Evidence Based Practice in Nursing Unit 2 Week 2 PICO Question and Problem PDF

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PICO Question and Problem

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Evidence-Based Practice in Nursing Unit 2 Week 2 PICO Question and Problem Amari Wiley Herzing University Tera Riddick PhD, FNP-C, PMHNP-BC, CDE Evidence-Based Practice in Nursing

Chosen topic: “For novice nurses, does a nurse mentorship program increase nurse retention compared with no mentorship?” PICO Question: PICO Elements

Keywords

P= patient or population

novice nurses, retention turnover

I= intervention C= comparison

nurse mentorship program no mentorship program

O= outcome

increased nurse retention

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Previous research has established that up to 18% to 30% of new graduates will leave their current position for a different practice environment or the profession altogether in the first year and up to 37%–57% will leave in their second year of practice (Sandler, 2020).” In many health care professions, the retention of personnel is an issue. Nurse retention is one of the most common cases we hear about. For years ensuring countries had enough nurses to replace older nurses who would retire or look for career changes has been nearly impossible to achieve. After a year of facing a pandemic, local and worldwide health care providers including nurses have been pushed to their limits. Combating nurse retention issues is a problem faced around the world. “…rate across the world is considered high, ranging from 15 to 44% (Dewanto & Wardhani, 2018).” It is estimated that by 2022, the need for replacement and new nurses will be approximately 1.05 million (Perry et al., 2018). Within health care, nurses provide the most hands-on patient care compared to other professionals in the same field. Nurses are near-constantly dealing with numerous patients on a daily basis. A decrease in nurses would greatly affect patient outcomes. The role of nurses includes fall prevention, administering medication, and attending to wounds. High nurse turnover means that nursing staff around the world will face an increase in their workload and low staffing levels which would increase the number of patients each nurse would be tasked with caring for, each contributing to unhappiness in the workplace. Unhappiness in the workplace leads to problems. “When nurses experience dissatisfaction, they likely have fewer resources to invest in doing their work carefully, instead of experiencing exhaustion and aversion to patients. Higher nurse exhaustion is associated with increased patient falls and medication errors (Perry et al., 2018).” Studies have found that once a nurse reaches over the age of thirty, remain single, and have worked in a hospital setting for at least three years, the risk of nurse turnover increases (Dewanto & Wardhani, 2018). Additional reasons why nurses leave, “most common causes of new graduate nurses increasing “intent to leave” included interpersonal violence, workplace stress, feelings of incompetence and low confidence related to practice, unit workload and interdisciplinary relationships (Sandler, 2020).” Nursing Solutions noted that the level of turnover varied upon nursing-related positions along with the department in which they worked. Costs faced by health care facilities to replace and hire new nurses has both direct and indirect costs found by Duffield and colleagues. “Direct costs are defined as those that relate to recruitment, a temporary replacement, and hiring of a new employee. Indirect costs are those spent administering termination and separation, and those costs associated with orientation, training, and productivity of new employees (Duffield et al., 2014).” In the study conducted by Duffield and colleagues, they looked at costs and turnovers of nurses in the United States, Canada, Australia, and New Zealand. According to their research, direct costs ranged from 50% of the total turnover costs in Australia and Canada to 65.1% in the United States and 86% in New Zealand. Indirect costs, were higher in Australia and Canada (roughly 50%), followed by the US (34.9%) and New Zealand (14%) (Duffield et al., 2014).” In a study conducted by Nursing Solutions, “the average cost of turnover for a bedside RN ranges from $37,700

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to $58,400 resulting in the average hospital losing $5.2M – $8.1M. Each percent change in RN turnover will cost/save the average hospital an additional $373,200 (Nursing Solutions, Inc., 2016).” Until this issue is dealt with health care facilities will continue to deal with high nurse turnover rates and the corresponding costs of replacing and hiring new nurses. This issue not only affects the level of care patients receive but it also affects hospital budgets, staffing levels and increases the risk of burning the remaining nursing staff out. Unfortunately, more nurses and related positions are being lost faster than they can be filled despite new nurses graduating yearly. Despite having new graduates, most new nurses will leave within their first year as a nurse. “More than half of 56.4% of the exited employees had less than two years of service. Employees with “5 – 10 years” and those with “more than 10 years” of tenure experienced a greater level of organization commitment (Nursing Solutions, Inc., 2016).” High turnover rates are detrimental to health care systems around the world, not just in the United States, more steps need to be done to give new nurses the help and support they need to continue in their chosen profession including guides to better transition from nursing school and clinical practice to real-life unpredictable situations instead of simply being told “you learn as you go,” or that “real-life nursing is nothing like nursing school.” References Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC Nursing, 17(S2). https://doi.org/10.1186/s12912-018-0317-8 Duffield, C. M., Roche, M. A., Homer, C., Buchan, J., & Dimitrelis, S. (2014). A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing, 70(12), 2703–2712. https://doi.org/10.1111/jan.12483 Nursing Solutions, Inc. (2016). 2016 National Healthcare Retention & RN Staffing Report. https://avanthealthcare.com/pdf/NationalHealthcareRNRetentionReport2016.pdf Perry, S. J., Richter, J. P., & Beauvais, B. (2018). The Effects of Nursing Satisfaction and Turnover Cognitions on Patient Attitudes and Outcomes: A Three-Level Multisource Study. Health Services Research, 53(6), 4943–4969.

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https://doi.org/10.1111/1475-6773.12997 Sandler, M. (2020). Why are new graduate nurses leaving the profession in their first year of practice and how does this impact on ED nurse staffing? A rapid review of current literature and recommended reading. Canadian Journal of Emergency Nursing, 41(1), 23–24. https://doi.org/10.29173/cjen66...