Research Critiques and PICOT Statement Final Draft (Research Paper Sample)

Research Critiques and PICOT Statement Final Draft
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Research Critiques and PICOT Statement Final Draft
Over the years, there has been an increase in burnout and stress-related cases among working nurses. Nurse burnout may be described as the physical, emotional, and mental exhaustion experienced by professional nurses as they discharge their health care duties. Some causes of burnout include working long hours, lack of sleep, poor working environments, the burden of quick decision-making, giving patients physical and emotional support, and caring for patients who may experience poor outcomes. Amongst health care workers, nurses are most prone to burnout symptoms, and this problem can have severe consequences for patients receiving care and services from them. Burnout could also lead to hopelessness, increased states of stress, cynicism, and depression. Another major contributing factor to burnout, which ultimately leads to increased turnover, is the growing demand for nurses in the US. Understaffed hospitals and overworked nurses often lead to burnout, and later, a high turnover as these nurses search for more environment-friendly health care facilities that attend to their needs. Various challenges characterize every nursing specialty, and some of these specialties may be more stressful than others. Some examples would be the Emergency Department and the Intensive Care Unit. Practitioners have undoubtedly explored the root causes of this practice problem and come up with different practical solutions. 
The PICOT question: Among emergency room nurses (P), will the implementation of improved working conditions (I), compared to current practice (C), reduce nursing burnout and turnover (O) when evaluated monthly over three months (T)?
Background
The quantitative studies by Elder et al. (2015) and Liu et al. (2015) explore the issue of inefficiency in the Emergency Department and how such issues enhance burnout among nurses and lead to high turnover. There is also a lack of information on the practicality of advanced practice nursing roles, physician-assisted triage, and medical assessment units. Addressing such issues is beneficial in ensuring improved clinical outcomes in health care settings. Conversely, the qualitative studies assess triage in health care settings and the adverse effects arising if it is not properly implemented. As Wolf (2017) explores the comprehension of triage among nurses, Mudallal Othman and Al Hassan (2017) analyze nurses' perceptions of burnout and how practical solutions can enhance safety in the Emergency Department.
Research question: Does improved working conditions in health care settings enhance efficiency and productivity while reducing burnout and turnover among nurses through associated activities?
The Articles' Support to the Nurse Practice Issue
The authors provide relative information that is useful in addressing the PICOT question. The information from both quantitative and qualitative studies can improve the working conditions in the health care specialties that accommodate nurses. Concerning qualitative analysis, the research established that one major solution was to reduce the working shifts among nurses. This option would also require training other nurses and adding to the workforce. Adding nurses would help reduce stress and burnout levels as they would not be overworked. Such would also enhance their productivity and level of safety when dealing with patients who need utmost care. Furthermore, the findings would also enable relevant stakeholders to develop practical solutions and policies that address the shortage in staffing, especially in the emergency department. 
Conversely, the quantitative analysis recommends adopting a High-Performance Computing simulator that would assist in the smooth integration of advanced practice nursing roles, physician-assisted triage, and medical assessment units to improve work performance and reduce nurse burnout and improve clinical outcomes in the emergency department. Both articles address in depth the issue of burnout among nurses working in the emergency department, and identifying such issues would provide the building blocks of a framework that practitioners can develop to enhance productivity. The proposed intervention from the PICOT question, which is to improve the working conditions, is in sync with the recommendations provided by the articles on how to reduce burnout and turnover cases.
Method of Study
Elder et al. (2015) uses the concept of experimental design to address the nurse practice issue in question. The independent and dependent variables, in this case, are used to formulate a tentative statement, and evidence is obtained from research carried out by the authors. Unlike Elder et al. (2015), Liu et al. (2015) offer a comprehensive analysis of what different authors have researched and endorses the practical solutions. Assessment of different literature works is helpful as it determines which frameworks have been tested and are efficient, compared to other solutions provided by scholars and practitioners working for the same cause, to reduce the level of burnouts among nurses and reduce turnover.
Relying on a systematic analysis of sources is, however, coupled with challenges as one cannot assess the degree of objectivity since there is no incorporated data or formulas that would affirm the study's results. Wolf et al. (2017), Mudallal et al. (2017), and Elder et al. (2015) employ experimental design to conduct their research and come up with solutions. Thematic structuring used in the qualitative analysis helped to identify the risks, causes, and preventive measures that directly and indirectly affect the practice issue of burnout and turnover, and provide an array of ideas that would structure the concept of the intervention measure, which is to improve the working conditions of the nurses. The thematic analysis also helped generate different themes that can help in further analysis concerning the practice issue.
Results of Study
Wolf et al. (2017) research the issue of triage and how best the nurses understand it. The authors assert that experienced nurses are more likely to make accurate triage decisions based on patient acuity and other factors than nurses with minimal experience. Other barriers facilitate this situation, such as inadequate staff, inadequate modes of training, language barrier, inadequate resources, and inappropriate use of technology. Such factors ultimately encourage health care facilities to rely more on experienced nurses, and this reliance often enhances burnout, as these nurses become overworked. Mudallal, Othman, and Al Hassan (2017) evaluate the impact of leader empowering behaviors, work conditions, and demographic conditions to establish how practitioners can address these factors to reduce burnout among nurses.
The authors concussively assert that a positive work environment promotes understanding among nurses and reduces turnover rates. This solution is supported by the cross-sectional, descriptive, and correlation study designs that can verify the objectivity of the results. Elder et al. (2015) apply high-performance computing to develop simulations that support the nurse practice intervention to improve working conditions. Their counterpart, Liu et al. (2015), addresses the importance of three strategies, namely medical assessment units, physician-assisted triage, advanced practice nursing roles, and their role in reducing nurse burnout in emergency departments. The successful integration of these three factors would enhance productivity among nurses and reduce the turnover rate.
Ethical Considerations
The American Nurses Association recommends a code of ethics and acceptable behavior for nurses under practice. According to Green and Johnson (2018), "The codes of ethics are used to guide professional nursing practice and role performance, including qualitative research. Nurse researchers are also guided by the Nuremberg Code, the Declaration of Helsinki, and the Universal Declaration of Human Rights in pursuit of ethical and safe nursing research." These sources provide validity to the nurse practice in ethical terms and encourage nurses to carry out their responsibilities in a manner consistent with offering quality services and the ethical obligations of the nursing profession. One ethical provision is to maintain confidentiality concerning private information. Confidentiality promotes the non-disclosure of sensitive information and respect for autonomy. The researchers have maintained this provision as they have provided general information related to the nurse practice issue in question.
Furthermore, they have maintained the privacy of the nurses by not disclosing their names or affiliation. However, the names of the health care facilities where the studies have been conducted are disclosed for objectivity purposes. Another ethical consideration, which the researchers have also taken into account, is obtaining informed consent. Informed consents are necessary to avoid a breach of privacy when accessing strategic information that can help the studies.
Outcomes Comparison
Regarding the PICOT question, it is proposed that improved work conditions will lead to a reduction in reported nursing burnout and a reduction in nursing turnover. The outcomes laid out are in sync with personal anticipated outcomes. Effective integration of advanced practice nursing roles, physician-assisted triage, and medical assessment units would help reduce burnout and turnover while improving patient and clinical outcomes in the e...