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Nursing Paper Unit 5 Assignment

Janet Johnson

Herzing University

8/14/2022

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The research design of the study

The research article by Dechawatanapaisal (2018) utilized a survey research design

method. This is a design method in which the primary source of data is a survey. The researcher

makes use of the survey to have a better understanding of the individuals or group of individuals

being studied relative to the topic or the concept of interest. In line with this article, the survey

method ensured that the participants engaged in self-reporting with the help of questionnaires so

that they better understand the impact of the highlighted factors. Kurnat-Thoma et al (2017) on

the other hand employed the evidence-based turnover analysis research design to undertake the

study. The main participants who were involved in the study included the nurses. The third

article by Stalpers et al (2015) employed the correlational research design method in which

relevant literature review studies were reviewed and relevant information collected.

Threats to external/internal validity

Internal validity refers to the extent or degree to which the relationship being tested is

trustworthy. The potential internal threats established from the articles include but are not limited

to; social interaction. The interaction that people have from different groups has a significant

impact on the outcome. For instance, the nurses who are working based on fixed hours are

resentful of the nurses who are working with flexible hours. This significantly impacts the job

satisfaction that employees go through. Another potential internal threat is regression towards the

mean. Employees, and nurses in this case who tend to score very low in the first survey many

times show a better and higher score in the next survey. This is in comparison with employees

who score averagely in the first score.

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External threats to validity, on the other hand, refer to the degree to which study results

can be applied in real-life situations or even to a group of events. The common threat to external

validity is sampling bias. There can be situations in which the sample selected is not the actual

representation of the population to be studied. In this case, for example, the nurses who have

been interviewed might be having pre-determined minds about how they feel about the situation.

This renders them unfit to represent a population sample. Another external threat is the

Hawthorne effect. This is a threat in which the participants selected for the study tend to change

their behaviors after realizing that they are being studied. For instance, the participants might

decide to avoid anxiety-inducing situations because they are conscious of what is being studied.

Potential legal/ethical issues within the article

The potential ethical issues include informed consent. In nursing and health-related

articles, informed consent is a common battle for nurses. Dilemma situations emerge in cases

where the patients together with their children have not been informed fully about the treatment

that they are supposed to go through. There are also issues pointing out that patients are not free

to ask questions yet they are not aware of the implication of the fear of the services they are

about to receive. The second ethical issue is inadequate staffing and resources. This is evident in

the articles that have been presented. The cost of healthcare has been on the rising daily. Patients

and nurses themselves are at great risk when the resources are not enough. This demands a

formulation of very hard decisions.

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Data analysis (be sure to elaborate on this more from your paper in week 4, providing

specifics about the results)

The research article by Dechawatanapaisal (2018) established that there three major

contributors to nursing turnover rates are lead exchange quality, organizational identification,

and job embeddedness. According to the results obtained, if these three can be taken good care of

in the organization, then it is evident that turnover rates will be taken good care of. These causes

are majorly engineered by the nature of the management of a facility. Kurnat-Thoma et al (2017)

on the other hand realized that the implementation of an onboarding program can significantly

reduce nurse turnover rates. According to the article, this can be attained through having quality

standards and procedures employees follow to join an organization. If the steps followed are the

right ones, then it is evident that turnover rates will be at their minimum. The third article

revealed that there exists a sensitive relationship between nurses and patients, which plays a role

in employee turnover. The environment that relationship between these two people creates a

robust environment in which other activities in the organization go on very well with minimum

disturbances.

Implications for evidence-based practice and how this article could be used to make an

evidence-based change

Evidence-Based Change (EBP) is a typical process that commences with a simple clinical

question and later goes ahead to finding critically appraising evidence. The article has played an

essential role in establishing a practice change that ought to be changed. The information that has

been provided by the articles gives a solid foundation for the follow up steps, that is integrating

evidence in the clinical expertise as well as patients preferences. Through the article, relevant

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organizations and bodies are well positioned to implement decisions that will address the

turnover rates. This will collectively bring change. The articles have enhanced the understanding

of internal and external threats as well as possible legal implications which might emerge.

Conclusion/summary of the evidence

In summary, there exists several factors influencing the working nature of the nurses as

well as their relationship with the patients whom they are meant to handle. Other inadequacies

that patients meet in town do not solely come from inadequate staffing of the nurses and their

high turnover rates. However, if the staffing issues can be addressed, many challenges faced by

patients would have been addressed. This is because the higher the number of nurses in place, the

better the services that are being offered since patients have more and enough time with the

patients.

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References

Dechawatanapaisal, D. (2018). Nurses' turnover intention: The impact of leader-member

exchange, organizational identification and job embeddedness. Journal of Advanced

Nursing, 74(6), 1380-1391. Nurses' turnover intention: The impact of leader‐member

exchange, organizational identification, and job embeddedness

Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and

registered nurse staff turnover—a 10-element onboarding program intervention. SAGE

Open Nursing, 3, 2377960817697712.

Stalpers, D., de Brouwer, B., Kaljouw, M., & Schuurmans, M. (2015). Associations between

characteristics of the nurse work environment and five nurse-sensitive patient outcomes in

hospitals: A systematic review of the literature. International Journal of Nursing Studies,

52(4), 817-835. https://doi.org/10.1016/j.ijnurstu.2015.01.005

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Appendix

Article/Reference (in APA format)

Purpos e of the Article/ Study Questi on

Variabl es (i.e.; Indepen dent vs. Depend ent)

Study Desig n

Sampl ing

Metho ds

Instru ment

Findings/ Results

Dechawatanapaisal, D. (2018). Nurses' turnover intention: The impact of leader-member exchange, organizational identification and job embeddedness. Journal of Advanced Nursing, 74(6), 1380-1391. Nurses' turnover intention: The impact of leader‐member exchange, organizational identification, and job embeddedness

The purpos e of this researc h was to look into the ways in which leader- membe r interch ange quality, organiz ational identity , and job embed dednes s all affect people' s propen sity to leave an organiz ation. The availab

Depend ent variable - Nurses' turnove r intentio n Indepen dent variable : leader- membe r exchan ge, organiz ational identifi cation, and job embedd edness.

Cross - sectio nal surve y

Conve nience sampli ng

Cross- sectio nal survey metho d

Self- report questi onnair e

The quality of exchange s between leaders and followers and job embeddi ng were found to be directly related. The impact of leader- member interchan ge quality on work embedde dness was partially mediated by individua ls' levels of identifica tion with

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le literatu re does not provide enough inform ation about this topic.

their respectiv e organizat ions. The analysis also backed the idea that job embedde dness acted as a mediator between organizat ional identity and turnover intent.

Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—a 10-element onboarding program intervention. SAGE Open Nursing, 3, 2377960817697712.

What are the relevan t ways of reducin g the nurse staff turnove r rate in the hospita l setting annuall y?

Depend ent variable - nurse staff turnove r.

Indepen dent variable - 10 element s onboar ding progra m interve ntion.

Evide nce- based turno ver analy sis appro ach

Source s strateg ically sampl ed

Standa rdized exit survey and review of record s.

Standa rdized exit survey .

The study findings showed an abnormal ly high turnover rate among new hires, that we needed a new onboardi ng program to better support new hires, and that

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we needed to work more closely with hospital/ unit directors and superviso rs to enhance the experien ce of new hires. To lower yearly hospital and RN staff turnover, we designed and impleme nted a 10- element program interventi on with a heavy emphasis on supportin g newly- hired employe es. The outcome was a reduction

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of staff turnover by 14 percent overall and 20 percent among new hires, both of which are statistical ly significa nt accompli shments.

Stalpers, D., de Brouwer, B., Kaljouw, M., & Schuurmans, M. (2015). Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: A systematic review of the literature. International Journal of Nursing Studies, 52(4), 817- 835. https://doi.org/10.101 6/j.ijnurstu.2015.01.005

The purpos e of this study was to conduc t a system atic literatu re review on the associa tions betwee n the workin g conditi ons of nurses and five

Depend ent variable - patient sensitiv e outcom e.

Indepen dent variable - nurse work environ ment charact eristics.

Syste matic revie w desig n.

Target ed sampli ng.

Syste matic review of literat ure.

Dutch versio n of Cochr ane's critical apprai sal instru ment.

There is an associati on between the work environm ent and the nurse sensitive- patient outcomes .

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patient outcom es that are particul arly import ant to nurses.