Research Critiques and PICOT Statement Final Draft

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Staff shortage in nursing

Student’s name: Liliana Faura

University affiliation: GCU

Date : 06/02/19

Course: NRS-443V

Title Here

Shortage of nursing is a problem faced in nursing. Despite the fact that there still is a growing demand for nurses, hospitals are still facing staff shortage. Due to the demand for health care services, there is an increasing need for staff. Nurses are needed to educate and provide care to patients who suffer from chronic conditions like dementia, diabetes, arthritis, and obesity among others. Some of the factors that have resulted in a shortage of nursing faculty include; lateness in career development, low salaries, and the looming retirement of large numbers of currently employed staff – please cite your source here. Therefore, the factors contributing to nursing shortage include; workload and work environment, aging populating, an aging workforce, and hospitals acuity among others – please substantiate these statements with statistics and citation – academic papers need to be fact driven, otherwise clearly state that this is your opinion.

The high mortality rate is caused by inadequate nurse services – it will be very important to cite your source here too. Due to the low staff in nursing, the present ones are overworked. This effect is spread to others and hence may result in errors. The overworking also may affect the staff since they may lose their morale in undertaking their care duties. The staff shortage in nursing also affects the quality of care. This is due to poor health care either due to overworking or lack of nurses – word choice – understaffing is a better choice. If the staff works as a team and it happens that some members are lacking, then the team may not function effectively .

PICOT question

P (patient/problem) - staff shortage in nursing levels – which area of nursing will you apply your practice change – will you be implementing change on the patient or the staffing side of things? This is very vaguely stated and needs to be significantly improved.

I (intervention) – lower nurse to patient ratios – what specific intervention are you proposing?

C (comparison) – higher nurse to patient ratios – how will this be implemented? Careful too, as increasing or decreasing patient ratios (when you have established in your previous narrative above that this leads to errors and poorer patient outcomes – may be considered unethical to do just for the sake of gathering data for research or EBP).

O (outcome) – patient safety and quality of care – what outcome will you measure that will indicate safety and quality?

T (time) – two years

How has staff shortage in nursing levels impacted nurse to patient ratios, patient safety, and quality of care in the last two years? – This is not a PICOT question, please revise in format and content.

Literature Evaluation Table

Student Name:

Summary of Clinical Issue (200-250 words):

PICOT Question: How has staff shortage in nursing levels impacted nurse to patient ratios, patient safety, and quality of care in the last two years?

Criteria	Article 1	Article 2	Article 3
APA-Formatted Article Citation with Permalink	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. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377843/	Zhu, J., Rodgers, S., & Melia, K. M. (2015). A qualitative exploration of nurses leaving nursing practice in China. Nursing open, 2(1), 3-13. https://onlinelibrary.wiley.com/doi/full/10.1002/nop2.11	Cox, P., Willis, W. K., & Coustasse, A. (2014). The American epidemic: The US nursing shortage and turnover problem. https://pdfs.semanticscholar.org/21d8/3d77233481b31852283688a9088c904b1158.pdf
How does the Article relate to the PICOT Question?	The article relates to the PICOT question as it discusses the impact of a few staff on the quality of care	The article relates to the PICOT question as it provides salient reasons as to why there is a shortage of nurses	The article relates to the PICOT question as it discusses the problem that the U.S. faced based on turnover and nursing shortage
Quantitative, Qualitative (How do you know)	This article is qualitative research because the researcher is more immersed in the subject matter	This article is qualitative research because the author used interviews and observation to compile data	This article is qualitative research because the author has immersed more on the subject matter.
Purpose Statement	To expand the evidence base on the effective use of mid-level health workers in emergency obstetric and neonatal care, and to identify the factors that would optimize the retention of these cadres and support their performance. Please simplify the statement above as it reads more into the purpose of the study, which the authors state as: This paper explores the perceptions of EmOC providers in Malawi on the critical factors of staff shortages and workload in their health facilities	To provide a theoretical understanding of nurses leaving nursing practice by exploring the processes of decision‐making by registered nurses in China on existing clinical care.	To determine the root problems of nursing turnover and, to assess what factors are driving the nursing shortage issue facing the U.S.
Research question	What is the impact of a few staff on patient care? This is an inaccurate research question based on what the authors stated their aim and purpose were.	How do leavers describe their experiences of being a clinical nurse during their entering, practicing and leaving the nursing practice? How do they explain their reasons for leaving the nursing practice?	What is the root problems of nursing turnover and what factors drive the nursing shortage issue facing the U.S.
Outcome	Clinical worsening Please state (if applicable) the outcome the study measured/examined. Please modify your response to all of the articles, as it was not answered accurately.	High nursing turnover Please state (if applicable) the outcome the study measured/examined	Poor quality care Please state (if applicable) the outcome the study measured/examined
Setting (Where did the study take place?)	Healthcare setting in Malawi	Healthcare setting in China	Healthcare setting in the U.S.
Sample	Health workers	leavers with different years of work experiences in all areas of clinical care	Nursing staff – They did not interview or even sample nursing staff, please refer to the article to discuss what their data source was
Method	Interviews please specify what type of interviews these were	Interviews	literature research review of case studies and semi-structured interview
Key Findings of the study	Lack of flexibility, inadequate skill mix, and mortality and morbidity rates affect nursing rates These were not the themes the authors stated as their results.	The factors that may lead to the nursing shortage is the imbalance of power perceived by individual nurses These were not the themes identified by the authors in their study.	The solutions to nursing turnover are; increased education, fellowship programs, monetary incentives, legislation initiate, and web-based training. These read more than what the authors provided for key findings. Please state what the primary drivers of retention and turnover they actually stated in the article.
Recommendations of the researcher	Revising staffing norms according to demand	Choosing to nurse as a stepping stone to future careers This was not stated as a recommendation in the article itself.	Provision of monetary incentives The authors discussed more than this in their list of recommendations.

Criteria	Article 4	Article 5	Article 6
APA-Formatted Article Citation with Permalink	Griffiths, P., Recio‐Saucedo, A., Dall'Ora, C., Briggs, J., Maruotti, A., Meredith, P., ... & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of advanced nursing, 74(7), 1474-1487. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033178/	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. https://www.ncbi.nlm.nih.gov/pubmed/17485766	Alshutwi S. (2017). The Influence of Supervisor Support on Nurses’ Turnover Intention. iMedPub Journals. Vol. 4 No. 2: 56 http://www.hsprj.com/health-maintanance/the-influence-of-supervisor-support-on-nurses-turnover-intention.pdf
How does the Article relate to the PICOT Question?	The article relates to the PICOT question because it discusses the relationship between nurse staff and omissions in nursing care.	The article relates to the PICOT question because it provides insights on how a shortage in nursing affects the hospital patient care.	The article relates to the PICOT question because it discusses how supervision may reduce staff shortage in nursing
Quantitative, Qualitative (How do you know)	This article is qualitative research because it has reduced data to numerical findings This is a NOT primary research article. Please replace with a primary research article for the purpose of this assignment.	This article is qualitative research because it has used tools such as surveys and questionnaires. This is NOT a qualitative research article. It is also more than a decade old and should not be used as basis for practice change in 2019.	This article is qualitative research because it has used deductive logic This is NOT a qualitative research article. It is also not a primary research article. Please replace with a primary research article for the purpose of this assignment.
Purpose Statement	To identify nursing care most frequently missed in acute adult inpatient wards and to determine evidence for the association of missed care with nurse staffing	To report the results of national random-sample surveys of RNs, physicians, and hospital CEOs and CNOs on their perceptions of the current nurse shortage	To review and critique the published empirical research on supervisor support as an approach to reduce turnover intention, and make recommendations for further research
Research question	What is the role of nursing staff in maintaining patient safety?	What is the impact of the nursing shortage on processes of care and hospital capacity?	What is the association between supervisor support and turnover intention?
Outcome	Mortality	Mortality	Clinical worsening
Setting (Where did the study take place?)	Healthcare setting	National surveys of registered nurses, physicians, and hospital executives	Healthcare setting
Sample	Registered nurses	National survey of physicians and registered nurses	Nurses
Method	Secondary data	Secondary data	Focus group
Key Findings of the study	Low Registered Nurse staffing is associated with reports of missed nursing care in hospitals.	Improvements in interdisciplinary teamwork and ensuring greater interdisciplinary education will help improve quality and building a safe environment for patients	Nursing policies are needed to promote supervisor supportive behaviors such as training programs and workshops.
Recommendations of the researcher	Planning and communication will reduce nursing turnover	Building teamwork	Supervisor support should be used as an innovative approach

References

Alshutwi S. (2017). The Influence of Supervisor Support on Nurses’ Turnover Intention. iMedPub Journals. Vol. 4 No. 2: 56

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.

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.

Cox, P., Willis, W. K., & Coustasse, A. (2014). The American epidemic: The US nursing shortage and turnover problem. Please complete the reference listing for this entry, per APA 6th edition.

Griffiths, P., Recio‐Saucedo, A., Dall'Ora, C., Briggs, J., Maruotti, A., Meredith, P., ... & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of advanced nursing, 74(7), 1474-1487.

Zhu, J., Rodgers, S., & Melia, K. M. (2015). A qualitative exploration of nurses leaving nursing practice in China. Nursing open, 2(1), 3-13.

�This is a bit confusing because the preceding and following statements refer to clinical nurse staffing shortage – rather than shortage of nursing faculty. Please revise to clarify.

�Word choice – fatigue would be more appropriate hee.

�The meaning of this statement is vague.

�All researchers are immersed in the subject matter they are currently studying – please limit your response to Qualitative or Quantitative as the standard responses you provided here is inaccurate. If you wish to enrich your reply, please specify the specific type of qualitative/quantitative research method rather than the explanation provided here.

�Please complete/revise this to accurately reflect the method employed by the authors.