Reference no: EM133580140

Program of Study: Doctor of Health Administration

Background of the Problem

Nurse burnout is a pervasive and concerning issue within the U.S. healthcare sector. The problem is a multifaceted problem characterized by emotional exhaustion, cynicism, and reduced effectiveness among nursing professionals (Schlak et al., 2021). Such phenomenon is intrinsically tied to the work environment and is defined as an occupational phenomenon by the World Health Organization (WHO, 2021). According to Lake et al. (2019) burnout has been shown to be the consequence of a poorly designed work environment regardless of occupation, indicating that burnout is less about the type of work, but rather how the work is designed, distributed, and managed. Lake et al. (2019) continues by saying that, for nurses, having a supportive work environment means having the appropriate autonomy, adequate staff and resources, and good working relationships with physicians and management. Professional autonomy empowers nurses to exercise their discretion and respond efficiently to patient care issues. Therefore, when these conditions are in place, nurses have 28% lower odds of developing burnout (Lake et al., 2019). In fact, a study of dedicated AIDS units, characterized by high levels of nurse autonomy, found that nurses had, on average, a 5-point lower burnout score when compared with units that had a more physician-centric model (Schlak., 2021). In addition, a strong relationship between workload and burnout has been reported, with one study concluding that nurses were 78% more likely to report burnout in hospitals with poor staffing conditions. However, poor working conditions are not only predictive of nurse burnout, but also adverse consequences for patients. A 2019 meta-analysis by Lake et al (2019) found that nurses in better work environments had 28% to 32% lower odds of developing job dissatisfaction, burnout, or intention to leave, and that patients had 8% lower odds of experiencing an adverse event or even death.

Problem Statement

The problem that warrants attention is the identification and understanding of the root causes of nurse burnout in the U.S. healthcare sector resulting in poor quality patient outcome. Nurse burnout is a critical issue with far-reaching consequences, affecting the well-being of nursing professionals and potentially compromising the quality of patient care (Schlak et al., 2021). According to Gharghozar & Hajbaghery (2020) nurse burnout is defined as a physical, psychological, emotional, and socially exhausted status caused by unsuccessfully managed job stress and limited social support. Research has explored the effects of healthcare provider burnout on patient care. In 2019, a systematic review found that nurse and physician burnout were associated with compromised patient safety, including higher rates of medical errors (Tawfit et al., 2019). Addition to patient safety, burnout may jeopardize the rapport between nurses and their patients. Patients report lower satisfaction and are less likely to recommend their hospital when cared for in settings where there are higher numbers of burned-out nurses (Tawfit., 2019; & Carthon et al., 2020). The problem calls for comprehensive exploration and analysis to pinpoint the factors contributing to nurse burnout. Previous research has underscored the importance of addressing nurse burnout and recognizing its potential impact on patient outcomes.

Several studies have provided substantial evidence supporting the assertion that nurse burnout is a prevalent concern within the U.S. healthcare sector. These studies, Lake et al. (2019); Tawfik et al. (2019); Lee & Chiyoung (2023); Kakemam et al. (2021); and Schlak et al. (2021) have consistently shown that a significant proportion of nurses, estimated to be between 35% and 45% of the workforce, experience burnout. Moreover, the concept of burnout is intrinsically linked to the work environment, as emphasized by the World Health Organization. The scholarly literature points to a range of factors that contribute to nurse burnout, including excessive workload; lack of staffing; role conflict; low autonomy; time pressure; interpersonal conflict between patients, guardians, and medical staff; and absence of leadership support (Dall'Ora et al., 2020). The globally pooled prevalence of nurse burnout is 11.2% (Woo et al., 2020). However, in other studies classifying burnout symptoms, nurse burnout was as high as 40.0% (Pradas-Hernández et al, 2018). Moreover, nurse burnout in the post-COVID-19 pandemic era has worsened. In a recent study, nurse burnout was as high as 68.0% (Smith et al., 2021). Therefore, mitigating nurse burnout can positively impact clinical outcomes, reducing mortality rates and improving the overall quality of patient care. Additionally, it can result in reduced healthcare costs and improved healthcare system efficiency. The study will build on prior research by examining the relationships between nurse burnout and clinical outcomes, including mortality, failure to rescue, and length of stay, while considering whether the nurse work environment could be leveraged to address nurse burnout and improve patient outcomes.

Purpose Statement

The primary purpose of this study is to comprehensively investigate the root causes of nurse burnout within the U.S. healthcare sector, particularly examining its link to diminished patient outcomes. The study aims to gain a deep understanding of the factors contributing to nurse burnout and its potential implications for the quality of patient care. Additionally, the study seeks to explore the complex connections between nurse burnout and clinical outcomes, such as mortality rates, failure to rescue incidents, and hospitalization durations. The ultimate objective is to assess the feasibility of implementing interventions within the nurse work environment to effectively address nurse burnout and subsequently enhance patient outcomes.

The study will involve the active participation of 350 registered nurses currently employed in five hospitals located within the state of Pennsylvania. These registered nurses will actively engage in semi-structured interviews as a fundamental component of the research. The research will be exclusively conducted within the geographical boundaries of the state of Pennsylvania, focusing on healthcare facilities and nursing professionals operating within this specific region. This localized approach ensures a tailored examination of nurse burnout within the context of Pennsylvania's distinct healthcare system.

To achieve the study's objectives, a phenomenological qualitative research approach will be employed, primarily relying on semi-structured interviews with registered nurses. This method will facilitate an in-depth exploration and analysis of nurses' experiences and perspectives concerning burnout and its potential influence on patient outcomes. Advanced qualitative data analysis techniques will be applied to extract meaningful insights from the interviews, enabling a comprehensive understanding of the research questions.

Research Question

1. What are the primary factors contributing to nurse burnout within the U.S. healthcare sector?

2. How do nurse work environment and organizational factors impact the development of burnout among nursing professionals?

3. What is the prevalence of nurse burnout within the state of Pennsylvania and how does it compare to national rates?

4. In what ways does nurse burnout affect the quality and safety of patient care?

5. How do patient outcomes, such as mortality rates and length of stay, vary in healthcare facilities with high levels of nurse burnout compared to those with low levels?

6. What interventions have been successful in reducing nurse burnout and improving patient outcomes in other healthcare systems?

7. What strategies can be implemented within the nursing work environment to effectively address nurse burnout and improve patient outcomes?