Stress and burnout among bone

marrow transplant unit nurses

during the COVID-19 pandemic
OBJECTIVES;

By the end of the presentation participants will be able to;

1. Define the research question and the objective of the study.

2. Describe how literature review was done during the study.
3. Explain the method of the study.
4. Verbalize the findings of the study.
5. Identify the literature gap, nursing implications and suggestions for future
studies.
Overview

● The purpose of the study was to identify stress and burnout level among
nurses of bone marrow transplantation unit due to Covid-19.
● A systematic review of 5 articles were done for the study which include
qualitative, quantitative and mixed method studies.
● The study used PICO model for the review.
INTRODUCTION

● During the Covid-19 pandemic healthcare professionals were the frontline

workers, among which the role of nurses is very crucial as they are involved in
the direct patient care.
● Due to criticality, nurses working in the bone marrow transplantation unit are
under mental and emotional stress
● The systematic review is performed to identify, analyze and interpret the key
factors causing burnout and stress among nurses working in the BMT unit.
RESEARCH QUESTION

● To examine the impact of Covid-19 on physical and mental health of the

nurses.
● To analyze the burnout and stress caused by covid-19 working in the BMT
unit.
LITERATURE REVIEW
● For the selection of articles Population, Exposure and Outcome PEO method
was used through electronic media (Google scholar) from 2020 till present.
● 5 article were shortlisted and were reviewed for the study.
Authors Year Country of Study Study type Study size

Ibrahim et al 2020 Saudi Arabia Qualitative Study -

Dwyer et al 2021 USA Qualitative and Quantitative 613

Wu et al 2020 China Quantitative 220

Cousino et al 2021 North America Quantitative 135

Shankar et al 2020 India Qualitative -

● During Covid-19 nurses were under immense stress especially the nurses
working with patients with terminal illness and undergoing high-risk treatment
such as BMT.
● As the patients are already immune-compromised the transmission of virus
can have fatal consequences causing stress, anxiety and burnout in the
nurses.
● Occupational stressors such as increased working hours, wearing PPE’s for
longer hours, fear of transmission, emotional and physical fatigue also
contributed, causing burnout.
METHOD

● Research Philosophy:
○ PRAGMATISM to analyze objective data
○ INTERPRETIVISM to study subjective data.
● Systemic Review to gather reliable, and resourceful research findings from
studies done on the subject.
● Secondary Data Analysis to review the key findings, analysis and data.
● Forming a Research Question that reflects the aim of the study, our objectives
for the study were;
○ To carry out a quality systemic review
○ To identify and explore researches that indicate the impact of stress and
burnout on the nursing staff working in bone marrow transplant units
● Use of appropriate keywords.
● Mixed Study Review was done including both qualitative and quantitative
studies.
● Using Phenomenology as a research design to study the experiences of the
nurses working in the BMT unit.
● Use of Population, Exposure, Outcome and type of study (POET) model.

Population (P) Nurses working in BMT healthcare units

Exposure (E) COVID-19 pandemic

Outcome (O) Burnout and high levels of stress

 ● Data extraction and forming the themes.
● Thematic review of the extracted data.
● Inclusion and Exclusion criteria
Inclusion Criteria Exclusion Criteria

Dated (2020-present) Dated ≤ 2020

Experience, views and impacts on nurses Patients and others

Burnout (emotional exhaustion) Secondary or primary diseases as own

Bone marrow transplant units and oncology departments No other secondary disease or treatment units

Qualitative and quantitative studies, descriptive studies, Secondary research reviews, systematic
FINDINGS AND SYNTHESIS
● The validity, reliability and trustworthiness of the studies used for the review
differ from one another.
● The methodical limitations faced during the study were;
○ Limited number of studies available regarding the stress and burnout among nurses during
pandemic and especially those working in BMT unit.
○ Inexperience in utilizing the literature through the databases
● Findings:
○ Nurses among all health care professional were most adversely affected.
○ Nurses were also suffering from compassion fatigue.
○ Work exhaustion was also higher among nurses.
○ Signs of PTSD (Post traumatic stress disorder) was also found among them
● Approaches to analysis:
○ Out of 5 only 3 studies mentioned there sample size.
○ The studies included nurses as a part of medical professionals as no separate study is done
on chosen aim.
○ Studies were reported from Saudi Arabia, China, India and USA.
○ Studies included Open and closed ended Questions.
○ Maslach Burnout Inventory was used as a gold standard for assessing Burnout.
○ Scales such as Professional Quality of Life (ProQOL), compassion satisfaction, burnout, and
secondary traumatic stress were used.
○ For descriptive analysis SPSS version 24 was utilize, and for exploratory study ANOVA, Chi-
square and Correlation was used.
DISCUSSION

The review highlighted that;

● The symptoms of burnout were present in the nurses causing tiredness,

fatigue, mental and emotional disturbances.
● It highlighted there is a need to provide mental and emotional support.

*However due to lack of data regarding nurses working in the BMT unit, the
objectives of the study were not achieved.
NURSING IMPLICATIONS

● An open communication system should be provide for nurse to share there

concern, which should be timely addressed by the organization.
● Management and awareness plan regarding the pandemic should be
incorporated in the work settings and intervention to reduce the burnout
should be taken.
● Further study should be done on nurses working the critical care areas
dealing with patients with fatal diseases that how pandemic has impacted
them.
LITERATURE GAP

● Inadequate work has been done regarding the topic.

● In some of the studies methodological practice was not clear which
questions the validity and quality of the study.
● Study design and sample size was not mentioned impacting the reliability of
the outcomes.

Further studies is required that how Covid has impacted nurses working in
different settings, how there mental physical and emotional health is affected.
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