Date of Award

Fall 12-13-2019

Document Type

DNP Project

Project Team Faculty Member

Dr. Wendy Hochreiter

Project Team Faculty Member

Dr. Valarie Yancey


Mindfulness, Wellbeing, Smartphone application, Mobile applications, Stress reduction, Resilience, Burnout, Self-care, Job satisfaction, Intent to leave, Advanced practice provider, Advanced Practice registered nurse, Family nurse practitioner, Physician assistant.



Burnout, attrition, and decreased work engagement among Advanced Practice Providers (APPs) are growing concerns and can have a negative influence on health care provider wellbeing. Chronic workplace stress is linked to various physical health problems, such as fatigue, insomnia, heart disease, depression, anxiety, and obesity. Chronic provider burnout is costly and extends to organizations and hospitals due to higher attrition, increased absenteeism, and decreased work engagement. Mindfulness-based stress reduction (MBSR) programs focus on the intent of practicing mindfulness to cultivate a state of being that is nonjudgmental, openhearted, friendly, curious, accepting, and compassionate. MBSR programs afford clinicians a way to decrease stress and burnout.

Interventions for providers that improve work-life balance are limited and not well understood. Initiation of the project was started to investigate whether an abbreviated mindfulness intervention could decrease burnout, perceived stress, and reduce intent to leave the organization among a cohort of APPs working at a large Midwest academic center with high attrition rates. The primary goal of the project was to introduce daily mindfulness exercises using a structured smartphone application to Nurse Practitioners (NP) and Physician Assistances (PA) during a two-week time frame. The desired outcome of the project was to determine if there was a reduction in burnout, perceived stress, and intent to leave.

A total of 85 APPs including 70 NPs, 14 PAs, and two certified nurse-midwives were invited to participate. The response rate was poor, 18.82% (n=16). Thirteen respondents (n=13) or 15.29% completed both the pre-and post-surveys. The project goals were evaluated using pre-and-posttest assessment tools along with a post-intervention survey to a convenience sample at a single institution. Using the Turnover Intention Scale (TIS-6), a six-item five-point Likert scale, and the Mini Z burnout (MZB) survey, a 10 item and one open-ended question to assess outcomes. Results of the pre-post intervention show no appreciative changes on intent to leave and burnout respectively. Because of the poor response rate statistical analysis was not possible. The pre-intervention survey responses indicate 56.25% of participants perceived their stress as high, 35.72% felt burned out, and 21.43% intended to leave the organization. Post-intervention survey responses indicate 42.86% of participants perceived stress their stress as high and 31.25% felt burned out, and 18.75% planned to leave as soon as possible.

A 10 item Likert-scale with 1 representing little impact and 10 representing maximum impact was utilized post-intervention to measure the general effectiveness of the project’s impact on APPs lives. Overall, 80 % of participants reported a positive impact on their lives and daily functioning. This quality improvement project supports the idea that smartphone MBSR interventions can be successfully delivered and implemented. However, further work is needed to evaluate if long term implementation of MBSR programs via smartphone application would be successful in reducing burnout and intent to leave.

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Reference list

Executive Summary_cbednar.docx (25 kB)
Executive Summary

Abstract Oct 11.docx (15 kB)

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Nursing Commons



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