Daily Indoor or Outdoor Work Break Intervention

Background
Nurses working in hospital environments are at risk for burnout. Exposure to nature has psychological benefits, but the effect of hospital gardens on nurse burnout is less understood.
Objective
To compare the effect on nurse burnout of taking daily work breaks in a hospital-integrated garden with the effect of indoor-only breaks.
Methods
A prospective crossover trial was conducted of nurses assigned to either 6 weeks of a work break in an outdoor hospital garden or 6 weeks of indoor-only breaks. After a 1-week washout period, break assignments were switched for a subsequent 6 weeks. The Maslach Burnout Inventory was administered at the beginning and end of each 6-week period, and a Present Functioning Visual Analogue Scale was completed at the start and end of each break to capture immediate psychological symptoms. Change scores were analyzed by using generalized estimating equations.
Results
For 29 nurses, for garden compared with indoor breaks, significant improvement was apparent in scores on the Maslach Burnout Inventory subscales for emotional exhaustion (4.5 vs -0.2; P < .001) and depersonalization (1.8 vs 0.0; P = .02) but not for personal accomplishment (-0.6 vs -0.0; P = .55). Compared with indoor breaks, total symptom scores on the Present Functioning Visual Analog Scale improved significantly when nurses took a break in the garden (garden vs indoor breaks, 4.0 vs 2.4; P = .04).
Conclusions
Taking daily work breaks in an outdoor garden may be beneficial in mitigating burnout for nurses working in hospital environments.

Rank: 70

First Author: Cordoza

Outcome: Emot. Exhaust./Comp. Fatig.,Burnout

Outcome p-value: Emotional Exhaustion/Compassion Fatigue:⭑⭑⭑, Burnout:⭑

Intervention Category: Reflection and Relaxation

D&B Study Quality Rating: 13.5

Reviewer Confidence: 2.5

Country: US

Study Design Type: Quasi-experimental

Materials Available to Implement: Interventions fully described in publication; settings were also described in publication. Corresponding author: https://www.researchgate.net/profile/Makayla-Cordoza.

Materials Available: yes

Organiz./Individ. Focus: Individual

Prevention Category: Primary,Secondary

Effect size Small:

Effect size Medium:

Reference: Cordoza, Makayla, Roger S. Ulrich, Bette J. Manulik, Stuart K. Gardiner, Paul S. Fitzpatrick, Teresia M. Hazen, Alar Mirka, and R. Serene Perkins. “Impact of Nurses Taking Daily Work Breaks in a Hospital Garden on Burnout.” American Journal of Critical Care 27, no. 6 (November 2018): 508–12. https://doi.org/10.4037/ajcc2018131.