Implementing an Acts of Kindness Intervention for Emergency Department Staff

Background:Professional nursing is inherently stressful. This stress negatively impacts nurses, hospitals, and patients in significant ways. Stress levels are disproportionately higher in emergency department (ED) nurses, with 30-55% of them suffering from moderate to high levels of burnout. These high levels lead to negative effects on nurses' well-being, and on the care they deliver to their patients. Various studies have shown personal stress-reduction strategies play an important role in combating stress and boosting resiliency. However, resources for coping strategies are not routinely offered for ED staff. The acts of kindness intervention was selected as a resource to combat this issue as research has shown the benefits of prosocial behaviors, such as acts of kindness, on individual measures such as personal happiness feelings of increased autonomy and self-efficacy. This intervention acts as a personal resource for coping with stress in an area of high burnout. Methods:A quality improvement project was developed by creating an acts of kindness intervention with the aim of increasing personal job resources at an ED in a suburban hospital in Utah. Participants were asked to perform five acts of kindness a week for four weeks. Participants included nurses, patient care technicians and health unit coordinators. Fourteen individuals participated in the intervention. Pre and post intervention surveys, which included the Maslach Burnout Inventory (MBI-HSS (MP)), were taken by those who agreed to participate. The MBI-HSS (MP) includes three domains of burnout. The Wilcoxon signed rank test was used to evaluate group pre and post median test scores in 2 the three domains of burnout. In addition, staff reported their uptake of the intervention and evaluated its usability and effectiveness.Results: In the three domains of burnout, feelings of emotional exhaustion (EE) reduced from a few times a month to once a month (W=246, p= 0.02), while depersonalization (DP) and personal accomplishment (PA) remained unchanged (W= 169, p= 0.10; W=148, p= 0.51). The majority of participants (100%) indicated they had a positive reaction to participating in the intervention. Themes identified in the qualitative responses included increased positivity toward work, elevation in mood, and an outward focus. Conclusion:The results of the project demonstrate the potential benefits of an acts of kindness project for ED staff. Feelings of emotional exhaustion decreased significantly, while depersonalization and personal accomplishment remained unchanged. Qualitative data suggests additional benefits apart from reduction in burnout levels. The program was initially met with general enthusiasm, and all participants positively regarded their experience upon completion. Data collected during this study adds to the growing body of knowledge on ED staff burnout and their desire for personal stress-reduction resources. Future projects should focus on developing strategies and solutions that facilitate greater resiliency among ED staff