Welcome, everyone. It's good to see everybody in person. It's an incredible honor to speak today on the work of our committee. And let's see if we can have slides. Thank you. Okay. Click left. That's right. So I don't have financial disclosures. Our subcommittee worked with Dr. Rincon, Theresa Rincon. Together, we were looking over their articles, and we're going to present today. Learning objectives for today, just to go over what we found, the themes and discussions, and overview the clinical implications. So for our search methods for the topics that we did, we had an inclusion criteria. And inclusion criteria will look at all the critical care journals and magazines where the nurse was a PI. As a main author, it was, like, our big thing. So just, okay, main author should be PI. And the population that we're discussing, it should be, like, in critical care or people who are working in the hospitals in different settings. And we'll look at the studies that were published in October 2021 through June 2022. So everything was published in all different journals. We all looked this through. Search terms will look at all the listed search terms. Graduate, nurse challenges, shortage, nursing shortage, workload, patient ratio, patient outcomes, quality of care, because we were trying to, like, think through what is it leading to, what we can come up with. Look at the acute care hospitals and critical care nursing. Look for the ICU. My colleague will be talking about sepsis, but sepsis was not a search theme. That topic came through the methodology of the article being researched and published. Our search strategy, our team. As you see, it's a lot of databases out there. We can do it, like, three of us, right? There's an entire team we're meeting for throughout the year. We kind of, like, conquered together. Look at the CINO, PubMed, Google. We did the dimensions of critical care, nursing research, critical care medicine, ACN. All of these articles were kind of conquered together. We decided, okay, who's going to be doing what, and we dedicated an hour of spare time off work, like, nothing to do at nursing, right? Nothing to do. And we just, like, you know, really, really did it together. So thank you, Dr. Yosef, Dr. Rincon, Dr. Shalom, Dr. Pinaya, Dr. Crago, Dr. Strasser. Thank you so much. We couldn't have done it without you. The study selection all together, when we look all together at the article we thought was going to be really good to look at, 133, we build up, like, a table of evidence. Yes, it does exist in the volunteer world. It's not only nursing school and APNs. And this is what kind of, like, shocked us, because when we look at the major themes, the number one theme was the nursing burnout. The amount of publication that came through the entire databases were talking about the nursing burnout. The second topic that arose due to the methodology and how good quality it was, it was number one sepsis. And we see throughout, you know, today's symposiums, all the topics. They talk about burnout, not only in nursing. They're talking about sepsis throughout the whole patient population. The article that we chose with Dr. Rincon, kind of, like, an interesting article. I know we asked you to review, like, this couple of articles for today, but for those who didn't have a chance, this is Dr. Sullivan with her team, did a very interesting article that put comparison of a nurse burnout before and during COVID pandemics. You know, like, they teach us in all this scholarly way how we're supposed to write an article, like, it's supposed to be methods and introduction, discussions and results, and that's it. So this article was unique, because the author, Dr. Sullivan, in her introduction said, we cannot look forward if we don't know the past. So this article, a couple of first pages, they're really dedicated on what our human society, when historically from very, very, like, very, very early ages, what pandemics was. And throughout, it brings us to the COVID-19 and where we are right now. The authors concluded, make recommendations, and they did not a systematic review. They did not do the review like we, in scholarly work, in nursing research, we used to look at the article. Just gave us a historical perspective. And within the study, they presented their own study. So let's go over this pretty quick. The key points of that, they look it up, the COVID-19 brought up like a wound, because it's a severe rating of a nurse burnout right there. It's a serious concern that leading to the negative nursing outcomes, leading consequently to the bad patient outcomes, and it's an urgent need for all the healthcare organization to do something about it. Otherwise, we're going to lose the workforce. And let's go over the study design. So preliminary results, they did a literature review. The authors, Dr. Sullivan and her team, did the literature review. This is the keyword that they used. They used the cross-sectional online survey from April 7th. Remember, March 5th, that's here in California, right? But April 7th, 2020, January 15th, 2021, they sent out the online survey to the participants and to assess four aspects of mental health, depression, anxiety, trauma, and burnout. They used widely available, free, you know, online, you can get it. It's Odenburg Inventory Tool that assess mental wellness and the level of burnout. I know in research we use Maslow Inventory Tool, but it has, like, more gradation into it. So the researchers, like, okay, let's just do a simple one. It's pandemics going on. We're not going to bury people with 32-whatever questions. So they just asked us a couple of questions. Look at the sample. Sample, all registered nurses through the 48 states, here in the United States. Utah and Alaska were not able to provide the results. So when we look at the research, this is what they had. And they included, like, two countries. The authors removed 327 participants just because they didn't really fully answer on all these eight questions that were provided. So, therefore, they lead us to the sample of 1,037. So just look pretty quick on this study design and let's see the methodology. And let me see what you guys think. If I go back. Here I go. The methods and design of this study were strong. What do you think? It was strong? It wasn't strong. It was a cross-sectional. Let me see. Let me go back. Previous. Yeah. So cross-sectional online survey. The time. The tool. And look at the sample. What do you guys think? Rebecca. I see. Yeah, I know. Yeah, cross-sectional is not always fun, right? So we can't really say, like, true research is like when we're doing the research, right? It's like cross-sectional is something. But what can we do, right? What about the sample size? What do you guys think? Do you have enough information about sample size? Yeah, not yet, right? Yeah, and then they use the eight questionnaire, so it's not really for that type of a study, right? For that type of a study, eight questions is not enough. Okay, let's see what we have next. So this is our results. Participants were 92. Demographics showed we have 92% female and 8% male. The highest percentage age group, 55 to 64. 55 to 64. That's 27%. 45 to 54, 24%. So kind of like equal distribution, as you see. Everybody participated. You see through across. The degree. So look at the degree association. Look, BSN has the highest. Doctorate, Master's, but BSN has the highest. And look at the population of the study. 39 students. 39% were nursing students. Employment, clinics, hospitals, 55%. The majority in some other that goes for the critical care. Locations were throughout. Urban, 55%. Suburban, 32%. So you see the location of the hospital throughout as well. And the residents. Okay. As a result, we see we have good representations, right? Across the globe, we have good representations. All the data in there for us. From the OBI tool, they look at the study and they see they have a very strong correlation with our qualitative questions. Capacity of the hospitals right now, right? Do you feel that there's a strong shortage of personal protective equipment? Every state except Utah and Alaska reported they're not good with protective personal equipment. And that's in the midst of pandemics. Right now, looking back, we can see the p-value shows. It's not just like a storytell that we see and we share with each other and we know. Now it's documented there and the study was done. Are you working overtime during COVID-19 pandemic? Look at the p-value, .001. We didn't have a choice, right? We're committed to our profession. And that was shown in the study. So the other negative significant correlations were what about the staffing and institution? As you see, the p-values right there are very strong. What about staffing? What about pay? How are we doing out there across the globe as an example of our representation throughout the United States? And let's see for significant findings of the study, what do you see for this article? What was the most one that we looked at? Is it with nursing staffing? Is it shortage of PPE? Forced overtime, workload? So reading this article, we for ourselves, we can rank it to your own story. Let's see if you have a story to share. How was it in your hospitals? Yeah, it was from April 2020 to 2021, yeah, to January 2021, right there. In the midst of the storm, right? Yeah. Another question, thank you for sharing. And we see we're trying to enlighten kind of like having not just like a dry discussion and from outside but having together. But it was all like, yeah, we can do it, you know, and we're all excited. here. Yeah, there was all of these things. Um, you know, war was never declared, so you didn't see, you weren't in war. But they were in war, and you don't know what you saw, and there was a war in mind. really good points. And think about timing. This was in the very beginning of the pandemic, and you think about some of these may have flipped now, right? One more question, yeah. Yeah, because what we're asking for from the leadership, like, hey, where is the support, right? And you're right there up front and trying to get it, only to know that federal government has allocation equal packages. It doesn't matter if you are like 1,000 bad institution or you're a 20 bad institution, but it's equal allocation to everything. That was bringing up exactly to the summary of the study, where it was a call for the urgent need to look through, like being present that we have a nurse burnout, right? But what we can do. So we just talk about the strategies, but the recommendations, look at the recommendation that the study actually come up with. The policy to protect nurses and your staff, and it's not only saying about the front line workers. The whole the leadership has to support the policy, to support the practice of the nurses, and have in place policies that would monitor the nursing burnout. And this free, easy, accessible tool can actually be running down in the units and have your studies with your nursing researchers in the institution monitor that burnout and have a pulse of your staff what's going on. They're asking to protect well-being by teaching mindfulness sessions, have a collaboration with any kind of organization that gives self-care techniques, have a psychological support as possible, and have it connected like a free phone call, free social worker that can come and provide some support. Prioritizing race and breaks. That's another big deal. Because when we work in a community hospital and work in an academic institution, so the researcher shows that prioritization of the rest of the breaks is really enormous. It's very valuable. Because let's say the nurse is working on a 1,000-bed institution. By the time they go to the break area, by the time they go to the cafeteria, how much time does it take? And versus in a community hospital, it should be a decorative break adjusted to the possibility where they're gonna get a break, especially with the pandemics and post-pandemics. They talk about providing meditation apps and the big deal for hospital administrators to talk about the budget and adequate staffing and pay. They didn't talk, a study did not talk about the travelers. But as a result, the NSPERAN-R test was used in statistical analysis, double-tailed. And it showed the staffing and nurses responding like, hey, I'll come extra if I can get a good reimbursement for that. Instead of seeing, for example, travel nurse, have your own staff that already trained, that already know what you're doing, coming in just for that extra pay. So have this negotiation with the nurse leaders at the hospital. So with this, we would like to say thank you to our research team for making this conversation possible. And any more discussions we have on the nurse burnout will be available right after this session. Thank you so much.

committee work

nursing burnout

literature review

COVID-19 pandemic

workforce shortages