Children's Hospital Los Angeles, Los Angeles, CA, USA.
University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA.
Worldviews Evid Based Nurs. 2020 Jun;17(3):213-220. doi: 10.1111/wvn.12450. Epub 2020 Jun 25.
Burnout is a substantial phenomenon across healthcare settings, affecting more than half of healthcare professionals and leading to negative patient and health system outcomes. Infusion center professionals (ICPs) are at increased risk of burnout attributed to high patient volume and acuity levels. Strategies to address burnout have been developed and prioritized by the American Medical Association (AMA), the World Health Organization, and other organizations.
This quality improvement project aimed to address perceived burnout, job-related stress, and job satisfaction among nurses, physician assistants, and medical assistants at a large pediatric hospital through integration of two infusion center (IC)-based staff engagement interventions.
A pre- and post-test study design was used. Existing team huddles in the IC were modified based on the AMA STEPS Forward program recommendations to incorporate appreciative inquiry and recognition into team and department events. Peer recognition was tailored toward institutional core values. The Mini-Z Burnout survey was administered before and 3 months after implementation of both interventions.
Pre- to post-intervention responses revealed a higher percentage of staff reporting no burnout (57.7% vs. 75%), low levels of job-related stress (58.8% vs. 65.5%), and satisfaction with current job (70.6% vs. 82.8%). Most participants agreed or strongly agreed that structured huddles (69%) and recognition events (82.8%) were beneficial and recommended continuation (65.5% and 82.8%, respectively). Open-ended responses regarding workplace stressors focused heavily on staffing and patient acuity.
Project outcomes support the integration of tailored interventions to reduce burnout among pediatric ICPs. Organizational commitment to addressing burnout can provide incentive to scale up institution-wide staff engagement interventions. Further study is needed to assess the efficiency and effectiveness of such tailored interventions across diverse settings.
burnout 是医疗保健领域的一个重要现象，影响了超过一半的医疗保健专业人员，并导致了负面的患者和医疗系统结果。输液中心专业人员（ICPs）由于患者数量和疾病严重程度较高，面临更高的 burnout 风险。美国医学协会（AMA）、世界卫生组织和其他组织已经制定并优先考虑了应对 burnout 的策略。
本质量改进项目旨在通过整合两项输液中心（IC）为基础的员工参与干预措施，解决一家大型儿科医院护士、医师助理和医疗助理感知的 burnout、工作相关压力和工作满意度问题。
使用了预测试和后测试的研究设计。在现有的 IC 团队中，根据 AMA STEPS Forward 计划的建议进行了修改，将赞赏性调查和认可纳入团队和部门活动中。同事认可针对机构核心价值观进行了定制。在实施两项干预措施之前和之后的 3 个月，使用 Mini-Z Burnout 调查进行了管理。
干预前到干预后的反应显示，报告无 burnout 的员工比例更高（57.7%比 75%），工作相关压力较低（58.8%比 65.5%），对当前工作的满意度较高（70.6%比 82.8%）。大多数参与者同意或强烈同意结构化的小组讨论（69%）和认可活动（82.8%）是有益的，并建议继续进行（分别为 65.5%和 82.8%）。关于工作场所压力源的开放性回答重点关注人员配备和患者严重程度。
项目结果支持整合量身定制的干预措施，以减少儿科 ICPs 的 burnout。组织对解决 burnout 的承诺可以激励在整个机构范围内实施员工参与干预措施。需要进一步研究来评估这种量身定制的干预措施在不同环境中的效率和效果。
