Nursing shortage Assignment 1

Nursing shortage

After discussion with your preceptor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal. Explain how your proposal will directly and indirectly impact each of the aspects.

Literature Evaluation Table

Student Name:

Change Topic: Nursing shortage

Criteria	Article 1	Article 2	Article 3	Article 4
Author, Journal (Peer-Reviewed), andPermalink or Working Link to Access Article	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://qualitysafety.bmj.com/content/qhc/28/9/706.full.pdf	Glette, M. K., Aase, K., & Wiig, S. (2017). The relationship between understaffing of nurses and patient safety in hospitals-A literature review with thematic analysis.https://uis.brage.unit.no/uis-xmlui/bitstream/handle/11250/2484383/OJN_2017121214354394.pdf?sequence=1&isAllowed=y	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.https://link.springer.com/content/pdf/10.1186/s12912-016-0181-3.pdf	Manesh, M. H., Singh, J. S. K., & Hussain, I. A. B. (2018). Transformational leadership and contextual performance: A quantitative study among nursing staff in kuala lumpur. International Journal of Management and Sustainability, 7(2), 101-112.https://www.researchgate.net/profile/Jugindar_Singh2/publication/327397656_Transformational_Leadership_and_Contextual_Performance_A_Quantitative_Study_among_Nursing_Staff_in_Kuala_Lumpur/links/5b987f49299bf14ad4d0a658/Transformational-Leadership-and-Contextual-Performance-A-Quantitative-Study-among-Nursing-Staff-in-Kuala-Lumpur.pdf
Article Title and Year Published	The title of the article is “Hospital nurse staffing and staff–patient interactions: an observational study.”It was published in 2019.	The title of the article is “The relationship between understaffing of nurses and patient safety in hospitals-A literature review with thematic analysis.”It was published in 2017.	The title of the article is “Nurse staffing and patient outcomes: a longitudinal study on trend and seasonality.”It was published in 2016.	The title of the article is “Transformational leadership and contextual performance: A quantitative study among nursing staff in kuala lumpur.”It was published in 2018.
Research Questions (Qualitative)/Hypothesis (Quantitative)	What is the association between nurse staffing levels, skill mix, and the quality and quantity of daytime interactions with patients in hospital wards?	How can understaffing amongst nurses in hospitals affect patient safety?	What is the longitudinal association between nurse staffing and patient outcomes?	What influence does transformational leadership have on employee’s contextual performance in the nursing sector in Kuala Lumpur?
Purposes/Aim of the Study	To examine the relationship between nurse staffing levels, skill mix and the quality and quantity of daytime interactions with patients in hospital wards	The aim is to increase the knowledge of understaffing of hospital nurses, and the consequences that understaffing may have on patient safety	To explore longitudinal association that exists between nurse staffing and patient outcome	To fill the gap that exists by determining the influence of intellectual stimulation, individualized consideration, inspirational motivation, and idealized influence have on contextual performance.
Design (Type of Quantitative, or Type of Qualitative)	This is a quantitative study that used an observational study.	This is a quantitative study that used thematic analysis.	This is a quantitative study that used a longitudinal study	This is a quantitative study.
Setting/Sample	Six wards at two English National Health Service hospitals	a literature search of the databases Chinal, Medline, Cochrane library, Isi Web of Science and Academic Search premiere was undertaken	Quarterly unit-level nursing data from 2004-2012 from the NDNQL	Healthcare setting in Kuala Lumpur
Methods: Intervention/Instruments	Secondary analysis of observational data	Literature review	Used 2004-2012 data obtained from NDNQL	Self-administered questionnaires
Analysis	Data were analyzed from 119-2 hour sessions in which care of 270 patients was observed	Thematic analysis was used.	A grouped mechanism was developed in the analysis	Descriptive and inferential statics was used for the analysis of data.
Key Findings	Low registered nurse staffing levels results in poorer quality interactions between patients and staffLow nursing staffing results in a wider negative effect with adverse consequences for patient experience and quality of care.	The nursing shortage affects patient safety negatively directly and indirectly	Changes in nurse staffing are associated with changes in rates of falls and pressure ulcersSeasonal nursing shortage contributes to seasonality in patient outcomes	Nurse leaders should adopt a transformational leadership style to influence and motivate nurses in managing stress, adapting changes and working towards organizational vision and goalsLeaders with individualized consideration can improve the performance of nurses
Recommendations	Policies and practices should focus on improving the retention and supply of registered nurses	Further research is required on the topic as articles in this study mentioned a lack of research, most especially in Nordic countries	More research is needed to study the underlying mechanisms of associations between nurse staffing and patient outcomes	Further research should include factors such as culture, age differences, ethnic differences, and religiosity. This will provide a better understanding of the factors that impact transformational leadership and performance.
Explanation of How the Article Supports EBP/Capstone Project	This article supports my EBP/capstone project as it has provided the effects of low registered nurse staffing levels in hospitals and different aspects such as quality interactions	This article supports my EBP/capstone project as it has discussed the issue of nurse understaffing and how it affects patient safety negatively.	This article supports my EBP/capstone project as the findings can be used in discussing the issue of nurse staffing and its effect on patients	This article supports my EBP/capstone project as it has provided theoretical and practical implications for the performance of nurses in the healthcare industry

Criteria	Article 5	Article 6	Article 7	Article 8
Author, Journal (Peer-Reviewed), andPermalink or Working Link to Access Article	Aiken, L. H., Cerón, C., Simonetti, M., Lake, E. T., Galiano, A., Garbarini, A., … & Smith, H. L. (2018). Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes, 29(3), 322-327.https://www.sciencedirect.com/science/article/pii/S0716864018300609	Rivaz, M., Momennasab, M., Yektatalab, S., & Ebadi, A. (2017). Adequate resources as essential component in the nursing practice environment: a qualitative study. Journal of clinical and diagnostic research: JCDR, 11(6), IC01. http://europepmc.org/article/PMC/5535389	Gan, I. (2020). How do nurse managers describe clinical nurses’ work arrangements? A qualitative study. Nursing Open, 7(1), 160-169.https://onlinelibrary.wiley.com/doi/full/10.1002/nop2.374	Griffiths, P., Dall’ora, C., & Ball, J. (2017). Nurse staffing levels, quality and outcomes of care in NHS hospital wards: what does the evidence say?. Health Work: Evidence Briefs, 1(1).https://eprints.soton.ac.uk/412518/1/staffing_levels_submitted.pdf
Article Title and Year Published	The title of the article is “Hospital nurse staffing and patient outcomes.”It was published in 2018.	The title of the article is “Adequate resources as essential component in the nursing practice environment: a qualitative study.”It was published in 2017.	The title of the article is “How do nurse managers describe clinical nurses’ work arrangements? A qualitative study.”It was published in 2020.	The title of the article is “Nurse staffing levels, quality and outcomes of care in NHS hospital wards: what does the evidence say?”It was published in 2017.
Research Questions (Qualitative)/Hypothesis (Quantitative)	What are the association of nursing staff, nurse skill mix, and nurse work environment with patient outcomes?	What is the Iranian nurses’ perceptions of the key constituent of the nursing practice environment	How do nurse managers describe nurses in different work arrangements?	What are the levels of staffing on wards associated with reported outcomes?
Purposes/Aim of the Study	To ascertain the relationship between nursing staff, nurse skill mix and nurse work environment with patient outcomes	To examine the perception of Iranian nurses on key constituents of the nursing practice environment	To understand how nurse managers describe nurses in alternative work arrangements	To examine the safe staffing levels in general wards.
Design (Type of Quantitative, or Type of Qualitative)	This is a qualitative study that used a cross-sectional dataset.	This is a qualitative study that used qualitative design.	This is a qualitative study that used exploratory study.	This is a qualitative study.
Setting/Sample	Healthcare setting in Chile	Twelve staff nurses, supervisors, and head nurses from different wards of five teaching hospitals	26 baccalaureate‐pre‐pared nurse managers located across the United States	MEDLINE, CINAHL, EMBASE, the Cochrane Library, and other databases
Methods: Intervention/Instruments	Same protocols and measures used in RN4CAST	A qualitative design with a conventional content analysis approach	Semi-structured interviews	Used MEDLINE, CINAHL, EMBASE, the Cochrane Library, and other databases
Analysis	The cross-sectional dataset was used for looking at some staffing and work environment measures, patient outcomes and hospital outcomes	Data analysis was undertaken using MAXQDA Software with a conventional qualitative content analysis method.	The constant comparative method was used for the analysis of the data collection phase.	The studies selected were from the UK that estimates the associations between nurse staffing levels on general wards and any quality or outcome measures
Key Findings	The nursing work environment is the hospital property	Practice environment plays a vital role in attracting and retaining skilled and experienced human resource	Nurses share common work identities, appreciate each others’ personalities and foster workplace relationships	Lower nurse staffing levels are associated with worse outcomes in general acute wards or patient groups
Recommendations	Adjusting severity at the patient level can ensure that variation between hospitals can be explained by nursing factors.	There is a need to undertake this research in a different practice environment and context as the results may be different.	There is a need for further study which should seek to explore alternative work arrangement’s impact on nurse career.	There is a need to have the required levels of HCA staffing to better analyze the problem.
Explanation of How the Article Supports EBP/Capstone	This article supports my EBP/capstone project as it discusses the importance of the nursing work environment in relation to the nursing shortage.	This article supports my EBP/capstone project as it discusses the importance of environment on attracting and retaining skills and human resources and how this can help deal with the nursing shortage.	This article supports my EBP/capstone project as it provides how nurse managers describe nurse alternative work arrangement and how it impacts future employment	This article supports my EBP/capstone project as it has discussed the issue of lower nursing staffing levels and how it impacts the patient outcome.

References

Aiken, L. H., Cerón, C., Simonetti, M., Lake, E. T., Galiano, A., Garbarini, A., … & Smith, H. L. (2018). Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes, 29(3), 322-327.

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.

Gan, I. (2020). How do nurse managers describe clinical nurses’ work arrangements? A qualitative study. Nursing Open, 7(1), 160-169.

Glette, M. K., Aase, K., & Wiig, S. (2017). The relationship between understaffing of nurses and patient safety in hospitals-A literature review with thematic analysis.

Griffiths, P., Dall’ora, C., & Ball, J. (2017). Nurse staffing levels, quality and outcomes of care in NHS hospital wards: what does the evidence say?. Health Work: Evidence Briefs, 1(1).

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.

Manesh, M. H., Singh, J. S. K., & Hussain, I. A. B. (2018). Transformational leadership and contextual performance: A quantitative study among nursing staff in kuala lumpur. International Journal of Management and Sustainability, 7(2), 101-112.

Rivaz, M., Momennasab, M., Yektatalab, S., & Ebadi, A. (2017). Adequate resources as essential component in the nursing practice environment: a qualitative study. Journal of clinical and diagnostic research: JCDR, 11(6), IC01.

© 2015. Grand Canyon University. All Rights Reserved.

© 2017. Grand Canyon University. All Rights Reserved.

Running head: SHORT STAFFING

SHORT STAFFING 5

Short staffing

Student’s name

Institutional affiliation

Date

The nursing shortage is an issue that is facing healthcare organizations. With the demand for healthcare services, there is a need for more staff. Nurse staffing is significant as it reduces nursing burnouts. Nursing shortage impacts healthcare organizations negatively (Msn, 2018). Due to a shortage of nurses, patients may end up receiving late treatment hence reducing the quality of services provided.

Thesis statement: Nursing shortage is an increasing issue facing healthcare organization and this has led to problems such as risks of medication errors among others. Therefore, there is a great need to identify interventions that can be used in increasing high nurse-to-patient ratios.

Evidence-based solution

The evidence-based solution for this issue is reducing the nurse staffing ratio which will help in reducing the rate of medication errors. This solution will reduce burnout among nurses and increase satisfaction among nurses (Buerhaus et al., 2007).

Nursing intervention

The nursing shortage will require an increase in nurses to bridge the gap between the nurses and patient ratio. Increasing the number of nurses will improve the quality of care hence reducing issues such as medication errors.

Patient care

Nursing shortage leads to issues such as an increase in errors and higher mortality rates. Due to high patient-to-nurse ratios, nurses end up feeling dissatisfied hence patients may end up having a higher mortality rate.

Health care agency

The nursing shortage is an issue that is increasingly facing the healthcare industry today. Healthcare organizations face an increasing challenge to meet the demand for healthcare services while being faced with the challenge of having a nursing shortage.

Nursing practice

Health professionals, from physicians to registered nurses among others provide health care services based on their field. However, an insufficient supply of nurses in all fields has resulted in issues such as medication errors.

PICOT STATEMENT

Population/problem

Today, there is an increase in medical errors in the healthcare system. Patients visit health care facilities for services that will improve their quality of life. This, however, has not been possible due to an increase in medical errors which results in more medical complications. These problems are associated with a high nurse-to-patient ratio. This paper addresses the relationship between nurse-to-patient rates and the risk of medication errors affecting the patient population in the medical surgery unit.

Intervention

The intervention is to reduce the nurse-to-patient ratio. A reduced number of patients served by each nurse reduces issues such as fatigue, stress, and burnout among nurses. This hence improves the quality of services provided. Additionally, it reduces adverse events and the risk of medication errors in the surgery units.

Comparison

The intervention will be compared to a case of no treatment to address medication errors. This problem may increase the risk of medication errors

Outcome

Increasing the number of nurses will reduce cases of medication errors. This positive outcome will be attained by reducing nurse burnout

Time

The outcome will be measured within a period of 12 months

The PICOT question: In the medical surgery unit population, how does reduction in the nurse-to-patient ration impact medication errors compared with no treatment within twelve months?

References

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.

Msn, T.L.C. (2018). No One Understands the Term, Nursing Shortage: Like a Nursing Student Does. Amazon Digital Services LLC – Kdp Print Us