EBP Project for Advancement in Career Essay

EBP Project for Advancement in Career Essay

EBP Project for Advancement in Career

Compassion fatigue (CF) is a concern among nurses who are particularly susceptible as a consequence of their increased workload even as they constantly witness others being sick and suffering. Their (nurses) desire to help others makes them susceptible to CF (Gustafsson & Hemberg, 2021). Nurses who are experiencing CF are characterized by irritability, anger and exhaustion, as well as negative coping behaviors (such as drug and alcohol abuse). Also, CF is characterized by reduced ability to feel empathy and sympathy, diminished satisfaction/enjoyment with work, impaired ability to care for patients and make decisions, and increased absenteeism from work. CF presents as stress resultant from exposure to traumatized persons. It involves the nurses experiencing stress resultant from being exposed to a traumatized individual, rather than the nurse experiencing the trauma (Aslan, Erci & Pekince, 2022). It is the convergence of cumulative burnout and secondary traumatic stress, causing the nurses to experience mental and physical exhaustion as their ability to cope with the traumatized patients is depleted. Empathy and compassion are key features in nursing care delivery. However, while they are helpful, they can also be burdensome when they cause negative effects on wellbeing, safety and physical and mental health among nurses dealing with patients experiencing distress and trauma (Gustafsson & Hemberg, 2021). EBP Project for Advancement in Career Essay


The EBP project proposal is presented for using a wellness program in reducing CF occurrence among nurses. The proposed project is guided by Clinical Excellence Through Evidence-Based Practice (CETEP) model. CETEP model incorporates components that would be considered essential in implementing a nursing practice change. The model offers a five-step framework for an adaptable process that can be applied in an EBP project (Grove & Gray, 2022).

  1. Defining the clinical practice question

This is the first step in the CETEP model. It involves formulating a searchable question that focuses on the population of interest, intervention the project seeks to explore, a comparison of the intervention against a control, outcomes the project seeks to achieve, and timeframe in which the outcomes would be achieved. The PICOT format question is presented: For nurses (P) will implementing a self-care program and wellness activities (I) compared to no wellness program (C) result in reduced compassion fatigue (O) over a period of six months (T)?

The population (P) of interest is identified as nurses whose key feature of interest is that they are particularly susceptible to CF given their unique characteristics and nature of their work. The expectation is that nurses would be at high risk of developing CF.

The intervention (I) is wellness program. It is anticipated that subjecting nurses to a structured wellness program would help nurses to rejuvenate and reduce opportunities for them to develop CF thus resulting in reduced incidences of CF. EBP Project for Advancement in Career Essay

The comparison (C) is not subjecting nurses to a wellness program. This is considered standard practice since a wellness program is a deliberate intervention.

The expected outcome (O) is a significant reduction in the number of nurses who experience CF among the nurses subjected to the intervention when compared to their counterparts not subjected to the intervention.

The time (T) in which the results would be discernible is approximated at six months. This time is projected as enough time to make the effects of the intervention discernible for comparison against the standard practice.

  1. Assessing the critical appraisal components

As earlier indicated, CF among nurses is an issue of concern. Aslan, Erci and Pikence (2022) report that nurses are at high risk of developing CF because they work in a stressful environment that has increasing workload because of patients with complex needs and nurse staff shortages. Repeated and constant exposure to a stressful work environment causes nurses to go into a progressive process of stress compassion. Compassion is an important quality among nurses since it allows them to provide care needed by patients. However, constantly meeting patients who are traumatized and suffering, and being unable to help these patients can causes the nurses to become desensitized to care and patients, a situation identified as CF. The implication is that failing to address CF and reduce its incidences would compromise the ability to nurses to provide the care needed by patients (Aslan, Erci & Pikence, 2022).

Gustafsson and Hemberg (2021) add to the discussion by noting that compassion is a necessary professional nursing value. Compassion is at the heart of caring, consisting of both the state of being and doing, guiding and allowing nurses to have the will to do good in terms of alleviating the suffering of patients. If well applied, compassion would allow nurses to perceive the pain and suffering of patients, and be motivated to practically intervene in alleviating the suffering and pain. While compassion is a necessary quality, it is challenged by nursing demands and constant exposure to patients’ suffering, irrespective of whether the nurse can actually intervene (Gustafsson & Hemberg, 2021).

Paiva-Salisbury & Schanz (2022) report on the need to build CF resilience. The study notes that extreme stress and burnout from helping others can be harmful to the profession welling of nurses. This is because there is a lack of education and awareness around nurses. This awareness highlights the need for a targeted wellness program.

Schorch et al. (2021) concedes that although CF among nurses is a concern, a wellness program can help in reducing CF. Conducting a study that evaluated the effectiveness of the wellness program, the study reported reduced CF and increased compassion satisfaction, self-care, healthy behaviors and CF knowledge. Besides that, the wellness program was reported to increase perceived level of positive interaction among nurses, social support, recognition, moral and teamwork (Schorch et al., 2021). EBP Project for Advancement in Career Essay

Jean Watson’s Human Caring Theory (HCT) supports the use of a wellness program. The theory notes that caring behavior, as presented in the wellbeing program, can contributed to the wellbeing and satisfaction of nurses. The absence of caring results in non-caring consequences and dissatisfaction, where the nurse feels like an object. The carative factors presented in the theory support and enhance the caring experience of nurses. This implies that the carative factors can be employed to support and enhance the professional experience of nursing. In applying HCT, the nurse is expected to cultivate sensitivity to oneself and others in terms of implementing the practice of self-reflection, displaying willingness to explore and understanding personal values, morals, emotions and beliefs, and having a healthy outlet for stress relief and overall wellbeing (Smith, 2020).

Applied in the wellness program, the carative factors allow the program to focus on eleven processes. First, cultivate the practice of equanimity and loving-kindness towards self and others as foundation of a caritas consciousness. This focuses on promoting a non-judgmental outlook. Second, enable, sustain and honor the deep belief system, honor, faith and subjective life world of self and others. Third, cultivate one’s own transpersonal practices and spiritual self, while going beyond the ego-self. Fourth, develop and sustain a caring, trusting and helping relationship with others. Fifth, being present to and supportive of the expression of feelings, whether negative or positive. Sixth, creatively using the self and all ways of knowing in the caring process. Seventh, engage in the artistry of caritas nursing. Eighth, engage in genuine learning and teaching experiences that attend to subjective meaning and unity of being. Ninth, create a healing environment at all levels. Tenth, tend to basic human needs by administering nursing acts of caring and healing. Eleventh, open and attend to the spiritual and existential unknowns of life and death. These identified processes wholeness, honor and healing, as well as contributing to the evolution of the nurse as an individual (Pajnkihar, Štiglic & Vrbnjak, 2017).

  1. Planning the implementation

The proposed EBP change involved subjecting nurses to a wellness program that involves applying caritas processes identified in HCT within a wellness program to reduce CF among nurses. Implementing the EBP change will require the approval of the facility administrators as the wellness program takes nurses away from their responsibilities. Ethical approval is not required as ethical safeguards are not appropriate or feasible for the EBP change (Hall & Roussel, 2022).

In addition, the program will require training resources for the nurses, allowing them to know what the program requires from them. This includes informing them about availability of confidential support for issues like anxiety, depression, substance abuse and stress, as well as guided support programs that rewards them for setting and accomplishing wellness goals. Besides that, nurses who require extra support initiatives will be offered access to professional support organization that communicate with them at a certain level of empathy and support to boost their confidence and satisfaction (Grove & Gray, 2022).

Communication with the program participants will be conducted through discussion forums, posters and presentations. These are appropriate methods for distributing the EBP change information to the nurse participants (Garcia-Dia, 2020).

There is an understanding that the wellness program must be continually improved. The process of improving the program requires that outcome data be used to determine its effectiveness. Towards this end, Professional Quality of Life Scale version 5 (ProQOL5) will be applied as the assessment tool to measure the level of CF the participants are exhibiting before and after the program implementation to determine its effectiveness in reducing CF among nurses (Gray & Grove, 2020). EBP Project for Advancement in Career Essay

  1. Implementing the practice change

The EBP practice change will be implemented through a wellness program that educates nurses on self-care and provides support in addressing the issues that contribute to CF, such as availing professional support to deal with workplace stress. This requires coordination with the facility administration who would avail the resources for implementing the program, to include availing training resources and support services as required. In addition, the nurse administrator and supervisors will be engaged in coordinating the implementation of the EBP change to ensure that the wellness program delivers on what it promised for the nurses within their units/departments (Garcia-Dia, 2019).

  1. Evaluating the practice change

The proposed EBP change focuses on implementing a wellness program with a view to reducing CF among nurses. This will make use of ProQOL5 as the assessment tool. This is a self-assessment tool that is freely available in 28 different languages. This assessment tool uses a five-level Likert scale that evaluates performance from 30 questions based on experiences over the last 30 days. Based on the score interpretation for compassion satisfaction questions, a score of 22 or less will indicate high CF, score of between 23 and 41 will indicate moderate CF, and score of 42 or more will indicate low CF (Stamm, 2009). The assessment will be administered at the beginning, middle and end of change program to track changes in CF scores as well as compare performance of intervention group against comparison group (Garcia-Dia, 2019).


In addition to the ProQOL assessment tool, feedback will be solicited from the participants. The feedback will be helpful in better understanding what the intervention does well and how it can be improved. The participant feedback will help in improving the wellness program, and make sure that it is adjusted to changes in the nurses’ population. In essence, the feedback will help with continuous improvement as it will highlight weaknesses and strengths in the intervention (Schmidt & Brown, 2019).


Aslan, H., Erci, B., & Pekince, H. (2022). Relationship between Compassion Fatigue in Nurses, and Work-Related Stress and the Meaning of Life. Journal of Religion and Health, 61(3), 1848-1860. https://doi.org/10.1007/s10943-020-01142-0

Garcia-Dia, M. (2019). Project Management in Nursing Informatics. Springer Publishing Company.

Gray, J. R., & Grove, S. K. (2020). Burns and Grove’s the Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence (9th ed.). Elsevier Inc. EBP Project for Advancement in Career Essay

Grove, S. K., & Gray, J. R. (2022). Understanding Nursing Research: Building an Evidence-Based Practice (8th ed.). Elsevier Inc.

Gustafsson, T., & Hemberg, J. (2021). Compassion fatigue as bruises in the soul: A qualitative study on nurses. Nursing Ethics, 29(1), 157-170. https://doi.org/10.1177/09697330211003215

Hall, H. R., & Roussel, L. A. (2022). Evidence-Based Practice: An Integrative Approach to Research, Administration, and Practice (3rd ed.). Jones & Bartlett Learning, LLC.

Paiva-Salisbury, M. L., & Schwanz, K. A. (2022). Building Compassion Fatigue Resilience: Awareness, Prevention, and Intervention for Pre-Professionals and Current Practitioners. Journal of Health Service Psychology, 48, 39-46. https://doi.org/10.1007/s42843-022-00054-9

Pajnkihar, M., Štiglic, G., & Vrbnjak, D. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction. PeerJ, 5, e2940. https://doi.org/10.7717/peerj.2940

Schmidt, N., & Brown, J. (2019). Evidence-Based Practice for Nurses: Appraisal and Application of Research (4th ed.). Jones & Bartlett Learning, LLC.

Schorch, K., Stamm, R., Priddy, D., & Taylor, C. (2021). A Wellness Program to Decrease Pediatric Postanesthesia Care Unit Staff Compassion Fatigue. Journal of Pediatric Health Care, 35(5), 526-541. https://doi.org/10.1016/j.pedhc.2021.04.003

Smith, M. C. (2020). Nursing Theories and Nursing Practice (5th ed.). F. A. Davis Company.

Stamm, B. H. (2009). Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL). https://img1.wsimg.com/blobby/go/dfc1e1a0-a1db-4456-9391-18746725179b/downloads/ProQOL_5_English_Self-Score.pdf?ver=1657301051771  EBP Project for Advancement in Career Essay

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