Date of Graduation

4-2021

Document Type

Capstone

Keywords

ICU or Critical Care or Intensive Care; Nurses; Fatigue; Burnout; Retention; Mitigation

Degree Name

Doctor of Nursing Practice (DNP)

Degree Level

Graduate

Advisor/Mentor

Marilou Shreve

Committee Member

Anna Jarrett

Abstract

Registered Nurses (RN) working in Intensive Care Units (ICU) report increased physical and emotional fatigue from a combination of various environmental factors. Fatigue is suspected as contributing to low retention rates of ICU RNs. A meeting was arranged with an ICU nursing director in an acute care facility in Northern Arkansas revealing the need for a clinical inquiry into the prevalence of fatigue. A review of literature further analyzed the impact of fatigue, management practices, safety culture in the workplace, the Occupational Fatigue/Exhaustion and Recovery (OFER) scale, the Copenhagen Burnout Inventory (CBI), and the Moral Distress Scale- Revised (MDS-R). The Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model has been identified as an underlying framework appropriate for this project given its usefulness in evaluating human factors and outcomes for the healthcare delivery system. The model benefits the clinical inquiry by aiding in the evaluation of questionnaires regarding fatigue and other issues associated with low nurse retention. A descriptive exploratory research design with a survey-method study is appropriate for the project being little is known regarding the particular phenomenon of fatigue in the critical care work environment. The proposed DNP project’s objectives are to survey ICU RNs using electronically delivered questionnaires, investigate alternative length shifts and other interventions aiming to mitigate fatigue, then propose recommendations for change in policy and practice before symptoms of nursing fatigue manifest into irreversible outcomes for ICU stakeholders.

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