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Mindfulness as an Intervention to Mitigate and Decrease Rates of Burnout in Registered Nurses: A Systematic Literature Review

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The aim of this review is to explore the effects of mindfulness-based interventions on Registered Nurse's rate of burnout and stress. Particularly focusing on the mitigation and decrease of burnout. Burnout is a multifaceted, complex issue that has become engrained

The aim of this review is to explore the effects of mindfulness-based interventions on Registered Nurse's rate of burnout and stress. Particularly focusing on the mitigation and decrease of burnout. Burnout is a multifaceted, complex issue that has become engrained in the culture of nursing and a widespread epidemic. Burnout has detrimental effects for the quality of life of the nurse, patient outcomes, interprofessional collaboration, and nursing practice. A systematic literature review incorporating qualitative data and analyzing the quantitative data was conducted. Studies on the effects of mindfulness-based interventions for nurses relating to burnout published between January 2008 and May 2018 were identified through a systematic search in electronic databases: CINHAL, Cochrane, Embase, Medline, PsycInfo, and PubMed. Gray literature was searched through Scopus and clinical trials were explored through clincialtrials.gov. Data analysis was based on 8 data points that were extracted from the research. A total of 17 articles were selected for inclusion in the systematic literature review. There were several different types of studies including single group intervention study, randomized control trial interventions studies, mixed model, quasi-experimental studies with controls, and a non-randomized controlled comparison. All relied on self-reporting scales and questionnaire for quantitative pre-post intervention changes. Overall, the 10 of the 17 studies found that there was a statistically significant decrease in burnout rates and an increase in mindfulness post intervention. Several other factors improved in a number of studies such as quality of life, decreased stress, increased sense of personal accomplishment, and decreased emotional exhaustion. There were also indications of an improvement in the individual's holistic well-being (e.g. inner state of calmness, awareness and enthusiasm) relating to improved mindfulness levels in 12 of the studies. Based on the results of this systematic review, mindfulness may be considered a potentially effective intervention for decreasing nurse burnout and mitigating future burnout. This intervention could be useful in a number of contexts including on-site and off-site programs with institutional support. Future research should explore longitudinal outcomes of mindfulness practice, symptom focused outcome measures, and multi-modal studies.

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2018-12

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Joy in Work: Addressing Nurse Burnout through Mindfulness

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Aim: To investigate the feasibility and efficacy of mindfulness as an intervention in reducing burnout and promoting joy in work for progressive care unit (PCU) nurses and nursing aides. Background: The Institute for Healthcare Improvement (IHI) describes a lack of joy in work

Aim: To investigate the feasibility and efficacy of mindfulness as an intervention in reducing burnout and promoting joy in work for progressive care unit (PCU) nurses and nursing aides. Background: The Institute for Healthcare Improvement (IHI) describes a lack of joy in work and the resultant burnout as a serious threat to healthcare workers and organizations. Few studies have examined this phenomenon in PCU nurses and aides. Method: Pre- and post-intervention surveys with established instruments on three variables, mindfulness, burnout, and joy in work, were administered to ten PCU nurses and aides (N = 7) at a city hospital. The intervention was the virtual IHI's mindfulness course and was guided by Martin Seligman's PERMA Model and the Iowa Model for Evidenced Based Practice. A paired sample t-test was used to evaluate changes in the pre-post survey responses. Results: Significant increase in joy in work based on an alpha value of 0.05, p = .041. Slight increase in mindfulness practice based on an alpha value of 0.05, p = .398. Burnout remained the same based on an alpha value of 0.05, p = .766. Conclusion: PCU nurses and aides who practiced mindfulness for 12 weeks scored the same on burnout scales and higher on the joy in work scales. Implications for Nursing Management: Nurse managers can incorporate mindfulness exercises at strategic times during the shift to reduce burnout and promote joy in work for nurses and aides. Future EBP projects should assess the effectiveness of different mindfulness activities in promoting nurses' emotional and psychological well-being in various care settings.

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2021-04-24

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Sustaining Depression Remission: Integrating Mindfulness-Based Modalities and Ketamine Infusion Therapy

Description

Major depressive disorder contributes to a growing disease burden globally, with limiting or
inadequate treatment options available to patients and healthcare providers. Traditional
medications to treat the disorder demonstrate modest efficacy while best outcomes are seen when
psychotherapy is implemented

Major depressive disorder contributes to a growing disease burden globally, with limiting or
inadequate treatment options available to patients and healthcare providers. Traditional
medications to treat the disorder demonstrate modest efficacy while best outcomes are seen when
psychotherapy is implemented adjunctively. Barriers to delivering optimal treatment can lead to
relapse, diminished psychosocial functioning, and suicide, a leading cause of death in the United
States. The purpose of this paper is to examine the rapid antidepressant effects of ketamine
combined with nurse-delivered mindfulness-based cognitive therapy to help reduce depression
severity and support remission. Research differentiating ketamine’s mechanism of action from
traditional anti-depressants and the efficacy of mindfulness-based interventions to reduce
depression, have led this evidence-based project integrating these modalities.

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Date Created
2021-04-20

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Stress in Healthcare Professionals: Caring for the Carers

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Background: Healthcare Professionals commonly experience elevated stress levels, and this issue has only further intensified by the ongoing COVID-19 pandemic. Mindfulness-based intervention have been shown to improve stress levels in diverse populations. Objective: The purpose of this project was to

Background: Healthcare Professionals commonly experience elevated stress levels, and this issue has only further intensified by the ongoing COVID-19 pandemic. Mindfulness-based intervention have been shown to improve stress levels in diverse populations. Objective: The purpose of this project was to evaluate if an online, multicomponent MBI can reduce stress levels in healthcare professionals enrolled in a graduate health program. Methods: Recruitment was conducted at two different Southwestern institutions via email announcement from university’s program directors. The brief, 12-day intervention involved (1) self-guided online educational modules, (2) one group course via the platform zoom, and (3) at home practice of guided meditation session. The Perceived Stress Scale-10 (PSS-10) was used to measure stress levels pre- and post-intervention. General feedback of experience was also inquired on Postsurvey. Results: Sample comprised of 17 health professionals enrolled in a graduate health program from two different Southwestern Institutions. Scores from PSS-10 in postsurvey (M=20.94, SD=6.04) were statistically significantly lower than scores in pre survey (M=24.24, SD=5.78), t(16) = 3.35, p = .004. A large effect size was detected with findings (d = .81). Conclusions: Mindfulness Based Interventions may be able to reduce stress levels in healthcare professionals. More literature should focus on mindfulness intervention tailored to the needs of healthcare professionals.

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Date Created
2021-05-03

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Reducing Polypharmacy with Mobile Apps Among Mental Health Patients

Description

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions,

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?

The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.

Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.

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Date Created
2019-04-29