Creating a PICO Question About Burnout Among Nurses

Burnout in nurses is a critical issue for the U.S. healthcare system, especially nowadays, due to an increased strain on its services. The discussion of this topic has been ongoing for many decades, yet the conclusive answer on how to resolve or efficiently alleviate this problem remains open. The work at a hospital is often highly intense and stressful, creating one of the most susceptible populations of nurses that require immediate attention. The impact of burnout on the healthcare system is immense, as it leads to increased turnover rates and an overall decrease in the quality of care (Geuens et al., 2019). Numerous studies on burnout reduction have outlined several potentially applicable interventions, which will be analyzed from the chosen systematic review and quasi-experimental articles. This essay will assess the issue of burnout among nurses in hospitals, identify evidence for its solution, and draw a PICO question that must be answered to improve the situation.

It is necessary to assess the population for the question. Healthcare workers require workplace adjustments to protect their health, both mental and physical, during their work since its toll is immense. I chose hospital registered nurses as the target population for the PICO question due to the intensity of their work environment. Bakhamis et al. (2019) state that “the incidence of burnout in RNs is as high as 70%” (p. 4). This career can cause severe issues with self-esteem that stem from often unappreciated efforts, disagreements with teammates or leaders, and negative patient interactions (Geuens et al., 2019). Moreover, the number of patients in hospital settings grows disproportionately faster than the number of nurses in these healthcare facilities, causing staffing issues that add stress (Bakhamis et al., 2019). In addition to these reasons, these nurses must adapt to the largest number of different care environments contained within a single institution. The PICO question will attempt to help the hospital nurses with the selection of the most optimal solution for the sources of high stress.

Further exploration of this issue can assist with developing an intervention tailored specifically for this setting. Many articles assess the impact of different interventions, outlining the extent of the perceived benefits from their implementation. Many solutions deal with the issues described above, although some focus on more specific factors. One of the most explored options is social support and stress relief groups organized specifically for nursing personnel (Alenezi et al., 2019). Another popular intervention ushers hospitals to create recognition programs for nursing personnel through various rewards, both monetary and non-monetary (Bakhamis et al., 2019). Since teamwork is often listed as a major source of stress, its resolution is also prioritized by some proposed interventions through innovative leadership strategies or exercises focused on improving collaboration (Geuens et al., 2019). The change of perceptions on stressful situations is the additional focus of several interventions that propose self-management through personal exercises and meditation (De Oliveira et al., 2019). Social support programs that are contained within a single hospital and do not invite people who do not share similar experiences present the best opportunity for stress relief due to their efficiency (Geuens et al., 2019). This intervention will serve as an intended course of action for this PICO question.

The results of Geuens et al. (2019) showed four main emerging themes associated with burnout and constituted the following. One is teamwork, two is personal and work situations, three, is manager, and four is passionate about being good or doing well. Specifically, the feeling of burnout was attributed to the level of discrepancy between the first individual vulnerability factor alongside three situational stressors resulting in RNs feeling burnout or stressed. Moreover, compared to the other sources of evidence, the appropriateness of Geuens et al. article in answering the PICO(T) question was founded on several negative consequences associated with RN burnout. Hence, calling for a burnout prevention intervention was critical to safeguard the well-being of individual nurses, healthcare organizations, and most importantly, the well-being the patients. Therefore, the information presented by Geuens et al. was considered the most credible for the health care issue.

The evidence reveals that there is a need to define a method for decreasing stress among nurses in an optimal way, yet not all methods are equally efficient or suffice all parameters that cause burnout. The presented information makes it possible to generate a viable PICO question that will be further explained with supporting evidence. Among nursing personnel working in hospital environments, how the introduction of localized social support groups can affect the stress levels of the chosen population in comparison with recognition programs, teamwork training, or self-management instructions? As the study by De Oliveira et al. presents the most comprehensive information on the topic through the literature review, the solution will be chosen among the assessed interventions from that paper. In turn, Bakhamis et al. present a thorough analysis of the reasons behind burnout that must be taken into consideration. Other studies provide additional evidence for other methods of stress reduction among nurses and improve the precision of the PICO question.

The criteria for determining the potential to answer the PICO(T) question lie in the sources’ ability to formulate evidence-based questions when using the PICOT format. Therefore, any source that emphasized the patient or population issue by defining who the patient was, age, race, health or disease status, gender, or race would provide the appropriate answer. Further, adherence to the remaining four aspects of the PICO(T) format about intervention, comparison, outcome, and time would warrant the researchers understanding of how the evidence-based practice would determine the potential to answer the question. That would be the case since the source would devise the appropriate plan for the patient, an alternative plan, potential outcomes, and the timeframe necessary to diagnose the problem.

The findings suggest that high levels of stress are detrimental to the quality of care, and it may be difficult to pick the optimal program that helps with their reduction. In relevance to the PICO question, the evidence explored in this paper presents a dire necessity to choose the most efficient method of reducing stress among the target population. The study by Bakhamis et al. (2019) reveals that “emotional exhaustion, depersonalization, and inefficacy” and the primary contributors to the issue (p. 7). In turn, several articles suggest that meetings positively affect the emotional state, help nurses connect, and increase group cohesiveness (Alenezi et al., 2019; Bakhamis et al., 2019). In-group training is the most prevalent and leads to improvements in the work environment, as well as personal well-being among personnel (De Oliveira et al., 2019). Due to this factor, strictly localized meetings for communal support were chosen as the primary option for the solution.

Evidence from these articles presents a clear path toward the most efficient method of addressing this long-standing issue. However, the outlined interventions differ in their efficiency and scope, requiring further investigation to ensure that there are no missed factors or opportunities for improvement. Recognition of achievements can decrease job dissatisfaction, yet it also introduces additional adverse factors, such as competition, while it also does not address teamwork adequately (Geuens et al., 2019). In turn, teamwork-oriented solutions can help with stress reduction by improving the work environment, but there are stress sources that are specific to the local community of nurses that will remain excluded by this approach (Geuens et al., 2019). Within the PICO question, this evidence points toward the need to give each worker a chance to share their problems, reflect on the communal experience, and work together on the betterment of the situation.

Some issues are expected to be resolved at least partially by the proposed intervention. In comparison with the other methods, localized social support groups cover all three main sources of stress, which is the focus of this intervention. Moreover, other problems within that setting can be resolved alongside high levels of stress. By creating local groups, hospitals can simultaneously increase teamwork among nursing personnel, as the level of organizational culture will increase through shared experiences. Since the stress levels of nurses affect the quality of care, it is expected that it will increase as well.

Therefore, the relevance of the findings from the sources lies in the need to develop an RN burnout prevention intervention that targets both the individual vulnerability factor and situational stressors. With such an intervention in place, nurses will be able to cope with burnout and stress in turn demonstrating enhanced success in their responsibilities. Among the aspects of a successful intervention prevention plan constitute a psycho-oncological training program, basic nursing care, and systematic nursing supervision. However, to achieve effective organizational characteristics that would ensure efficiency in the intervention plan, healthcare facilities must increase their staff, minimize workloads, and improve their nurse-to-patient ratio. The outcome of such an inclusion would improve the times needed by nurses to rest while the workload would also decline due to an increased nurse-to-patient ratio. Hence, the influence attributed to factors that impact clinical performance would be enhanced due to a decline in burnout and RN work-related stress.

In conclusion, burnout is a critical issue that requires a complex approach unique to each local population of hospital nurses. The presented PICO question poses a valid solution for the population that appears to be the most affected by the selected issue. Social support groups are shown to be highly efficient in reducing stress among nurses and improving their teamwork by providing space to express concerns and work on improving the work environment. In comparison with other approaches, this method covers all three primary sources of burnout among the target population.


Alenezi, A., McAndrew, S., & Fallon, P. (2019). Burning out physical and emotional fatigue: Evaluating the effects of a programme aimed at reducing burnout among mental health nurses. International Journal of Mental Health Nursing, 28(5), 1045-1055. Web.

Bakhamis, L., Paul, D. P., Smith, H., & Coustasse, A. (2019). Still an epidemic: The burnout syndrome in hospital registered nurses. The Health Care Manager, 38(1), 3-10. Web.

De Oliveira, S. M., De Alcantara Sousa, L. V., Vieira Gadelha, M. D., & Do Nascimento, V. B. (2019). Prevention actions of burnout syndrome in nurses: An integrating literature review. Clinical Practice & Epidemiology in Mental Health, 15(1), 64-73. Web.

Geuens, N., Franck, E., Verheyen, H., De Schepper, S., Roes, L., Vandevijvere, H., Geurden, B., & Van Bogaert, P. (2019). Vulnerability and stressors for burnout within a population of hospital nurses: A qualitative descriptive study. Canadian Journal of Nursing Research, 53(1), 16-26. Web.

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