Literature Review While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project. A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a 750- 1,000 word review that includes the following sections

Literature Review

As the pandemic continues in the United States, critical care nurses (CCRN) are facing challenges that need to be addressed in order to create better working conditions. Because of the increased demands of CCRNs specific job tasks, CCRN are at a higher risk of developing burnout, which is “chronic workplace stress that isn’t managed” (Rehder, et.al, 2021). In order for CCRNs to mitigate burnout, healthy coping strategies must be implemented. The PICOT question: If CCRNs experience burnout due to chronic workplace stress (P), can the use of healthy coping strategies (I), instead of ignoring burnout (C), be beneficial in the reduction of stress levels, giving CCRNs work-life balance (O) within 6 months (T)? This paper will compare and contrast literature research questions, sample populations and limitations while recommending further research for future studies. Research Questions Compared The majority of the research articles used in this paper focuses on the topic of burnout. Each paper has their own questions related to burnout but the papers focused on healthy coping mechanisms to mitigate burnout. For example, 5 of the 8 articles (Denning, et.al 2021; Green, et.al, 2020; Mohammed, et.al, 2021; Rapp, et.al, 2021, Rehder, et.al, 2021) focused their research on coping skills to reduce burnout in healthcare workers such as utilizing yoga, mindfulnessmeditation, sleep, seeking support in other healthcare professional (friends, colleagues) or implementing other healthcare professionals for help (therapist, primary care physician) (Rapp, et.al, 2021). The last three articles (Garcia & Marziale, 2018; Koutsimani, et.al, 2021; Sengul, et.al, 2021) focus on mentation and statistics in burnout. Koutsimani, et.al (2021) states that burnout causes impaired mental cognition, executive functioning, attention and inhibition, multitasking, and flexibility while Mohammed, et.al (2021) report that 43% of nurses that practiced self-care techniques rated low levels of burnout compared to 23% of nurses that ignored burnout. While the articles did not focus on maladaptive coping skills, it should be noted that some CCRNs will utilize alcohol, drugs and reckless behaviors in order to handle burnout. Sample Populations Compared The majority of the research articles sample populations focused on nurses, between ages 21 to 55, with female gender being two-thirds and male gender being one-third and experience levels between one to forty years. Four of the articles (Denning, et.al 2021; Green, et.al 2020; Mohammed, et.al 2021; Rapp, et.al, 2021) sample populations focused on male and female

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