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Case Study Investigation Decreases Burnout While Improving Interprofessional Teamwork, Nurse Satisfaction, and Patient Safety

Hellyar, Mary, MSN, RN, CCRN; Madani, Catherina, PhD, RN; Yeaman, Sarah, BSN, RN, CCRN; O'Connor, Kelly, BSN, RN; Kerr, Kim M., MD; Davidson, Judy E., DNP, RN, FCCM, FAAN

doi: 10.1097/CNQ.0000000000000243
Original Articles

Prevention of burnout is a national imperative, and blame-free investigations of clinical events are advocated. Reflective inquiry techniques are helpful in processing adverse events while minimizing blame. The purpose of this project was to develop an interprofessional peer review program (Case Study Investigation) to process emotions, improve teamwork, and optimize patient outcomes. This evidence-based practice project was conducted in a 12-bed intensive care unit using reflective inquiry techniques to perform peer case review across disciplines. Significant improvements were seen in percent strongly agree to the 2 satisfaction questions asked: “I feel free to speak up regarding issues that may affect patient care” (increased from 37% to 73%, χ2 = 6.19, P < .05), and “There is open communication between physicians and nurses” (rose from 33% to 73%, χ2 = 7.53, P < .05). In total, 95% perceived improvement in interprofessional teamwork. Burnout decreased significantly at 6 months (n = 22, M = 18.40, SD = 3.36) from baseline scores (n = 27, M = 21.96, SD = 4.47), F 2,72 = 4.48, P < .02. Central line–associated infections decreased from 3.6 per 1000 to 0 per 1000 catheter-days. Catheter-related urinary tract infections decreased from 2 per 1000 to 0 per 1000 patient-days. Both were sustained below benchmark. Reflective inquiry decreases nurse burnout while improving perceived interprofessional teamwork and employee satisfaction, and measurements of patient safety.

Jacobs Medical Center Medical/Surgical Intensive Care Unit (Mss Hellyar and Yeaman and Drs Madani and Kerr), Intensive Care Unit (Ms O'Connor), and Education Development and Research (Dr Davidson), University of California San Diego Health.

Correspondence: Mary Hellyar, MSN, RN, CCRN, Jacobs Medical Center Medical/Surgical Intensive Care Unit, University of California San Diego Health, 200 West Arbor Dr, San Diego, CA 92103 (mhellyar@ucsd.edu).

Blinding: Vignettes are devoid of identifiers and modified to decrease risk of staff/physician/patient identification without changing intent of the content.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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