Leadership Impact on Nurse Burnout: A Comprehensive Research Proposal
Question
How does modern leadership style influence the effectiveness of quality improvement strategies addressing burnout in frontline nurses within healthcare settings?
Answer
Background:
Burnout can happen as a result of chronic work environment stress that has been left unmanaged. In the healthcare sector, burnout is common amongst nurses, and this may be directly linked to working long hours, and persistent performance of physically and emotionally challenging tasks. Nurses’ responsibility of caring for people at their most vulnerable times, including during end-of-life situations further increases the amount of workplace stress they experience. It is common in most nursing settings, but it could be argued that the level may vary depending on the work setting, patient care demand, and environmental factors. According to a 2020 survey, 62% of nurses experience burnout, this percentage is slightly raised among younger nurses of 25 years and below at 69%. Freudenberger (1974) referred to the idea of burnout as emotional exhaustion experienced by people working in public service, while Maslach (1982) proposed working directly with people may lead to burnout. Maslach, Jackson, & Leiter, 1996 identified burnout can impact personal accomplishment, attitude of distrust, and unhealthy self-evaluation in the employment and role, Overall burnout may lead to feelings of fatigue and a carefree attitude toward their work.
Nurses’ burnout has been increasingly explored and researched in recent years. This phenomenon appears to be more apparent in the healthcare system (Happell, Martin, & Pinikahana, 2003). Hence, employers must explore ways to protect nurses from experiencing the impact of burnout in their work environment. According to research, nurses' experience of burnout differs depending on the work setting, some suggest burnout is higher for nurses working in intensive care units, while others indicate that psychiatric nurses exhibit significant levels of burnout than nurses in other specialities (Pompili et al., 2006, Sahraian et al., 2008).
Introduction:
It has been found that it is necessary to encourage nurses not only to sustain professional benefits as well as mental health assistance for the patients but also to ensure stable mental health and well-being of their own. It has been found that one of the most common reasons behind increased burnout is considered to be inefficient management of workload as well as insufficient availability of resources and benefits thus leaders or team heads must focus on implementing different strategies to identify issues faced by these nurses as well as provide support and flexibility in work (Zhang et al., 2021). Evidence has supported the fact that empowering and implementing modern leadership styles helps in minimizing the feeling of exhaustion, and emotional breakdown as well as personalization within the nurses with the help of trust and respect by the leaders and the organization (Jose, Dhandapani & Cyriac, 2020). Focusing on the rising issue of burnout as well as the role of modern leadership strategy in nursing, The following research proposal focuses on providing a brief structure of research that needs to be conducted on the rising concern.
Literature Review:
According to a study conducted by Leclerc et al., (2022), the healthcare system throughout the world has sustained a major transformation over the past few years due to the rising risk of the COVID-19 pandemic it has enforced a major shortage of workforce, increased stress as well as seismic shift within the frontline health care professionals. The healthcare system has sustained increased migration, turnover, burnout, gig economy as well as slow destruction from the frontline nursing professionals which has hampered the care and service delivery within the healthcare organization. The researcher in the study focused on analyzing the impact of leadership on the rising complications faced by these frontline nurses and found that leaders using different leadership styles had a potential impact on mitigating a certain level of challenges faced by the nurses within the setting (Leclerc et al., 2022).
Another study carried out by Bergstedt and Wei, (2020), highlighted that the nursing staff must inform different strategies and leadership styles to minimize the rising issue of staff shortage, burnout and turnovers within the nursing profession. The study also emphasized that engagement of nurses within a team with proper consideration and support witnessed decreased feelings of stress, workload or burnout as well as ensured increased satisfaction within their work premises. Leadership by the nurses possesses the potential as well as the responsibility to influence the work environment for the nurses as well as motivate them to perform better with minimized complications and challenges. It helps in improving the organizational functioning and outcomes as well as ensures enhanced service delivery improved job satisfaction as well and customer loyalty (Bergstedt & Wei, 2020).
Also, Wei et al., (2020), stated in the study that burnout in nurses has been one of the major challenges that are frequently reported throughout the world and it demands significant action in order to restore the service provided by the healthcare system. It has been found that nursing leadership has a significant impact on enhancing the quality of care provided by the nurse as well as reducing the nurse's burnout rate worldwide it focuses on enhancing the engagement of nurses as well as providing empowerment to every professional within the nursing setting in order to ensure job satisfaction as well as motivation to perform better (Wei et al., 2020). There is limited information that focuses precisely on modern leadership styles used by Frontline nurses to minimize the chances of burnout and enhance quality improvement. Thus the research study must focus precisely on different modern leadership styles and their impact on quality improvement within the frontline nurses and associated challenges of burnout.
Aims and Objectives:
After analyzing the above-discussed literature review as well as the background information identified the research study aims to analyze and evaluate the impact of modern leadership style on quality improvement in cases of increased burnout in frontline nurses within the health care system. Focusing on the aim of the research study, the below mentioned are the three identified objectives based on which the research study will be conducted.
Objective one: The objective of the research study is to identify the impact of burnout on frontline nurses within health care settings.
Objective two: It intends to evaluate the factors that increase the risk of burnout within these nurses.
Objective three: It also focuses on analyzing the significant impact of leadership strategies in quality improvement to overcome the rising complication of burnout in frontline nurses throughout the health care system.
Research Question / Hypothesis:
Regardless of the statistics around the level of burnout in healthcare, it is crucial to identify approaches to manage this phenomenon. A vast number of research studies have identified factors required to reduce burnout impact in the work environment, one example is the leadership of an organization. It is suggested that leadership behaviors can empower, and improve nurses’ commitment, job satisfaction, and quality of care. Structural and psychological empowerment were found to be important for decreasing burnout and subsequently reducing nurse turnover, however, it may be argued that leadership style or quality could play a key role in the effectiveness of workplace burnout strategies (Mudallal, Othman and Al Hassan, 2018).
The research question thus aims to explore the impact of leadership style and quality on the effectiveness of burnout management policies or approaches for nurses through a qualitative research approach. This research approach explores reasons and examines how and why a program or phenomenon functions.
Research question: Does Modern leadership style play a Key Role in the effective Quality improvement approaches to address burnout in frontline nurses in health settings?
Hypothesis:
The research study will focus on two hypothesis which includes null and alternative hypothesis in order to analyze and evaluate the evidence available about the research question. The Null Hypothesis in any study always focuses on predicting no relationship or effect between different variables whereas the alternative hypothesis focuses on certain sets of relationships between different variables (Leppink, O’sullivan & Winston, 2017).
Null hypothesis: The modern leadership style does not have any impact on quality improvement in cases of burnout in frontline nurses within the healthcare system.
Alternative hypothesis: The modern relationship style has a certain level of impact on enhancing the quality improvement outcomes in cases of rising burnout in frontline nurses within the health care system.
Methodology:
The research study intends to focus on qualitative research as a significant and appropriate methodology for conducting the research on the above-mentioned research question. Qualitative research is known to be a type of research design that focuses on exploring and providing in-depth understanding and insight regarding the issue or complication within the population it focuses on analyzing and evaluating hypothetical information descriptive evidence in order to conduct further analysis and investigation to understand quantitative suggestions (Maher & Dertadian, 2018). Qualitative data are textual, these data can be used to examine knowledge and information around a specific issue, problem, program, or the experience of people. Examples of data collection for this research question are often Surveys, Interviews, and Focus Groups (Bhat, 2019). In the following study qualitative research will provide the study with a better opportunity to understand the perceptions values as well and experiences of nurses in relation to the research question. Thus, often in the field of healthcare and nursing research studies professionals focus on using qualitative research methodology as one of the core methodologies for conducting in-depth studies (Aspers & Corte, 2019). Qualitative research not only assists professionals in generating information but at the same time helps in understanding The needs, interpretations as well and demands of the nurses involved in the study.
Methods:
Focusing on the selected qualitative research methodology, the research proposal intends to use a systematic review of literature as a research method for conducting the study further. A systematic review of literature helps in identifying evaluating as well and synthesizing evidence in order to develop a precise and well-structured conclusion of available information that has a significant role in evidence-based practice. It is considered to be an independent academic method that is used in a research study with an aim to evaluate a range of appropriate literature evidence in relation to the identified research topic or research question (Thomas et al., 2020). It focuses on identifying assessing and evaluating a wide range of literature evidence that is available on different electronic databases in order to sustain a significant set of information that is reliable and justifiable in relation to the matter of concern in the study. Thus, in the research study, a systematic review of the literature will be conducted to answer the research question (Boland, Dickson & Cherry, 2017). In order to carry out a systematic review of literature, it will be necessary to conduct a well-structured literature search which often includes the identification of database keywords structuring search strategy as well and identifying sets of inclusion and exclusion criteria. This approach involves searching reliable databases such as Google Scholar, PubMed Science Direct, and other similar databases, using keywords related to the research question. This process is crucial to establish existing knowledge and identify relevant work and detailed quality assessments will be used for exploring data diversity and suitability strength of research conclusion and need for future research. Collected Data will be summarised and then interpreted to identify bias and limitations (Khan et al., 2003).
Search Strategy:
To conduct a systematic review of literature it is necessary to structure a well-organized and appropriate search strategy to conduct literature search. A literature search is known to be a systematic and structured search for literature pieces of evidence from a wide range of data that has been earlier published by different researchers to identify the effective and appropriate quality of reference on respective research topics. To identify analyze and collect good quality and effective literature evidence for the research study it will be necessary to conduct a literature search using well well-structured search strategy from different databases (Lefebvre et al., 2019). The initial step of the search strategy will include the identification of significant keywords from the research question as it will help in making the search precise and accurate. The below-mentioned are the identified keywords from the research questions that will be used in conducting the literature search.
“Modern Leadership”, “Quality Improvement”, “Burnout”, “Frontline Nurses” And “Health Care”.
These identified keywords will further be arranged with different Boolean operators to make the search precise enough to avoid getting a cluster of inappropriate research evidence. Boolean operators such as OR, AND, NOT or AND NOT help in combining or excluding certain keywords while conducting literature surges in different electronic databases. The identified keywords along with the mentioned Boolean operators will be arranged and a search for appropriate literature evidence will be conducted in different electronic databases which include Pub Med, Medline, and Google Scholar (Paez, 2017).
Inclusion and Exclusion Criteria:
After conducting of search for literature using such a strategy a wide range of literature evidence will be identified from different electronic bases that have a certain level of similarity or interaction with the identified research question. To narrow down the search as well as collect appropriate and necessary literature evidence from electronic databases a well-structured inclusion and exclusion criteria will be identified and used. These inclusion and exclusion criteria will help in involving research articles and literature evidence that are directly associated with the research question and have a necessary role in providing a positive impact on the study (Patino & Ferreira, 2018_. The below mentioned are the certain identified inclusion and exclusion criteria that will be involved in the research study to make the literature search precise and accurate.
| Inclusion criteria | Exclusion criteria |
| Articles and journals that have been published after the year 2000 and 17 till 2023 will be included in this study as a fresh set of information. | Articles and journals that have been published before the year 2017 will be excluded from the research study in order to avoid the inclusion of any outdated evidence. |
| Articles and journals that are peer-reviewed will only be included in the research study to maintain the authenticity and significance of the evidence included. | Articles and journals that are not peer-reviewed will be excluded in order to avoid the involvement of any unauthentic and relevant information in the research. |
| Articles and journals that have been published in the English language will only be included in the study. | Articles and journals that have been published in any other language apart from the English language will be excluded in order to make the research appropriate at the international level. |
| Articles and journals that provide access to the entire article will only be included in the research study | Articles and journals that provide access to only abstracts will be excluded for the further conduction of research |
| Articles and journals that have direct relations with the identified keywords and research question will only be included | Whereas articles with limited involvement of the keywords as well as relation to the research question will be excluded. |
Data collection:
Data collection is the process of gathering and collecting information from various sources to analyze and make informed decisions based on the data collected. This can involve various methods, such as surveys, interviews, experiments, and observation (Flick, 2017). The decision on data collection methods depends on various factors such as the researcher's background; research question, availability of evidence, and the researchers’ preferences (Saks, M. & Allsop, J. 2019). In order to carry out a well-structured data collection for the research study Critical Appraisal Skills Programme or CASP Checklist Will be used as a direct collection tool California is known to be one of the most commonly used data collection tools that is appropriate and relevant for different type of study designs. It helps in analyzing research articles or literature evidence in three chief areas which include clinical relevance, validity as well and results (Buccheri & Sharifi, 2017). The articles that will be selected to conduct the research will be analyzed using the CASP checklist and data will be collected based on their nature of research design as it provides different checklists for different methodologies used in any research.
Data analysis:
After the collection of data using the CASP checklist, the research study will further focus on conducting a well-structured analysis of data in order to provide a concluding statement to the study. Data analysis is considered to be a process that is used to inspect, clean, transform as well and interpret data or evidence that has been collected. It helps in discovering and identifying different insights and valuable information in order to draw a supportive decision-making conclusion. The research study is intended to use thematic analysis as the key methodology for data analysis as it helps in analyzing and evaluating qualitative information that is obtained through descriptive evidence (Heeringa, West & Berglund, 2017). It provides a significant pattern to the qualitative data and with the help of selection of certain codes, definite themes are selected for analysis of evidence. Information collected through data collection is further distributed into different themes to identify and analyze the collected information into respective categories in relation to the research question (Terry et al., 2017).
Feasibility of the research:
Feasibility of the research Resembles the chances of completion of any study without any barriers and complications with a successful outcome. It focuses on evaluating a wide range of factors that have a potential impact on the conduction and completion of the study. These factors include legal procedures, economic investment, technical aspects as well and scheduling of the procedure as the following study focuses on conducting a systematic review of literature, thus complication or challenges associated with a wider range of economic investment is ineffective as well as technical factors also become minimal (Southwood, 2018). As all the information is collected from electronic databases which provide free access to a wide range of research articles and journals relevant to the research topic it will be possible enough to complete the study without getting influenced by the identified factors.
Ethical consideration:
Ethical consideration in any research study helps in setting certain principles that have a key role in guiding the research design and procedures in an ethical and legal manner. The principles that are often included in any research account for confidentiality anonymity, informed consent voluntary participation effective communication and potential identification of harm. The following research study as intended to use a systematic literature review for conducting qualitative research becomes questionable to certain ethical principles. These include effective communication, potential identification of harm maintaining informed consent (Arifin, 2018). The research study does not include any primary participant of human thus involvement of involuntary participation as a key principle in ethical consideration is neglected. In the research study, it is necessary to ensure informed consent by informing the authorities and superiors regarding the detailed information about the research study and the procedures that have been used. Further, it will be necessary to ensure that proper citation and referencing of the selected literature evidence is maintained throughout the research study (Hasan et al., 2021). It will help in maintaining the authenticity of the research study as well as avoid violation of any legal and ethical laws associated with copyright and plagiarism.
Limitations of the study:
Every research study has a certain set of limitations that function while conducting and completing the study and it needs to be considered in order to avoid occurrence in future. On analysis of the limitations in the following study, it has been found that a major risk of selection bias may be incorporated while conducting the study as the study focuses on including articles that provide information supporting the research question. Articles that may provide contradicting information related to the research questions Will not be considered and included in the study which might create the risk of bias. One of the other limitations that have been identified accounts for limitation in information availability as articles published after the year 2017 are only included which might reduce the diversity as well as the availability of a wider range of information.
Time plan: Gantt chart
In order to structure the research study and complete each task in the appropriate time duration, a well-structured Gantt chart has been prepared as it is considered to be one of the project management tools that helps in illustrating the designated task completed at the respective time duration (Lock, 2020). It helps in planning and organizing a project or research and assists in the completion of the entire study within the identified time frame.
