educational intervention aimed at increasing clinic nursing staff’s knowledge and perception of burnout signs/symptoms and relaxation techniques.
Procedures:
You will participate in a four-week educational program consisting of small group discussions. You will also be asked to complete a pre-and post-intervention survey.
Risks and Benefits:
There are no anticipated risks associated with this study. The potential benefits include increased awareness of burnout and improved stress management skills.
Confidentiality:
Your responses will remain confidential and will only be used for research purposes.
Voluntary Participation:
Your participation is voluntary, and you may withdraw without penalty.
Contact Information:
If you have any questions, please contact [Your Name] at [Your Email] or [Your Phone Number].
Consent:
By signing below, you agree to participate in this study.
Participant Name: ___________________________
Signature: ___________________________
Date: ___________________________
Tables
Finance Table
Budget
EXPENSES
Cost
REVENUE
Amount
Direct Costs
Billing
$0
– Facilitator fees
$1,000
Grants
$0
– Educational materials
$200
Institutional budget support
$1,500
– Survey printing
$50
Indirect Costs
– Overhead (meeting space)
$300
Total Expenses
$1,550
Total Revenue
$1,500
Net Balance
-$50
