Evidence-Based Proposal- Final

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Abstract

It is a common attribute that nurses work hard and that they have a lot on their plate, although the unknown attribute relates to the assessment of the effects of all this hard work and stress that the nurses undergo. Being stressed as well as exhausted has turned out to be such a typical attributes that different nurses and stakeholders in the industry strive to know of the long term effects. The essay encompasses an assessment of questionnaires, surveys, and studies that that tough on the issue of nurse burnout and the consequent stress. Stress in the workplace is not only responsible for exhaustion and burnout but also can make them perform at lower rates on their assigned tasks which affect patient care. It is additionally evident that stress impacts sleep habits, impairs driving, and consequently hurts employees’ psychological and mental states. The proposal implements an assessment of the issues that affect the stress and burnout in nurses, the methods of investigating the stressors. It will additionally encompass the strategies that will be employed in evaluating the data collection strategies and the means that will be employed in disseminating the findings to the stakeholders.

Ayala, Elizabeth., Carnero, Andres M.(2013) Determinants of Burnout in Acute and Critical Care Military Nursing Personnel: A Cross-Sectional Study from Peru. PLOS One. 8. 1-7.

The study completed by Elizabeth Ayala along with Andres M Carnero was carried out in a large military hospital in Lima Peru, focusing on the acute as well as the critical care departments. Their desire was to assess how common burnout was among the 93 nursing professionals that were considered and if they were more impacted by the socio-demographic attributes or by the job-related factors. The study was premeditated by the higher the emotional tiredness scores Furthermore, the lower the personal accomplishment scores, the elevated the degree of burnout. Their study led to the termination that the nursing personnel in the Peruvian hospital ought to center their pre-emptive measures on younger and less practiced staff along with the younger, have children, single, or work in the most delicate critical care areas.

Carter, David (2014). Nursing Care Left Undone in European Hospitals. American Journal of       Nursing. 114.1

David Carter, a representative of the AJN, drafts this article concerning assured attributes of nursing being abandoned and left undone. It is not essentially the nurses’ mistake, but as a result of the additional responsibilities they have to accomplish each day with each patient and that certain tasks are getting ignored. The study, Nurse, found that the tasks that are ignored the most are comforting along with talking to the patient. 53% indicated that these psychosocial actions were getting the lowest priority.

Drach- Zachary, Anat., Marzuq, Nabil (2012).The weekend matters: exploring when and how        nurses best to recover from work stress. Journal of Advanced Nursing. 69. 578-589

The endeavor of Anat Drach-Zahavy and Nabil Marzuq was to assess how nurses’ best recuperate when excessively exhausted, whether it is days off midweek or the weekend. They additionally wanted to know the activities were best used in promoting relaxation. The Days off were found to be important for nurses as it not only aids in recovering their mental health but also their physical health as well.

Duffin, Christian. (2009). We need more nurses, Specialists agree. Nursing Standard. 30. 2

The survey was administered in the UK where nurse professionals were asked specifically survey questions furthermore report how they feel about their job, and were consequently analyzed by Christian Duffin. When asked why they like their job or why they had the desire to be a Nurse their responses were that “I at all times wanted to become a nurse” or “I desired the feeling that I made a difference” including “I desired to put a smile on the face of a child’s.” Based on the survey outcomes they are not simple things to come by as it is difficult to feel successful in your job when you are regularly stressed out from your surroundings. Almost 80% reported their supreme pressure was understaffing, as well as impractical targets along with the lack of resource.

Fenwick, Rob. (2013) Nurses cannot cope with staff shortages and overcrowding. Emergency       Nurse. 21.1

The report by RCN reveals that they have been encountered numerous nurse complaints concerning shortages along with overcrowding. They have way too numerous people to take care of, for the overall staff that they have on duty. The attribute is making things to get ignored furthermore deserted, making it, so people have got to carry out duties that are out of their job descriptions. If nursing workforce fails to carry out that they are not trained or sanctioned to carry out, it places not only their job in jeopardy but also the safety of the patients which in turn might generate an even superior predicament for the healthcare facility. Their reports indicate that that as the result of overcrowded along with being short staffed they are compelled to turn people away moreover send them to alternative facilities.

Galbraith, Nail D., Brown, Katherine E. (2011) Assessing intervention effectiveness for reducing    stress in student nurses: quantitative systematic review. Journal of Advanced Nursing 67.     709–721.

Niall and Katherine wanted to discover the categories of interventions that are efficient for reducing stress among the student nurses and additionally desired to offer advice to the prospect student nurses. Even as students are schooling, they frequently face sickness, attrition as well as absence, all caused by the degrees of stress they acquire. There is an enormous deficiency of nurses worldwide, but there is also a huge withdraw rate in nursing school as well, which makes it is significant that while in school they find out how to deal furthermore manage stress early on. It was established that in the majority cases, stress intercessions were not flourishing and that the successful attribute though was every individual’s plan. It was established helpful if they all possessed their means of dealing with stress, whether it is personal or organizational.

Garcia, Guadalup Manazano., Calvo, Juan Carlos Ayala. (2011) International Nursing       Review.Emotional exhaustion of nursing staff: influence of emotional annoyance and   resilience.60.101-107.

Guadalupe and Juan Carlos utilized the paper in studying the emotional tiredness levels in nurses furthermore how they are predisposed by the emotional irritation and resilience. Emotional overtiredness has always been a huge issue in a nurse’s job moreover used to communicate it to sarcasm also how it impacts professional competence. The survey was disseminated to nurses from five dissimilar hospitals in the north of Spain, other than the average reply rate was just 40% consequently results are logically a little skewed. Out of the 200 surveys fulfilled, there was a noteworthy relationship between emotional irritation and emotional overtiredness whereas toughness seemed to protect against emotional overtiredness.

Kendall- Raynor, Petra.(2009). NHS staff survey shows nurses feel overworked and            understaffed. Nursing Standard. 23. 1

Petra Kendall-Raynor addressed the survey done by nurses as well as midwives working in the NHS in England.  Of the 45,000 nurses moreover midwives who responded to the study, they reported that they sense their confidence has inadequate staff numbers places additional stress on them in addition to making them feel they cannot implement their jobs properly. The attribute causes a domino effect as they now are understaffed moreover having to work more hours. Not only do the nursing professionals work additional hours for every shift but reported to be working at least five additional unpaid hours per week. The implication of the situation is that the nurses, as well as midwives, feel as if they are not paid enough for not just doing their job but are also doing others work.

Kennedy, Maureen Shawn. (2014). The New Criterion: The Nurse as Family Doctor. American    Journal Of Nursing. 114. 1

Author Maureen, a registered nurse, explains the augmentation of the Nurse Practitioners turning out to be the primary care provider. The increase is as a result of a lack of physicians although it has affected nursing professionals in a positive light. Their responsibilities along with job duties have enlarged, but they are not just allowed to be considered as “primary care” but also allowed to fill moreover give out prescriptions. The AANP implemented a national study enquiring whether people had or have known someone treated by an NP and how at ease they feel with it, with both coming back with optimistic results. There have been various negatives attributes from this as the added responsibilities have added on stress along with over working. Registered nurses are required to work more hours than they do and by the end of 2015, the echelon of school to become a Nursing professional will change from a Masters to a Doctoral Degree.

Kowalski, Christopher., Ommen, Oliver., Driller, Elke., Ernstmann, Nicole., Wirtz, Markus A.,     Kohler, Thorsten., Pfaff, Holger. (2010) Burnout in nurses- the relationship between    social capital in hospitals and emotional exhaustion. Journal of Clinical Nursing. 19.   1654-1663.

Christoph, Oliver, Elke, Nicole, Markus, Thorsten, and Holger submitted a questionnaire to 1325 nurses from four diverse hospitals in West Germany in the year 2002. They began the study as it was said that 15-45% of nurses in Western Countries were suffering from burnout along with emotional exhaustion. If it were possible to prevent the burnout, the nurses would lessen not only their medical errors but also reduce the mounting turnover rates of nurses. Their survey established that workload is certainly related to burnout in nurses since it keeps escalating. Their studies contributed to the conclusions that if workload would be reduced and decision autonomy is increased then, emotional overtiredness could be avoided and thus prevent nurses from burning out of their job.

Larnjeira, Carlos. (2011). The effects of perceived stress and ways of coping in a sample of Portuguese health workers. Journal of Clinical Nursing. 21. 1755–1762.

Carlos reports that it is an ordinarily known detail that the field of nursing is recognized for staff shortages, overworking, furthermore stress. Relying on this universal knowledge the study was done to assess the impacts of stress along with different coping strategies. The study involved 3 Portuguese hospitals with 102 nurses. 52.2% of the nurses indicated that numerous different factors caused the high-stress levels. The first fact was on the patient death along with dying which was reported by 32.8%; the second is emergency situations that were reported by 22.8%, while the last with 18% was the low supportive associations in the workplace. The most regular answers about the coping strategies were self-controlling, playful problem solving plus organization, along with social shore up from not only co-worker but outer friends and family as well. The survey accomplished that stress can be coped with if there is have appropriate coping strategies. The coping strategies can augment not only their job performance but also their quality of life.

McIntosh, B, Sheppy, B. (2013).Effects of Stress on Nursing integrity. Nursing Standard. 27. 35    39

Mcintosh and Sheppy report centers on how stress has impacted the integrity of nursing staff as well as how it has distorted their patient care. It has been conceded that there is a connection between stresses with patient care in a pessimistic manner. The common assertion is that integrity of nursing employees has diminished making them more vulnerable not only to stress but overtiredness and anxiety thus probably affecting their deliverance of individual care. The augmented burden has created a desire to design coping strategies to ensure that personal care of patients does not carry on being neglected. It is thus evident that reducing stress levels can generate superior quality care. Stress can be lessened via addressing the issues of turnover rates, staff shortages, designing clear treatment plans, furthermore promoting coping strategies.

Nelson, Roxanne. (2014),.Can A Nurse Be Worked to Death? American Journal of Nursing.          114.2

Roxanne from The AJN reports on the precise issue concerning stress along with exhaustion in the Hospital setting. A registered nurse from Ohio, Elizabeth Jasper, was requested to work a 12-hour overnight shift owing to a scarcity in staff that the administrators knew. Going home after that shift Jasper was caught up in a car crash where she was fatally injured. Thus, the article addresses the issue of who is at fault, the hospital or Elizabeth? In the year 2010, the American Automobile Association anticipated that one in every six deadly accidents was as a result of a sleep-deprived driver. In the year 2007, the journal Sleep established that two-thirds of nurses indicated at least a single episode of sleepy driving in a four-week interlude.

Teo, Stephen TT., Yeung, Melissa., Chang, Esther. (2011) Organizational stressors were   moreover nursing job outcomes in Australian public and non-profit healthcare       organizations. Journal of Clinical Nursing. 21. 1443–1452

Stephen, Melissa and Esther were a team of the self-completion online questionnaire that had been sent to haphazardly selected nurses working in nurse related occupations in public as well as non-profit healthcare organizations, with 251 questionnaires being collected. Their desire was to assess how the administrative stressors impacted the nursing work result. The administrative stressors included things as resource scarcity or pay that is not what they would like it to be in comparison to the others doing similar jobs. The results indicate that the resource stressors were connected to job dissatisfaction whereas time stressors were more connected to the psychological strain. The work associated social shore up methods was indicated to aid in the alleviation of some of the negative effect as well as augment not only job pleasure but psychological health.

Toh, Shir Gi., Ang, Emily., Devi, M Kamala. (2012) A systematic review of the relationship           between the Nursing shortage and job satisfaction, stress and burnout levels among        Nurses in Oncology/Haematology settings. Journal of Evidence- Based Healthcare. 10. 126-141.

Shir Gi, Emily, and Kamala conducted a correlational study to assess how employee shortages along with job insufficiencies impacted the nurses’ degrees of stress, how they considered their job, along with how burnout they were. The studies exposed an optimistic association between registered nurses in the oncology units furthermore shortages in employees. Dissimilar demographics along with dissimilar work surroundings implicated the dissimilar stress levels along with burnout on the job, but it was an established that nurses with. Full time, more experience and superior qualifications were more likely to point staffing insufficiency to their levels of stress, therefore, escalating their levels of burnout contrasted to the newer nurses.

Developing an Implementation Plan

Obtaining necessary approval(s) and securing support from leadership and staff

Health care organizations are critical research environments that important in advancing evidence-based practice. A research project encourages the researcher to find answers to questions of importance to clinical practice. When undertaking such activities, it is important to obtain approval from key stakeholders. The approval can be obtained before approaching participants or before data collection process.  There are different ways by which both formal and informal approvals may be obtained. Formal approval will be obtained from Institutional Review Board. This can be carried out by filling out a project organizational feasibility form or a nursing research form. The forms are necessary for obtaining administrative approval for staff research. Signatures could also be obtained from Clinical operation director, nurse manager, DUHS chief nursing officer, Nursing research scientist or Chief nursing officer.

It will also be necessary to obtain support and participation of peers and leadership. The participation and support granted by leadership will be invaluable to the success of the study. Obtaining Leadership support will enhance buy-in and enthusiasm and serve to speed up the completion of the project. The first step to securing support from peers and leadership will involve the identification of key stakeholders. The key stakeholders include individuals who will be directly involved or affected by the study. Those directly involved include members of the organization who form part of the population from which data can be obtained from for the purpose of the study. Such may include staffing pool or patient population. Leadership forms part of the key stakeholder group as they have vested interest in the results of the study. The second step will involve getting feedback from the stakeholders early in the process through a commitment to participate and leadership buy-in. The level of commitment can vary among stakeholders (Weinberg & Creed).

Current problem, issue, or deficit requiring a change

Quality in healthcare is influenced by numerous factors. Factors of the patient, the provider of healthcare and factors linked to the healthcare organization and the broader health care system affect healthcare service quality. A critical factor in quality is healthcare staff.  With the current changes in policy, health care workers face mounting stress. For example, the Affordable Care Act has resulted in significant changes in healthcare organizations.  These changes have overburdened health professionals, resulting in increased burnout, dissatisfaction and the loss of care providers. While are expected to access services through Affordable Care arrangement, there has not been an increase in sizable workforce required to meet the heightened demand.

The health care staff is, therefore, facing a critical shortfall. These among other factors have increased burnout and stress among healthcare providers. Stress has a negative impact on the quality of healthcare in the fragile system.  Work stress remains important concerns in nursing affecting both staff and organizations. Regardless of how stress is perceived, it yields physiologic reactions that may, in the end, contribute to low quality in services and illness to the affected individual. It may contribute to absenteeism and turnover both of which impact the quality of care (Isikhan et al., 2004).

Detailed explanation of proposed solution

The most effective solution to reduce work stress among healthcare workforce includes organization strategies directed towards healthcare workforce. Healthcare staffs seem to be overexposed numerous psychosocial stressors including Long work hours, Lack of control,  Shift work, Insufficient resources, the Inadequate structure of communication flow, Interpersonal conflicts, Poor reward systems and other healthcare settings. Organizations can develop unique ways to reduce stress while reducing poor patient outcomes. Human resource strategies include optimal work scheduling, sufficient rewards, work control, adequate staffing, effective leadership and provision of advancement opportunities.  Healthcare organizations can keep staff energized and encourage staff them to take necessary breaks. Such programs can be implemented at low costs. Essentially, organizations can create environments that do not promote burnout or stress (Poissonnet & Véron, 2000).

Rationale for selecting proposed solution

Currently, a system overload is inevitable. In fact, policy changes may increase workloads. Such factors may not be within healthcare organization’s control. On the other hand, increased stress may further destabilize the health care system.  Solutions that stem out of the organization are the most significant to the current problem in the short run. In the long run, interventions that stem out from policies may be required to solve the problem. The concept of stress is highly relevant to the health care workforce in general and organizations. Currently, the American health care infrastructure is experiencing workforce shortages and is not adequately equipped to effectively or efficiently meet such a vast influx of patients.

Providing training to new health professionals may take a considerable amount of time. Without more individuals joining the healthcare organizations from institutions to share in roles and responsibilities, among existing staff, the system will be characterized by new frustrations with care delivery including longer wait times, shortened time with providers, greater difficulty having access to providers,  increased costs, and a general system overload. This will increase the exposure of healthcare professionals a myriad of stressors in their work. Thus, the most appropriate solution involves designing working conditions and influencing job characteristics that affect how tasks are designed (Shapiro et al., 2005).

Review of Literature

The problem of stress has been assessed in nursing by various researchers. Some of the commonly identified causes of stress include work design, job characteristics, and elements of patient care, responsibility, decision making and change. Healthcare staffs’ role has long been viewed to be stress-filled based upon human suffering, physical labor, staffing, work hours and interpersonal relationships that are primary to the work staff do. Despite the relevance, the effects of stress on quality care, patient outcomes, and patient safety are not well defined by evidence. However, the link has been explored in various investigations only a few suggestions have been made on how to alleviate the problem. Compassion fatigue and Moral distress have been identified as some of the consequences of nursing stress. The two factors have received exceptional attention from researchers in recent times.  Stress is often largely attributed to shift-work, emotional demands, interpersonal relationships, physical labor, suffering and work hours and other pressures that are primary work (Ruotsalainen et al., 2008).

Other factors that have increased stress include increasing workload, budget cuts, the increasing utilization of sophisticated innovations and constant organizational changes. Studies have firmly identified that increasing exposure to stressors generates sizeable job stress, resulting in a range of problematic long and short-term results. Stress has also been associated with a decrease in job satisfaction, absenteeism, turnover and physical complaints. Other studies have documented that increased levels of stress add to feelings of self-doubt, inadequacy, irritability, lower self-esteem, and somatic disturbance. Another study shows that nurses tend to have disproportionately higher rates of psychiatric outpatient consultation, mortality, general illness, psychiatric admissions and stress-related diseases.  Research findings show that multiple pressures related to healthcare setting and nursing responsibilities translate into considerable stress levels among healthcare professionals. Findings also show that nurses consistently report the significantly high levels of stress among all healthcare staff. Management styles particularly the relationships between managers and healthcare staff has been found to be an important factor examining stress. They also identify stress as one of their top concerns. Unfortunately, only a few studies have been conducted on organizational interventions (Tennant, 2001).

Description of implementation logistics

Organizational as well as Person-directed interventions can be used in the process of reducing stress. Any changes need to be integrated into organizational structure, workflow and culture.   Leadership and staff have responsibilities to ensure that the changes are successfully implemented.  For example, work scheduling requires the involvement of all affected staff by managers. The involvement encourages feedback and staff commitment to the program. The implementation of interrupted or shorter work schedules would reduce stress levels. While organizational interventions are considered effective, it would be great if leaders establish and implement measures that have a real tangible stress-reducing effect. The programs must also be incorporated into organization’s culture. The integration into organization culture encourages the long-term commitment to the implementation of the program. Incorporation into organization culture is important as healthcare organizations are involved in taking care of other peoples’ lives.  Thus, human errors or mistakes that may result from stressors may be expensive and sometimes irreversible. The healthcare organization’s leadership and staff will be responsible for initiating the change overseeing the implementation process.

Resources required for implementation

There are different resources that will be required for implementation. The first critical resource involves funds necessary to conduct research activities. Funds will be used to ensure that assessment tools reach participants and the printing resources necessary in the collection of data. Surveys will be used for the research work. Questionnaires will be used as the assessment tools during the survey process.  The research study will involve the compilation of data from individuals.  Given that ethnographic thoughts will be necessary for the study, the researcher will be resolved to get individual’s account of reality, as compared to taking up one general version of reality.

Thus, the survey approach will be the most appropriate for the study. Questionnaires will be utilized as the instrument for data collection.  The questionnaires will be open-ended questions to allow the researcher to discover the answers of the respondents. The researcher will first develop a letter of beginning created for this study and send it through the mail to all of the study participants. The requirements of the study will be discussed in advance with the respondents. The questions will be categorized thematically in order to ease the process of analysis. The questionnaires will be distributed online in the form of online surveys. The approach will allow the researcher to reach a large number of participants. It will also allow participants more freedom to express their views in their own terms. With the kind of data collection instrument, it will be more likely to obtain as much related data as possible due to the in detail answers likely to be gathered from the study participants. The questionnaires will also produce rich, dependable and proportional qualitative data. The data collected will then be investigated in a range of ways to create findings.

Developing an Evaluation Plan and Disseminating Evidence

Introduction

There has never been a simple description of the state of nursing workforce stress and burnout in the present as well as the future state. The discussions that surround the assessment of the issue are complex and interrelated, with the most common situation being that there has never been a unitary solution to the problem. The application of a systems review of the issue has been able to offer the best comprehension as well as depth in the assessment of the relationships that exist between the diverse variables.

Thus, the assessment of the solution is as a result of the growing nurse stress and burnout that is posing a huge threat to the ability of hospitals, long-term care facilities as well as others in the provision of timely access to the quality care. The nurse staffing stress and burnout is the chief contributor to the growing reduction in the number of staffed patients’ beds that are available for services, increase in the cost of accessing care as well as the growing concern on the quality of care. The proposed solution, in this case, involves the assessment of the endemic problem of the nursing stress and burnout that has been resulting in the continued delivery of poor healthcare services to the patient (Huston, 2013). The solution seeks to address the causes of the nurse stress and burnout in a bid to reduce the endemic effects of the stress and burnout, promote the accommodativeness of the workplace environment and thus promote the quality of healthcare services that they were nursing personnel delivers to their clients.

The methods that are to be applied in the assessment of the effectiveness of the proposed solution are going encompass:

  1. Conducting an assessment of the stakeholder and staff attitudes relating to the workplace attributes that contribute to their contentment before as well as after implementing the solution. The assessment, in this case, will involve the implementation of a survey via the use of Likert scale that will be meant to collect the attitudes that the nursing stakeholders as well as the nurse staff. The survey will assist in mapping the attitudes on the work environment that other than contributing to the turnover of the personnel, make it impossible for these work environments to attract new hires (Garbarino & Holland, 2009).
  2. The assessment of the solution is additionally going to encompass the assessment of the staff recruitment rates before and after implementing the solution. The attribute is going to involve the comparing the HR records to see the changes that have occurred once the solution has been implemented on the ability of the facilities to attract new staff to cover the stress and burnout they have been encountering (Link & Vonortas, 2013). The assessment of the rates of recruitment before as well as after implementing the solution will be a vital evaluation tool to inform us on whether the solution is effective.
  3. The fact that the stress and burnout of the nurses has had a direct adverse impact on the quality of healthcare patients’ access will thus involve implementing an assessment of the patients’ admission and discharge surveys before as well as after implementing the change in the facilities. The inadequacy of the nurses that the healthcare facilities have has always implied that the facilities have had inadequate staff to cater for their patients who have been contributing to the deplorable state of health care (Huston, 2013). Thus in conducting admission as well as discharge surveys is going to present a clear picture on whether the solution aimed at solving the stress and burnout has an impact on the quality of care delivery.

The Variables

The variables that will be critical in the evaluation of the solution that is aimed at resolving the challenge of nursing stress and burnout are going to encompass:

  1. The perceptions as well as attitudes of the stakeholders involved in the delivery of nursing education as well as the facility personnel. The assessment of the perceptions and attitudes of the personnel involved in the delivery of the nursing education will offer vital information as to why the nursing profession is failing to attract enough candidates to ameliorate the challenge of stress and burnout. The assessment of the views and attitudes of the nursing staff, on the other hand, will offer vital views on why their counterparts are quitting and pursuing other professions.
  2. The views and attitudes of the patients on the quality of care they are receiving from the facilities. One of the reasons that there is a lot of clamor surrounding the issue of resolving the problem of the nursing stress and burnout is in a bid to improve the quality of care delivery to the patients. Thus, the assessment of the patient attitudes, as well as perception before as well as after admission, will inform us on whether the solution designed is meeting the objective of enhancing the quality of care delivery.
  3. The additional variable that will be employed in evaluating the solution will be on the nursing retention strategies an organization employs to ensure they keep their nurses. It follows that the retention of nursing personnel is dependent on how they value or does not value their staff. One of the main causes of the nursing stress and burnout relates to the high nurse personnel turnover which is directly associated with how an organization deals with its employees.
  4. The last variable will involve conducting an assessment of the available strategies that are being employed by organizations to aid in keeping the aged workforce active as they try to deal with the stress and burnout problem.

In educating the project participants, the project will employ such tools as power point presentations that will describe the current situation, the solutions and what the stakeholders should do. Implementation of road project shows will additionally be a tool to be employed as it allows accessing many participants easily, allowing to address the diverse stakeholders feedback on the spot. Project status meeting will further be employed to offer a regular update of the project, reviewing the issues that the stakeholders would need further clarification (Angel, 2012).

In the evaluation of the project outcomes, the diverse tools to employ will include surveys that will assist in assessing the views and attitudes of the stakeholders before and after the implementation of the solution to assess the progress. Focus groups will additionally be involved in assessing the attitudes of the staff following the launch of the solution. Interviews of the diverse stakeholders will further be a vital tool in the assessment of the project outcomes (Angel, 2012).

The rationale behind the dissemination of the project results will entail raising awareness of, educating the stakeholders, engaging the stakeholders, promoting my solution as well as ensuring that the solution is sustainable. In the disseminating of the project result to the key stakeholders, the strategies that will be employed encompass reports, the organization websites as well as journal articles that other than presenting the results will further help in transmitting information on the project. The additional methods that will be employed in disseminating the results to the key stakeholders will encompass conference presentations, telephone and video conferences as they offer a medium to involve these stakeholders who could be in different locations (Angel, 2012). The dissemination of the importance of project outcomes to the larger nursing community is going to encompass strategies as newsletters, press releases as well as flyers as they offer an excellent platform to reach a huge number of stakeholders fast. Web sites and emails also present a platform to reach the nursing community ad it allows the teams to communicate in diverse modes as video and audio files between the members (Miner & Mine, 2013).

References

Angel, A., (2012). Collaborative and Distributed E-Research: Innovations in Technologies. IGI Global.

Ayala, Elizabeth., Carnero, Andres M.(2013) Determinants of Burnout in Acute and Critical Care Military Nursing Personnel: A Cross-Sectional Study from Peru. PLOS One. 8. 1-7.

Fenwick, Rob. (2013) Nurses cannot cope with staff shortages and overcrowding. Emergency       Nurse. 21.1

Garbarino, S., & Holland, J. (2009). Quantitative and Qualitative Methods in Impact Evaluation and Measuring Results. University of Birmingham Press.

Huston, C., (2013). Professional Issues in Nursing: Challenges and Opportunities. Lippincott Williams & Wilkins.

Isikhan, V., Danis, M. Z. & Comez, T. (2004). Job stress and coping strategies in health care professionals. European Journal of Oncology Nursing, 8(3), 234-244.

McIntosh, B, Sheppy, B. (2013). Effects of Stress on Nursing integrity. Nursing Standard. 27. 35   39

Poissonnet, C. M., & Véron, M. (2000). Health effects of work schedule in healthcare professions. Journal of clinical nursing, 9(1), 13-23.

Ruotsalainen, J., Marine, A., Serra, C., & Verbeek, J. (2008). Interventions for reducing occupational stress in health care workers. Scandinavian journal of work, environment & health, 169-178.

Teo, Stephen TT., Yeung, Melissa., Chang, Esther. (2011) Organizational stressors were   moreover nursing job outcomes in Australian public and non-profit healthcare       organizations. Journal of Clinical Nursing. 21. 1443–1452

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