Summary and Ethical Considerations in Nurse Understaffing Research

Research summary and Ethical Considerations
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Research Summary and Ethical Considerations
Introduction
Quality health care delivery is paramount in the entire health care sector. Like other businesses, healthcare organizations have sought to control cost and maximize profits. This practice often calls for the reduction of staffing levels and reduction in wasting and duplication of duties. However, new evidence suggests that reducing staffing levels often makes the few available nurses to strain while trying to meet the needs of the overwhelming patient; hence affecting patient outcomes. This paper will summarize a research article that aimed at finding out the association between nurse staffing and patient outcomes. It will also discuss the implications of the study’s findings to nursing.
Article
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: DOI 10.1186/s12912-016-0181-3.
Background of Study
Problem: According to various survey studies in the United States, understaffing of nurses is a major problem threatening patient safety and quality care. The American Nurses Association proposed that staffing laws and regulations should be present to enable sufficient nurse staffing in health care facilities. As a result, in 2003 several States of America came up with nurse staffing laws and policies that demand hospitals and health centers to disclose their levels of staffing to the public. These laws and policies gradually led to increased levels of nurse staffing in 2008, resulting in an improved patient outcome, as the total nursing hours per patient day increased.
It may seem obvious that hiring more nurses in a hospital can lead to the improved patient outcome; however, many research studies about the relationship between the number of nurses and patient outcome have been inconclusive. In one of the American states that have had the staffing law for several years, researchers carried out a study to find out if there is a relationship between legislation and an improvement in patient outcome. However, they did not find any association between the two. Other findings from several kinds of literature showed that an increase in nurse staffing contributes to low mortality rate among patients.
Purpose: Most of these previous studies based their conclusions on cross-sectional and meta-analyses perspectives. However, this research article intends to examine the relationship between nurse staffing and patient outcomes from a different point of view, that is, longitudinal perspective.
Objective: To find out the association between nurse staffing and patient outcomes in time trends and seasonal levels.
Concepts: Patient safety, inpatient falls, data aggregation, Hospital-acquired pressure ulcers, and patient outcomes, nurse staffing.
Methods of Study
A quantitative longitudinal research method was used. The researchers used data from the National Database of Nursing Quality Indicators, which provided data concerning the monthly level of nurse staffing and inpatient falls and quarterly data on pressure ulcers. Data on pressure ulcers were involved only those that occurred after admittance (Hospital-acquired pressure ulcers). The study included all units that reported to National Database of Nursing Quality Indicators with a minimum of 1 year of data between 2004 and 2012. It analyzed a total of 12,435 units and13,339 units for pressure ulcers, and inpatient falls respectively.
The researchers conducted a first round analysis on the unit seasonality and trend of pressure and fall rates in units with complete data. Comprehensive pressure ulcer data were present in 849 units while fall data were present in 1240 units. The study used a linear model to test the seasonality and time of each unit based on 36 quarterly observations, and then performed calculations.
The study adopted aggregation and grouping technique to reduce temporal variations and to help in including the relationship of both seasonal and time with nurse staffing and outcomes. The researchers divided the units into groups, aggregated a...