Reka Somodi, DNP,
Nurse Practitioner
University of Pennsylvania School of Nursing
Philadelphia, Pennsylvania
Disclosure information not submitted.
Susan Renz, Phd, DNP
GNP
University of Pennsylvania, United States
Disclosure information not submitted.
Adam Shiroff, MD
MD
Hospital of The University of Pennsylvania, United States
Disclosure information not submitted.
Mark Mikkelsen, MD, MSCE,FCCM
Physician
Hospital of the University of Pennsylvania, United States
Disclosure information not submitted.
Meeta Kerlin, MD, MS
MD
Perelman School of Medicine, University of Pennsylvania, United States
Disclosure information not submitted.
Lewis Kaplan, MD, FACS, FCCP,FCCM
Professor, Surgery
Perelman SOM, U of Pennsylvania
Philadelphia, Pennsylvania
Disclosure information not submitted.
Title: An Abbreviated Mindfulness-Based Stress Reduction Intervention to Mitigate Burnout in Critical Care
Introduction and Hypothesis: Burnout Syndrome (BOS) results from persistent and inadequately managed occupational stress, and commonly impacts critical care clinicians. BOS impairs patient safety, patient satisfaction, productivity, employee retention, and drives absenteeism, depression, anxiety, alcohol and drug abuse, and suicidality. Few effective rescue strategies exist. This study explores whether a mindfulness-based stress reduction intervention (MBSR) embedded in critical care advanced practice provider (APP) workflow mitigates against one or more key BOS domains - emotional exhaustion, depersonalization, and reduced personal accomplishment.
Methods: Utilizing a pretest/posttest design. 166 APPs in nine intensive care units at a academic quaternary care center were assessed using the Maslach Burnout Inventory (MBI). Twenty-eight participants received virtual MBSR training in January 2021 followed by a 10-minute MBSR intervention during each of their clinical shifts from February 1 to April 28, 2021. Pre- and post-intervention MBI assessment (April 28, 2021) scores were compared using Wilcoxon-signed rank testing; significance assumed for p< 0.05.
Results: Mean pre-intervention MBI scores (n=28) were emotional exhaustion 26.9, depersonalization 2.0, and personal accomplishment 33. All participants completed MBSR activities during their clinical shifts (3 MBSR sessions for 8 weeks). Twenty completed post-intervention MBI assessment and demonstrated mean emotional exhaustion of 23.5 with a 1.75 reduction (p< 0.133), depersonalization of 1.8 with a 1.5 reduction (p< 0.112), and personal accomplishment of 36 with an increase of 3.53 (p< 0.021).
Conclusion: MBSR - a brief intervention - favorably impacts BOS in critical care APPs by reducing depersonalization. While it is easy to embed in daily workflow, the durability of shift-driven MBSR and its ability to address other BOS domains merits assessment in APPs, as does extension to other clinician groups.