NURS FPX 6085 Assessment 2 Problem Statement (PICOT)
Student Name
Capella University
NURS-FPX6085 MSN Practicum and Capstone
Prof. Name
Date
Problem Statement (PICOT)
Hospital systems continue to face persistent nurse burnout and workforce shortages, both of which threaten care quality, patient safety, and organizational stability. Registered nurses working at the bedside are especially susceptible to emotional fatigue, disengagement, absenteeism, and turnover. These issues often increase operational costs, worsen staffing gaps, and reduce continuity of care.
This quality improvement proposal examines whether a structured nurse retention strategy can improve workforce outcomes when compared with routine organizational practices. The proposed intervention combines mentorship, wellness resources, flexible scheduling, and leadership involvement. The intended purpose is to lower burnout, strengthen job satisfaction, improve retention, and support better patient outcomes within a six-month implementation period.
Current evidence indicates that organizations using comprehensive retention strategies often report stronger staff morale, reduced turnover intention, and improved care delivery. Therefore, this initiative focuses on practical and evidence-based actions that can be implemented in hospital environments experiencing staffing stress.
PICOT Question
| PICOT Element | Description |
|---|---|
| Population (P) | Hospital-based registered nurses experiencing burnout and staffing shortages |
| Intervention (I) | Comprehensive nurse retention strategy including mentorship, wellness programs, flexible scheduling, and leadership engagement |
| Comparison (C) | Existing standard practice without structured retention supports |
| Outcome (O) | Reduced burnout and turnover, improved job satisfaction, enhanced patient care quality |
| Time (T) | Six months |
Full PICOT Question
Among hospital-based registered nurses experiencing staffing shortages and burnout, how does implementation of a nurse retention strategy that includes mentorship, wellness programming, and flexible scheduling, compared with current practice lacking these supports, influence burnout levels, turnover rates, and job satisfaction over six months?
Need Statement
This project responds to a major healthcare quality and workforce management concern: rising nurse burnout combined with persistent staffing shortages. When hospitals are unable to retain experienced nurses, patient safety risks increase, workloads intensify, and service delivery becomes less reliable.
Burnout has been associated with emotional exhaustion, reduced professional engagement, medical errors, and intentions to leave the profession. According to the American Nurses Association (ANA, 2024), many hospital nurses report symptoms of burnout, with inadequate staffing identified as a leading contributor.
Addressing this issue is necessary for several reasons:
- Improve workforce stability
- Reduce turnover-related recruitment and training costs
- Strengthen nurse well-being
- Enhance patient safety and satisfaction
- Build long-term organizational resilience
Because nursing professionals are central to hospital operations, evidence-based retention interventions are now an operational necessity rather than an optional initiative.
Population and Setting
The target population includes registered nurses employed in hospital settings, particularly in high-acuity departments such as:
- Intensive care units
- Emergency departments
- Medical-surgical units
- Step-down or telemetry units
These clinical areas often involve demanding patient loads, emotionally intense situations, frequent interruptions, and high documentation burdens. Such conditions significantly contribute to stress, fatigue, and dissatisfaction (Galanis et al., 2023).
The proposed setting is a mid-sized urban hospital network with internal indicators showing above-average burnout, turnover, and staffing strain. Urban hospitals commonly manage large and diverse patient populations, which increases workflow complexity and service demand. Teaching and referral institutions may face additional pressures because they balance education, specialty care, and high patient acuity.
Focusing on this environment allows implementation of solutions that may also be transferable to other hospitals facing similar workforce challenges.
Intervention Overview
The proposed intervention includes three coordinated components designed to address both emotional and operational causes of burnout.
Wellness and Resilience Support
This component provides:
- On-site or virtual counseling services
- Stress management education
- Mindfulness-based resilience training
- Mental health referral pathways
Evidence suggests resilience-based programs can reduce compassion fatigue and emotional strain among healthcare workers (D’Antoni et al., 2025).
Mentorship and Professional Support
Structured mentoring pairs experienced nurses with newer or early-career staff. This may improve confidence, belonging, career development, and retention. Leadership coaching and recognition practices are also included.
Flexible Scheduling and Staffing Optimization
This component focuses on:
- Fairer shift distribution
- Reduced unnecessary overtime
- Self-scheduling options where feasible
- Better workload balancing
Because staffing shortages are a major predictor of burnout, operational scheduling reforms are essential.
| Intervention Area | Expected Benefit |
|---|---|
| Wellness Programs | Lower stress and emotional exhaustion |
| Mentorship | Increased engagement and retention |
| Flexible Scheduling | Better work-life balance |
| Leadership Support | Improved trust and morale |
Potential Communication and Collaboration
Successful implementation requires coordinated communication across professional groups. Hospitals may use several approaches.
Multidisciplinary Team Meetings
Regular meetings involving nurses, physicians, case managers, and allied health staff can improve shared understanding of workflow issues and patient needs (Baek et al., 2023). However, scheduling meetings in busy environments may be difficult.
Digital Communication Systems
Secure platforms and shared electronic records support real-time communication and reduce misunderstandings. Some staff may need training or change-management support.
Mentorship Networks
Mentorship encourages collaboration by connecting novice staff with experienced clinicians, promoting knowledge transfer and emotional support.
| Strategy | Strength | Limitation |
|---|---|---|
| Team Meetings | Shared decision-making | Time intensive |
| Digital Platforms | Faster communication | Technology resistance |
| Mentorship | Professional support | Requires mentor availability |
Comparison of Approaches
An alternative or complementary strategy is a shared governance model. Shared governance gives nurses a stronger voice in organizational decisions and promotes interdisciplinary accountability (McKnight & Moore, 2022).
Unlike wellness and scheduling interventions, which directly target burnout symptoms and workload stressors, shared governance focuses more on empowerment, autonomy, and leadership participation.
| Approach | Primary Focus | Time to Impact |
|---|---|---|
| Wellness + Retention Strategy | Burnout reduction and retention | Moderate |
| Shared Governance | Culture and autonomy | Longer-term |
Although shared governance can create lasting cultural improvements, it may require more time and organizational restructuring before measurable results occur. Combining governance reforms with wellness and staffing strategies may provide the strongest overall outcome.
Initial Outcome Draft
The primary measurable objective is a 25% reduction in nurse burnout scores within six months after implementation. Secondary outcomes include:
- Lower turnover intention
- Improved job satisfaction scores
- Better staff engagement
- Reduced absenteeism
- Improved patient care indicators
This outcome aligns with the intervention goal of creating a healthier and more sustainable nursing workforce.
Time Estimate
Planning Phase (4–6 Weeks)
Activities include:
- Designing program content
- Engaging stakeholders
- Reviewing staffing data
- Securing leadership approval
- Preparing evaluation tools
Implementation Phase (6 Months)
Activities include:
- Launching mentorship programs
- Delivering resilience sessions
- Adjusting schedules and staffing processes
- Monitoring survey and workforce metrics
Potential barriers may include resistance to change, scheduling conflicts, and limited resources. Early stakeholder engagement can reduce these risks.
Literature Review
Current literature strongly supports multi-component retention strategies to address nurse burnout and shortages.
Leadership, Career Growth, and Retention
AbdELhay et al. (2025) found that transformational leadership, career advancement opportunities, and work-life balance significantly improve nurse retention.
Burnout Following COVID-19
Martin et al. (2023) reported that pandemic-related pressures intensified nurse stress and burnout, reinforcing the need for structured support systems.
Determinants of Intent to Stay
Pressley and Garside (2023) identified leadership quality, workplace environment, and development opportunities as major influences on retention.
Burnout Causes in U.S. Nurses
Shah et al. (2021) linked burnout to high workloads, insufficient staffing, and emotional stress.
Recruitment and Retention Strategies
Simonsen and Fleischer (2024) emphasized mentorship, wellness supports, and strategic workforce planning.
Workforce Shortage Drivers
Tamata and Mohammadnezhad (2022) found shortages were associated with poor job satisfaction, compensation concerns, and limited growth opportunities.
Staffing and Overtime
Bae (2024) concluded that understaffing, mandatory overtime, and long work hours increase burnout and turnover intention.
Resource Allocation
Butler et al. (2022) highlighted the importance of strategic workforce resource management during staffing crises.
Policy-Based Retention Solutions
Lasater (2024) supported evidence-based policies such as mentorship and wellness programs to improve nurse retention.
Conclusion
Nurse burnout and staffing shortages require immediate, evidence-driven action. A comprehensive retention model that combines mentorship, wellness programming, leadership engagement, and flexible scheduling offers a practical strategy for hospitals seeking measurable improvement.
Research consistently shows that when organizations invest in nurse well-being and supportive work environments, burnout declines while retention and job satisfaction improve. Implementing this six-month initiative can strengthen workforce resilience, stabilize staffing, and improve patient care outcomes. Hospitals that proactively address these issues are better positioned to sustain safe, high-quality care delivery.
References
AbdELhay, E. S., Taha, S. M., El-Sayed, M. M., Helaly, S. H., & AbdELhay, I. S. (2025). Nurses retention: The impact of transformational leadership, career growth, work well-being, and work-life balance. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-02762-1
American Nurses Association. (2024, April 25). Nurse burnout: What is it & how to prevent it. https://www.nursingworld.org/content-hub/resources/workplace/what-is-nurse-burnout-how-to-prevent-it/
Bae, S.-H. (2024). Nurse staffing, work hours, mandatory overtime, and turnover in acute care hospitals affect nurse job satisfaction, intent to leave, and burnout: A cross-sectional study. International Journal of Public Health, 69. https://doi.org/10.3389/ijph.2024.1607068
NURS FPX 6085 Assessment 2 Problem Statement (PICOT)
Baek, H., Han, K., Cho, H., & Ju, J. (2023). Nursing teamwork is essential in promoting patient-centered care: A cross-sectional study. BMC Nursing, 22(1), 433. https://doi.org/10.1186/s12912-023-01592-3
Butler, C. R., Webster, L. B., & Diekema, D. S. (2022). Staffing crisis capacity: A different approach to healthcare resource allocation for a different type of scarce resource. Journal of Medical Ethics, 50(9). https://doi.org/10.1136/jme-2022-108262
D’Antoni, F., Matiz, A., & Crescentini, C. (2025). Mindfulness-oriented professional resilience training to reduce compassion fatigue in healthcare workers: A pilot study. Healthcare, 13(2), 92. https://doi.org/10.3390/healthcare13020092
Galanis, P., et al. (2023). Increased job burnout and reduced job satisfaction for nurses compared to other healthcare workers after the COVID-19 pandemic. Nursing Reports, 13(3), 1090–1100. https://doi.org/10.3390/nursrep13030095
NURS FPX 6085 Assessment 2 Problem Statement (PICOT)
Knapp, T. C. (2022). The nurse staff pandemic. Journal of Radiology Nursing, 41(2), 74–75. https://doi.org/10.1016/j.jradnu.2022.02.007
Lasater, K. B. (2024). Addressing the nurse retention crisis—Leveraging policies supported by evidence. JAMA Network Open, 7(7). https://doi.org/10.1001/jamanetworkopen.2024.21635
Martin, B., Kaminski-Ozturk, N., O’Hara, C., & Smiley, R. (2023). Examining the impact of the COVID-19 pandemic on burnout and stress among U.S. nurses. Journal of Nursing Regulation, 14(1), 4–12. https://doi.org/10.1016/S2155-8256(23)00063-7
McKnight, H., & Moore, S. M. (2022). Nursing shared governance. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549862/
Pressley, C., & Garside, J. (2023). Safeguarding the retention of nurses: A systematic review on determinants of nurses’ intentions to stay. Nursing Open, 10(5), 2842–2858. https://doi.org/10.1002/nop2.1588
Shah, M. K., et al. (2021). Prevalence of and factors associated with nurse burnout in the U.S. JAMA Network Open, 4(2), 1–11. https://doi.org/10.1001/jamanetworkopen.2020.36469
NURS FPX 6085 Assessment 2 Problem Statement (PICOT)
Simonsen, M. K., & Fleischer, M. (2024). Building a strategy for the recruitment and retention of nurses in healthcare: A contemporary issue. Nordic Journal of Nursing Research, 44. https://doi.org/10.1177/20571585241276740
Tamata, A. T., & Mohammadnezhad, M. (2022). A systematic review study on the factors affecting the nursing workforce shortage in hospitals. Nursing Open, 10(3), 1247–1257.