Doctor of Nursing Practice (DNP) Final Projects

The purpose of this project is to implement an on-site mindfulness-based intervention to reduce stress and burnout among mental health care workers. Healthcare professionals are among the most stressed of any profession, and mental health workers are at an extremely high risk for burnout and compassion fatigue (Christopher & Meris, 2010) with an estimated 21% to 67% of mental health workers reporting that they experience high levels of burnout (Salyers et al., 2011).

After researching the literature, it was evident that practicing mindfulness can lead to less stress and higher job satisfaction. In an effort to combat this problem, an on-site mindfulness intervention was implemented at an outpatient psychiatric setting for eight weeks. Twenty-seven mental health workers gave their consent to be part of the study, and eleven were able to complete the study and self-assessment surveys for three time periods. The Maslach Burnout Inventory (MBI) (the Human Service Version) and a 1-item job satisfaction were used to measure the effect of intervention on employees’ levels of stress and job satisfaction.

A non-parametric Friedman test of differences among repeated measures was conducted and findings were not significant when comparing the average total scores of means between pre-, post-, or 1-month follow-up for Emotional Exhaustion (p = .148), Depersonalization (p = .223), Personal Achievement (p = .784) and job satisfaction (p = .422). The positive outcomes cited by participant support the thesis that the on-site mindfulness-based intervention is better than no intervention though the effect was not statistically significant.

In the United States obesity continues to be a growing issue in the adult population, which is compounded by the fact that many people have had antidepressant therapy at some point in their lives. Health problems such as metabolic syndrome, diabetes, skeleton/joint issues and more can stem from obesity. These comorbid health care problems can increase the costs at the state and federal levels. This paper will examine obesity and its relation to antidepressant therapy in depressed adults that are obese or endeavoring to avoid further weight gain. Research indicates that antidepressant therapies have shown a greater propensity towards weight gain, though few research studies show weight loss.

Intervention: 10 minutes of nutritional counseling during office visits. Setting: Family psychiatric clinic in the southwest of the United States.

Methods: Data collection process: Depressed adults on antidepressant therapies were randomly selected.

Instrumentation: Weight scale, National Literacy Scale, pamphlet (for teaching) and height scale. Data collected was at baseline, 4 weeks and 8 weeks.

Outcomes: 14 Participants agreed to the project, 10 completed to the 4-week mark and 4 finished the project to the 8-week mark. 10 female participants and 4 male participants. The remaining 4 participants showed 1.6% reduction in body mass index, which correlated with an increase in nutritional learning from baseline to 8-weeks.

Recommendations: Nutritional counseling is a non-pharmacological intervention for achieving and a desired weight, which has shown positive results in varying populations and clinical situations.

Background: Alarming levels of burnout in mental health care staff is a significant concern not only for the organization but for the individual as well. Identifying and addressing burnout ought to be an essential protocol in a behavioral health organization. Currently, burnout remains an ongoing concern for mental health care organizations as it is associated with negative impacts for staff, patients, families, and the organization.

Method: The purpose of this project is to utilize the Maslach burnout inventory (MBI) survey tool to measure burnout pre and post intervention. The intervention utilized will be mindfulness-based interventions (MBI) to reduce burnout among mental healthcare workers. Implementing mindfulness interventions has evidence that it reduces burnout rates in mental health care staff. Current literature supports mindfulness-based interventions and have showed a decrease in burnout, stress, and depersonalization.

Results: The pre-intervention results were as followed: emotional exhaustion; 40, depersonalization; 20.4 and personal accomplishment 32. The post-intervention results emotional Exhaustion; 28, depersonalization; 14.90 and personal accomplishment 30. It was found that the category for emotional exhaustion was statistically significant as it had a P value .040, whereas depersonalization was not statistically significant as the P value was .171 and personal accomplishment was not statistically significant as the P value was .577.

Discussion: The use of MBI as an intervention has robust literature supporting the effectiveness in decreasing burnout and stress in mental health care staff.