Literature Evaluation Table

Student Name:

Change Topic: Nursing shortage

Criteria

Article 1

Article 2

Article 3

Article 4

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M. (2019). Hospital nurse staffing and staff–patient interactions: an observational study. BMJ quality & safety, 28(9), 706-713.

https://qualitysafety.bmj.com/content/qhc/28/9/706.full.pdf

Glette, M. K., Aase, K., & Wiig, S. (2017). The relationship between understaffing of nurses and patient safety in hospitals-A literature review with thematic analysis.

https://uis.brage.unit.no/uis-xmlui/bitstream/handle/11250/2484383/OJN_2017121214354394.pdf?sequence=1&isAllowed=y

He, J., Staggs, V. S., Bergquist-Beringer, S., & Dunton, N. (2016). Nurse staffing and patient outcomes: a longitudinal study on trend and seasonality. BMC nursing, 15(1), 60.

https://link.springer.com/content/pdf/10.1186/s12912-016-0181-3.pdf

Manesh, M. H., Singh, J. S. K., & Hussain, I. A. B. (2018). Transformational leadership and contextual performance: A quantitative study among nursing staff in kuala lumpur. International Journal of Management and Sustainability, 7(2), 101-112.

https://www.researchgate.net/profile/Jugindar_Singh2/publication/327397656_Transformational_Leadership_and_Contextual_Performance_A_Quantitative_Study_among_Nursing_Staff_in_Kuala_Lumpur/links/5b987f49299bf14ad4d0a658/Transformational-Leadership-and-Contextual-Performance-A-Quantitative-Study-among-Nursing-Staff-in-Kuala-Lumpur.pdf

Article Title and Year Published

The title of the article is “Hospital nurse staffing and staff–patient interactions: an observational study.”

It was published in 2019.

The title of the article is “The relationship between understaffing of nurses and patient safety in hospitals-A literature review with thematic analysis.”

It was published in 2017.

The title of the article is “Nurse staffing and patient outcomes: a longitudinal study on trend and seasonality.”

It was published in 2016.

The title of the article is “Transformational leadership and contextual performance: A quantitative study among nursing staff in kuala lumpur.”

It was published in 2018.

Research Questions (Qualitative)/Hypothesis (Quantitative)

What is the association between nurse staffing levels, skill mix, and the quality and quantity of daytime interactions with patients in hospital wards?

How can understaffing amongst nurses in hospitals affect patient safety?

What is the longitudinal association between nurse staffing and patient outcomes?

What influence does transformational leadership have on employee’s contextual performance in the nursing sector in Kuala Lumpur?

Purposes/Aim of the Study

To examine the relationship between nurse staffing levels, skill mix and the quality and quantity of daytime interactions with patients in hospital wards

The aim is to increase the knowledge of understaffing of hospital nurses, and the consequences that understaffing may have on patient safety

To explore longitudinal association that exists between nurse staffing and patient outcome

To fill the gap that exists by determining the influence of intellectual stimulation, individualized consideration, inspirational motivation, and idealized influence have on contextual performance.

Design (Type of Quantitative, or Type of Qualitative)

This is a quantitative study that used an observational study.

This is a quantitative study that used thematic analysis.

This is a quantitative study that used a longitudinal study

This is a quantitative study.

Setting/Sample

Six wards at two English National Health Service hospitals

a literature search of the databases Chinal, Medline, Cochrane library, Isi Web of Science and Academic Search premiere was undertaken

Quarterly unit-level nursing data from 2004-2012 from the NDNQL

Healthcare setting in Kuala Lumpur

Methods: Intervention/Instruments

Secondary analysis of observational data

Literature review

Used 2004-2012 data obtained from NDNQL

Self-administered questionnaires

Analysis

Data were analyzed from 119-2 hour sessions in which care of 270 patients was observed

Thematic analysis was used.

A grouped mechanism was developed in the analysis

Descriptive and inferential statics was used for the analysis of data.

Key Findings

Low registered nurse staffing levels results in poorer quality interactions between patients and staff

Low nursing staffing results in a wider negative effect with adverse consequences for patient experience and quality of care.

The nursing shortage affects patient safety negatively directly and indirectly

Changes in nurse staffing are associated with changes in rates of falls and pressure ulcers

Seasonal nursing shortage contributes to seasonality in patient outcomes

Nurse leaders should adopt a transformational leadership style to influence and motivate nurses in managing stress, adapting changes and working towards organizational vision and goals

Leaders with individualized consideration can improve the performance of nurses

Recommendations

Policies and practices should focus on improving the retention and supply of registered nurses

Further research is required on the topic as articles in this study mentioned a lack of research, most especially in Nordic countries

More research is needed to study the underlying mechanisms of associations between nurse staffing and patient outcomes

Further research should include factors such as culture, age differences, ethnic differences, and religiosity. This will provide a better understanding of the factors that impact transformational leadership and performance.

Explanation of How the Article Supports EBP/Capstone Project

This article supports my EBP/capstone project as it has provided the effects of low registered nurse staffing levels in hospitals and different aspects such as quality interactions

This article supports my EBP/capstone project as it has discussed the issue of nurse understaffing and how it affects patient safety negatively.

This article supports my EBP/capstone project as the findings can be used in discussing the issue of nurse staffing and its effect on patients

This article supports my EBP/capstone project as it has provided theoretical and practical implications for the performance of nurses in the healthcare industry

Criteria

Article 5

Article 6

Article 7

Article 8

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

Aiken, L. H., Cerón, C., Simonetti, M., Lake, E. T., Galiano, A., Garbarini, A., … & Smith, H. L. (2018). Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes, 29(3), 322-327.

https://www.sciencedirect.com/science/article/pii/S0716864018300609

Rivaz, M., Momennasab, M., Yektatalab, S., & Ebadi, A. (2017). Adequate resources as essential component in the nursing practice environment: a qualitative study. Journal of clinical and diagnostic research: JCDR, 11(6), IC01. http://europepmc.org/article/PMC/5535389

Gan, I. (2020). How do nurse managers describe clinical nurses’ work arrangements? A qualitative study. Nursing Open, 7(1), 160-169.

https://onlinelibrary.wiley.com/doi/full/10.1002/nop2.374

Griffiths, P., Dall’ora, C., & Ball, J. (2017). Nurse staffing levels, quality and outcomes of care in NHS hospital wards: what does the evidence say?. Health Work: Evidence Briefs, 1(1).

https://eprints.soton.ac.uk/412518/1/staffing_levels_submitted.pdf

Article Title and Year Published

The title of the article is “Hospital nurse staffing and patient outcomes.”

It was published in 2018.

The title of the article is “Adequate resources as essential component in the nursing practice environment: a qualitative study.”

It was published in 2017.

The title of the article is “How do nurse managers describe clinical nurses’ work arrangements? A qualitative study.”

It was published in 2020.

The title of the article is “Nurse staffing levels, quality and outcomes of care in NHS hospital wards: what does the evidence say?”

It was published in 2017.

Research Questions (Qualitative)/Hypothesis (Quantitative)

What are the association of nursing staff, nurse skill mix, and nurse work environment with patient outcomes?

What is the Iranian nurses’ perceptions of the key constituent of the nursing practice environment

How do nurse managers describe nurses in different work arrangements?

What are the levels of staffing on wards associated with reported outcomes?

Purposes/Aim of the Study

To ascertain the relationship between nursing staff, nurse skill mix and nurse work environment with patient outcomes

To examine the perception of Iranian nurses on key constituents of the nursing practice environment

To understand how nurse managers describe nurses in alternative work arrangements

To examine the safe staffing levels in general wards.

Design (Type of Quantitative, or Type of Qualitative)

This is a qualitative study that used a cross-sectional dataset.

This is a qualitative study that used qualitative design.

This is a qualitative study that used exploratory study.

This is a qualitative study.

Setting/Sample

Healthcare setting in Chile

Twelve staff nurses, supervisors, and head nurses from different wards of five teaching hospitals

26 baccalaureate‐pre‐pared nurse managers located across the United States

MEDLINE, CINAHL, EMBASE, the Cochrane Library, and other databases

Methods: Intervention/Instruments

Same protocols and measures used in RN4CAST

A qualitative design with a conventional content analysis approach

Semi-structured interviews

Used MEDLINE, CINAHL, EMBASE, the Cochrane Library, and other databases

Analysis

The cross-sectional dataset was used for looking at some staffing and work environment measures, patient outcomes and hospital outcomes

Data analysis was undertaken using MAXQDA Software with a conventional qualitative content analysis method.

The constant comparative method was used for the analysis of the data collection phase.

The studies selected were from the UK that estimates the associations between nurse staffing levels on general wards and any quality or outcome measures

Key Findings

The nursing work environment is the hospital property

Practice environment plays a vital role in attracting and retaining skilled and experienced human resource

Nurses share common work identities, appreciate each others’ personalities and foster workplace relationships

Lower nurse staffing levels are associated with worse outcomes in general acute wards or patient groups

Recommendations

Adjusting severity at the patient level can ensure that variation between hospitals can be explained by nursing factors.

There is a need to undertake this research in a different practice environment and context as the results may be different.

There is a need for further study which should seek to explore alternative work arrangement’s impact on nurse career.

There is a need to have the required levels of HCA staffing to better analyze the problem.

Explanation of How the Article Supports EBP/Capstone

This article supports my EBP/capstone project as it discusses the importance of the nursing work environment in relation to the nursing shortage.

This article supports my EBP/capstone project as it discusses the importance of environment on attracting and retaining skills and human resources and how this can help deal with the nursing shortage.

This article supports my EBP/capstone project as it provides how nurse managers describe nurse alternative work arrangement and how it impacts future employment

This article supports my EBP/capstone project as it has discussed the issue of lower nursing staffing levels and how it impacts the patient outcome.

References

Aiken, L. H., Cerón, C., Simonetti, M., Lake, E. T., Galiano, A., Garbarini, A., … & Smith, H. L. (2018). Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes, 29(3), 322-327.

Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M. (2019). Hospital nurse staffing and staff–patient interactions: an observational study. BMJ quality & safety, 28(9), 706-713.

Gan, I. (2020). How do nurse managers describe clinical nurses’ work arrangements? A qualitative study. Nursing Open, 7(1), 160-169.

Glette, M. K., Aase, K., & Wiig, S. (2017). The relationship between understaffing of nurses and patient safety in hospitals-A literature review with thematic analysis.

Griffiths, P., Dall’ora, C., & Ball, J. (2017). Nurse staffing levels, quality and outcomes of care in NHS hospital wards: what does the evidence say?. Health Work: Evidence Briefs, 1(1).

He, J., Staggs, V. S., Bergquist-Beringer, S., & Dunton, N. (2016). Nurse staffing and patient outcomes: a longitudinal study on trend and seasonality. BMC nursing, 15(1), 60.

Manesh, M. H., Singh, J. S. K., & Hussain, I. A. B. (2018). Transformational leadership and contextual performance: A quantitative study among nursing staff in kuala lumpur. International Journal of Management and Sustainability, 7(2), 101-112.

Rivaz, M., Momennasab, M., Yektatalab, S., & Ebadi, A. (2017). Adequate resources as essential component in the nursing practice environment: a qualitative study. Journal of clinical and diagnostic research: JCDR, 11(6), IC01.

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Short staffing
Student’s name
Institutional affiliation
Date

The nursing shortage is an issue that is facing healthcare organizations. With the demand for healthcare services, there is a need for more staff. Nurse staffing is significant as it reduces nursing burnouts. Nursing shortage impacts healthcare organizations negatively (Msn, 2018). Due to a shortage of nurses, patients may end up receiving late treatment hence reducing the quality of services provided.
Thesis statement: Nursing shortage is an increasing issue facing healthcare organization and this has led to problems such as risks of medication errors among others. Therefore, there is a great need to identify interventions that can be used in increasing high nurse-to-patient ratios.
Evidence-based solution
The evidence-based solution for this issue is reducing the nurse staffing ratio which will help in reducing the rate of medication errors. This solution will reduce burnout among nurses and increase satisfaction among nurses (Buerhaus et al., 2007).
Nursing intervention
The nursing shortage will require an increase in nurses to bridge the gap between the nurses and patient ratio. Increasing the number of nurses will improve the quality of care hence reducing issues such as medication errors.
Patient care
Nursing shortage leads to issues such as an increase in errors and higher mortality rates. Due to high patient-to-nurse ratios, nurses end up feeling dissatisfied hence patients may end up having a higher mortality rate.
Health care agency
The nursing shortage is an issue that is increasingly facing the healthcare industry today. Healthcare organizations face an increasing challenge to meet the demand for healthcare services while being faced with the challenge of having a nursing shortage.
Nursing practice
Health professionals, from physicians to registered nurses among others provide health care services based on their field. However, an insufficient supply of nurses in all fields has resulted in issues such as medication errors.
PICOT STATEMENT
Population/problem
Today, there is an increase in medical errors in the healthcare system. Patients visit health care facilities for services that will improve their quality of life. This, however, has not been possible due to an increase in medical errors which results in more medical complications. These problems are associated with a high nurse-to-patient ratio. This paper addresses the relationship between nurse-to-patient rates and the risk of medication errors affecting the patient population in the medical surgery unit.
Intervention
The intervention is to reduce the nurse-to-patient ratio. A reduced number of patients served by each nurse reduces issues such as fatigue, stress, and burnout among nurses. This hence improves the quality of services provided. Additionally, it reduces adverse events and the risk of medication errors in the surgery units.
Comparison
The intervention will be compared to a case of no treatment to address medication errors. This problem may increase the risk of medication errors
Outcome
Increasing the number of nurses will reduce cases of medication errors. This positive outcome will be attained by reducing nurse burnout
Time
The outcome will be measured within a period of 12 months
The PICOT question: In the medical surgery unit population, how does reduction in the nurse-to-patient ration impact medication errors compared with no treatment within twelve months?

References
Buerhaus, P. I., Donelan, K., Ulrich, B. T., Norman, L., DesRoches, C., & Dittus, R. (2007). Impact of the nurse shortage on hospital patient care: Comparative perspectives. Health affairs, 26(3), 853-862.
Msn, T.L.C. (2018). No One Understands the Term, Nursing Shortage: Like a Nursing Student Does. Amazon Digital Services LLC – Kdp Print Us

After discussion with your preceptor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal. Explain how your proposal will directly and indirectly impact each of the aspects.

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