UC Irvine

ABSTRACT OF THE DNP PROJECT FINAL PAPER

EFFECTS OF A SMARTPHONE APP-BASED YOGA ON EMERGENCY ROOM NURSE BURNOUT

by

Robyn LopezDoctor of Nursing Practice, Family Nurse Practitioner in Nursing Science University of California, Irvine, 2022 Assistant Adjunct Professor Dana Rose Garfin, Chair

Registered nurses make up approximately 30% of healthcare workers, yet there is still a critical shortage in this profession. The nursing shortage is a notorious phenomenon and accounts for devastation in healthcare, including sentinel events, lost costs, and poor health outcomes for patients and nurses. Yet, despite this, shortages continue to grow with no relief in sight. One of the identified factors of the nursing shortage is occupational burnout, defined “as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed” and is characterized along three dimensions: 1) feelings of energy depletion or exhaustion, 2) increased mental distance from one’s job/ feelings of negativism or cynicism related to one's job and 3) reduced professional efficacy (WHO, 2019). Emergency Room (ER) nurses are particularly vulnerable to burnout, with nurses frequently calling off, changing positions, or leaving the profession altogether. ER nurses experience chaotic, unpredictable environments, frequent traumatic events such as unexpected deaths, injured children, and workplace violence more than any other specialty of nursing (Adriaenssens et al., 2012). ERs are frequently overcrowded and understaffed, leaving ER nursing stretched to their max. This toll often leads to mental health issues, substance use, and even suicide (Pietrantoni et al., 2008). In the last few decades, studies have examined how to help healthcare workers, including nurses, deal with occupational burnout, what contributing factors play a role and how to reduce turnover rates.Since feelings of stress and anxiety contribute to burnout, recent studies have also examined ways to mitigate these factors, including mindful-based practices and more specifically yoga. Yoga has proven to be a promising intervention to reduce burnout in the nursing population in emerging research. In this project, yoga was used as a modality specifically for the ER nurse population using a Smartphone application called DownDog®. Ten participants from various ERs; ranging in age, gender, and shift, engaged in 4 weeks of yoga, twice per week via the Smartphone app DownDog®. The project was to determine if after the 4 weeks, participant’s feelings of stress, anxiety, and burnout were decreased using pre- and post-data from the Perceived Stress Scale (PSS), General Anxiety -7 scale (GAD-7), and Maslach’s Burnout Index (MBI). The scales were provided via Qualtrics along with a short, post-semi-structured qualitative questionnaire. With a 60% compliance rate, quantitative measures showed improvement in anxiety levels, occupational exhaustion, depersonalization/loss of empathy, lack of personal accomplishment, and overall, burnout. In the qualitative portion, only one participant did not find the yoga intervention effective, while five considered it moderately beneficial, and three found it very beneficial. The intervention was found to be either somewhat or significantly useful for all participants. In the semi-structured survey, 7 out of 9 participants said they would continue yoga, while only one said they liked the yoga but would prefer an in-person class. In conclusion, the participants reported decreased feelings of anxiety and burnout after the 4-week intervention and the more classes taken by the participants, the more benefit was attained. Although limited to a small sample size and self-reported attendance, the feasibility of DownDog® along with the benefits of practicing yoga showed to have positive results and is a promising solution to ER nurse burnout.