Reducing nurse leader stress through the implementation of an evidence-based program for building resilience capacity

Author(s) Information

LaceyLou LefereFollow

Nature and scope of the project

The long-standing need for the holistic well-being support of nurses has been highlighted by the Covid-19 pandemic. With three-fourths of the nursing workforce reporting exhaustion or burnout in 2020, nurses need strategies for building resilience - what many call the antidote to stress and burnout, now more than ever. This project seeks to bridge the gap between the recognition of the need for comprehensive well-being support for nurse leaders and the application of a realistic, effective, evidence-based program for building resilience capacity.

Synthesis and analysis of supporting literature

Resilience is being defined and quantified in the literature, but there are limited strong evidence-based interventions noted for building resilience capacity in healthcare workers. One intervention that appears in application both within and outside of healthcare is HeartMath®. Through a variety of implementation strategies in settings from healthcare to law enforcement and from the community to academia, HeartMath® training has demonstrated a realistic option for reducing stress and improving resilience in populations who receive the intervention, according to the literature. In the studies that were reviewed, the POQA-R4 was a statistically sound tool for the evaluation of program effectiveness.

Project implementation

The HeartMath® Resilience Advantage program will be offered to nurse leaders across seven sites of hospital-based care by way of four virtual 90-minute workshop sessions in early 2023 - facilitated by a HeartMath® Certified Trainer.

Evaluation criteria

The effectiveness of the program will be evaluated using the Personal and Organizational Quality Assessment – revision 4 (POQA-R4) tool to measure stress, which is an indicator for resilience capacity. The POQA-R4 is an assessment of workplace quality based on a survey questionnaire, which gathers self-report information on socio-demographic and key psychological and workplace elements that contribute to the overall quality and effectiveness of an organization. (The survey is confidential; only summary, anonymous data will be provided to the Principle Investigator by a Research Scientist from the HeartMath Research Center.)


TBD - There will be analysis of pre/post-intervention trended data from the POQA-R4, as well as matched-pairs t-test for statistical significance.


TBD - The successful implementation of this project would support building the business case for organizational investment in the nursing workforce in such a way that helps build personal resilience capacity by reducing stress, such as with the HeartMath® Resilience Advantage program.



Reducing nurse leader stress through the implementation of an evidence-based program for building resilience capacity