DNP-835 Quality and Sustainability Paper: Part 1 

Grand Canyon University DNP-835 Quality and Sustainability Paper: Part 1  – Step-By-Step Guide

This guide will demonstrate how to complete the Grand Canyon University DNP-835 Quality and Sustainability Paper: Part 1 assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for DNP-835 Quality and Sustainability Paper: Part 1          

Whether one passes or fails an academic assignment such as the Grand Canyon University DNP-835 Quality and Sustainability Paper: Part 1      depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for DNP-835 Quality and Sustainability Paper: Part 1          

The introduction for the Grand Canyon University DNP-835 Quality and Sustainability Paper: Part 1    is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for DNP-835 Quality and Sustainability Paper: Part 1          

After the introduction, move into the main part of the DNP-835 Quality and Sustainability Paper: Part 1     assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for DNP-835 Quality and Sustainability Paper: Part 1          

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for DNP-835 Quality and Sustainability Paper: Part 1          

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for DNP-835 Quality and Sustainability Paper: Part 1 

Health organizations exist to deliver quality, safe, and efficient outcomes to their populations. Healthcare stakeholders, including healthcare providers adopt evidence-based interventions to achieve these outcomes. Care interventions such as interprofessional collaboration contribute to the creation and sustenance of best practices in the provision of patient care services. Healthcare providers should be able to propose, implement, monitor, and evaluate measures to inform the effectiveness of quality improvement initiatives adopted in their organizations. Therefore, the purpose of this research is to explore the different safety and quality in healthcare and programs in a facility.

Definitions

Quality is the level in which the healthcare services offered to individuals, families, or communities increase their potentials of achieving their desired health outcomes. Healthcare providers utilize their expertise knowledge and skills to assess, plan, and deliver care that achieve quality outcomes. Consequently, quality measurement is the assessment of whether the services offered met quality domains. The domains include efficiency, effectiveness, timeliness, patient-centeredness, and equity. Quality measurement should be objective, evidence-based, and accurate (Endeshaw, 2020). Safety entails the provision of care services that are free of errors and exposure of patients to adverse events. Safety measurements asses the degree to which patients were predisposed to harm in the care process (Schwappach & Niederhauser, 2019).

Quality and safety have significant implications to nursing practice today. Accordingly, nurses have to adopt care interventions that contribute to quality outcomes such as patient satisfaction, resource efficiency, timeliness, and equitable. Nurses also should embrace models of quality care obtained from sources of evidence-based data. Nurses also provide safe care to their patients. They make evidence-based decisions that minimize harm and optimize gains from the given care (Endeshaw, 2020). For example, they advocate for patient safety culture in their organizations to ensure the use of care interventions that minimize the potentials of patient harm.

Table

Evaluation

Several factors act as barriers that affect the provision of care that improve patient and organizational outcomes. One of the barriers is staffing shortages. Most of the health organizations in America currently experience  a shortage of nurses. The shortage is attributed to a range of factors that include high rate turnover among nurses, retiring nursing workforce, unhealthy working conditions, and the imbalance between nurses being trained and those retiring or exiting the workforce. Nursing shortage adversely affects organizational and patient outcomes. First, it increases the workload for the few staff in an organization, hence, burnout and occupational stress among them. Nursing shortage also increases the risk of adverse events in the care process such as medication errors and delays or skipped care. organizations suffer from high operational costs incurred from hiring, training, and maintaining its staff (Marć et al., 2019). Therefore, staff shortage affects patient and organizational outcomes.

The other barrier to optimum patient and care outcomes in service delivery is the lack of competencies by healthcare providers. Healthcare providers should be competent in the delivery of evidence-based interventions for disease management in their practice. They should be able to identify and critique the different sources of evidence that inform their practice. Lack of knowledge and skills in these areas result in the provision of suboptimal care to patients, families, and communities (Challinor et al., 2020). Organizations also suffer from the lack of continuous improvement in the quality and safety of their services, hence, the need for change.

Solutions

Health organizations can implement staff-centered interventions to address the issue of staff shortages. Nurse-centered interventions such as empowering them, providing safe working conditions, and promoting their professional development are effective in addressing the issue of nurse shortages. Additional interventions such as ensuring flexible work schedules, providing counseling services, and increasing nurses’ involvement in the care processes also reduce nurses’ turnover, addressing the issue of nursing shortage. Health organizations can also provide regular training opportunities to their staff to address the barrier of their lack of knowledge and skills (Challinor et al., 2020). Regular training opportunities help staff to develop the competencies they need in the translation of evidence into practice.

Facilitators

One of the facilitators of optimum care and organizational outcomes in healthcare is culture of patient safety. Health organizations strive to instill their staff culture of ensuring safety and quality outcomes. The characteristics of this culture includes the use of evidence-based interventions, shared decision making, active patient engagement in the care process, and interprofessional collaboration. A culture of patient safety ensures that healthcare providers constantly engage in the identification of novel interventions to improve care and organizational outcomes (Hessels et al., 2019). As a result, patients benefit from the delivery of high quality, safe, and efficient care. In addition, organizations benefit from resource efficiencies and increased consumer confidence on the quality and safety of care it offers.

The other facilitator to improved care and organizational outcomes is effective leadership and management. Organizations that adopt leadership styles such as democratic, and transformational leadership styles have enhanced performance because of the adoption of employee and patient-centered interventions. The leadership should support the use of strategies such as teamwork and open communication by the caregivers. The leadership should also recognize the importance of providing opportunities for employee growth and development, hence, the delivery of high quality, safe and efficient services to the population (Cummings et al., 2021; Labrague et al., 2020). Therefore, healthcare organizations can use leadership as an approach to improving care outcomes for their populations.

Healthcare Entity

The healthcare facility is a tertiary hospital that has been in existence for the past two decades. The hospital provides both emergency and general care services. It leads in the region in the provision of high-quality, safe and efficient specialized and general care. The hospital is a 250-bed capacity. It is also a medical training institution. It is a for profit private institution. It ranked among the top twenty hospitals in the state based on care quality and consumer rating. The hospital is a champion in the use of best practices in the provision of patient care services.

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Quality and or Safety Issue

The quality and safety issue that is currently being measured at the facility is catheter-associated urinary tract infections (CAUTIs). CAUTIs are part of nosocomial infections that contribute to a high rate of morbidity and mortality in the United States of America. According to the Centers for Disease Control and Prevention (CDC), about 75% of urinary tract infections that patients develop during their hospital stay are catheter-associated (CDC, 2019). The risks for patients developing CAUTIs rises significantly in cases of prolonged urinary catheter use and lack of standardized guidelines for catheter insertion and care in an institution. CAUTIs are associated with adverse outcomes. They include prolonged hospitalizations, increased healthcare costs, and even death from complications such as bacteremia (Shadle et al., 2021).  

Based on the above implications, the facility has been measuring CAUTIs to inform the quality and safety of care offered to patients in the institution. It has been collecting data and presenting results monthly to guide in the evaluation of the adopted quality improvement initiatives in the organization. The measures of CAUTIs are used in nursing to introduce and sustain best practices in the prevention of CAUTIs. Nurses use the data to evaluate the different evidence-based practice projects and guidelines that have been adopted to address the problem.

Quality and or Safety Program

The facility currently has a care bundle that has been adopted to prevent and minimize the risk and rates of CAUTIs. The program targets all the critically ill patients inserted with urinary catheters. The intervention is nurse-led since they are mainly involved in catheterization. The bundled interventions include the provision of staff education on CAUTIs prevention and best practices, catheter removal protocol, and electronic daily checklist. The project was implemented three months ago and will be ongoing for the next nine months. The tracking of the quality improvement program focuses on several measures. They include rates of catheter-associated urinary tract infections, number of patients catheterized in the hospital monthly, hospital costs incurred by patients affected by CAUTIs, and length of hospital stay. It also focuses on the additional interventions given to patients affected by CAUTIs and adverse outcomes such as bacteremia, complicated urinary tract infections, and mortality rate.  

Several things are working with the quality improvement program. First, nurses have actively been involved in the consistent use of the bundled interventions in catheter insertion, care, and removal. Their dedication is largely attributed to their active involvement and training offered to them on the implementation of the interventions. The other thing that is working with the project is the adequate institutional, leadership, and management support. There was adequate provision of the resources needed for the implementation of the project to its completion. The leadership and management also provide the support that nurses need by acting as coaches and mentors.

Variables

Several variables have been used in tracking the above project. One of them is resource utilization. Resources are tracked against a developed work breakdown structure and budget allocation for the different tasks of the project. The other variable is cost. Cost incurred by catheterized patients who develop and those who do not develop CAUTIs are collected and compared to obtain insights into the impact of the project. The other variables include length of hospital stay and adverse outcomes such as deaths among the affected populations (Shadle et al., 2021).

Conclusion

In summary, quality and safety measures have considerable significance to nursing practice. Nurses should be proactively involved in identifying barriers, facilitators, and solutions to factors affecting optimum organizational and care outcomes. The described facility has been collecting measures on CAUTIs. It has implemented a bundled intervention to address the problem, with a focus on measures that track the success of the project.

References

CDC. (2019, October 1). Catheter-associated Urinary Tract Infections (CAUTI) | HAI | CDC. https://www.cdc.gov/hai/ca_uti/uti.html

Challinor, J. M., Alqudimat, M. R., Teixeira, T. O. A., & Oldenmenger, W. H. (2020). Oncology nursing workforce: Challenges, solutions, and future strategies. The Lancet Oncology, 21(12), e564–e574. https://doi.org/10.1016/S1470-2045(20)30605-7

Cummings, G. G., Lee, S., Tate, K., Penconek, T., Micaroni, S. P. M., Paananen, T., & Chatterjee, G. E. (2021). The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership. International Journal of Nursing Studies, 115, 103842. https://doi.org/10.1016/j.ijnurstu.2020.103842

Endeshaw, B. (2020). Healthcare service quality-measurement models: A review. Journal of Health Research, 35(2), 106–117. https://doi.org/10.1108/JHR-07-2019-0152

Hessels, A., Paliwal, M., Weaver, S. H., Siddiqui, D., & Wurmser, T. A. (2019). Impact of Patient Safety Culture on Missed Nursing Care and Adverse Patient Events. Journal of Nursing Care Quality, 34(4), 287–294. https://doi.org/10.1097/NCQ.0000000000000378

Labrague, L. J., Nwafor, C. E., & Tsaras, K. (2020). Influence of toxic and transformational leadership practices on nurses’ job satisfaction, job stress, absenteeism and turnover intention: A cross-sectional study. Journal of Nursing Management, 28(5), 1104–1113. https://doi.org/10.1111/jonm.13053

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage – a prospect of global and local policies. International Nursing Review, 66(1), 9–16. https://doi.org/10.1111/inr.12473

Schwappach, D. L. B., & Niederhauser, A. (2019). Speaking up about patient safety in psychiatric hospitals – a cross-sectional survey study among healthcare staff. International Journal of Mental Health Nursing, 28(6), 1363–1373. https://doi.org/10.1111/inm.12664

Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit. Critical Care Nurse, 41(2), 62–71. https://doi.org/10.4037/ccn2021934

DNP-835A Quality and Sustainability Paper Part 2 Sample

Quality and Sustainability Paper: Part 2 

Individuals and communities encounter health problems varying in severity, type, and required interventions. Despite their health condition, patients visit health care facilities looking forward to comprehensive treatment and support that facilitate holistic healing. As a result, health care organizations and staff should be adequately prepared and resourced to address patient needs. Their ability varies with resources, specialization areas, and the complexity of illnesses. Although it is a universal obligation to provide high-quality and safe care, health care professionals’ capacity is often hampered by their wellness (Søvold et al., 2021). The implication is that health care staff should be physically, mentally, and emotionally optimal to provide patient-centered care. The purpose of this paper is to discuss an appropriate program for addressing a quality and safety issue based on a change management theory. 

Proposed Evidence-Based Quality and/or Safety Program 

Quality and safety issues vary across health care facilities, necessitating different interventions. In the reference health care facility (IHC), nurse burnout is the main issue hampering care quality and patient safety. According to Ryu and Shim (2021), a nursing shortage is the primary cause of nurse burnout since it increases nurses’ emotional, mental, and physical fatigue. Situations that increase the routine workload are also to blame for the increased rates of nurse burnout in health care facilities. While evaluating such situations and their implications in nursing practice, Krebs (2021) noted that nurse burnout has intensified since the COVID-19 outbreak due to the increased emotional and mental drain facing frontline workers. The impacts are severe hence the need for effective, evidence-based, and sustainable solutions.  

From a health care perspective, quality and safety programs for enhancing outcomes at IHC should be multifaceted due to the multilayered nature of the problems. Regarding nurse burnout, intervention programs vary in goals, the severity of the problem, and projected outcomes. Organizational resources and the ability to sustain quality improvement programs determine the choice. Appropriate programs for nurse burnout include self-care opportunities, resilience training, and leadership support. Roux and Benita (2020) underlined the importance of self-care in addressing nurse burnout and recommended a holistic program. In this case, self-care should include physical, inner, and social self-care. Like self-care, resilience programs and leadership support help nurses cope with workplace stressors. Overall, their effectiveness depends on nurses’ participation and the intensity of burnout.  

Program Selection 

Among these programs and others, a comprehensive mental wellness program that focuses on resilience building is the most effective. In agreement with Søvold et al. (2021), nurses should be optimally healthy to diagnose and treat patients according to patient needs. The implication is that nurses’ ability to provide patient-centered care is determined by their mental wellness. However, optimal mental health is not the only requirement for nurses’ optimal performance. The current workplace also requires resilient nurses to cope with workplace stressors. According to Zhai et al. (2021), resilience building improves nurses’ resilience, improving their ability to cope with workplace stress and depression by improving their physical and emotional well-being. Improving nurses’ physical and emotional well-being is crucial to increasing their coping capacity, well-being, and preparedness to perform their everyday roles. 

The comprehensive design of the mental wellness program will undoubtedly lead to better outcomes. Currently, IHC relies on a mental wellness program without the resilience aspect of responding to nurse burnout. The American Nurses Foundation (2022) reported that health care facilities design mental wellness programs to help nurses identify and reduce stress reactions before they develop into complex problems. A core component of such programs is assisting nurses in speaking about their experiences. This support can be provided by nurse leaders or mental health experts. The other vital component is providing nurses with anti-burnout resources. The proposed program will improve outcomes by improving nurses’ coping abilities at IHC. If the program is implemented effectively, it will ensure that the nursing staff is mentally, emotionally, and physically healthy to work happily and resiliently. 

Potential Obstacles and Interventions 

Quality and safety improvement programs encounter different obstacles depending on the designs, implementation timelines, and engagement level. A potential problem that may hinder the implementation of the mental wellness and resilience program is resources. Like other health care facilities, IHC operates on a budget. Therefore, introducing a program that consumes massive organizational resources may affect the implementation of other programs. Anti-burnout resources, resilience training, and the program’s sustainability require adequate financial support. Such support may not be available at IHC hence affecting the program’s implementation and timeliness. The other potential obstacle is the availability of the nursing staff. To save resources and time, nurses should attend the resilience training program as one or several organized groups. However, their routine roles and engagement levels may affect such formations. Indeed, this is a key barrier that can affect the overall planning, program cost, implementation timelines, and evaluation. 

An effective intervention to address the resource barrier is actively engaging the management and looking for external support. As a key stakeholder, organizational management should be actively involved in program implementation. In this case, leaders should understand the feasibility of a program to support it fully (Hussain et al., 2018). The best way to overcome the availability of the nursing staff is to modify or customize the resilience training to ensure that nurses must not attend it physically. For instance, they can be trained via Zoom meetings and other online means after work. Online facilitation can also save costs since its main resource requirement is an internet connection. 

Stakeholders and their Roles 

Program implementation requires a collaborative approach since the tasks involved are diverse and of different complexity levels. Stakeholders’ role is critical due to their (stakeholders) interest in organizational change and quality improvement. One of the stakeholder groups within IHC needed to implement the program is organizational management. According to Sharma (2021), organizational management dictates an organization’s values and culture. Similarly, IHC has management that makes key decisions and must be involved in program implementation. The other key stakeholder group is nurse leaders and departmental leaders. They lead unit-level changes, and they have a massive influence on decision-making. The last important group is the nursing staff. The program cannot be successfully implemented without their input and active participation. 

The role of each group and the engagement level vary with organizational rank and ability to influence change. The primary role of the management in program implementation is to provide an appropriate climate for changes to occur and support quality improvement through resources (Sharma, 2021). Among the managerial staff at IHC, the human resource manager can oversee the program’s implementation and serve as the link between the nurses and the management. Nurse leaders assess the needs of patients and nurses; thus, they understand the types and scope of interventions required to address problems hampering outcomes. As a result, their role is to design the scope of wellness programs and training required to improve nurses’ coping ability at IHC. The role of nurses in program implementation is to participate and apply the knowledge for self-development.  

Change Management Theory 

Health care organizations should continually address their problems to achieve better outcomes. Change management is critical to organizational success, and change usually succeeds in organizations that embrace continuous quality improvement. Hussain et al. (2018) described change management as the continuous renewal of an organization’s direction, structure, and capacities to enable it to respond to the customers’ ever-changing internal and external needs. Since change occurs rapidly in the health care sector, organizations must respond at the same speed. Change theories provide a framework for implementing change and evaluating its outcomes (Hussain et al., 2018). They are designed to help organizational leaders and managers to drive change appropriately and plan for it using a structure for quick response to internal and external environmental forces.  

Among many change management theories, Kurt Lewin’s change management theory is the most appropriate to use in implementing the mental wellness and resilience program. Lewin’s change theory includes three fundamental concepts: driving forces, restraining forces, and equilibrium (Petiprin, 2023). In organizational change, driving forces are the organizational elements that favor change; they push the organization in the direction that causes change. Restraining forces are organizational factors that hamper change by countering the driving forces (Hussain et al., 2018). A suitable example is a culture resistance to change. A state of equilibrium is achieved when the driving forces balance with the restraining forces implying that change no longer occurs.  

Kurt Lewin proposed that change occurs in three steps. Vital in procedural change implementation, the steps include unfreezing, changing, and refreezing (Petiprin, 2023). In the unfreezing stage, change leaders focus on making people discard old patterns that were somehow counterproductive. In IHC, unfreezing should be primarily about doing away with the current program for nurse burnout and moving towards a more effective program. However, this can only be achieved after identifying and addressing barriers to change. Petiprin (2023) suggested that resistance to change and group conformity are common barriers to change in the unfreezing stage. Change leaders should understand their dimensions and implications and address them appropriately. 

The chaning stage primarily entails moving to a new level. According to Petiprin (2023), the change stage is characterized by significant changes in thoughts, processes, and behaviors. In other words, the change phase involves moving the organization and people to a more liberating and productive phase. In IHC, successful change will be marked by adopting a comprehensive wellness program that includes resilience building. The refreezing stage is critical in organizational change since it helps to establish change as a new habit (Hussain et al., 2018). Similarly, the new program should be supported to become the standard operating procedure. Therefore, techniques to sustain the program should be identified and executed to foster sustainable change. 

From a change perspective, Lewin’s change theory is the most effective for implementing the proposed program since it facilitates procedural change. It ensures that change occurs in steps and activities in each step are clearly outlined. Organizational change is also easy to implement using Lewin’s change management theory since change occurs in only three steps. Importantly, Lewin stresses sustainable change. Hailemariam et al. (2019) described sustainable change as one that achieves long-lasting outcomes. In the same lens, IHC should strive to achieve lasting change to enjoy its benefits for a long time. 

Health care research supports change management through Lewin’s change theory for promoting nurses’ mental wellness and in implementing other programs. For effective program implementation and to model desired behaviors, health care professionals should be involved in critical processes. Similarly, health care staff should be involved when implementing the mental wellness and resilience program at IHC. Hussain et al. (2018) stressed a similar approach as stressed under Lewin’s change model. When nurses are actively involved in the unfreezing phase, the change and refreezing phases become easier since barriers to change are minimal. Sovold et al. (2021) also stressed the importance of nurses’ engagement in programs to improve their mental well-being, as underlined in Lewin’s change theory. Irrespective of the type and scope of a program, a theory-based approach is crucial to ensure there is a framework that outlines basic change implementation steps, outcome evaluation, and strategies for achieving sustainable change.  

Expected Outcomes of the Program and Sustainability Approaches 

Expected Outcomes of Program Implementation 

Health care professionals’ overall health determines their productivity immensely. Optimizing nurses’ mental wellness and making them more resilient will help to improve their overall productivity. As Ryu and Shim (2021) observed, nurse burnout hampers nurses’ productivity since it affects their concentration and physicality to cope with the workload. In this case, helping nurses at IHC to identify and effectively respond to nurse burnout will help them to be more resilient and encounter fatigue. From a performance dimension, burnout prevention enhances job satisfaction. As a result, cases of absenteeism will reduce profoundly, and work loss associated with absenteeism will reduce proportionately.  

Besides improving employee productivity, the mental wellness and resilience program will promote cost-effective care. Besides high-quality and safe care, health care organizations have a professional and ethical mandate to provide cost-effective care. One way of achieving cost-effective care is preventing events that increase medical costs, such as medical errors. As a barrier to patient safety, nurse burnout increases medical errors and turnover rates (Brooks Carthon et al., 2019; Kelly et al., 2021). Medical errors are costly since they increase health complications and hospitalizations. A high turnover rate increases replacement costs. Preventing nurse burnout can help to avoid or reduce costs associated with medical errors and nurse turnover.  

Sustaining the Outcomes 

The current workforce and nurses joining the profession should be adequately assisted to cope with nurse burnout. Sustaining intervention programs will help to achieve long-term gains in IHC. The first appropriate strategy for achieving the projected outcomes is to adopt the mental wellness and resilience program as an organizational policy. Through such a policy, the management can set aside funds for yearly training of nurses on mental wellness and resilience. The other appropriate intervention is continuous resource facilitation for nurses. For instance, anti-burnout resources are highly effective in enabling nurses to cope with workplace fatigue (American Nurses Foundation, 2022). Handouts, interaction forums, and mental health apps that enhance coping are appropriate resources for supporting nurses. The last strategy is nurse orientation. In this case, new nurses joining IHC should be adequately oriented into the organization. An effective orientation component is cognitive rehearsal training that helps nurses identify and respond to stressors such as workplace incivility (Kousha et al., 2022). Jointly, these interventions will help to achieve the positive outcomes associated with the program for a long time.  

Conclusion 

Health care professionals work in complex care environments with varying work demands. A high workload is detrimental to their performance, as witnessed in IHC. Accordingly, organizational managers, nurse leaders, and other change agents should design and implement effective programs for enhancing performance. As discussed in this paper, a mental wellness and resilience program would improve outcomes among nurses in IHC. Its projected outcomes are improved coping, high job satisfaction, and high nurses’ ability to provide cost-effective care. Lewin’s change theory is the most appropriate to implement the program. The theory stresses the importance of sustainable change achieved in three steps: unfreezing, changing, and refreezing.  

References 

American Nurses Foundation. (2022). United Health Foundation launches $3.1 million partnership with American Nurses Foundation to fight nurse burnout and attrition. https://www.nursingworld.org/news/news-releases/2022-news-releases/united-health-foundation-launches-$3.1-million-partnership-with-american-nurses-foundation-to-fight-nurse-burnout-and-attrition/ 

Brooks Carthon, J. M., Hatfield, L., Plover, C., Dierkes, A., Davis, L., Hedgeland, T., Sanders, A. M., Visco, F., Holland, S., Ballinghoff, J., Del Guidice, M., & Aiken, L. H. (2019). Association of nurse engagement and nurse staffing on patient safety. Journal of Nursing Care Quality, 34(1), 40–46. https://doi.org/10.1097/NCQ.0000000000000334 

Hailemariam, M., Bustos, T., Montgomery, B., Barajas, R., Evans, L. B., & Drahota, A. (2019). Evidence-based intervention sustainability strategies: a systematic review. Implementation Science, 14(1), 1-12. https://doi.org/10.1186/s13012-019-0910-6 

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002 

Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(1), 96–102. https://doi.org/10.1016/j.outlook.2020.06.008 

Kousha, S., Shahrami, A., Forouzanfar, M. M., Sanaie, N., Atashzadeh-Shoorideh, F., & Skerrett, V. (2022). Effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses: a randomized controlled trial. BMC Nursing, 21(1), 1-9. https://doi.org/10.1186/s12912-022-00930-1 

Krebs, N. (2021). Amid rising COVID-19 hospitalizations, nurses face increasing risk of burnout. Indiana Public Media. https://indianapublicmedia.org/news/amid-rising-covid-19-hospitalizations,-nurses-face-increasing-risk-of-burnout.php 

Petiprin, A. (2023). Lewin’s change theory. Nursing Theory. https://nursing-theory.org/theories-and-models/lewin-change-theory.php 

Roux, N., & Benita, T. (2020). Best practices for burnout self-care. Nursing Management, 51(10), 30-35. doi: 10.1097/01.NUMA.0000698116.82355.0d 

Ryu, I. S., & Shim, J. (2021). The influence of burnout on patient safety management activities of shift nurses: the mediating effect of compassion satisfaction. International Journal of Environmental Research and Public Health, 18(22), 12210. 

Sharma, F. C. (2021). Organizational behavior. SBPD Publications. 

Søvold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S., Qoronfleh, M. W., Grobler, C., & Münter, L. (2021). Prioritizing the mental health and well-being of healthcare workers: an urgent global public health priority. Frontiers in Public Health, 9, 679397. https://doi.org/10.3389/fpubh.2021.679397 

Zhai, X., Ren, L. N., Liu, Y., Liu, C. J., Su, X. G., & Feng, B. E. (2021). Resilience training for nurses: a meta-analysis. Journal of Hospice & Palliative Nursing, 23(6), 544-550. https://doi.org/10.1097/njh.0000000000000791