Answer for NRS 465 Literature Evaluation Table Finalized PICOT Question: In nurses working in critical care settings (P), how does mindfulness and self-care practice (I) compared to normal practice (C) affect burnout prevention and reduction (O) within six months (T)?

Answer for NRS 465 Literature Evaluation Table

Finalized PICOT Question: In nurses working in critical care settings (P), how does mindfulness and self-care practice (I) compared to normal practice (C) affect burnout prevention and reduction (O) within six months (T)?

Literature Search Strategy Employed

Searching for literature for evidence-based practice (EBP) intervention to address a clinical issue is essential as it allows nursing students to get evidence from current studies. Consequently, I used the Nursing and Health Sciences Research Guide offered by the Grand Canyon University (GCU) library to access a variety of databases and resources. These database focus on research in the nursing field and other health sciences areas. The databases that I searched for the articles included PubMed which is a free search engine that allows one to access primarily the MEDLINE database of references and abstracts on nursing and other life sciences. The second database was CINAHL or the Cumulative Index to Nursing and Allied Health Literature which offers a rich source of peer-reviewed articles, research studies and other resources related to nursing and allied health. The keyword used included burnout in nursing, mindfulness, self-care, and positive effects. These key words also entailed integrating Boolean operators like AND/ OR to enhance the search results.

Criteria	Article 1	Article 2	Article 3	Article 4
APA Reference All peer reviewed journal articles should be current (published within the last 5 years) and closely relate to the PICOT question developed earlier in this course. Include the GCU permalink or working link used to access the article.	Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with Nurse burnout in the US. JAMA network open, 4(2), e2036469-e2036469. DOI:10.1001/jamanetworkopen.2020.36469	Othman, S. Y., Hassan, N. I., & Mohamed, A. M. (2023). Effectiveness of mindfulness-based interventions on burnout and self-compassion among critical care nurses caring for patients with COVID-19: a quasi-experimental study. BMC nursing, 22(1), 305. DOI: https://doi.org/10.1186/s12912-023-01466-8	Monroe, C., Loresto, F., Horton-Deutsch, S., Kleiner, C., Eron, K., Varney, R., & Grimm, S. (2021). The value of intentional self-care practices: The effects of mindfulness on improving job satisfaction, teamwork, and workplace environments. Archives of psychiatric nursing, 35(2), 189-194. DOI: 10.1016/j.apnu.2020.10.003	Lee, S. H., & Joo, M. H. (2023, June). The Moderating Effects of Self-Care on the Relationships between Perceived Stress, Job Burnout and Retention Intention in Clinical Nurses. Healthcare, 11(13): 1870.
Purpose/Aim of Study	The purpose of this study was to determine the prevalence of nurse burnout and related factors that place nurse at risk for burnout	The aim of this study was to determine effectiveness of mindfulness-based interventions on burnout, mindfulness, and self-compassion among critical care nurses (CCN) providing care for COVID-19 patients.	The aim of this study was to evaluate the effectiveness of intentional self-care practices on reducing burnout among nurses and workplace environment through measuring job satisfaction and teamwork among nurses.	The aim of this study was to determine the significance of self-care through identifying its effects as a moderating variable on the interactions between perceived stress, job burnout, and retention among clinical nurses.
Research questions (Qualitative)/Hypothesis (Quantitative)	What were the most recent US national estimates of nurse burnout and the associated factors that may put nurses at risk for burnout?	The research question was; What is the effects of MBIs on burnout, mindfulness, and self-compassion for nurses caring for COVID-19 patient? The hypothesis for the study is that critical care nurses (CCN) who engage in MBIs have reduced levels of burnout, higher levels of mindfulness and greater self-compassion compared to those who do not engage in these interventions.	The research question for the study was: Did implementation of Project7 in an inpatient acute care unit affect job enjoyment, teamwork, and fall rates. The researchers hypothesized that registered nurses (RN) staff on the inpatient care unit who implemented Project7 experienced better job satisfaction rates and teamwork than inpatient acute care units that did not implement the initiative. The second hypothesis was that fall rates would decline over time in the unit.	The hypotheses in this study were: i). Self-care has a moderating impact on the relationship between perceived stress and retention in clinical nurses ii). Self-care has a moderating effect on the intersection between job burnout and retention in clinical nurses.
Design Type of quantitative or type of qualitative study design	The design for the study was quantitative.	The study used quantitative approach or design.	The study used a qualitative design.	The study is quantitative
Setting Where did the study take place? What type of setting – inpatient, outpatient, etc.?	The study took place in the United States and involved nurses in a variety of clinical and practice settings.	The setting were three intensive care units in quarantine hospitals in Egypt.	The setting was an inpatient acute care unit.	The study occurred in two university hospitals and one general hospital all located in Seoul, South Korea.
Sample Number and characteristics of participants	The sample comprised 50, 273 nurses who responded to the national survey.	The sample comprised 30 nurses working in the selected setting.		The study sample was 174 clinical nurses at the selected hospitals.
Methods Interventions/Instruments	The authors used a cross-sectional survey method	The authors used a quasi-experimental prospective method and conducted pre-and-post-test assessments in both intervention and control groups.	Comparison between inpatient units using data from National Database of Nursing Quality Indicators (NDNQI) and Practice Environment Scale (PES)	The researchers uses a survey questionnaire that comprised several questions on perceived stress, burnout, retention intention, and self-care.
Analysis How were the data that were collected analyzed?	The analysis entailed using descriptive statistics to characterize the responses from nurses. The authors used means and standard deviation for continuous variables and for categorical variables, frequencies.	The authors analyzed collected data from the study using the statistical package for social sciences.	The authors analyzed mean scores and standard deviations on job satisfaction and teamwork using analysis of Variance (ANOVA). The software analyzed the different in mean scores on job satisfaction and teamwork between the implemented projects.	The authors used descriptive statistics to analyze the genera features of participants and t-test as well as analysis of variance for comparison. The researchers also used moderated multiple regression to determine the moderating effects of self-care on the interaction between perceived stress and retention intention
Outcomes/key findings of the study and implications for nursing practice (Summary of study results)	Findings suggest that burnout is a serious patient safety issue among nurses in the US who leave their jobs. The authors assert that many nurses considering leaving the profession site burnout as the primary reason	The outcomes show that MBI sessions are effective in lowering emotional exhaustion and depersonalization. They also increase degree of mindfulness and self-compassion among nurses in critical care settings.	The findings show that nurses in the acute care units who implemented Project7 had increased job satisfaction levels compared to units that did not implement it. Therefore, the project is a cost-effective self-care practice to reducing burnout among nurses.	The authors assert that self-care reduces burnout and job burnout increases the turnover as nurses leave. Therefore, self-care is essential for nurses in any setting.
Recommendations of the Researcher	The article recommends that health systems and stakeholders should focus on implementing known approaches or strategies to alleviate burnout. These include having sufficient nursing staff and reducing the number of hours per shift.	The researchers recommend integrating these interventions to reduce burnout and improve resilience among nurses in critical care units and other areas of care provision.	The authors recommend the use of this tool because it offers an effective and accessible mindfulness framework for managers and directors to enhance job satisfaction, teamwork, and reduce burnout to establish healthier work spaces for CCNs.	The researchers recommend having programs that educate nurses on the significance of self-care to improve their rates of retention in clinical settings. The authors also recommend more support infrastructure to reduce job burnout and improve self-care.
Explain how this article supports your proposed PICO(T) question and Capstone Change Project	The article is critical as it demonstrates that burnout is a serious nursing issue that requires intervention. The article supports the PICOT question by demonstrating that level of the problem and supports Capstone Change Project by providing sufficient evidence on the need for an intervention.	The article supports the PICOT as it shows that the suggested intervention is effective in reducing burnout. The article is essential for the Capstone Change Project as it demonstrates sufficient evidence for implementation of the EBP intervention.	The study supports the PICOT as it shows that the intervention is effective and based on evidence. The study and its outcomes are essential for the Capstone Change Project as they illustrate the critical evidence for implementing the interventions based on its benefits in the long-term.	The article is essential for the PICOT as it shows the effectiveness of self-care in reducing burnout and other negative effects. The study also supports the project by determining the significant role that self-care plays in improving job satisfaction and retention among nurses.

Criteria	Article 5	Article 6	Article 7	Article 8
APA Reference (include the GCU permalink or working link used to access the article)	Burner, L. R., & Spadaro, K. C. (2023). Self-care skills to prevent burnout: A pilot study embedding mindfulness in an undergraduate nursing course. Journal of holistic nursing, 41(3), 265-274. https://doi.org/10.1177/08980101221117367	Wei, H., Kifner, H., Dawes, M. E., Wei, T. L., & Boyd, J. M. (2020). Self-care strategies to combat burnout among pediatric critical care nurses and physicians. Critical care nurse, 40(2), 44-53. DOI: 10.4037/ccn2020621	Penque, S. (2020). Mindfulness to promote nurses’ well-being. Nursing management, 50(5), 38-44. DOI: 10.1097/01.NUMA.0000557621.42684.c4	Smith, S., (April 3, 2023) Impact of a Mobile Meditation Application Among Hospital-Based Acute Care Nurses. OJIN: the online journal of issues in nursing, 28(2). DOI: 10.3912/OJIN.Vol28No02PPT75
Purpose/Aim of Study	The purpose of the article was to explore the effects of mindfulness education and self-care skills training among undergraduate nursing students concerning stress and self-care.	The purpose of the article was to determine perceptions of self-care strategies to help professional nurses and physicians reduce and overcome burnout in pediatric critical care settings.	The purpose of the study was to examine the effects of mindfulness-based stress reduction (MBSR) on job-important factors that entail mindfulness, self-compassion, empathy and work satisfaction as well as job burnout.	The purpose of the study was to propose an intervention to enhance compassion satisfaction, compassion fatigue and mindfulness using the Headspace meditation application.
Research questions (Qualitative)/Hypothesis (Quantitative)	The hypothesis for the study was that many nursing students experience burnout during their academic program and this has negative effects in their success and patient care	What are the self-care strategies that professionals perceive for be helpful to combat burnout?	The hypothesis for the study was that mindfulness, self-compassion, empathy, serenity, work satisfaction will increase after implementing the MBSR intervention The second hypothesis was that job burnout will reduce following the MBSR intervention	The hypothesis was to improve compassion satisfaction, compassion fatigue, and mindfulness among nurses in different settings.
Design Type of quantitative or type of qualitative study design	Qualitative design	Qualitative design	Quantitative design as it entailed using a quasi-experimental, longitudinal and pre-and-post-test, correctional study.	The study used a quantitative approach based on online surveys for the participants.
Setting Where did the study take place? What type of setting – inpatient, outpatient, etc.?	The setting entailed having in-person mindfulness sessions to first-year nursing students.	The study occurred in a 20-bed pediatric intensive care unit and an 8-bed intermediate care unit in a children’s hospital in the U.S.	The setting entailed all patient care units.	The setting comprised various clinical and nursing practice areas.
Sample Number and characteristics of participants	The sample included 67 students enrolled in a nursing skills course.	The sample entailed nurses in the two settings.	The final sample for the study was 61 nurses who completed the MBSR program after others dropped out.	Sample consisted of 23 participants.
Methods Interventions/Instruments	The intervention or method was four in-person mindfulness educational session and four-week follow-up.	The researchers used information flyers and emails to introduce the study.	The intervention or instrument was a self-administered survey. The authors used six self-administered data collection tools to get information from the participating nurses.	The authors used Professional Quality of Life (ProQOL 5 and Mindfulness Attentive Scale (MAAS) surveys to collected pre-and-post-intervention data using Survey Monkey Online.
Analysis How were the data that were collected analyzed?	The researchers used descriptive statistics to measure the outcomes or results of the intervention.	The researchers used a qualitative descriptive model to analyze the collected data and determine themes or patterns.	The authors used descriptive analysis to summarize the nurse demographic data. They analyzed results using paired t-tests.	The authors used various tools to analyze the data leading to descriptive approach.
Outcomes/key findings of the study and implications for nursing practice (Summary of study results)	The results show that students who used mindfulness techniques improved their self-care by close to 10%. However, they did not sustain this results based on the follow ups. The authors concluded that mindfulness education improves self-care among nursing students.	The authors found six main self-care strategies to reduce burnout among nurses and physicians. For instance, performing emotional hygiene and recognizing one’s dynamic nature and contributions at work.	The findings show that job burnout reduced and nurses improved their psychological wellness based on certain factors like self-compassion, mindfulness, and serenity.	The findings show that meditation through Headspace application led to better outcomes. These include mindfulness and compassion satisfaction. Burnout also decreased as the results showed that compassion fatigue declined yet it is related to burnout syndrome.
Recommendations of the Researcher	The researcher recommend more studies to enhance the integration of mindfulness courses to attain the benefits that it offers, especially coping skills among nurses and nursing students.	The researchers recommend having self-care strategies at individual and institutional levels to promote health and wellbeing of healthcare professionals and lower burnout. The implication is that the professionals should also care for themselves to lower burnout rates.	The researchers recommend that nurse leaders in different settings should advocate mindfulness programs to assist their staff members redirect negative thoughts and reframe difficult circumstances. The article is emphatic that mindfulness is a critical tool for nurses to enhance their wellness and overcome burnout.	The article recommends the integration of these initiatives, especially the mobile applications, to reduce burnout among nurses in different settings.
Explain how this article supports your proposed PICO(T) question and Capstone Change Project	The article is essential as it illustrates the importance of mindfulness as an intervention to reduce and mitigate stress. The article supports the Capstone project by illustrating sufficient evidence for better outcomes.	The article proves that self-care is an effective intervention to reduce burnout among nurses. The article supports the Capstone Project by demonstrating that self-care improves wellness and reduces negative effects of burnout.	The article supports PICOT by showing that nurses can reduce burnout and improve wellness when they implement evidence-based interventions like mindfulness. The article supports the Capstone project by demonstrating the effectiveness of mindfulness as an EBP intervention.	The study is essential to the PICOT question as it illustrates positive outcomes mindfulness as a criticak intervention to reduce and manage burnout. The article supports the project by providing sufficient evidence about the efficacy of the intervention for implementation as an EBP best practice.

Conclusion

The evaluation of existing evidence based on the literature evaluation table shows the effectiveness of using mindfulness and self-care to reduce burnout among nurses in different settings, including critical care practice like the ICU. The table and the searched articles are important as they illustrate the importance of these interventions for nurses in diverse situations, especially improving their wellness, psychological aspects, and overall job satisfaction. The articles use different designs and methods to determine the critical role of mindfulness and self-care for nurses.

Answer for NRS 465 Literature Evaluation Table Finalized PICOT Question: In nurses working in critical care settings (P), how does mindfulness and self-care practice (I) compared to normal practice (C) affect burnout prevention and reduction (O) within six months (T)?