Inadequate nursing staffing
In this assignment, you will write a critical appraisal that demonstrates comprehension of two qualitative research studies.
For this assignment, use the nursing practice problem and two qualitative peer-reviewed research articles you identified in Topic 1 (or two new articles based on instructor feedback in Topic 1). In a 1,000-1,250-word essay, summarize two qualitative studies.
Use the “Research Critique Guidelines – Part I” document to organize your essay.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Inadequate nursing staffing
Inadequate nursing staffing
Inadequate nursing staffing
In the current century, nursing care services have evolved to be more focused on value-based care, hence the need to implement optimal staffing to ensure high-quality patient outcomes and effective care, which is also cost-efficient. The lack of enough nurses at the patient’s bedside or for patients’ support exposes them to the likelihood of bad things happening. Nursing staffing is widely associated with the patient outcomes levels in the hospitals on various treatments because the nursing activities affect quality outcomes and readmission rates, hence the need to avoid inadequacy in nursing staffing for a quality work environment and efficacy in achieving quality patient outcomes.
PICOT Question; Does the nurse’s staffing influence the length of stay, medical errors, patient falls, and rate of reinfection among the ambulatory or outpatients compared with the inpatients with low nurse staffing rates after seven days?
Background of studies
The association between nurse staffing and omissions in nursing care: A systematic review by Griffiths et al., (2018)
This study is a systematic review of the possible association between the number of nursing staff available in a hospital and the nature of ommissions likely to be experienced during nursing care. According to the research, there has been a wide association between levels of staffing in nursing departments and the nature of patient outcomes; however, the problem is that what causes the relationships is not certain, while factors such as nursing care ommissions have been proposed as the core factors as the right indicators for the beauty in staffing. The study’s main objectives are to identify the most common nursing care that is missed out on when giving care to adult patients in acute inpatient wards and establish the evidence that associates the rates of missed care and the level of staffing. This study is significant to nursing because it discovers that there are high chances of missed nursing care when a facility has low registered nursing staffing. Hence any form of missed nursing care should automatically indicate a staffing inadequacy. The study, however, does not provide clear research questions to be answered.
Nurse staffing impacts patient and nurse outcomes by Rafferty, (2020)
According to this study, the problem to be investigated is that there is little evidence available to evaluate if the hospitals with fewer patients have better outcomes in their patient survival because the nurses there look after fewer patients. The research study is significant because it concludes that the nurses and patients in hospitals with favorable staff have consistently better outcomes than those in less staffed facilities. The main objective was to examine the impact that nursing staff levels have on patient mortality, rescue failures, and nurses’ dissatisfaction without forgetting other factors such as burnout and provision of quality care.
How do these articles support inadequate nursing staffing?
According to Griffiths et al., (2018), there is an undisputed association between the low registers of nursing staffing in hospitals and the prevalence of missed nursing care. As a result, the missed nursing care in the hospitals should serve as the major indicator used for staffing adequacy. For example, it shows which failures are attributed to the inadequacy and which ones can be subject to further investigation. This study is essential because it states clearly that the lower the nursing staffing levels, the higher the chances of missed care, hence can be associated with the impact experienced in the acute impatient units with fewer nurses to provide care. It can be stipulated that the missed care potentially causes high chances of medical errors, longevity in stay, and increased infection rates among the patients. Therefore the research by Griffiths et al., (2018) is essential for answering the PICOT question. This research’s interventions and comparison groups are the patients in acute adult inpatient wards. However, the actual control group is unclear because the research is a systemic review.
The research by Rafferty, (2020) examines how the nursing staff levels in hospitals or patient to nurse ratio affect the outcome of patients. The outcomes considered here are patient mortality, the failure to rescue, burnout, and nurse dissatisfaction levels. The article answers the PICOT question by indicating that patients in hospitals with low-level nursing staffing are highly associated with relatively lower outcomes compared o those with favorable staffing. The patient outcomes considered here as significant in the picot question outcomes such as length of stay, medical errors, patient falls, and rate of reinfection. These outcomes are associated with nursing staffing, job dissatisfaction, and burnout nurses experience due to low-level nurse staffing.
Methods of Study
Griffith’s et al., (2018)) applies a systematic review of various studies to explore the association between the levels of nursing staffing and the outcomes for the patient within the acute wards in hospitals. The methodology was a review that followed the right review methods outlined and recommended by the health research methods. The search h methods used were comprehensively based on the literature reviews on nursing staffing and search for specific terms on various health databases such as MEDLINE, NHS, EED, CEA, and HTA (Griffiths et al., 2018). The methodology used in this study is very practical and robust because it comprehensively focuses on the previous literature and deduces conclusions from various empirical research conducted that associated with the specific terms associated with nurse staffing and others like missed care. The research method is very comprehensive because it depends on comprehensive research for a qualitative analysis hence very effective. However, the limitation is that the study could potentially miss the focus and omit essential aspects of care; additionally, there could beb higher chances of publication bias while looking at the sources o draw from.
The research by Rafferty, (2020) on the impact of nursing staffing on patient outcome applied a comprehensive cross-sectional analysis which combined the nursing survey data with their discharge abstract across various hospitals. The participants in this research comprised 3984 nurses, and other members included patients in the general wards, orthopedic wards, and vascular surgery wards, with the total sample size being 118752. The benefit of this research methodology is that it is comprehensive research that interacts with the nurses and patients hence having first-hand experience with the hospital environments. However, the sample size used is a large tool, which may be inaccurate in other aspects; however, the outcomes are encouraging and align with the expected outcomes and PICOT question for this research.
Results of studies
Griffiths et al., (2018) showed that in the studies they reviewed, eighteen indicated missed care evidentially. More than 75 percent of the nurses in the reviews indicated reports of having omitted care in their responsibilities. Fourteen of the papers reviewed discovered that low nursing staff levels were associated with increased rates of reported missed care. However, little association was given between additional supporting workers to reducing missed care within those hospital facilities (Griffiths et al., 2018). The implication of this study in nursing practice is essential because it concludes that the lower the nursing staff, the more the missed care in hospitals, hence the need to have adequate nurse staffing in hospitals.
Rafferty, (2020) finds out that patients and nurses with favorable nursing staffing levels have better outcomes in the hospitals than those who have poor staffing. They discovered that patients in hospitals with high patient-to-nurse ratios have higher mortality rates than those with low patient-to-nurse ratios. They conclude that the nurse levels have a massive impact on the patient outcomes and consequently affect the nurse retention in those healthcare facilities. The study’s implication on nursing practice is that it forecasts the requirements for nursing staffing based on its linkage with the quality care. It can be concluded that the nurse’s abilities, training, and staffing levels are essential in impacting patient outcomes.
These are the set principles that ensure its design and applied practices properly guide the research. Every researcher must adhere to the considerations to ensure the protection of rights, embrace integrity, and have valid research. The first ethical consideration is to ensure proper levels of result communication. The communication of results should be honest and scientifically curated for credibility and reliability (Saltz & Dewar, 2019). The steps involved in this ethical consideration are avoiding plagiarism and falsifying data to be used in the research. Instead, for both types of research, there is nonplagiarism, plus the data used are from original research and a systemic review with acknowledgment to the publishers. The next consideration is confidentiality, majorly applied in the second research, whereby the participants in the research are known, yet their identity is hidden. This ensures that participants’ rights to privacy are embraced and protected because the data used is anonymous. There is proper unanimity in the participant details in a sample size for the research .
The increased length of stay, medical errors, patient falls, and rate of reinfection in every facility highly depends on the reduced chance of nurses’ efficacy. A low-level nursing staff increases the chances of medical errors hence further burnout, unsatisfaction, and inefficacy. There is a dire need for hospitals to recruit and train enough nurses. Enough nurses are resourceful to the hospitals and makes it easier to achieve the best quality outcomes for patients.
Griffiths, P., Recio-Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., Smith, G. B., & Ball, J. (2018). The association between Nurse Staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74(7), 1474–1487. https://doi.org/10.1111/jan.13564
Rafferty, A. M. (2020, September 30). Nurse staffing impacts on patient and nurse outcomes. Anne Marie Rafferty. Retrieved June 4, 2022, from https://journals.rcni.com/nursing-standard/feature/nurse-staffing-impacts-on-patient-and-nurse-outcomes-ns.35.10.40.s29/full
Saltz, J. S., & Dewar, N. (2019). Data Science Ethical Considerations: A systematic literature review and proposed Project Framework. Ethics and Information Technology, 21(3), 197–208. https://doi.org/10.1007/s10676-019-09502-5