AbstractNursing burnout and fatigue will affect every nurse at some point in his or her career with many contributing factors. Nurses are the front line of health care services. The effects of nursing burnout and fatigue can directly affect patient care and the nurses own health. Prevention tactics and education provided to the nursing staff is essential to physical and mental stability. The online databases involved were Pubmed Query, CINAHL Complete, and EBSCO Discovery. The literature is peer reviewed and ranked by using the evidence hierarchy. The framework used to mold the study is the IOWA model. The Maslach Burnout Inventory General Survey (MBI-GS) will be completed before the initiation of the study and then again two months after interventions took place. The study will be conducted at Children’s Hospital of New Orleans in the Pediatric Intensive Care Unit.  Interventions including counseling, educational resources, engagement in group activities, healthy nutritional options for both day shift and night shift, and unit lead relaxation techniques will be implemented to reduce nursing burnout and fatigue. Related constraints include lack of participation from staff. Keywords:nursing burnout, fatigue, prevention    Problem or Knowledge Focused Triggers- Nursing Fatigue and BurnoutAs nurses, we are the front line of health care services. Nursing burnout and fatigue will affect every nurse at some point in his or her career. Nurses work long hours, sacrifice time away from their families, and have an increased amount of emotional and physical stress. Nurses also have increased responsibilities without mandatory break times, increased patient acuity, and lack of ancillary staff. Following those things mentioned above lack of sleep, exercise, and the proper diet result in lack of self-care which ultimately affects patient care. Contributions to burnout include moral distress, emotional and spiritual demands creating the perception of excessive workload, and stressors associated with physical and psychological environments (Rushton et al., 2015). The pediatric intensive care unit can be very challenging, demanding, and strenuous in many ways. It can also be very rewarding as well. Many experienced and valuable nurses on my unit are leaving due to many of the factors listed above. This evident problem is concerning and needs to be addressed.  As anewer nurse, learning from experienced nurses is very valuable. The fatigue andburnout of experienced nurses is evident. Encouraging and promoting ways toprevent burnout and fatigue from happening to bedside nurses is important. Avariety of clinical and intellectual experience in every unit is essential. Ona day to day basis nurses may be faced with stressful life or death situationsthat can be emotionally and physically draining, which can lead to nursingfatigue and burnout very fast. TheIOWA Model was chosen as a framework for this study. The IowaModel is a widely used framework for the implementation of evidence?basedpractice (“Iowa Model”, 2017). This model helps to promote the use of evidencebased practice, and is a guideline to show how facilities can promote quality,safe, and effective care using evidence based practice. There are always thingschanging in nursing, new medications, practices, and policies ect. The modelhelps to keep new research organized according the changes that will help toimprove care and enforce change. Literature ReviewByusing the University of Louisiana at Lafayette’s online database, all of the literature reviewed for this project is peer reviewed andranked by using the evidence hierarchy. The literature reviewed all show thatnursing fatigue and burnout is a growing issue in the healthcare field, butalso implements ways to help reduce the rising trend. A cross-sectional surveyand structured questionnaire completed by Bogaert, Timmermans, Weeks,Heusden,Wouters, & Franck (2014) used to  investigate the impact that burnout has ona  nurses environment, work ethics, andpatient care and safety. Various unit- level associations were identifiedbetween environmental factors, work characteristics, and burnout dimensions. Inaddition, there were many independent variables such as nursing management unitlevel, emotional exhaustion, turnover rates, and medication errors just to namea few. The level five-ranked study suggested that a stable work environmentimproves patient safety outcomes, when unit-favorable perceptions are meetresulting in decreased levels of nursing burnout. The cross- sectional studythat was completed by Khasmisa, Oldenburg, Peltzer, & Ilic (2015) examinedthe relationships between work related stress, burnout, job satisfaction andthe overall general health of nurses. The participants included in the studywere given five questionnaires to take Socio-Demographic Questionnaire (SDQ),Nursing Stress Inventory (NSI), Maslach Burnout Inventory- Human ServicesSurvey( MBI-HSS),  Job SatisfactionSurvey(JSS) , and General Health Questionnaire (GHQ).  In result concluding that  Burnoutclearly impacts on the mental health and wellbeing of nurses, which is mostlikely compromising productivity, performance and the quality of patient care (Khasmisaet al., 2015). The study also states that stress management programs includingeducation training, and stress reduction strategies are linked to minimizingburnout and increasing the overall health of nurses.Some nurses develop resilient coping strategies and adapt tostressful work experiences, mitigating the development of common maladaptivepsychological symptoms (Mealer et al., 2014). A randomized control trial, andintervention study completed over a twelve-week period. Educational classes,counseling, exposure sessions, and stress reduction exercises were allinterventions that were performed within a two-day period. In conclusion, afterimplementation of the training programs there was a significant decrease inresilience, environmental stressors, posttraumatic stress syndrome (PTSD), andburnout syndrome. A two phase project completed by Rushton, Batcheller,Schroeder,& Donohue ( 2015) was  performed to increase the resilience of nurseswhile improving retention and reducing turnover.   Inphase one the cross sectional survey used to determine the areas of highstress, and in phase two by using survey tools including the Maslach BurnoutInventory Survey, Moral Distress Scale, Perceived stress scale, Meaning scale,and Hope scale were used to assess the nurses charteristics and determine thefactors that involve burnout. Concluding, that moral distress was predictor ofall aspects of burnout, and the relationship between burnout and resilience waspowerful. Physical and emotional well-being had a direct association withgreater resilience.ResolutionAs theliterature clearly states there are many problems that directly related tonursing fatigue and burnout. Education and awareness were mentioned in theliterature-reviewed sources quite often. At Children Hospital of New Orleans,educational resources can be used to bring awareness and prevent nursingfatigue and burnout. Mandatory assignments will be created and presented intothe Children’s Hospital Intranet for all nurses with to complete with CEUcredits as a reward for completion. Counseling, educational resources, unitlead relaxation techniques, and healthy nutritional options for all shifts. Counselingthat is available for day shift and night shift will allow nurses to expresstheir feelings of concern and allow for open communication. Educationalresources such as videos, and models presented in the intranet allows nurses toimplement ways to prevent nursing burnout. Unit led relaxation before and afterevery shift will allow a release of endorphins and decrease stress. Lastly,allowing for the cafeteria to be open until at least 10:30pm to allow for nightshift employees, patients, and family member to have a healthy well balancedmeal. Nurses who practiced a healthy lifestyle weresignificantly more likely to provide guidance and counseling to families onhealthy behaviors and promote personal health and wellness (Hasson et al.,2018). All of these methods will help to preventnursing burnout and fatigue as well as provide a stable work environment,well-balanced personal and mental health. Nurses with spiritual and mentalwell-being, hope, and resilience were protected against burnout (Rushton etal., 2015).Implementation PlanAllnurses in the Pediatric Intensive Care Unit at Children’s Hospital of NewOrleans will be encouraged to complete the Maslach Burnout Inventory GeneralSurvey (MBI-GS) initially before the start of the project. As stated byBianchi, (2015) The Maslach Burnout Inventory General Survey (MBI-GS) is a 16question survey measuring exhaustion, cynicism, physical fatigue, andprofessional efficacy. Flyers and email reminders will be posted and sent toall nurses to complete the survey. Nurses will be allowed to choose anyintervention to be able to participate, but more than one is suggested. Overthe two month period nurses will be able to provide verbal feedback. Biweeklymeetings will take place at times available for both day shift and night shiftto attend, to obtain feedback from the nurses participating.Monitor & Analyze Outcome DataThe best way to evaluatethe change that has been implemented would be to have a formal discussion withthe nurses, and have complete the MBI-GS survey again to evaluate the outcomeof the plan. Nursing fatigue and burnout affects everyone differently, so thechanges implemented may benefit one more than another. Feedback from the staffis imperative to determine whether the implemented strategy that was beneficialor not. Nursing Research should be conducted under real-world conditions and inthe setting where the findings are intended to be applied (Battagila et al,2018).By communicating effectively, change will evolve. Knowledge and evidence derived from scholarly methods should drive our clinical practice, decisions and change to improve the way we deliver care (Curtis et al, 2016). The most appropriate way to share the information with others at my facility would be to send an email to all of the nurse staff on the unit, and to create flyers to post in the break room and nurses station. This will show the outcome of the benefits that are available.Evaluation and Dissemination of PlanUpon completion of theproject, the results and findings should be shared with all staff members.Dissemination of the plan can be done in many ways.   Bycommunicating effectively, change will evolve. Knowledge and evidence derivedfrom scholarly methods should drive our clinical practice, decisions and changeto improve the way we deliver care (Curtis et al, 2016). The most appropriateway to share the information with others at my facility would be to send anemail to all of the nurse staff on the unit, and to create flyers to post inthe break room and nurses station. This will show the outcome of the benefitsthat are available. EBP cannot evolve unless communication channels in thesocietal system are used effectively to bring about change (Schmidt & Brown,2015). SummaryNurses are the frontline in healthcare. Nursing burnout has no boundaries and can affect manythings impacting personal health and patient care in a negative way. Thephysical and mental stability of nurses should be a priority to administrationas well as the nurses themselves. By working as a team to reduce nursingfatigue and burnout, patient safety and satisfaction will increase. Providingsafe and effective care is priority. Bringing education and awareness aboutnursing fatigue and burnout and implanting the ways to prevent it will allowfor a safer work environment, personal well-being, and proficient patient careexperiences. ReferencesBattagila, C., & Glasgow, R.E. (2018) Pragmatic dissemination and implementation research models, methods and measures and their relevance to nursing research. Nursing Outlook. Doi: 10.1016/j.Bianchi, R. (2015). What is ‘severe burnout’ and can its prevalence be assessed? Intensive Care Medicine, 41 (1), 166. doi:10.1007/s00134-014-3534-y.Bogaert, P.V., Timmermans, O., Weeks, S.M., Heusden, D.V., Wouters, K., & Franck, E. (2014). Nursing Unit Teams Matter: Impact of Unit-Level Nurse Practice Environment, Nurse Work Characteristics, and Burnout on Nurse Reported Job Outcomes, and Quality of Care and Patient Adverse Events- A Cross-Sectional Survey. International Journal of Nursing Studies, 51(8), 1123-1134. Doi: 10.1016/j.ijnurstu. 2013.12.009.Curtis, K., Shaban, R. Z., & Cibsidne, J.(2016). Translating research findings to clinical nursing practice. Journal of Clinical Nursing, 26(5-6), 862-872. Doi: 10.1111/jcon. Hasson, R., Strak, A. H., Constantini, N., Polak, R., Verboy, G., Edelstein, N., Stein-Zamir, C.    (2018). “Practice What You Need Teach” Public Health Nurses Promoting Healthy Lifestyles: Program Evaluation. Journal of Ambulatory Care Management, 41(3), 171. Retrieved from http://ezproxy.ucs.louisiana.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct-true&AuthType=ip,cookie,uid,url&db-edo&AN=129968629&site=eds-live Khasmisa, N., Oldenburg, B., Peltzer, K., & Ilic, D. (2015). Work Related Stress, Burnout Job Satisfaction and General Health of Nurses. International Journal of Environmental Research and Public Health, 12(1), 652-666. Doi: 10.3390/ijerph120100652 Mealer, M., Conrad, D., Evans, J., Jooste, K., Solyntjes,J., Rothnaum, B., & Moss, M. (2014), Feasibility and Acceptability of a Resilience Traning Program for Intensive Care Unit Nurses. American Journal of Critical Care, 23 (6). Doi: 10.4037/ajcc2014747 Rushton, C.H., Batcheller, J., Schroeder, K.,& Donohue, P. (2015). Burnout and Resilience Among Nurses Practicing in High- Intensity Settings. American Journal of Critical Care: An Official Publication, American Association of Critical- Care Nurses, 24(5), 412-420. doi: 10.4037/ajcc2015291. Schmidt, N. A., & Brown, J. M. (2015). Evidence-based practice for nurses: Appraisal and application of research. Jones and Bartlett Learning.Get Help With Your AssignmentIf you need assistance with writing your assignment, our professional assignment writing service is here to help!Find out more