Evidence-Based Practice Project: Literature Review Essay

Evidence-Based Practice Project: Literature Review Essay

Evidence-Based Practice Project: Literature Review

Acute care nurses are a group of healthcare professionals that provide care for patients with complex health needs. Their role in the care provision predisposes them to stress, anxiety, occupational burnout, and stress. The mental healthproblems that the acute care nurses are predisposed to in their practice not only affect their health and wellbeing but also the safety and quality of patient care. Evidence-based interventions that can be used in stress management and reduction by the acute care nurses exist. Mindfulness-based interventions are part of the evidence-based treatments that are recommended for the practice site. Mindfulness-based interventions promote a meta-cognitive mechanism referred to as decentring or reperceiving, which helps in managing negative thoughts and experiences and the development of effective coping against stressors. Despite its effectiveness, the hospitalhas not implemented the use of mindfulness-based interventions in stress reduction among acute care nurses, hence, the focus of this project.  The purpose of this paper is to review the research articles that will help answer the PICOT question: Among acute care nurses, does the provision of mindfulness-based interventions (MBIs) reduce stress levels as compared to no intervention within eight months period?


Search Methods

The articles for the project were obtained from various databases. A search was performed on databases that included CINAHL, EMBASE, Cochrane Library, PubMed, and Google Scholar. The search terms that were used included mindfulness-based interventions, mindfulness-based interventions in nursing, mindfulness-based interventions in healthcare, mindfulness-based practices and stress in nursing, and effectiveness of mindfulness-based interventions in nurses’ mental health. The inclusion criteria for the selected articles included those that focused on the use of mindfulness-based interventions on nurses and other healthcare workers, investigated the effectiveness of mindfulness-based interventions on stress and other mental health problems, written in the English language, and published over the last five years. Articles that did not meet the above inclusion criteria were excluded from use in the review.

Synthesis of the Literature

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Eight articles were selected for this literature review. The first study is the research by Daigle et al. (2018)that investigated the effect of mindfulness-based stress reduction intervention on wellbeing and rates of perceived nursing errors among hospital nurses. The study was a randomized controlled trial where 37 nurses were randomly assigned to the intervention group and 33 to the control group. The study results demonstrated that mindfulness-based intervention led to significant improvements in the distress level experienced by nurses. There was also a high level of treatment satisfaction among the participants. The intervention also led to error rate improvement in the participants in the intervention compared to the control group.

Ghawadra et al. (2019) conducted a systematic review that explored the studies that used mindfulness-based interventions to determine their effect on reducing psychological distress among nurses. The researchers undertook a literature search on databases that included EBSCO host, PubMed, Science Direct, Web of Science, and Springer Link. The included articles were published between 2002 and 2018 in the English language and focused on the intervention use in nurses. The search led to nine articles, which showed that mindfulness-based interventions lead to a reduction in stress, depression, anxiety, burnout, and improved job satisfaction among nurses.

Hente et al. (2020) conducted a longitudinal, mixed-methods, observational study to assess the efficacy of mindfulness-based cognitive therapy delivered onsite on reducing stress levels and improving well-being in an interdisciplinary chronic care health care team. The data for the study was collected using a survey that was developed using validated assessment tools for measuring training effectiveness. The participants completed surveys before the training and at 1 and 15 months post-training. Data obtained from 24 professionals working in cystic fibrosis centers showed statistically significant improvements in perceived stress, empathy, anxiety, depersonalization, perspective talking, resilience, negative affect, and perspective-taking.

Kang and Myung (2022) conducted a meta-analysis of randomized controlledtrials that examined the effects of mindfulness-based interventions on mental health nurses. The researchers performed a search on databases that included EMBASE, PubMed, CINAHL, and Cochrane that led to the acquisition of nine randomized controlled trials that used 572 participants. Data analysis demonstrated that the intervention groups had significantly improved psychological distress and wellbeing compared to participants in the control groups. No statically significant differenceswere noted in job-related outcomes.

Lomas et al. (2019)performed a systematic review and meta-analysis to determine the impact of mindfulness-based interventions on the wellbeing of healthcare professionals. The authors performed a literature search on databases with eligibility criteria that included studies that focused on the wellbeing of healthcare providers following the use of mindfulness-based interventions. The search led to 41 articles. Data analysis demonstrated that mindfulness-based interventions led to positive outcomes and improvement in the wellbeing of the healthcare providers.

Strauss et al. (2021)conducted a randomized controlled trial of mindfulness-based cognitive therapy for life to determine its effect on stress levels among healthcare workers. The participants included 234 healthcare workers who were randomly assigned to the intervention and control groups. The analysis of data using mixed regression analysis showed that mindfulness-based interventions ameliorated stress compared to control intervention. The interventions also improved the anxiety, depression, and well-being of the participants.

Sulosaari et al. (2022) conducted a systematic review that examined the effectiveness of mindfulness-based interventions on the psychological well-being of nurses. The study utilized 11 randomized controlled trials and quasi-experimental studies with 1009 participants. The articles were obtained from online databases with the approach to data analysis aligning with PRISMA protocol. The results of the study showed that mindfulness-based interventions improve nurses’ psychological wellbeing. Penque (2019)conducted a quasi-experimental study that investigated the effects of mindfulness-based interventions on the wellbeing of the nurses. Participants were recruited and enrolled to participate in mindfulness-based interventions. The study results showed that the intervention led to improvement in the well-being of the nurses.

Comparison of Articles

The selected articles share the similarity of exploring the effectiveness of mindfulness-based interventions in stress and other mental health problems that nurses and healthcare workers experience. However, the articles differ significantly based on the adopted study designs. The majority of the selected studies are systematic reviews and meta-analyses (Ghawadra et al. 2019; Lomas et al. 2019; Sulosaari et al. 2022). The remaining studies are quasi-experimental research, randomized controlled trials, and mixed-method studies (Daigle et al. 2018; Hente et al. 2020; Kang &Myung, 2022; Penque, 2019; Strauss et al. 2021). The studies also differ based on their limitations. The studies by Daigle et al. (2018), Kang and Myung (2022), and Strauss et al. (2021) had the highest level of reliability and validity compared to the other studies. The authors randomized their participants into intervention or control groups, eliminating the risk of bias in the reported findings.

The studies also differ based on their recommendations. Accordingly, most of the non-experimental studies, mixed methods, and quasi-experimental studies also recommend the need for large randomized controlled trials to determine the effectiveness and efficacy of mindfulness-based interventions in reducing stress among healthcare providers. The included randomized studies also recommend the need for larger investigations in different settings to determine the effect of the intervention.

The selected studies also differ significantly based on their conclusions. Daigle et al. (2018) concluded in their study that mindfulness-based behavioral interventions could also be used in addressing nursing errors. Ghawadra et al. (2019) concluded that creative and effective approaches to delivering mindfulness-based behavioral interventions should be explored to enhance its outcomes. Hente et al. (2020) concluded that future studies should determine the optimal training dose for mindfulness-based interventions and the durability of its associated benefits. They also raised the need for future studies to determine the generalizability of the effectiveness of the intervention to other healthcare workers.

Suggestions for Future Research

The selected studies provide insights into the areas that should be considered in future studies examining the effectiveness of mindfulness-based interventions in addressing stress among nurses. First, the studies suggest the need for future studies to explore the effectiveness of mindfulness-based interventions in improving quality and safety indicators in nursing. They recommend the need for the studies to explore other issues that include medication errors in nursing practice, as they relate to the wellbeing of the nurses. The studies also suggest the need for large randomized studies to investigate the effectiveness of mindfulness-based interventions in managing stress among nurses. Large randomized studies would enhance the generalizability of the findings to a wide population.

The studies also recommend the need for future studies to explore the effectiveness of the intervention in other settings besides acute care environments. The findings will inform if the intervention has universal applicability to addressing the crucial issues in nursing practice. The selected studies also recommend that future studies should focus on determining the number of training sessions that should be utilized to achieve the desired effect in stress management. Accordingly, future studies should inform about the therapeutic dose that is needed to ensure the efficiency in the delivery of mindfulness-based interventions. The effectiveness of mindfulness-based interventions in the longterm has not been explored. As a result, the selected studies suggest the need for future studies to determine the sustainability of mindfulness-based interventions in managing stress among nurses and other healthcare workers.


Overall, the selected studies demonstrate that stress among nurses is a crucial problem that increases the risk of safety, quality, and efficiency concerns in healthcare. Evidence-based interventions for stress management by healthcare providers exist. The proposed project focuses on the use of mindfulness-based interventions to manage stress among acute care nurses. Data analysis in the selected articles demonstrates that mindfulness-based interventions are effective in stress management in nurses and other healthcare providers. The interventions improve their wellbeing, depression, anxiety, resilience, and negative affect. The selected studies share similarities in their focus on stress and other mental health problems that nurses and other healthcare providers experience in their practice. They differ in the selected methodologies, limitations, and conclusions. The overall recommendations from the selected studies include the need for large randomized studies examining the effectiveness of mindfulness-based interventions in stress management. Therefore, it is expected that the proposed project will replicate the findings reported in the selected articles.


Daigle, S., Talbot, F., & French, D. J. (2018). Mindfulness-based stress reduction training yields improvements in well-being and rates of perceived nursing errors among hospital nurses. Journal of Advanced Nursing, 74(10), 2427–2430. https://doi.org/10.1111/jan.13729

Ghawadra, S. F., Abdullah, K. L., Choo, W. Y., &Phang, C. K. (2019).Mindfulness-based stress reduction for psychological distress among nurses: A systematic review.Journal of Clinical Nursing, 28(21–22), 3747–3758. https://doi.org/10.1111/jocn.14987

Hente, E., Sears, R., Cotton, S., Pallerla, H., Siracusa, C., Filigno, S. S., & Boat, T. (2020). A Pilot Study of Mindfulness-Based Cognitive Therapy to Improve Well-Being for Health Professionals Providing Chronic Disease Care.The Journal of Pediatrics, 224, 87-93.e1. https://doi.org/10.1016/j.jpeds.2020.02.081

Kang, M.-J., &Myung, S.-K. (2022). Effects of Mindfulness-Based Interventions on Mental Health in Nurses: A Meta-Analysis of Randomized Controlled Trials. Issues in Mental Health Nursing, 43(1), 51–59. https://doi.org/10.1080/01612840.2021.1949765

Lomas, T., Medina, J. C., Ivtzan, I., Rupprecht, S., &Eiroa-Orosa, F. J. (2019). A Systematic Review and Meta-analysis of the Impact of Mindfulness-Based Interventions on the Well-Being of Healthcare Professionals.Mindfulness, 10(7), 1193–1216. https://doi.org/10.1007/s12671-018-1062-5

Penque, S. (2019).Mindfulness to promote nurses’ well-being.Nursing Management, 50(5), 38–44. https://doi.org/10.1097/01.NUMA.0000557621.42684.c4

Strauss, C., Gu, J., Montero-Marin, J., Whittington, A., Chapman, C., &Kuyken, W. (2021). Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life. International Journal of Clinical and Health Psychology, 21(2), 100227. https://doi.org/10.1016/j.ijchp.2021.100227

Sulosaari, V., Unal, E., & Cinar, F. I. (2022).The effectiveness of mindfulness-based interventions on the psychological well-being of nurses: A systematic review.Applied Nursing Research, 64, 151565. https://doi.org/10.1016/j.apnr.2022.151565


The purpose of this assignment is to write a review of the research articles you evaluated in your Topic 5 “Evidence-Based Practice Project: Evaluation of Literature” assignment. If you have been directed by your instructor to select different articles in order to meet the requirements for a literature review or to better support your evidence-based practice project proposal, complete this step prior to writing your review.

A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT. You will use the literature review in this assignment in NUR-590, during which you will write a final paper detailing your evidence-based practice project proposal.

In a paper of 1,250-1,500, select eight of the ten articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article:

Introduction – Describe the clinical issue or problem you are addressing. Present your PICOT statement.
Search methods – Describe your search strategy and the criteria that you used in choosing and searching for your articles.
Synthesis of the literature – For each article, write a paragraph discussing the main components (subjects, methods, key findings) and provide rationale for how the article supports your PICOT.
Comparison of articles – Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).
Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
Conclusion – Provide a summary statement of what you found in the literature.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

3.2: Analyze appropriate research from databases and other information sources to improve health care practices and processes.

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