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Nursing Open Mar 2023This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses. (Meta-Analysis)
Meta-Analysis Review
AIM
This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses.
DESIGN
This study applied a systematic review design.
METHODS
Using Cochrane library guidelines, five electronic databases were systematically searched (Research 4life-PubMed/Medline, Scopus, Embase, CINAHL) from 2010-2021. The remaining articles with pertinent information were presented in a data extraction sheet for further thematic analysis. A Reporting Items for Systematic Reviews and Meta-Analysis Flow Diagram was adopted and used. The studies published from 2010-2021 and in English language were examined and included in the systematic review.
RESULTS
Four themes were identified as factors influencing the nursing workforce shortage, including Policy and planning barriers, Barriers to training and enrolment, Factors causing nursing staff turnover and Nurses' stress and burnout. Nursing workforce shortage is a global challenge that roots in multiple causes such as individual, educational, organizational and managerial and policy-making factors.
Topics: Humans; Hospitals; Job Satisfaction; Nursing Staff, Hospital; Workforce
PubMed: 36303066
DOI: 10.1002/nop2.1434 -
International Journal of Nursing Studies Jul 2021Burnout, characterized by emotional exhaustion, depersonalization, and decreased personal accomplishments, poses a significant burden on individual nurses' health and... (Review)
Review
BACKGROUND
Burnout, characterized by emotional exhaustion, depersonalization, and decreased personal accomplishments, poses a significant burden on individual nurses' health and mental wellbeing. As growing evidence highlights the adverse consequences of burnout for clinicians, patients, and organizations, it is imperative to examine nurse burnout in the healthcare system.
OBJECTIVE
The purpose of this review is to systematically and critically appraise the current literature to examine the associations between nurse burnout and patient and hospital organizational outcomes.
DESIGN AND DATA SOURCES
A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was conducted. PubMed, CINAHL, PsychInfo, Scopus, and Embase were the search engines used. The inclusion criteria were any primary studies examining burnout among nurses working in hospitals as an independent variable, in peer-reviewed journals, and written in English. The search was performed from October 2018 to January 2019 and updated in January and October 2020.
RESULTS
A total of 20 studies were included in the review. The organizational-related outcomes associated with nurse burnout were (1) patient safety, (2) quality of care, (3) nurses' organizational commitment, (4) nurse productivity, and (5) patient satisfaction. For these themes, nurse burnout was consistently inversely associated with outcome measures.
CONCLUSIONS
Nurse burnout is an occupational hazard affecting nurses, patients, organizations, and society at large. Nurse burnout is associated with worsening safety and quality of care, decreased patient satisfaction, and nurses' organizational commitment and productivity. Traditionally, burnout is viewed as an individual issue. However, reframing burnout as an organizational and collective phenomenon affords the broader perspective necessary to address nurse burnout. Tweetable abstract: Not only nurse burnout associated w/ worsening safety & quality of care, but also w/ nurses' organizational commitment and productivity. Reframing burnout, as an organizational & collective phenomenon is necessary.
Topics: Burnout, Professional; Hospital Administration; Humans; Job Satisfaction; Nursing Staff, Hospital; Patient Safety; Patient Satisfaction
PubMed: 33901940
DOI: 10.1016/j.ijnurstu.2021.103933 -
Medicine Jun 2020Numerous systematic reviews and meta-analyses on the interventions to reduce burnout of physicians and nurses have been published nowadays. This study aimed to summarize... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Numerous systematic reviews and meta-analyses on the interventions to reduce burnout of physicians and nurses have been published nowadays. This study aimed to summarize the evidence and clarify a bundled strategy to reduce burnout of physicians and nurses.
METHODS
Researches have been conducted within Cochrane Library, PubMed, Ovid, Scopus, EBSCO, and CINAHL published from inception to 2019. In addition, a manual search for relevant articles was also conducted using Google Scholar and ancestral searches through the reference lists from articles included in the final review. Two reviewers independently selected and assessed, and any disagreements were resolved through a larger team discussion. A data extraction spreadsheet was developed and initially piloted in 3 randomly selected studies. Data from each study were extracted independently using a pre-standardized data abstraction form. The the Risk of Bias in Systematic reviews and assessment of multiple systematic reviews (AMSTAR) 2 tool were used to evaluate risk of bias and quality of included articles.
RESULTS
A total of 22 studies published from 2014 to 2019 were eligible for analysis. Previous studies have examined burnout among physicians (n = 9), nurses (n = 6) and healthcare providers (n = 7). The MBI was used by majority of studies to assess burnout. The included studies evaluated a wide range of interventions, individual-focused (emotion regulation, self-care workshop, yoga, massage, mindfulness, meditation, stress management skills and communication skills training), structural or organizational (workload or schedule-rotation, stress management training program, group face-to-face delivery, teamwork/transitions, Balint training, debriefing sessions and a focus group) and combine interventions (snoezelen, stress management and resiliency training, stress management workshop and improving interaction with colleagues through personal training). Based on the Risk of Bias in Systematic reviews and AMSTAR 2 criteria, the risk of bias and methodological quality included studies was from moderate to high.
CONCLUSIONS
Burnout is a complicated problem and should be dealt with by using bundled strategy. The existing overview clarified evidence to reduce burnout of physicians and nurses, which provided a basis for health policy makers or clinical managers to design simple and feasible strategies to reduce the burnout of physicians and nurses, and to ensure clinical safety.
Topics: Burnout, Professional; Humans; Nurses; Physicians; Workload
PubMed: 32590814
DOI: 10.1097/MD.0000000000020992 -
Patient Education and Counseling Mar 2021Global migration and linguistic diversity are at record highs, making healthcare language barriers more prevalent. Nurses, often the first contact with patients in the... (Review)
Review
OBJECTIVE
Global migration and linguistic diversity are at record highs, making healthcare language barriers more prevalent. Nurses, often the first contact with patients in the healthcare system, can improve outcomes including safety and satisfaction through how they manage language barriers. This review aimed to explore how research has examined the nursing workforce with respect to language barriers.
METHODS
A systematic scoping review of the literature was conducted using four databases. An iterative coding approach was used for data analysis. Study quality was appraised using the CASP checklists.
RESULTS
48 studies representing 16 countries were included. Diverse healthcare settings were represented, with the inpatient setting most commonly studied. The majority of studies were qualitative. Coding produced 4 themes: (1) Interpreter Use/Misuse, (2) Barriers to and Facilitators of Quality Care, (3) Cultural Competence, and (4) Interventions.
CONCLUSION
Generally, nurses noted like experiences and applied similar strategies regardless of setting, country, or language. Language barriers complicated care delivery while increasing stress and workload.
PRACTICE IMPLICATIONS
This review identified gaps which future research can investigate to better support nurses working through language barriers. Similarly, healthcare and government leaders have opportunities to enact policies which address bilingual proficiency, workload, and interpreter use.
Topics: Allied Health Personnel; Communication Barriers; Delivery of Health Care; Humans; Quality of Health Care; Workload
PubMed: 32994104
DOI: 10.1016/j.pec.2020.09.017 -
Lancet (London, England) Nov 2016Physician burnout has reached epidemic levels, as documented in national studies of both physicians in training and practising physicians. The consequences are negative... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Physician burnout has reached epidemic levels, as documented in national studies of both physicians in training and practising physicians. The consequences are negative effects on patient care, professionalism, physicians' own care and safety, and the viability of health-care systems. A more complete understanding than at present of the quality and outcomes of the literature on approaches to prevent and reduce burnout is necessary.
METHODS
In this systematic review and meta-analysis, we searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, and the Education Resources Information Center from inception to Jan 15, 2016, for studies of interventions to prevent and reduce physician burnout, including single-arm pre-post comparison studies. We required studies to provide physician-specific burnout data using burnout measures with validity support from commonly accepted sources of evidence. We excluded studies of medical students and non-physician health-care providers. We considered potential eligibility of the abstracts and extracted data from eligible studies using a standardised form. Outcomes were changes in overall burnout, emotional exhaustion score (and high emotional exhaustion), and depersonalisation score (and high depersonalisation). We used random-effects models to calculate pooled mean difference estimates for changes in each outcome.
FINDINGS
We identified 2617 articles, of which 15 randomised trials including 716 physicians and 37 cohort studies including 2914 physicians met inclusion criteria. Overall burnout decreased from 54% to 44% (difference 10% [95% CI 5-14]; p<0·0001; I=15%; 14 studies), emotional exhaustion score decreased from 23·82 points to 21·17 points (2·65 points [1·67-3·64]; p<0·0001; I=82%; 40 studies), and depersonalisation score decreased from 9·05 to 8·41 (0·64 points [0·15-1·14]; p=0·01; I=58%; 36 studies). High emotional exhaustion decreased from 38% to 24% (14% [11-18]; p<0·0001; I=0%; 21 studies) and high depersonalisation decreased from 38% to 34% (4% [0-8]; p=0·04; I=0%; 16 studies).
INTERPRETATION
The literature indicates that both individual-focused and structural or organisational strategies can result in clinically meaningful reductions in burnout among physicians. Further research is needed to establish which interventions are most effective in specific populations, as well as how individual and organisational solutions might be combined to deliver even greater improvements in physician wellbeing than those achieved with individual solutions.
FUNDING
Arnold P Gold Foundation Research Institute.
Topics: Burnout, Professional; Efficiency; Humans; Mindfulness; Physicians; Quality of Health Care; Stress, Psychological
PubMed: 27692469
DOI: 10.1016/S0140-6736(16)31279-X -
BMJ Open Jun 2023There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19.
UNLABELLED
There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19.
OBJECTIVES
To synthesise evidence since 2015 on the impact of interventions designed to address well-being and burnout in physicians, nurses and allied healthcare professionals.
DESIGN
Systematic literature review.
DATA SOURCES
Medline, Embase, Emcare, CINAHL, PsycInfo and Google Scholar were searched in May-October 2022.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Studies that primarily investigated burnout and/or well-being and reported quantifiable preintervention and postintervention outcomes using validated well-being measures were included.
DATA EXTRACTION AND SYNTHESIS
Full-text articles in English were independently screened and quality assessed by two researchers using the Medical Education Research Study Quality Instrument. Results were synthesised and presented in both quantitative and narrative formats. Meta-analysis was not possible due to variations in study designs and outcomes.
RESULTS
A total of 1663 articles were screened for eligibility, with 33 meeting inclusion criterium. Thirty studies used individually focused interventions, while three were organisationally focused. Thirty-one studies used secondary level interventions (managed stress in individuals) and two were primary level (eliminated stress causes). Mindfulness-based practices were adopted in 20 studies; the remainder used meditation, yoga and acupuncture. Other interventions promoted a positive mindset (gratitude journaling, choirs, coaching) while organisational interventions centred on workload reduction, job crafting and peer networks. Effective outcomes were reported in 29 studies, with significant improvements in well-being, work engagement, quality of life and resilience, and reductions in burnout, perceived stress, anxiety and depression.
CONCLUSION
The review found that interventions benefitted healthcare workers by increasing well-being, engagement and resilience, and reducing burnout. It is noted that the outcomes of numerous studies were impacted by design limitations that is, no control/waitlist control, and/or no post intervention follow-up. Suggestions are made for future research.
Topics: Humans; Quality of Life; COVID-19; Health Personnel; Physicians; Workplace; Burnout, Psychological; Delivery of Health Care; Nurses
PubMed: 37385740
DOI: 10.1136/bmjopen-2022-071203 -
Work (Reading, Mass.) 2021Work-related stress can be defined as an individual's reactions to work characteristics and indicates a poor relationship between coping abilities and work environment.... (Review)
Review
BACKGROUND
Work-related stress can be defined as an individual's reactions to work characteristics and indicates a poor relationship between coping abilities and work environment. If unmanaged, stress can impact mental and physical health (e.g., causing depression and cardiovascular disease). Many individuals use maladaptive stress-coping strategies, such as sedentary activities, unhealthy eating behaviors, and alcohol consumption, which do not contribute to long-term stress management. In contrast, stress reduction programs can help people manage and effectively reduce stress in the long term.
OBJECTIVE
To gather the state of the art of work-related stress interventions, their efficacy and applications.
METHOD
The PsycINFO and EBSCOHost databases were used. The search was carried out between January 28 and March 30, 2019. Inclusion criteria were full text available, text in English or Spanish and a study population comprising workers.
RESULTS
Twenty-nine articles that included interventions involving aromatherapy, bibliotherapy, cognitive-behavioral therapy, exercise, alternative medicine, mindfulness, technology, stress management and sensory intervention were analyzed. The interventions showed significant reductions in stress, anxiety, depression and burnout; however, most of the studies were not based on specific stress models, and control groups often received no intervention whatsoever. As a result, it is challenging to draw conclusions regarding the success of the interventions, especially if they are novel.
CONCLUSION
The results suggest that there is a broad portfolio of successful interventions regarding work-related stress. Most of the successful interventions were based on mindfulness; however, aerobic exercise and bibliotherapy may also be successful. The structure and level of evidence appear to be very relevant to the development of a successful intervention.
Topics: Anxiety Disorders; Exercise; Humans; Mindfulness; Occupational Stress; Workplace
PubMed: 34511476
DOI: 10.3233/WOR-213577 -
PloS One 2021Does time management work? We conducted a meta-analysis to assess the impact of time management on performance and well-being. Results show that time management is... (Meta-Analysis)
Meta-Analysis
Does time management work? We conducted a meta-analysis to assess the impact of time management on performance and well-being. Results show that time management is moderately related to job performance, academic achievement, and wellbeing. Time management also shows a moderate, negative relationship with distress. Interestingly, individual differences and contextual factors have a much weaker association with time management, with the notable exception of conscientiousness. The extremely weak correlation with gender was unexpected: women seem to manage time better than men, but the difference is very slight. Further, we found that the link between time management and job performance seems to increase over the years: time management is more likely to get people a positive performance review at work today than in the early 1990s. The link between time management and gender, too, seems to intensify: women's time management scores have been on the rise for the past few decades. We also note that time management seems to enhance wellbeing-in particular, life satisfaction-to a greater extent than it does performance. This challenges the common perception that time management first and foremost enhances work performance, and that wellbeing is simply a byproduct.
Topics: Adult; Female; Humans; Job Satisfaction; Male; Stress, Psychological; Time Management
PubMed: 33428644
DOI: 10.1371/journal.pone.0245066 -
European Review For Medical and... May 2019Medication administration accounts for 40% of the nursing clinical activity in hospitals and nurses play a central role in granting the patient safety, as they are... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Medication administration accounts for 40% of the nursing clinical activity in hospitals and nurses play a central role in granting the patient safety, as they are directly responsible for the patient care. This review aims at analyzing the correlation between the clinical risk management and the occurrence of medication errors and the effects of the shift work (such as excessive fatigue and sleep deprivation after a shift in hospital) on inpatient nurses.
MATERIALS AND METHODS
This paper adheres to the relevant EQUATOR guidelines. A systematic review was conducted according to the PRISMA statement and pertinent articles were selected based on inclusion criteria and quality assessment factors. Two reviewers searched the bibliographic databases PubMed, Scopus, Cochrane, CINAHL to collect all the available articles in English and Italian issued between 1992 and August 2017.
RESULTS
The reviewers analyzed 19 of the 723 initially extracted references, as they focused on the impact of workload, shifts and sleep deprivation on the probability of making medication errors.
CONCLUSIONS
The main reasons behind medication errors are stress, fatigue, increased workload, night shifts, nurse staffing ratio and workflow interruptions. These factors can have a significant negative impact on the health and the performance of the employees. It is desirable to extend and deepen the research to identify appropriate measures to minimize medication errors.
Topics: Humans; Medication Errors; Nurses; Patient Safety; Shift Work Schedule; Work Schedule Tolerance; Workload
PubMed: 31173328
DOI: 10.26355/eurrev_201905_17963 -
Occupational Medicine (Oxford, England) Jun 2019Nursing is characterized by a working articulation in shifts to ensure continuity of care throughout the 24 h. However, shift work and the resulting desynchronization of...
BACKGROUND
Nursing is characterized by a working articulation in shifts to ensure continuity of care throughout the 24 h. However, shift work and the resulting desynchronization of circadian rhythms may have adverse effects on nurses' health.
AIMS
To describe the effects of shift work and desynchronization of circadian rhythms on nurse's health.
METHODS
Databases: PubMed, Cinahl, Scopus, Embase and Ilisi. Search terms (free terms, MeSH): 'nurses', 'shiftwork', 'nightwork', 'sleep disorder, circadian rhythm', 'work schedule tolerance', 'breast neoplasm', 'metabolic syndrome X', 'metabolic cardiovascular syndrome', 'Cardiovascular disease', 'stress', 'diabetes'. We included all randomized controlled trials, observational studies, reviews and papers studying nurses' shift work. Quality assessment of the retrieved papers was verified according to Dixon-Woods checklist.
RESULTS
Twenty-four articles were analyzed. Literature review has shown that shift work involves an alteration in psychophysical homeostasis, with a decrease in performance. It is an obstacle for social and family relationships, as well as a risk factor for stress, sleep disorders, metabolic disorders, diabetes, cardiovascular disorders and breast cancer.
CONCLUSIONS
An organized ergonomic turnaround can be less detrimental to the health of nurses and more beneficial for the healthcare providers. Therefore, we suggest organizing studies to assess whether improving nurses' health would lead to a reduction in miscarriages, absenteeism and work-related stress.
Topics: Breast Neoplasms; Cardiovascular Diseases; Circadian Rhythm; Female; Humans; Male; Metabolic Diseases; Nurses; Occupational Stress; Sleep Disorders, Circadian Rhythm; Work Schedule Tolerance
PubMed: 31132107
DOI: 10.1093/occmed/kqz063