Literature review

Criteria

Article 1

Article 2

Article 3

Article 4

Author, Journal (Peer-reviewed), and permalink or working link to access the article

Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M.

BMJ Quality & Safety, 28(9),

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

Cho, E., Sloane, D. M., Kim, E.-Y., Kim, S., Choi, M., Yoo, I. Y., Lee, H. S., & Aiken, L. H.

International Journal of Nursing Studies, 52(2), 535–542

https://doi.org/10.1016/j.ijnurstu.2014.08.006

Cho, S.-H., Lee, J.-Y., Hong, K. J., Yoon, H.-J., Sim, W.-H., Kim, M.-S., & Huh, I

Journal of Korean Academy of Nursing Administration, 26(1), 42.

https://doi.org/10.11111/jkana.2020.26.1.42

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyombwe, T., & Astin, F.

European Journal of Cardiovascular Nursing

https://doi.org/10.11111/jkana.2020.26.1.42

Article Title and Year Published

Hospital nurse staffing and staff-patient interactions: an observational study. 

2019

Effects of nurse staffing, work environments, and education on patient mortality: An observational study. 

2015

Determining Nurse Staffing by Classifying Patients Based on their Nursing Care Needs. 

2020

The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis.

2018

Research Questions (Qualitative)/ Hypothesis (Quantitative) and Purpose/Aim of the study

Research question: what is the relationship between nurse staffing and staff-patient interactions?

The purpose: The study aimed at exploring the associations between the levels and skills of nurse staffing and the quality and quantity of their interactions with patients in hospital wards.

Research question: what is the link between nursing characteristics and patient outcomes?

The aim of the study: to explore the impact of nursing staffing, education, and environment on the mortality of patients.

Research question: what is nursing staffing in terms of patients’ nursing care needs?

The aim of the study: to determine nursing staffing through the classification of nursing care needs of patients.

Research question: what is the effect of nursing staffing levels on patient outcomes?

Aim of the study: To determine the associations between nurse staffing levels and the outcomes of nurse-sensitive patients in acute specialist units.

Design (Type of Qualitative or Quantitative)

Quantitative design that relied on Multilevel regression models.

Quantitative design that relied on survey data.

Quantitative design that relied on cross sectional data.

Quantitative design that relied on secondary data.

Setting/Sample

Data was collected from six wards at two English National Health Service hospitals.

Data was obtained from the patient discharge data and the staff of the 14 high-technology hospitals, South Korea.

Four general wards at a tertiary hospital.

86 registered nurses and 780 inpatients.

Nine electronic databases published between 2006 and 2017.

Methods: Intervention/ Instruments

Information was obtained through observation of the staff-patient interactions in 238 hours.

The information was generated from survey data from the nursing staff and the patient discharge data from 1st January to 31st December 2008.

Cross-sectional data was obtained through observation of nursing activities and measurement of patient’s nursing care needs.

Searching the nine electronic databases.

Analysis

Data analysis was carried out in a total of 119 sessions each of two hours in which a total of 270 patients under care were observed. Analysis was done using the multivariate regression model.

Logistic regression models were used to analyze the effects of nurse staffing, environment, and education on patient mortality.

Statistics on the nursing care needs of patients and nursing activities.

Systematic reviews of cross-sectional studies and meta-analysis of homogenous studies.

Key Findings

Out of the 3076 interactions observed, 299 interactions, which account for 10%, were rated as negative. Negative rating increased with the increase in the number of nurses, and agitation and age of the patient.

The results indicated that the three nursing characteristics are associated with patient mortality. In nurse staffing, additional patient per nurse put the risk of patient mortality to 5% within 30 days of admission.

The current nursing of the tertiary hospital was as low as 53%, and it affected the provision of nursing care needs to patients.

The high levels of nurse staffing were found to be linked to a reduction in medical errors, hospital-acquired infections, mortality, and an increase in levels of nurse interventions within 90 minutes. A higher level of nurse staffing decreased the risk of mortality by 14%.

Recommendations

The change of the quality and quantity of staff-patient interactions is associated with low staffing levels of the registered nurses. Low RN staffing levels are associated with changes in quality and quantity of staff–patient interactions. The use of assistant staffs does not increase the interactions. Thus, there is a need to increase the number of registered nurses to help in the supervision of assistant staff and thus, increasing staff-patient interactions.

In-hospital deaths can be prevented by adding more nurses with a Bachelor of Science in Nursing Degree and improving work environments.

The is a need to employ appropriate and safe staffing to help in the provision of nursing care needs to patients; thus, improving the quality of patient care.

Nurse-to-patient ratio needs to be adequate to help in improving patient care in acute care.

Explanation of How the Article Supports EBP/ Capstone Project

This article is relevant to the project because it examines the association between nurse staffing and the staff-patient interactions that are aimed at promoting patient outcomes.

This article supports the capstone project because it provides tangible evidence that providing adequate nurse-to-patient staffing ratio helps in improving the quality of patient care by reducing mortality.

This article supports the project by showing that increasing nurse staffing helps in the provision of quality patient care.

The article supports the project by presenting evidence on the patient outcomes that are affected by the nurse-to-patient ratio.

Criteria

Article 5

Article 6

Article 7

Article 8

Author, Journal (Peer-reviewed), and permalink or working link to access the article

Needleman, J.

BMJ Quality & Safety, 26(7), 525–528.

https://doi.org/10.1136/bmjqs-2016-006197

Olley, R., Edwards, I., Avery, M., & Cooper, H.

Australian Health Review, 43(3), 288.

https://doi.org/10.1071/ah16252

Shin, S., Park, J.-H., & Bae, S.-H.

Nursing Outlook, 66(3), 273–282.

https://doi.org/10.1016/j.outlook.2017.12.002

Song, Y., Hoben, M., Norton, P., & Estabrooks, C. A.

JAMA Network Open, 3(1), e1920092

https://doi.org/10.1001/jamanetworkopen.2019.20092

Article Title and Year Published

Nursing skill mix and patient outcomes. 

2016

Systematic review of the evidence related to mandated nurse staffing ratios in acute hospitals. 

2019

A systematic review and meta-analysis.

2018

Association of Work Environment with Missed and Rushed Care Tasks Among Care Aides in Nursing Homes. 

2020

Research Questions (Qualitative)/ Hypothesis (Quantitative) and Purpose/Aim of study

Research question: what is the relationship between nursing skill mix and patient outcomes.

Research question: What effects do nurse staffing ratios have in acute hospitals?

The aim of the study: To evaluate the research on nurse staffing methods and relate these methods to various patient outcomes.

Research question: what is the relationship between nurse staffing and nurse outcomes?

Aim of the study: to assess empirical studies on the relationship between nurse outcomes and nurse staffing.

Research question: is there an association between work environment and uncomplete or rushing nursing care tasks among the nursing home aides?

Aim of the study: To assess the association between the work environment and the crucial missing care tasks in the nursing homes.

Design (Type of Qualitative or Quantitative)

Qualitative design that relied on survey data.

Qualitative design that relied on empirical evidence and systematic reviews.

Qualitative design that relied on meta-analysis.

Quantitative design that relied on survey data and cross-sectional study.

Setting/Sample

Data from hospitals in six European nations.

English language publications published from 1st January 2010 to 30th April 2016.

Peer-reviewed articles from various databases published between January 2000 and November 2016.

A random sample of 93 urban nursing care homes.

4016 care aides.

Methods: Intervention/ Instruments

The information about 30-day inpatient mortality was obtained from patient surveys and administrative record sets.

PRISMA methodology was used.

Systematic reviews and meta-analyses of the identified articles.

Computer-aided and complete structured interviews were used.

Analysis

Reported nursing skill mix and patient outcomes.

A systematic review of the available literature

A meta-analysis of information on the relationship of nurse-to-patient ratio and nurse outcomes.

Information on the characteristics of workers, the demographic characteristics, facility characteristics, and health region was analyzed.

Key Findings

There is an association between nursing mix skills and patient outcomes. There were significant rates of challenges experienced by patients and nurses. Nurses were found to experience burnout and dissatisfaction at work.

Staffing methodologies use evidence-based practices to promote patient safety.

There is a demand for an adequate nurse-to-patient ratio depicted from the four staffing methodologies searched.

The higher nurse staffing ratio is associated with job dissatisfaction, burnout, and an increase in the tendency to quit the job.

Nursing home aides in favorable working conditions were 66% less likely to rush care works and 59% less likely to miss care tasks.

Recommendations

Patient care and safety are put at risk when there is no adequately trained nurse staffing. Therefore, policymakers and healthcare administrators should work to increase nurse staffing for safe and effective healthcare delivery.

The safety of patients in an acute hospital setting should be improved through the use of adequate staffing methodologies.

There is a need to have optimal nurse-to-patient ration in order to reduce the nurse outcomes that may hinder the quality of healthcare.

The work environment should be modified to improve nursing home care; thus, enhancing the quality of nursing.

Explanation of How the Article Supports EBP/ Capstone Project

The article supports the project by depicting that patient outcomes are affected by nursing characteristics.

This article supports the project by showing the implications of nurse-to-patient ratio to patient outcomes.

This article supports the project because it explains the implications of having a higher nurse-to-patient ratio on nurse outcomes that may, in turn, hinder patient outcomes.

This article relates to the project because improving the work environment involves the provision of an adequate nurse-to-patient ratio. This article discusses the implications of a poor work environment on the quality of patient care.