Best evidence statement (BESt). Decreasing compassion fatigue among pediatric intensive care nurses using self-care skills and compassion fatigue training.
General
Guideline Title
Best evidence statement (BESt). Decreasing compassion fatigue among pediatric intensive care nurses using self-care skills and compassion fatigue training.
Bibliographic Source(s)
- Cincinnati Children’s Hospital Medical Center. Best evidence statement (BESt). Decreasing compassion fatigue among pediatric intensive care nurses using self-care skills and compassion fatigue training. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 2013 Jul 17. 5 p. [6 references]
Guideline Status
This is the current release of the guideline.
Recommendations
Major Recommendations
The strength of the recommendation (strongly recommended, recommended, or no recommendation) and the quality of the evidence (1a-5b) are defined at the end of the “Major Recommendations” field.
It is recommended that nurses working in pediatric intensive care settings receive training that includes compassion fatigue awareness, coping strategies, stress management, relaxation techniques and self-care interventions to decrease the level of compassion fatigue experienced in the work environment (Marine et al., 2009 [1a]; Gunusen & Ustun, 2010 [2a]; Kravits et al., 2010 [4a]; Meadors & Lamson 2008, [4a]).
Definitions:
Table of Evidence Levels
| Quality Level | Definition |
|---|---|
| 1a† or 1b† | Systematic review, meta-analysis, or meta-synthesis of multiple studies |
| 2a or 2b | Best study design for domain |
| 3a or 3b | Fair study design for domain |
| 4a or 4b | Weak study design for domain |
| 5a or 5b | General review, expert opinion, case report, consensus report, or guideline |
| 5 | Local Consensus |
†a = good quality study; b = lesser quality study
Table of Language and Definitions for Recommendation Strength
| Language for Strength | Definition |
|---|---|
|
It is strongly recommended that…
It is strongly recommended that…not… |
When the dimensions for judging the strength of the evidence are applied, there is high support that benefits clearly outweigh risks and burdens (or visa-versa for negative recommendations). |
|
It is recommended that…
It is recommended that… not… |
When the dimensions for judging the strength of the evidence are applied, there is moderate support that benefits are closely balanced with risks and burdens. |
| There is insufficient evidence and a lack of consensus to make a recommendation… | |
Note : See the original guideline document for the dimensions used for judging the strength of the recommendation.
Clinical Algorithm(s)
None provided
Scope
Disease/Condition(s)
Compassion fatigue, including burnout, emotional exhaustion, and workplace stress
Guideline Category
- Counseling
- Prevention
Clinical Specialty
- Critical Care
- Nursing
- Pediatrics
Intended Users
- Advanced Practice Nurses
- Hospitals
- Nurses
Guideline Objective(s)
To evaluate, among pediatric intensive care nurses, if functional knowledge of compassion fatigue and the practice of self-care skills, compared to not, demonstrates less compassion fatigue
Target Population
Nurses working in pediatric intensive care settings who provide direct patient care
Interventions and Practices Considered
Compassion fatigue training, including the functional knowledge of compassion fatigue and the practice of self-care skills
Major Outcomes Considered
Reduction of compassion fatigue
Methodology
Methods Used to Collect/Select the Evidence
- Searches of Electronic Databases
Description of Methods Used to Collect/Select the Evidence
Search Strategy
- Databases : CINAHL, MEDLINE
- Search Terms : Compassion Fatigue, Self-Care, Burnout, Workplace Stress, Coping, Intensive Care Nursing, Pediatric Nursing
- Limits, Filters, Search Dates : Limited to English literature; all search dates included.
- Date Search Done : April 9, 2013
Number of Source Documents
Not stated
Methods Used to Assess the Quality and Strength of the Evidence
- Weighting According to a Rating Scheme (Scheme Given)
Rating Scheme for the Strength of the Evidence
Table of Evidence Levels
| Quality Level | Definition |
|---|---|
| 1a† or 1b† | Systematic review, meta-analysis, or meta-synthesis of multiple studies |
| 2a or 2b | Best study design for domain |
| 3a or 3b | Fair study design for domain |
| 4a or 4b | Weak study design for domain |
| 5a or 5b | General review, expert opinion, case report, consensus report, or guideline |
| 5 | Local Consensus |
†a = good quality study; b = lesser quality study
Methods Used to Analyze the Evidence
- Systematic Review
Description of the Methods Used to Analyze the Evidence
Not stated
Methods Used to Formulate the Recommendations
- Expert Consensus
Description of Methods Used to Formulate the Recommendations
Not stated
Rating Scheme for the Strength of the Recommendations
Table of Language and Definitions for Recommendation Strength
| Language for Strength | Definition |
|---|---|
| It is strongly recommended that… It is strongly recommended that…not… | When the dimensions for judging the strength of the evidence are applied, there is high support that benefits clearly outweigh risks and burdens (or visa-versa for negative recommendations). |
| It is recommended that… It is recommended that… not… | When the dimensions for judging the strength of the evidence are applied, there is moderate support that benefits are closely balanced with risks and burdens. |
| There is insufficient evidence and a lack of consensus to make a recommendation… |
Note : See the original guideline document for the dimensions used for judging the strength of the recommendation.
Cost Analysis
A formal cost analysis was not performed and published cost analyses were not reviewed.
Method of Guideline Validation
- Peer Review
Description of Method of Guideline Validation
This Best Evidence Statement (BESt) has been reviewed against quality criteria by two independent reviewers from the Cincinnati Children’s Hospital Medical Center (CCHMC) Evidence Collaboration.
Evidence Supporting the Recommendations
References Supporting the Recommendations
- Gunusen NP, Ustun B. An RCT of coping and support groups to reduce burnout among nurses. Int Nurs Rev. 2010 Dec;57(4):485-92. PubMed
- Kravits K, McAllister-Black R, Grant M, Kirk C. Self-care strategies for nurses: A psycho-educational intervention for stress reduction and the prevention of burnout. Appl Nurs Res. 2010 Aug;23(3):130-8. PubMed
- Marine A, Ruotsalainen JH, Serra C, Verbeek JH. Preventing occupational stress in healthcare workers (Review). Cochrane Collaboration. 2009;1:1-44.
- Meadors P, Lamson A. Compassion fatigue and secondary traumatization: provider self care on intensive care units for children. J Pediatr Health Care. 2008 Jan-Feb;22(1):24-34. PubMed
Type of Evidence Supporting the Recommendations
The type of supporting evidence is identified and graded for each recommendation (see the “Major Recommendations” field).
Benefits/Harms of Implementing the Guideline Recommendations
Potential Benefits
Decreased incidence of compassion fatigue among pediatric intensive care nurses
Potential Harms
Not stated
Qualifying Statements
Qualifying Statements
This Best Evidence Statement addresses only key points of care for the target population; it is not intended to be a comprehensive practice guideline. These recommendations result from review of literature and practices current at the time of their formulation. This Best Evidence Statement does not preclude using care modalities proven efficacious in studies published subsequent to the current revision of this document. This document is not intended to impose standards of care preventing selective variances from the recommendations to meet the specific and unique requirements of individual patients. Adherence to this Statement is voluntary. The clinician in light of the individual circumstances presented by the patient must make the ultimate judgment regarding the priority of any specific procedure.
Implementation of the Guideline
Description of Implementation Strategy
Applicability Issues
Implementation of a compassion fatigue training program would require trained instructors educated in the components needed to meet the desired objectives, including compassion fatigue awareness, self-care and coping skills. Resources required would include a comfortable learning environment, materials and supplies needed for training, such as paper or electronic copies of materials for participants, and presentation equipment. Participants would require time away from the patient care area for training which could be incorporated into approved educational time. Small numbers of participants could attend multiple sessions, due to the limitations of removing a large number of staff from the unit at one time.
Implementation Tools
- Audit Criteria/Indicators
Institute of Medicine (IOM) National Healthcare Quality Report Categories
IOM Care Need
- Staying Healthy
IOM Domain
- Effectiveness
Identifying Information and Availability
Bibliographic Source(s)
- Cincinnati Children’s Hospital Medical Center. Best evidence statement (BESt). Decreasing compassion fatigue among pediatric intensive care nurses using self-care skills and compassion fatigue training. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 2013 Jul 17. 5 p. [6 references]
Adaptation
Not applicable: The guideline was not adapted from another source.
Date Released
2013 Jul 17
Guideline Developer(s)
- Cincinnati Children’s Hospital Medical Center - Hospital/Medical Center
Source(s) of Funding
Cincinnati Children’s Hospital Medical Center
No external funding was received for development of this Best Evidence Statement (BESt).
Guideline Committee
Not stated
Composition of Group That Authored the Guideline
Team Leader/Author : Julianne Andreotta, BSN, RN, CPN, Cardiac Intensive Care Unit
Support/Consultant : Barbara K. Giambra, MS, RN, CPNP, Evidence-Based Practice Mentor, Center for Professional Excellence, Research and Evidence-Based Practice
Financial Disclosures/Conflicts of Interest
Conflict of interest declaration forms are filed with the Cincinnati Children’s Hospital Medical Center (CCHMC) Evidence-Based Decision Making (EBDM) group. No financial or intellectual conflicts of interest were found.
Guideline Status
This is the current release of the guideline.
Guideline Availability
Available from the Cincinnati Children’s Hospital Medical Web site.
Availability of Companion Documents
The following are available:
- Judging the strength of a recommendation. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 2008 Jan. 1 p. Available from the Cincinnati Children’s Hospital Medical Center.
- Grading a body of evidence to answer a clinical question. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 1 p.
- Table of evidence levels. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 2008 Feb 29. 1 p. Available from the Cincinnati Children’s Hospital Medical Center.
In addition, suggested process or outcome measures are available in the original guideline document.
Patient Resources
None available
NGC Status
This NGC summary was completed by ECRI Institute on December 2, 2013.
Copyright Statement
This NGC summary is based on the original full-text guideline, which is subject to the following copyright restrictions:
Copies of this Cincinnati Children’s Hospital Medical Center (CCHMC) Best Evidence Statement (BESt) are available online and may be distributed by any organization for the global purpose of improving child health outcomes. Examples of approved uses of CCHMC’s BESt include the following:
- Copies may be provided to anyone involved in the organization’s process for developing and implementing evidence-based care guidelines.
- Hyperlinks to the CCHMC website may be placed on the organization’s website.
- The BESt may be adopted or adapted for use within the organization, provided that CCHMC receives appropriate attribution on all written or electronic documents.
- Copies may be provided to patients and the clinicians who manage their care.
Notification of CCHMC at EBDMInfo@cchmc.org for any BESt adopted, adapted, implemented or hyperlinked to by a given organization and/or user, is appreciated.
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