Author ORCID Identifier

https://orcid.org/0009-0002-6883-3968

Date of Graduation

2024

Document Type

Dissertation

Degree Type

PhD

College

School of Nursing

Committee Chair

Jennifer Mallow

Committee Member

Kesheng Wang

Committee Member

Suzy Walter

Committee Member

Tina Antill Keener

Committee Member

Tim Cunningham

Abstract

Background: Nurse burnout is a global health priority that has been compounded by Coronavirus 2019 (COVID-19). Organizational theory states that nurse burnout is directly impacted by operant mechanisms (nurse characteristics, nurse specialization) and hospital-wide models. The purpose of this study is to determine the relationship between hospital wide models (evidence-based care, team-based care, discharge planning, care coordination), operant mechanisms (nurse characteristics, nurse specialization), and outcomes (nurse burnout) before and after COVID-19.

Research Question: The specific aim of this study is to determine the relationship between hospital wide models (evidence-based care, team-based care, discharge planning, care coordination) and operant mechanisms (nurse characteristics, nurse specialization) and outcomes (nurse burnout) before and after COVID-19.

Methods: A secondary data analysis using the 2018 and 2022 NSSRN data set was used to analyze frequencies of operant mechanisms (nurse characteristics, nurse specialization) and hospital-wide models. Chi-square for independence test was used to compare the difference in nurse characteristics between those who left the profession before and after COVID-19. Chi- square for independence tests were performed and analyzed to describe the relationship between operant mechanisms, hospital-wide models, and nurse burnout. Significant results were analyzed using a general linear regression to determine predictive and protective factors.

Results: Participants were found to be older in age 30 to 64 (85%) in 2018, than in 2022, with nurses only ranging in age from 30 to 54 (51.6%). Nurses were found to not be working in nursing due to retirement, family caregiving, and burnout. Evidence-based care and team-based care were both reported at least somewhat in over half the sample in 2018 and 2022. The highest degree in nursing, years since graduation, age, year (before and after COVID-19), advanced practice certification, and team-based care were found to the predictive factors in the general linear regression analysis. Evidence-based care was not found statistically significant in the general linear regression analysis.

Conclusion: The study findings indicate that COVID-19 did influence nurse burnout. Highest degree in nursing, years since graduation, age, year (before and after COVID-19), advanced practice certification, and team-based care were all found to be predictive factors for nurse burnout. Evidence-based care was found to be a protective factor for nurse burnout. Future research should focus on investigating hospital-wide models that mitigate burnout and are prepared for catastrophic events. Additionally, future research needs to focus on the socio-economic, cultural and health disparities within burnout to provide further information on burnout and the effects on these groups.

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