Research paper

2

Annotated Bibliography 2

Consequences of Nurses Labor Shortage on Patient Care and Mortality Rate

Author Note

Statement of Topic

The nurses' labor shortage has been an issue of concern in the US. With the rising number of patients in healthcare facilities, the shortage of nurses very has adverse effects on the patient care and mortality rate. This paper will provide the perspective of the consequences that the shortage of nurses has led to regarding patient care and mortality rate. That will help identify effective mitigation strategies that can be used to prevent the adverse effects caused by the shortage of nurses and simultaneous increase in the number of patients in the healthcare facility.

Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., Bruyneel, L., Rafferty, A. M., Griffiths, P., Moreno-Casbas, M. T., Tishelman, C., Scott, A., Brzostek, T., Kinnunen, J., Schwendimann, R., Heinen, M., Zikos, D., Sjetne, I. S., Smith, H. L., & Kutney-Lee, A. (2012). Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ, 344(7851), 17–20. https://doi.org/10.1136/bmj.e1717

Aiken et al. (2020) investigate the effects of the number of nurses on some patient KPIs such as patient care. The study investigated the relationship between patient care, patient safety, and the number of nurses in Europe. Thus, it has contributed to the data regarding the topic. According to the article, ‘Each additional patient per nurse increased the possibility of the nurses reporting poor quality care provided to the patients (pg 8).” Thus, the article will be relevant to the topic of discussion as it contributes more data that can be used in the study. Thus, it will be used as evidence in the research study to be conducted.

Bradley, S., Kamwendo, F., Chipeta, E., Chimwaza, W., de Pinho, H., & McAuliffe, E. (2015). Too few staff, too many patients: a qualitative study of the impact on obstetric care providers and on quality of care in Malawi. BMC Pregnancy and Childbirth, 15(1), 65–65. https://doi.org/10.1186/s12884-015-0492-5

The article investigated the effects of the increasing number of patients and the reducing number of nurses on obstetric care and on the quality of care that is provided to the patients. According to Bradley et al. (2015), “the shortages of the staff have a significant and negative impact on the maternal outcomes in low-income countries (pg 1).” Thus, the study indicates that the reduction or the low number of nurses has a negative effect on patient care. The article will be used to provide more information and inform the topic under discussion. It will be used to prove that a reduction in the number of nurses has an adverse effect on patient care in numerous departments.

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://doi.org/10.1136/bmjqs-2018-008948

The research study investigated the relationship between hospital nursing and staff-patient interactions. According to the study, it indicates that existing evidence indicates that a reduction in nurse staffing has an adverse effect on the quality of care that is provided to the patients. The research article is relevant to the topic under discussion as it adds to the information on the topic. It relates to the topic under discussion and it provides data that can be used to indicate the consequences of nurses shortage on patient care and mortality rates. Thus, the article recommends that more nurses should be employed to improve the quality of care provided as well as the patient care provided.

Brooks, M. V., & Gaietto, K. J. (2019). The shortage of expert nephrology nurses and patient quality care indicators: A quantitative cross-sectional study. CANNT Journal (1996), 29(3), 13–.

The article indicates that the nurses that work in internal medicine need the expertise, education, and time to increase the patient outcomes of their patients. The quantitative cross-sectional study studied the effects of the shortage of nephrology nurses in inpatient care. According to the study, patient care reduced significantly and the mortality rate increased significantly due to the shortage of nurses. The study is relevant to the research being carried out as it addresses the topic. It will contribute to more data that will be used in the research study to identify the consequences of the shortage of nurses in patient care and the mortality rate. The author asserts that “Recruitment of new nurse into the nephrology nursing specialty needs to be a priority (pg 19).”

Buerhaus, P. I., Donelan, K., Ulrich, B. T., Norman, L., Williams, M., & Dittus, R. (2015). Hospital RNs’ and CNOs’ perceptions of the impact of the nursing shortage on the quality of care. Nursing Economic, 23(5), 214–.

The article by Buerhaus et al. (2015) investigates how the nursing shortage affects the quality of care that is provided to the patients. The article indicated that a shortage in nurses affected the quality of care provided to the patients negatively as the nurses are overworked thus increase=ing the possibility of reduction in patient safety as well as the time used to attend to each patient. This article is relevant to the topic under discussion. That is because it provides relevant information that can be used to inform and support the arguments that shortages of nurse practitioners have a negative effect on patient care as well as mortality rate.

Griffiths, P., Maruotti, A., Recio Saucedo, A., Redfern, O. C., Ball, J. E., Briggs, J., Dall’Ora, C., Schmidt, P. E., & Smith, G. B. (2019). Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study. BMJ Quality & Safety, 28(8), 609–617. https://doi.org/10.1136/bmjqs-2018-008043

According to the article, “The days where the admissions per registered nurse exceeded 125% of the ward mean were associated with an increased hazard of death (pg 9).” That indicates that indicated that the number of nurses was directly proportional to the mortality rate in the healthcare facilities. The healthcare facilities that have more nurses experience lower mortality rates. However, those with fewer or fewer nurses have a higher mortality rate as the nurses should attend to more patients. The study is relevant to the topic under discussion as it addresses the topic. Thus, it will be used to indicate how the shortage of nurses affects the mortality rate of patients.

Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicentre study. BMC Health Services Research, 19(1), 864–864. https://doi.org/10.1186/s12913-019-4688-7

Haegdorens et al. (2019) investigated how the nurse staffing, as well as the nurse’s level of education, affected the mortality rate of the patients. Thus, the study indicated that an increase in nurse staffing, as well as the education level of the nurses, reduced the mortality rate of the patients in the medical and surgical wards. This article is relevant to the topic under discussion as it provides more information on how nurse staffing affects the mortality rate of the patients. Additionally, it provides the variable of nurse education level and how it affects the mortality rates. According to the study, “The proportion of nurse bachelor hours and the nurse staffing in a healthcare facility correlated with the mortality rate in the healthcare facility.”

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), 60–60. https://doi.org/10.1186/s12912-016-0181-3

He et al. (2016) investigated the relationship between nurse staffing and patient outcomes. One of the indicators of patient outcomes of the care provided to the patient. According to the article, it indicated that nurse staffing and patient outcomes have associations both at the trend and seasonal levels. Thus, nursing staffing affects patient care. The article will be relevant to the topic being discussed as it provides data that will be used to support how the consequences of shortage in nursing affect patient care and mortality rates. Thus, it will be used as a part of the literature review in the study.

Jung, M., Park, H., Kang, D., Park, E., Jeon, K., Chung, C. R., & Yang, J. H. (2020). The effect of bed-to-nurse ratio on hospital mortality of critically ill children on mechanical ventilation: a nationwide population-based study. Annals of Intensive Care, 10(1), 159–159. https://doi.org/10.1186/s13613-020-00780-7

Jung et al. (2020) investigated the effects of nurse staffing on the mortality rate of children that were on mechanical ventilation. According to the article, such children need a lot of care to improve their health outcomes. Thus, an increase in the bed-to-nurse ratio indicates that one nurse should attend to more patients thus reducing the patient outcomes. That increases the mortality rate of the children and vice versa. The article is relevant to the topic under discussion. It provides more information and ta that can back up and be used to identify the consequences of a shortage in nurse staff and the mortality rate and the patient care in a healthcare facility.

Khoja, M. A. (2018). Registered nurses’ knowledge and care practices regarding patients with dysphagia in Saudi Arabia. International Journal of Health Care Quality Assurance, 31(8), 896–909. https://doi.org/10.1108/IJHCQA-06-2017-0106

Khoja (2018) investigated how the knowledge of the nurses that are employed in a healthcare facility affects patient care. The study used a self-administered survey to collect the information. According to the article, the knowledge of the nurses also affects the patient care provided to the patients. In some instances, healthcare facilities have low nurse staffing. Although that affects patient care negatively, adding knowledge to the nurses through training can improve the patient care provided to the patients. The article is relevant to the topic under discussion as not only does it indicate the consequences of a shortage of nurses but it also explores the effects of increased expertise.

Kim, Y., Kim, H.-Y., & Cho, E. (2020). Association between the bed-to-nurse ratio and 30-day post-discharge mortality in patients undergoing surgery: a cross-sectional analysis using Korean administrative data. BMC Nursing, 19(1), 17–17. https://doi.org/10.1186/s12912-020-0410-7

Kim et al. (2020) investigate the association between the number of nurses per patient and the mortality rates of the patients that were undergoing surgery. The article indicated that when the number of nurses was increased, they attended to fewer patients thus reducing the mortality rate of the patients after they underwent surgery. That indicates that when the number of nurses was reduced, they serve more patients thus increasing the mortality rate of the patients. The study is relevant to my research as it will be used to inform the topic. Additionally, it will be used as part of a literature review to indicate the consequences of the shortage of nurses on mortality rate and patient care.

Kutney-Lee, A., Sloane, D. M., & Aiken, L. H. (2013). An Increase In The Number Of Nurses With Baccalaureate Degrees Is Linked To Lower Rates Of Postsurgery Mortality. Health Affairs Web Exclusive, 32(3), 579–586. https://doi.org/10.1377/hlthaff.2012.0504

The article investigates the relationship between the nursing staff with high expertise and the post-surgery mortality rate. The article indicates that most patients when not given the required patient care may die after surgery. The study indicates that a reduction in the nurse staffing increases the workload of the nurses thus increasing the post-surgery mortality rate. However, the article indicated that more expertise among the nurses also affected the outcomes of the patients. That is because nurses with more expertise provide better patient care to their patients. It was identified that more expertise among the nurses increases patient care. The study is relevant as it provides relevant information to the topic under discussion.

Liang, Y. W., Tsay, S. F., & Chen, W. Y. (2012). Effects of nurse staffing ratios on patient mortality in Taiwan acute care hospitals: a longitudinal study. Journal of Nursing Research, 20(1), 1-8.

https://doi.org/10.1097/JNR.0b013e3182466ddc

Liang et al (2012) investigated the effects of understaffing on the patient mortality rate in Taiwan. The article identified that the workload of the nurses is 2 to 7 times the number of nurses in the healthcare facilities. Thus, according to the article, the shortage of nurses is one of the reasons why there are numerous preventable deaths in healthcare facilities (pg 6). The article is relevant to the topic that was chosen. That is because it addresses the consequences of nursing shortage on patient mortality. Thus, the study will be used to inform the research article and provide evidence in the study.

Martsolf, G. R., Gibson, T. B., Benevent, R., Jiang, H. J., Stocks, C., Ehrlich, E. D., Kandrack, R., & Auerbach, D. I. (2016). An Examination of Hospital Nurse Staffing and Patient Experience with Care: Differences between Cross-Sectional and Longitudinal Estimates. Health Services Research, 51(6), 2221–2241. https://doi.org/10.1111/1475-6773.12462

Martsolf et al. (2016) investigated how healthcare facilities' nurse staffing affected the patient experience with the care that was provided to them. The study used a longitudinal and cross-sectional study design to identify how hospital nursing affected patient care. The results of the article indicate that hospital nurses had a direct relationship with the patient experiences with the care provided to them. That is because hospitals with more nurses provided better patient care to their patients. That is because, with more nurses, each nurse attends to a fewer number of patients thus giving them more attention. The study is relevant as it addresses the topic under discussion effectively.

Park, S. H., Boyle, D. K., Bergquist-Beringer, S., Staggs, V. S., & Dunton, N. E. (2014). Concurrent and Lagged Effects of Registered Nurse Turnover and Staffing on Unit-Acquired Pressure Ulcers. Health Services Research, 49(4), 1205–1225. https://doi.org/10.1111/1475-6773.12158

The study investigates the effects of a high nurse turnover rate and staffing and patient care in healthcare facilities. Park et al. (2014) indicated that “A high registered nurse turnover is an essential factor that affects the pressure ulcers rates and the registered nurses needed for high-quality ulcer rates (pg 6).” That indicates that a high rate of nurse turnover has a negative effect on patient care. The article recommends that more nurse practitioners should be employed to ensure that high-quality patient care is maintained in a healthcare facility. This article is relevant to the topic of discussion as it provides data used relevant to inform the topic.

Rafferty, A. M. (2018). Nurses as change agents for a better future in health care: the politics of drift and dilution. Health Economics, Policy and Law, 13(3-4), 475–491. https://doi.org/10.1017/S1744133117000482

The article reviews the healthcare sector in the United Kingdom in the 70th Anniversary of the National Health Service to reflect on the strategic direction of the nursing policy and the extent to which nurse practitioners can realize the potential that they have to promote a better future in the healthcare sector. Rafferty (2018) indicates that nurse practitioners affect the patient care provided to the patients in healthcare facilities. Thus, when the nurses are numerous, the workload per nurse is reduced enabling them t provide effective and high-quality patient care to the patients thus creating a better opportunity for the growth of the health industry. The study is relevant to the topic as it provides more information on the topic.

Rochefort, C. M., Abrahamowicz, M., Biron, A., Bourgault, P., Gaboury, I., Haggerty, J., & McCusker, J. (2021). Nurse staffing practices and adverse events in acute care hospitals: The research protocol of a multisite patient‐level longitudinal study. Journal of Advanced Nursing, 77(3), 1567–1577. https://doi.org/10.1111/jan.14710

Rachefort et al. (2021) investigated the patient-level longitudinal association between the risk o adverse events in acute care healthcare facilities and the nurse staffing practices. According to the article, the nurse staffing practices used in acute care healthcare facilities had effects on patient care. The study identified some of the factors that reduce patient care in acute care healthcare facilities. “Four high impact adverse effects that were evaluated in the study included the failure to rescue, hospital-acquired pneumonia, in-hospital falls, and venous thromboembolism. This article is relevant to the topic under discussion as it provides more data on the topic.

Shang, J., You, L., Ma, C., Altares, D., Sloane, D. M., & Aiken, L. H. (2014). Nurse employment contracts in Chinese hospitals:impact of inequitable benefit structures on nurse and patient satisfaction. Human Resources for Health, 12(1), 1–1. https://doi.org/10.1186/1478-4491-12-1

The study investigated the nurses' employment contracts and how they led to patient satisfaction. An increase in patient care leads to increased patient satisfaction. Thus, when patient care reduces, patient satisfaction is likely to reduce as well. The study indicated that the contracts given to the nurses affected patient satisfaction in various ways. For instance, if the contracts increased nurse satisfaction, they increased the patient care despite the workload that they had. That is because they were motivated to work harder. On the other hand, if the contracts reduced the nurses' morale as well as the nurses' satisfaction, it also has d a negative effect on patient satisfaction indicating that it affected patient care negatively. The article is essential to my study as it will be used to inform the topic.

Veenstra, M., & Gautun, H. (2021). Nurses’ assessments of staffing adequacy in care services for older patients following hospital discharge. Journal of Advanced Nursing, 77(2), 805–818. https://doi.org/10.1111/jan.14636

The article investigated the effectiveness of nurse staffing adequacy in improving patient care for older patients in hospitals. According to the article, nurses are the primary health providers as they interact more with the patients. Thus, more nurses would reduce the workload per nurse and thus increasing the patient care provided to the older patients in hospitals. The article was relevant to the topic of discussion as it provides information that can be used to identify how nurse staffing affects the provision of high-quality care to patients in healthcare faculties. Thus, it will be used as evidence in the research study.

Woo, B. F. Y., Lee, J. X. Y., & Tam, W. W. S. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15(1), 63–63. https://doi.org/10.1186/s12960-017-0237-9

Woo et al. (2017) investigated the effects of the role of the nurses in increasing the clinical outcomes, patient satisfaction, quality of care as well as emergency and critical care settings. According to the article, nurses are essential in improving patient care. Therefore, when the nurses are fewer or have a lower level of expertise in a healthcare facility, there are more likely to reduce the patient care provided to the patients in the facility. The service provided more information about the relationship pf patient care and the nurse practitioners in a healthcare facility. Thus, it is relevant to the topic under discussion.