Evidence-based practice

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Evidence-based practice

 

 

 

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Evidence-based practice

 

 

Evidence-based practice

Evelyn Chicas

Herzing University

Professor Koenig

NU560-7: Research Methods and Evidence-Based Practice

June 6, 2021

PICO Question

Short-staffing among nurses does affect patient care and clinical outcomes?

Introduction

Short-staffing in medical practitioners most specifically nurses are not very uncommon. Short-staffed shifts usually occur when the number of admitted patients in a care unit surpasses the highest capacity per nurse set by standards of clinical safety and quality. However, unfortunately, short-stuffing in nursing is a very common occurrence in almost every department of healthcare centers. Nowadays, prevalence of chronic illnesses increases the clinical load hence, is majorly responsible for short. However, in this study, the author is going to analyze and explain three different articles on the topic.

Study analysis

In the study of Enns, C. L., & Sawatzky, J. A. V. (2016) the concept of emergency nurses’ perspective on factors affecting patient care was studied. One of the main objectives of the study was to find the association between the staff-shortage and patient care and clinical outcome. It is a interview-based qualitative descriptive study, where as part of a larger study, a subsample of emergency nurses of Manitoba hospitals, Canada were interviewed by the researchers. They were asked with two important questions including “what does care mean to you?”, and “What affects caring in your practice in the emergency department”. However, the first question is not relevant in aspect of this study, therefore, author is to focus more on the second question that was asked to the nurses in order to find whether staff-shortage affects patient care or not specifically in emergency department. Nurses who work in public hospitals in Manitoba, Canada were chosen as participants of the study and interview was designed and conducted by the researchers. Tools that have been used by the researchers include tape-recorded face-to-face interviews with individual participants. Descriptive interviews were made. In this study, staffing issues were significantly stated by the participants that it directly affects their ability to deliver optimal nursing care (Enns & Sawatzky, 2016).

In the second study chosen by the author, the researchers designed a quantitative review in order to ‘identify nursing care most frequently missed in acute adult inpatient wards and determine evidence for the association of missed care with nurse staffing’ (Griffiths et al.,2018). This study is a quantitative systematic review, where the researchers obtained relevant evidences from Cochrane Library, Embase and Medline and CINAHL. Quality appraisal tool was been followed and it was based on the National Institute for Health and Care Excellence Quality Appraisal Checklist for studies reporting correlations and associations. In this study, a total of 14 studies found association between higher reports of missed care and low staffing levels.

The study of Smith et al., 2020, was a retrospective, observational study and the study was developed by the researchers in order to investigate the association between failure to respond to patients with deranged physiology and nurse staffing levels. Patients’ vital signs and administrative data were been obtained from a total of 32 general wards of an acute hospital located in England. The participants of this study were nursing staffs. National Early Warning Score was been used in order to assess vital signs of the patients and to know the association of staff shortage with impaired care. In this study, it has been shown that staffing levels of registered nurse highly influence the rates of failure to provide proper response for patients with most abnormal vital signs.

 

Reference

Enns, C. L., & Sawatzky, J. A. V. (2016). Emergency nurses’ perspectives: Factors affecting caring. Journal of Emergency Nursing42(3), 240-245. Carol L.EnnsMN, RN Jo-Ann V.SawatzkyPhD, RN

Griffiths, P., Recio-Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., Smith, G. B., Ball, J., & Missed Care Study Group (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of advanced nursing74(7), 1474–1487. https://doi.org/10.1111/jan.13564

Smith, G. B., Redfern, O., Maruotti, A., Recio-Saucedo, A., Griffiths, P., & The Missed Care Study Group. (2020). The association between nurse staffing levels and a failure to respond to patients with deranged physiology: a retrospective observational study in the UK. Resuscitation149, 202-208. https://doi.org/10.1016/j.resuscitation.2020.01.001

 

Appendix

Matrix Table

Article/Reference (in APA format) Purpose of the Article/Study Question Variables (i.e.; Independent vs. Dependent) Study Design Sampling Methods Instrument Findings/Results
               
Enns, C. L., & Sawatzky, J. A. V. (2016). Emergency nurses’ perspectives: Factors affecting caring. Journal of Emergency Nursing42(3), 240-245. Carol L.EnnsMN, RN Jo-Ann V.SawatzkyPhD, RN

The main objective of this study is to explore the perspective of nursing staffs regarding staff shortage and the association of it with care standard and patient outcome. Dependent variable: Patient outcome

Independent variable: Staff shortage

It is a qualitative study where invitation to participate in this study were mailed to all ED nurses in the province of Manitoba, Canada by the provincial nurses’ regulatory body. The researchers of this study have mailed all ED nurses in the province of Manitoba, Canada by the provincial nurses’ regulatory body. Where a total of 17 convince sample of registered nurse was selected from an overwhelmingly positive response. Qualitative research methodology. Tape recorder and data analysis tools Staff-shortage has impact over care standard.
Griffiths, P., Recio-Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., Smith, G. B., Ball, J., & Missed Care Study Group (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of advanced nursing74(7), 1474–1487. https://doi.org/10.1111/jan.13564 The purpose of the study is to assess the association between nurse staffing and omissions in nursing care Dependent variable: Missed care

Independent variable: Nurse staffing

Qualitative systematic review A total of 11,269 references were obtained. Following exclusion, 57 studies were kept for further review and from them 40 papers were excluded due to not measuring associations with nurse staffing, type of article, not adult medical/surgical wards and reporting medication errors without discriminating errors due to delayed or omitted administration To develop this quantitative systematic review the researchrs searched CINAHL, Cochrane Library, and Embase and Medline. Research appraisal and data analysis tools A total of 14 studies found a significant association between low nurse staffing levels and higher reports of missed care.
Smith, G. B., Redfern, O., Maruotti, A., Recio-Saucedo, A., Griffiths, P., & The Missed Care Study Group. (2020). The association between nurse staffing levels and a failure to respond to patients with deranged physiology: a retrospective observational study in the UK. Resuscitation149, 202-208. https://doi.org/10.1016/j.resuscitation.2020.01.001 The main purpose of this study is to explore the association between nurse staffing levels and a failure to respond to patients with deranged physiology Routinely collected patients’ vital signs and administrative data were been used in order to find the association with nurse staffing. Dependent variable: Failure to respond to patients with deranged physiology

Independent variable: Nurse staffing levels

Random sampling Retrospective, observational study NEWS analysis, patients’ vital sign assessment tools and data analysis tools. Staffing levels directly influence the rates of failure to respond for patients with the most abnormal vital signs
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