NURS 7302 University Of Texas Rio Grande Valley Nurse Burnout Discussion

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werobyyr

Health Medical

University Of Texas Rio Grande Valley

Lila A Fuentes DNP APRN FNPBC

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Why nurse burnout is a real issue in healthcare and what can organizations do about it.

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NURS 7302 LET COURSE SYLLABUS 2018 - 2019 (SUMMER 2019) Lilia A. Fuentes, DNP, APRN, FNP-BC Associate Professor Associate Dean for Faculty Affairs – School of Nursing Master of Science in Nursing Family Nurse Practitioner Program Email: Lilia.A.Fuentes@utrgv.edu Office: EHABE 2.210 956-665-2384 (Office) 956-665-2875 (Fax) 1 NURS 7302.90L: PRACTICE INTERVENTION PROJECT COURSE SYLLABUS Course Title Practice Intervention Project (PIP) Course Number NURS 7302.90L Course Description This course is required for non-thesis students. It involves delineation of a problem/issue/project related to the student’s clinical or functional area, review of pertinent literature, and development of a proposed solution with steps in implementation and evaluation methodology. The student will give a written and oral presentation of the project to a selected audience. Course Credit Three semester hours. Course Grade The grade for the course will be entered as “Credit” when requirements have been met and “No Credit” when they have not been met. Students receiving no credit must register each semester until requirements are met. Requirements for the course must be completed in the semester/summer session enrolled. Students requesting an incomplete grade must submit A Request for Incomplete Grade form, available from the School of Nursing (SON), along with documentation and/or supporting rationale. Approval by the SON Director and College Dean is required for an incomplete grade. Students requesting an incomplete grade must have completed at least 75% of the course in addition to having a “passing” status in the course. Course Objectives Course objectives are based on the UTRGV Graduate Nursing Student Learning Outcomes, American Association of Colleges of Nursing’s (AACN) The Essentials of Master’s Education in Nursing, 2011 (E) and the National Organization of Nurse Practitioner Faculties’ (NONPF) Nurse Practitioner Core Competencies, 2014 (NPCC). Upon the completion of the course, the student will be expected to demonstrate graduate level student learner objectives that include: 1. Integrate theory, evidence, clinical judgment, research, and interprofessional perspectives to analyze literature pertinent to the problem/issue/process/project in order to improve practice and associated health outcomes. (E.IV-1); (NPCC-SF; L; Q; PI; P; HDS; E) 2 2. Perform rigorous critique of evidence derived from databases to generate meaningful evidence for nursing practice pertinent to confronted problem/issue/process/project. (E.IV-5, 6); (NPCC-SF; PI; TIL; HDS; E) 3. Formulate a proposal to study the problem/issue/process/project by designing a system change strategy whether through the application of practice guidelines or the implementation of new models of care delivery and coordination based on current evidence. (E.II-6, 7; E.III-2, 6; E.IV-3); (NPCC-L; Q; PI; TIL; P; HDS; E) 4. Assume a leadership role in the collaboration and effective implementation of the practice intervention using effective communication (scholarly writing, speaking, and group interaction) skills. (E.II-2); (NPCC-L; Q; TIL) 5. Utilize information and communication technologies, resources and principles of learning in the implementation of the practice intervention. (E.V-5); (NPCC-TIL) 6. Demonstrate the ability to use complexity science and systems theory in the evaluation of the effectiveness of the intervention. (E.II-4); (NPCC-SF; Q; PI) *NPCC - Scientific Foundation (SF); Leadership (L); Quality (Q); Practice Inquiry (PI); Technology and Information Literacy (TIL); Policy (P); Health Delivery System (HDS); Ethics (E); Independent Practice (IP) Graduate Student Learning Outcomes Graduate Student Learning Outcomes facilitate evaluation of learning as students progress in the curriculum toward the intended Graduate Outcomes. The Student Learning Outcomes are that the student will: 1. Function as a scholar with critical thinking skills supported by theories from the behavioral, physical, and nursing sciences. 2. Demonstrate organizational and systems leadership in the application of client/patient care interventions, incorporating informatics and health care technology to improve population health care outcomes. 3. Collaborate as a member of an inter-professional health care team to advocate for safe and effective client/patient care, being cognizant of cultural, societal, economic, political, and ethicolegal issues. 4. Promote quality improvement in the provision of culturally competent care to diverse populations through integration of health policy, planned programs, education, and advocacy. 5. Translate and integrate scholarship and research into masters-level practice that is grounded in the sciences and humanities. 3 Students with Disabilities Students with a documented disability (physical, psychological, learning, or other disability which affects academic performance) who would like to receive academic accommodations should contact Student Accessibility Services (SAS) as soon as possible to schedule an appointment to initiate services. Accommodations can be arranged through SAS at any time, but are not retroactive. Students who suffer a broken bone, severe injury or undergo surgery during the semester are eligible for temporary services. Pregnancy, Pregnancy-related, and Parenting Accommodations Title IX of the Education Amendments of 1972 prohibits sex discrimination, which includes discrimination based on pregnancy, marital status, or parental status. Students seeking accommodations related to pregnancy, pregnancyrelated condition, or parenting (reasonably immediate postpartum period) are encouraged to contact Student Accessibility Services for additional information and to request accommodations. Student Accessibility Services: Brownsville Campus: Student Accessibility Services is located in Cortez Hall Room 129 and can be contacted by phone at (956) 882-7374 (Voice) or via email at ability@utrgv.edu. Edinburg Campus: Student Accessibility Services is located in 108 University Center and can be contacted by phone at (956) 6657005 (Voice), (956) 665-3840 (Fax), or via email at ability@utrgv.edu. Mandatory Course Evaluation Period Students are required to complete an ONLINE evaluation of this course, accessed through your UTRGV account (http://my.utrgv.edu); you will be contacted through email with further instructions. Students who complete their evaluations will have priority access to their grades. Online evaluations will be available on or about: Summer 10-week Session August 8th – 15th Scholastic Integrity As members of a community dedicated to Honesty, Integrity and Respect, students are reminded that those who engage in scholastic dishonesty are subject to disciplinary penalties, including the possibility of failure in the course and expulsion from the University. Scholastic dishonesty includes but is not limited to: cheating, plagiarism (including self-plagiarism), and collusion; submission for credit of any work or materials that are attributable in whole or in part to another person; taking an examination for another person; any act designed to give unfair advantage to a student; or the attempt to commit such 4 acts. Since scholastic dishonesty harms the individual, all students and the integrity of the University, policies on scholastic dishonesty will be strictly enforced (Board of Regents Rules and Regulations and UTRGV Academic Integrity Guidelines). All scholastic dishonesty incidents will be reported to the Dean of Students. Sexual Harassment, Discrimination, and Violence In accordance with UT System regulations, your instructor is a “Responsible Employee” for reporting purposes under Title IX regulations and so must report any instance, occurring during a student’s time in college, of sexual assault, stalking, dating violence, domestic violence, or sexual harassment about which she/he becomes aware during this course through writing, discussion, or personal disclosure. More information can be found at www.utrgv.edu/equity, including confidential resources available on campus. The faculty and staff of UTRGV actively strive to provide a learning, working, and living environment that promotes personal integrity, civility, and mutual respect that is free from sexual misconduct and discrimination. If students, faculty, or staff would like confidential assistance, or have questions, they can contact OVAVP (Office for Victim Advocacy & Violence Prevention) at 665-8287, 882-8282, or OVAVP@utrgv.edu. Course Drops According to UTRGV policy, students may drop any class without penalty earning a grade of DR until the official drop date. Following that date, students must be assigned a letter grade and can no longer drop the class. Students considering dropping the class should be aware of the “3-peat rule” and the “6drop” rule so they can recognize how dropped classes may affect their academic success. The 6-drop rule refers to Texas law that dictates that undergraduate students may not drop more than six courses during their undergraduate career. Courses dropped at other Texas public higher education institutions will count toward the six-course drop limit. The 3-peat rule refers to additional fees charged to students who take the same class for the third time. Student Services Students who demonstrate financial need have a variety of options when it comes to paying for college costs, such as scholarships, grants, loans and workstudy. Students should visit the Students Services Center (U Central) for additional information. U Central is located in BMAIN 1.100 (Brownsville) or ESSBL 1.145 (Edinburg) or can be reached by email (ucentral@utrgv.edu) or telephone: (888) 882-4026. In addition to financial aid, U Central can assist students with registration and admissions. 5 Students seeking academic help in their studies can use university resources in addition to an instructor’s office hours. University Resources include the Learning Center, Writing Center, Advising Center and Career Center. The centers provide services such as tutoring, writing help, critical thinking, study skills, degree planning, and student employment. Locations are: • Learning center: BSTUN 2.10 (Brownsville) or ELCTR 100 (Edinburg) • Writing center: BLIBR 3.206 (Brownsville) or ESTAC 3.119 (Edinburg) • Advising center: BMAIN 1.400 (Brownsville) or ESWKH 101 (Edinburg) • Career center: BCRTZ 129 (Brownsville) or ESSBL 2.101 (Edinburg) Teaching Methods The student will begin an outline of the proposed problem/issue/project before soliciting a Director and Committee Member. The Director will work closely with the student to guide progress. An appropriate venue for presentation or implementation will be selected by the Director. A suggested contract and timeline for the Director and Student is included. Evaluation This course will be offered on a credit/non-credit basis. Credit will be given upon acceptance and presentation of the project and completion of a scholarly paper. Committee Selection Selection of Director and Committee Member should follow the criteria addressed later in this syllabus. PIP Content Outline The following is suggested as an appropriate arrangement of content for the PIP. Variations will occur depending upon content area and related subheadings. 1. Title page 2. Table of Contents page 3. Abstract (Usually completed after most of the paper has been written) 4. Introduction and Statement of Problem/Issue (Includes the conceptual and empirical background) 5. Significance of the Problem 6. Quality Measures 6 7. Description of the Project/Program/Solution 8. Theoretical Framework 9. Review of Related Literature 10. Steps in Project Implementation 11. Evaluation of Project 12. Implications for Health Outcomes 13. Project Summary / Conclusion 14. References 15. Appendix Presentation of Project Guidelines Presentation Guidelines Each student is required to present their project to their PIP Faculty/Director for approval way in advance of the student committing to the approved venue. The student should also be aware that no project presentation will be approved without steps 1 – 9 being completed and reviewed by the PIP Director. All students must follow intervention implementation guidelines as specified on the Intervention Implementation Guidelines and Intervention Implementation Rubric forms on page 13 through 15 of the course syllabus. Preparation Guidelines The PIP written document must be as follows: • • • • • • Times New Roman 12-point font ONLY Double spaced 1-inch margins left, 1-inch margins right, top, and bottom Running head and page numbers upper right No number in title page APA format including but not limited to references, abbreviations, text citations, and headings as explained in the Publication Manual of the American Psychological Association, 6th Ed. http://www.apastyle.org/ Academic dishonesty including plagiarism is a serious academic offense and may result in disciplinary action according the UTRGV Scholastic Integrity guidelines. Please be aware that all submitted drafts/papers will be placed through SafeAssign which is a tool used to prevent plagiarism and to create opportunities to help students identify how to properly attribute sources rather than paraphrase. SafeAssign is effective as both a deterrent and an educational 7 tool. SafeAssign compares submitted assignments against a set of sources to identify areas of overlap between the submitted assignment and existing works. If a student’s draft is deemed more than 50% matched to other sources, the student will be warned and asked to rewrite the draft. Any final paper submissions deemed more than 50% matched to other sources will result in the student being reported to the Dean of Students, dropped from the course and expelled from the graduate program. Selection of Committees for Practice Intervention Project NURS 7302 Practice Intervention Project requires a Project Director. A committee member may be added in addition to the Project Director. The PIP Director must be from the School of Nursing Faculty and have either full or associate Graduate Faculty status. The second member does not require graduate faculty status. This may be someone from the School of Nursing, another department in the University, or the professional community. Selecting the committee members is a very important task. They should be selected to assist because of expertise in the content, methodology, or to facilitate access to a population. They will be responsible for approving and signing off on the project and paper. Committee members should be selected as soon as possible after enrolling in the PIP course. Required Forms Students are responsible for obtaining committee member signatures on the following two forms and submitting the original copy to the Course Coordinator and the Assistant Director of Graduate Nursing Education as indicated: • Practice Intervention Committee Membership Form submitted at the beginning of work on the PIP. • Report of the Practice Intervention Project Examination Committee Form submitted upon successful completion of the PIP. This form and an original copy of the PIP must be submitted to the Course Coordinator and the Assistant Director of Graduate Nursing Education in order to receive course credit. In addition to the application for graduation required by the university, all required courses must be successfully completed in order to participate in graduation ceremonies. 8 NURS 7302.90L: PRACTICE INTERVENTION PROJECT COMMITTEE MEMBERSHIP Student Name: Student Identification Number: Date: Committee Members Name Institutional Position 1. Director 2. Member 9 Area of Expertise REPORT OF THE PRACTICE INTERVENTION PROJECT EXAMINATION COMMITTEE Student: Title of Practice Intervention Project: Date Project Presented: Date Paper Reviewed/Approved: SIGNATURES OF COMMITTEE MEMBERS Director Member 10 PROJECT Calendar* (Note: Some students may move along faster than others. The dates are suggested to help organize so that all components of the PIP will be completed before week 8). Suggested Date Task to be completed/submitted for review End of Week 2 (June 14 ) th Table of Contents Introduction & Statement of Problem/Issue End of Week 3 (June 21st) Significance of the Problem Quality Measures Description of the Project/Program/Solution End of Week 4 (June 28th) Theoretical Framework Review of Literature Steps in Implementation End of Week 5 (July 5th) End of Week 9 (Aug. 2nd) Confirm Presentation Appointment: • Confirm date, time, and place for presentation with venue and PIP director • All of the above tasks should have been reviewed by PIP director before presentation is confirmed Last day to schedule a presentation (if the above tasks have not been met, the student will not be allowed to schedule a presentation and given the opportunity to drop the course) **Last day to drop or withdraw from courses** NO need to drop PIP, a “NC” (no credit) will show up on your transcript. Final draft paper due (NO EXCEPTIONS) Week before Finals (Aug. 9th) Last day to submit previously reviewed PIP papers Final Paper Due (Aug. 14th) STUDENTS MUST SUBMIT A HARD COPY AND AN ELECTRONIC COPY OF THEIR FINAL PIP! Start of Week 7 (July 15th) July 29th *It is the student’s responsibility to initiate contact routinely and make arrangements to meet with his/her PIP Director regularly. If no contact has been established within 1 month of the start of the semester, the student will need to drop the course and retake in the coming semester. 11 Section Front Matter I. II. I. II. III. IV. V. VI. Introduction Significance of the Problem Quality Measures Description of the Project/Program/Soluti on Theoretical or Conceptual Framework Review of Related Literature # of Pages* Included Includes the title page and a onepage abstract of the project The conceptual and empirical background facts Explanation of why it is important for this to be addressed What impact it may have Explanation of quality measures, standards of care, practice guidelines associated with project A brief description of what the overall plan is to address the problem Identification and discussion of the supporting theory or conceptual framework for the project Review of research studies related to the variables in the project 2 1–2 2–3 2 VIII. Steps in Implementation Evaluation of Project Includes how the project was assessed, planned, description of what was developed for presentation or implementation and the plan for evaluating the project 2–4 4-6 Actual evaluation of the project. 1–2 IX. X. XI. Implications for Health Outcomes Project Summary / Conclusion References Evaluation of quality measures, standards of care, practice guidelines as they relate to health outcomes. Personal reflection on the project 1–2 1–2 Listing of all references cited in the text of the paper 3–6 XII. Appendices Copies of documents discussed in the paper *Approximate number of pages 12 The abstract is written after the PIP is presented to reflect each component addressed in the sections that follow Address the issue in general Goes beyond the general into specifics for the local area / institution / clinic where the project will be implemented Address any quality measures, standards of care or practice guidelines associated with project Described in general 1-2 5–8 VII. Additional Comments Special attention should be made as to how the TF/CF is specifically linked to the project Sub-sections should be created to address evidence-based research for each area being addressed including one on the TF/CF use in areas related to the PIP Sub-sections should be created for each area being addressed. Detailed descriptions are expected, i.e., permissions, recruitment of attendees, presentation content, Powerpoint content, description of evaluation tool, etc. Should address who, what, when, where, and summary of the actual evaluation by participants How did the project address quality measures, standards of care, practice guidelines? Did/will it improve health outcomes? How? Your evaluation of strengths, challenges, opportunities and disposition of project (i.e., will it be incorporated into the organization?) Correct APA format required. The number of references should be sufficient to support the variables in the project. Primary sources are encouraged, including those considered classic. Current information is that which has been published within the last five years Must be in order of presentation in paper Intervention Implementation Guidelines 1. The PIP project must be related to advanced practice in nursing and benefit a group, population, or community rather than an individual patient. The student may partner with another entity such as a clinical agency, school, health department, church, government, organization or community group. However, the student is responsible for assuming the leadership role in his/her project. 2. The PIP project must utilize evidence-based research that can be translated into practice. 3. The significance of the problem and literature review must support the need for the project. 4. Data from the clinical site must indicate a need for quality improvement work which affords the student the opportunity to improve something. 5. Quality process and quality tools can assist students to obtain measurable improvements. FOCUS is based on the original PDSA cycle developed by Edward Deming as a continuous model of quality improvement. This tool may help you organize an approach to your PIP project: Find a process to improve, What do you plan to change (preF data that demonstrates the problem)? Organize an effort to work on Who will be involved and what O improvement, support do you need? Clarify current knowledge of What is the current state of the C the process, science? How is it related to this process or practice? Understand process variation Outline specifically how the current U and performance capability process works (if there is one at all). Select changes aimed at Choose the intervention or S performance or process interventions being cognizant of improvement, social, economic and cultural issues. Plan the change, Analyze and How do you plan to measure the P predict results. effect of the change? Do it. Execute the plan taking small steps D in controlled circumstances. S Study. Check the project results/evaluation. Act. Take Action How do you sustain the gains in A regards to health outcomes. 13 6. Although education is often a part of quality improvement work it cannot be the full scope of the project. The PIP project must clearly demonstrate an outcome that will or has the potential to improve patient care or a system change that impacts patient outcomes. 7. The intervention needs to be concise and provide a full and clear description of the problem, background, quality measures connected to health issue, evidence-based solutions, purpose of the project, proposed solution(s), implications for health outcomes, evaluation, and “deliverables” the agency will receive at the conclusion of the project. “Deliverables” include but are not limited to the following: • • • • • • • • • • In-service Pamphlet/brochure Algorithm Clinical protocol/guideline Flow sheet Screening tool Policy Manuscript for publication Video Manual 8. All presentations need to have learning/presentation objectives. Writing objectives is not easy. Please refer to Writing Instructional Objectives in order to help you develop objectives for your presentation. Please make sure to have these approve by your PIP Director/Course Coordinator. 9. All project clinical problem, presentations, “deliverables”, venue, etc. must be approved by the Course Coordinator before scheduling the implementation of the intervention. 10.All projects must have an evaluation process. Evaluation is a crucial component of intervention projects. It encompasses the set of tools that are used to measure the effectiveness of the practice intervention project. Whether it is a pre-test/post-test and/or an overall intervention evaluation (5-point Likert Scale), please include an evaluation process with your intervention. Pre/Post-tests must contain at least 10 questions. An overall project evaluation must contain outcomes based on project objectives and at least three other intervention objectives. The evaluation process must be approved by your PIP Director prior to the implementation of the project. 14 Intervention Implementation Rubric S=Satisfactory U=Unsatisfactory Presentation Content Outline: OBJECTIVES: Presents clear and concise project/presentation objectives PROBLEM: Describes a clinical problem, the significance of the problem and how the problem has impacted nursing, healthcare, and/or patient populations (give statistics on the problem) QUALITY MEASURES: Identifies crucial quality measures/standards/guidelines (CMS, Health People 2020, national organizations, etc.) associated with the problem and why they are important THEORETICAL FRAMEWORK: Introduces a theoretical framework that is congruent with the proposed design/plan EVIDENCE: Critically reviews the evidence through a literature review SOLUTION PROPOSAL: Introduces a plan that effectively addresses the clinical problem; the proposed intervention/plan must address quality measures and how it will improve health outcomes supported by the evidence EVALUATION PROCESS: Systematic method for collecting information for evaluating project effectiveness and efficiency. REFERENCES: Complies with APA format Presentation/Deliverables/Professionalism Provides professional “deliverables” to agency making sure to identify them as a project by a graduate nursing student from UTRGV Delivers a professional presentation which complies with APA format Provides professional feedback to questions making sure to cite current research S U Comments ______________________________________________________________________________ Faculty Signature Date 15
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Running head: NURSE BURNOUT PRACTICE INTERVENTION PROJECT

Why Nurse Burnout is a Real Issue in Healthcare and What Can Organizations Do about It
Names
Institution

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NURSE BURNOUT PRACTICE INTERVENTION PROJECT

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Why nurse burnout is a real issue in healthcare and what can organizations do about it
Nursing is a field that allows no margin for error. For nurses to provide services that
guarantee high-quality and patient safety, it is essential that they are at their best physical,
psychological, and physiological state. Unfortunately, nurses are susceptible to physical,
mental, and emotional strain that arises from working for long hours and their inability to
handle these pressures. This results in nurse burnout, which is defined as the physical,
emotional, and psychological stress or strain that affects nurses, and which leads to dulled
emotions, detachment, and low levels of motivation in one’s work (Van Bogaert, Peremans.
Van Heusden, Verspuy, Kureckova, Van de Cruys & Franck, 2017). This is a problem that
affects both the nurses and the patients. In nursing practice, the relationship and interaction
between the nurses and the patients are vital as it has a major influence on the quality and
relevance of services that these nurses offer. In this regard, research has shown that nurse
burnout negatively affects the satisfaction of both the nurses and the patient often leads to
poor health outcomes and high chances of errors (Hall, Johnson, Watt, Tsipa & O'Connor,
2016). It is thus important that every healthcare facility strives to resolve any cases of nurse
burnout as a way of raising its quality of services and improving the welfare of the patient.
Nurses encounter many risks of burnout than most other professions. Watching the
patients suffer, striving to ensure the recovery of all patients, having busy schedules, putting
others ahead of oneself, and having to work for extended hours, among others, not only
expose nurses to physical strain and stress, but they also expose them to high risks of
emotional and mental stress (Ribeiro, Filho, Valenti, Ferreira, de Abreu … Ferreira, 2016). In
the past, many healthcare organizations did not clearly understand the concept, diagnosis,
effects, and measures to address the problem of nurse burnout. Despite increased research and
awareness of the problem, Van Bogaert et al. (2016) report that many facilities still fail to
mitigate the problem. In return, this negatively affects service delivery and the welfare of the

NURSE BURNOUT PRACTICE INTERVENTION PROJECT

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patients and the nurses alike. However, ongoing research and increased attention in this field
present healthcare providers with a solution and an opportunity to design projects or programs
that can address this problem. The purpose of this practice intervention project is to explore
the significance of nurse burnout and suggest a program that healthcare organizations can
implement to address this problem.
Significance of the problem
Patient safety and quality of care have always been guiding factors in nursing practice
and other healthcare fields. Unfortunately, these values have been ignored in the past, and
they have never been accorded the attention that they deserve. In 1999, a study report by the
Institute of Medicine (IOM) that was corroborated by many other studies showed that the
healthcare industry lacked the necessary measures to address the problem of patient safety. In
its report, IOM attributed between 44,000 and 98,000 annual deaths to preventable medical
errors (Makary & Daniel, 2016). Surprisingly, this number exceeded many of the leading
causes of death at the time despite medical errors not being recognized as a major cause of
death or an inhibitor of patient safety and quality care. As such, healthcare providers were
tasked with formulating measures that could uphold these two values in their practice through
the prevention of unnecessary medical errors.
Nurse burnout is one of the key inhibitors of quality services and patient safety as it
directly inhibits the attachment between nurses and the patients while also raising the chances
of errors. As Ribeiro et al. (2016), the emotional health of nurses is important as it enhances
communication among themselves and between themselves, physicians, and patients. In this
case, detachment results in poor relations that may negatively affect the welfare of the
patients. This is more so the case in vital sections of healthcare, such as primary care that
requires personal engagement and interaction between nurses and patients.

NURSE BURNOUT PRACTICE INTERVENTION PROJECT

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Burnouts impair communication and collaboration among healthcare providers. In this
regard, nursing practice is a field that demands critical concentration and collaboration among
different parties. Any breakdown in communication can lead to errors that could be costly for
a healthcare provider. Studies have shown that, besides the close to 98,000 patients who die
due to preventable medical errors, between $73.5 and $ $98 billion are directly associated
with these errors each year (Makary & Danie...


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