• Implementation of Mindfulness with Emergency Nurse Practitioners to Decrease Burnout

      Brown, Jennifer C.; Rawlett, Kristen (2020-05)
      Problem & Purpose: The emergency department is challenging due to its fast-paced and highly stressful environment. Nurse Practitioners (NPs) are at risk for increased stress and decreased well-being leading to burnout. This quality improvement project aim was to teach nurse practitioners the skill of mindfulness, specifically guided sitting meditation. With effective intervention, it is expected that the skill of mindfulness can directly impact stress and well-being with the goal of decreasing burnout amongst the group. The Maslach Burnout Inventory (MBI) tool was used to identify burnout. Methods: This quality improvement project involves nurse practitioners that work in an urban emergency department in the Mid-Atlantic region. NPs were invited to four mindfulness sessions over a 12 week period focused on guided sitting meditation. The MBI pretest was administered to the NPs at the start of the mindfulness session and then they had access to a self-guided sitting meditation via electronic file after each session. The NPs were encouraged to practice the guided sitting meditation for 10 minutes a day for at least 5 days a week independently and report weekly the frequency of use. Results: Brief mindfulness, specifically guided sitting meditation can impact burnout, Twenty-one NPs participated in four mindfulness sessions completing the MBI both pre and post sessions. Means scores for Emotional Exhaustion (EE) showed a positive trend going from 25.1 to 22.9 (p=0.27) Depersonalization (DP) also showing a positive trend declining from 9.9 to 9.3 (p= 0.70) However, neither was statistically significant.
    • Mindfulness for Psychiatric Day Hospital Patients

      Milone, Jessica M.; Scrandis, Debra (2019-05)
      Background and Local Problem: Psychiatric day hospitals are vital for preventing hospitalizations and re-admissions to psychiatric inpatient units. Evidence from the literature on mindfulness-based therapies shows the most significant benefit for patients with depressive and anxious symptoms; these are 60 percent of the client symptoms at the selected day hospital. This quality improvement project implemented a mindfulness program to assist staff in educating and sustaining this program. Interventions: The purpose of this project was to implement and evaluate a mindfulness program for psychiatric day hospital outpatients, using the Daily Mindful Responding Scale on admission and discharge. The curriculum was a shortened mindfulness program with two 15-minute meditations every day using public domain mindfulness meditations. Groups were administered by the lead therapist or mental health technician. The Daily Mindful Reminding Scale was completed by each participant on admission and discharge. This scale was simplified with collaboration by the author to a 5th grade reading level. Results: Total mindfulness scores for 15 participants were analyzed using a paired t-test. The mean scores increasing from admission (M=17.73, SD=5.25) to discharge (M=26.13, SD=5.25); the results were statistically significant; t= -4.00, P= <0.01, one-tailed. Limitations of this study included small sample size due to low census and admission to the program. Rate of completion of the study was 15/25. Patients who did not complete the study either discharged against medical advice or were admitted inpatient due to worsening of symptoms. Conclusions: The author recommends continuing the program in that several patients did have an increase in mindfulness. Continued evaluation of the program with a larger sample size is recommended.
    • Mindfulness-Based Meditation and Stress Reduction in Healthy Adults

      Jacob, Nomy Thomas; Scheu, Karen (2020-05)
      Problem & Purpose: Stress is a significant public health concern contributing to serious health consequences in our communities. Studies show that managing stress can be achieved by practicing evidence-based, mindful meditation (MM) daily, and an evidence-based tool kit can help to guide practice. At a community outreach health department in rural Maryland, there was a steady inquiry by community members for guidance on how to manage stress as there was a lack of programming and education. The purpose of this quality improvement (QI) project was to implement and evaluate the feasibility of the MM program among healthy, stressed adults in the community. Methods: The 12-week MM program had three phases. The pre-intervention phase included a train the trainer program that prepared the project champions (PC) to facilitate MM programs in various community settings. The intervention phase included a six-week pilot program where a sample from the community [project participants (PP)] participated. In the post-intervention phase, the PP practiced MM daily and concluded with a reunion. Pre-post questionnaires assessed the knowledge and skill level of PC related to stress and its management, as well as the resource tool kit’s usefulness. An audit tool provided a feasibility measure of the number of pilot sessions completed by each PP. In the end, a survey questionnaire assessed the usefulness of the program. The framework used for this project was Roger’s theory of diffusion of innovation. Results: The post-survey showed an increase in knowledge and skill level of PC and their perception of using the tool kit. More than 70% of PP attended each week's pilot class, and 100% stated that the MM program was useful. Conclusion: MM is a brief and cost-effective stress management intervention that is easy to implement in various community settings. Practicing MM for five minutes helps to reduce stress.