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Capella University

NURS-FPX8004: Advanced Doctoral Writing for Nurses

Professor Name

Submission Date

Application of the MEAL Plan

(M) Pulmonary hypertension is a severe heart disorder characterized by excessive pressure in the blood vessels, which affects the delivery of oxygen to various parts of the body. (E) The condition occurs in a variety of populations. However, it is more common in women and non-Hispanic blacks, and may occur due to a variety of underlying conditions such as heart disease, liver cirrhosis, blood clots, and heredity. (A) The difficulty in early diagnosis is that the initial symptoms of the disease include fatigue and difficulty in breathing, which in most cases causes a delay in treatment before the disease progresses to more serious stages. Although there are many treatment methods, such as oral medicines, inhaled therapy, and oxygen therapy, pulmonary hypertension is an incurable disease, which underlines the relevance of prevention strategies. (L) It is important to understand all these about pulmonary hypertension to help healthcare providers determine how to effectively monitor early cases and apply the recommended interventions to manage the disease, which is becoming increasingly prevalent with age and greatly affecting the quality of life of patients.

Scholarly Article Summary

The phenomenon of nurse burnout is a serious occupational risk in health facilities, and this fact can be explained by the emotional vulnerability and diminished individual achievement that affects not only individual nurses but also the healthcare delivery system. As Jun et al. (2021) pointed out, a systematic review of several studies found that nurse burnout had negative relationships with several organizational outcomes, such as patient safety, nurse productivity, and patient satisfaction levels. Nurse burnout has a range of prevalence rates of 5 to 50. The correlation between nurse burnout and organizational outcomes proves that the issue is not only an individual issue but also a systemic one, and that, to address the problem, a systems-based, not an individual-based strategy is needed. The identification of nurse burnout as an organizational phenomenon offers a platform through which an elaborate intervention can be formulated that has the potential of improving both the well-being of the nurses and the quality of healthcare provision.

Practice Site Description

The practice site is a 250-bed acute care hospital located in the southeast of the United States and very much serving a three-county rural catchment area. The environment where it is based is an acute care not-for-profit healthcare with affiliations to a larger Health System region and provides a wide variety of services in the diagnostic and therapeutic operations, which include emergency services, medical-surgical units, obstetrical and pediatric services, and multiple specialty clinics. The physical layout of the location is a main five-story building built in 2010 with certain additions and modernization due to the emergence of new services and technologies (Nurse Manager, personal communication, April 10, 2025). Marshfield Clinic is situated in a community where there is a mix of agricultural lands and manufacturing lands, as well as a large number of individuals belonging to the group of the elderly and an increasing number of Hispanics, and, therefore, the special focus is given to the access to healthcare and the level of cultural sensitivity (Nurse Manager, personal communication, April 10, 2025).

The setting of the practice has the typical top-down management approach where the chief executive officer oversees other department heads like the nursing, medical, and operations directors ( Nurse Manager, personal communication, April 10, 2025). The nursing department is a participant in shared governance in which the decisions concerning the nursing workforce are taken by the frontline employees along with the management (Nurse Manager, personal communication, April 10, 2025). The culture of a patient-centered population-driven healthcare organization that is people-driven is another strength, which is demonstrated in the stated mission statement and manifested in system-wide practices (Quek et al., 2021). The center enjoys good relationships with the community and other training institutions, where they offer practicum placements in schools. The hospital spends its resources on evidence-based programs and the implementation of information technology, which is still a frequent issue in rural hospitals. The hospital leadership also promotes an organizational culture of communication, whereby the staff is free to communicate, which can be in terms of town meetings and an open-door policy as a listening organization, and getting suggestions.

Practice Problem Analysis and Significance

The issue of nurse burnout in the southeastern acute care hospital is a problem that has become an issue of interest since the data shows that the degree of emotional exhaustion and depersonalization in the nursing staff of the facility has increased by 35 percent over the past 1.5 years (Li et al., 2024). Hospital employee records indicate that the turnover rate of the nurses has been 27 percent, which is significantly higher than the national average of 17 percent in the case of midsize rural hospitals (Nurse Manager, personal communication, April 10, 2025; Bae, 2022). The findings of the internal survey Q3 2024 revealed that 68 percent of nursing staff felt a high level of emotional exhaustion, and the general patient satisfaction with nursing care level was lower by 15 percent (Li et al., 2024). The issue is not new to the facility: recent national surveys indicate that the nurse burnout rate of nurses working in hospitals is 35-45% in the United States (Flaubert et al., 2021). The plants in the rural areas with even greater rates due to the shortage of resources and staff.

The gap in practice is urgent and has a great impact on the results of patient care and the effectiveness of the organization. The number of medication administration errors and missed nursing documentation has risen by 22 percent and 18 percent, respectively, in the last year, which was reported by our incident reporting system, and these have been attributed to high burnout rates among nurses (Nurse Manager, personal communication, April 10, 2025). The patient safety and quality care requirement (Standard PI.01.01.01) of the Joint Commission prescribes that healthcare organizations should have effective systems to identify and address the quality improvement gaps, and thus the practice gap related to burnout is a breach of standards (Ibrahim et al., 2022). The rate of financial losses is considerable, and the organization will have to devote approximately $2.1m annually to temporary staffing in order to replace the gaps left by the workers who are burned out (Bromfield & Kanyogonya, 2024). The identified practice issue is in dire need of a carefully orchestrated quality improvement plan that would potentially help the organization improve the nurse retention rates, the quality of patient care, the organization’s productivity, and stability.

Implications of Practice Problem

The scenario of nurse burnout in an acute care facility in the southeastern part of the country presents a variety of concerns in the layer of organizational settings. Other costs occur due to overtime costs, in addition to the costs of employing temporary nurses. Also, the downward changes in productivity are the indirect costs, and so is the possible loss of revenue because of low scores in patient satisfaction. The organizational culture is observed to have an impact on the workplace because burnout causes poor teamwork and low staff morale that can translate to worsening the organizational culture required to sustain professionalism and innovation (Sulaeman et al., 2024). Having a healthcare policy perspective, the facility will be at risk of failing to comply with the quality standards provided by The Joint Commission and may lose its state accreditation due to its failure to address national standards of nursing care. The ethical problems are based on the moral discomfort that the nurses feel when operating in limited conditions, and legal implications are the increased risk of mistakes and careless behavior caused by burnout.

Conclusion

The paper gives an in-depth insight into the different elements of nurse burnout at the said southeastern acute care healthcare facility. The evaluation showed a crucial practice concern that can be widespread in healthcare service provision and delivery, organizational performance, and personal patient outcomes and experiences. The disastrous statistics, such as an increase of 35 percent in the reported burnout symptoms and 27 percent in turnover, are far beyond the national average of 17 percent turnover in midsize rural hospitals (Nurse Manager, personal communication, April 10, 2025; Bae, 2022). The mentioned decrease in the patient satisfaction rates, as well as an increase in the number of medication errors, indicate a correlation between nurse burnout and the decline in the quality of care.

References for NURS FPX 8004 Assessment 1

Bae, H. (2022). Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review. International Nursing Review, 69(3), 392–404. https://doi.org/10.1111/inr.12769

Bromfield, S. M., & Kanyogonya, V. (2024). Pursuing the unachievable: Examining worker burnout in Ontario’s public employment services. Alternate Routes: A Journal of Critical Social Research, 34(1). https://alternateroutes.ca/index.php/ar/article/view/22559

Flaubert, L., Menestrel, L., Williams, D. R., & Wakefield, M. K. (2021). Supporting the health and professional well-being of nurses. In www.ncbi.nlm.nih.gov. National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK573902/

Ibrahim, S. A., Reynolds, K. A., Poon, E., & Alam, M. (2022). The evidence base for US Joint Commission hospital accreditation standards: Cross-sectional study. British Medical Journal (BMJ), 377. https://doi.org/10.1136/bmj-2020-063064

Jun, J., Ojemeni, M. M., Kalamani, R., Tong, J., & Crecelius, M. L. (2021). Relationship between nurse burnout, patient, and organizational outcomes: Systematic review. International Journal of Nursing Studies, 119, 1–12. https://doi.org/10.1016/j.ijnurstu.2021.103933

Sulaeman, R., Amien, N. N., Budiadi, H., Fitriani, H., & Ismiyatun, I. (2024). Toxic workplace culture: Causes and consequences. The Journal of Academic Science, 1(4), 384–394. https://doi.org/10.59613/p9hfcf75

 

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