Research Critique and PICOT Statement

Research Critique and Picot Statement Nurse Staffing and Patient Outcomes HYUNJEONG KIM Grand Canyon University NRS-433V Date   PICOT statement Among Patients in hospitals and critical care (P), does increasing the number of nurses per patient (I) improve patient outcome (O), compared to maintaining the patient-nurse ratio, during hospitalization (T). Qualitative West, E., Barron, D. N., Harrison, D., Rafferty, A. M., Rowan, K., & Sanderson, C. (2014). Nurse staffing, medical staffing and mortality in intensive care: an observational study. International journal of nursing studies, 51(5), 781-794. Problem Statement Nursing shortage is one of the challenges facing the profession, and past research has shown that nurse staffing ratios affect the patient outcomes and the quality of care and patient safety. Since evidence supports that some complications and the rate of mortality can be prevented, it is important to address nurse-patient staffing ratios. In the study, the researchers sought to investigate the relationship between nursing staffing and mortality rates in clinical settings. Hospitals have to address the nursing staffing problems and meet patient needs, and this is more difficult in the Intensive Care Unit, where the patients are under constant monitoring Since past research has highlighted that adequate nursing levels reduce the workload, it is likely that addressing nursing shortages will improve health outcomes. Intensive care units cater to the critical care needs of patients, and changes in the morality rate and hospitalization stay indicate patient outcome. Even as the researchers observed the subjects, they sought to identify the relationship between nurse support staff and patient outcomes. There is a need to identify factors that are restrictive and supportive to improving the quality of care in intensive care units. Purpose and Research Questions In the study, the researchers aimed to establish the impact of nurse staffing on patient mortality in intensive care units. Subsequently, the study’s design evaluated differences of survival rates in critical care settings when considering nurse-patient staff ratios and workload. The research questions in the study were addressed as the hypotheses, which were then tested Does increasing the number of nurses in the ICU improve patient outcome and reduce the cases of patient mortality? Does having more number of consultants and support staff in the ICU reduce the mortality rates? Does increasing nurse workload affect patient outcome and survival rates? How does nurse and medical staffing influence the quality of care? The research questions were related to the stated study aim and objectives, and the methods were appropriate, since medical staff working in the ICU were surveyed. Even as surveillance is one of the key factors, which affects patient outcome in the ICU, the role of nurse staffing in influencing patient outcome should also be considered in these clinical settings. Literature Review The study reviewed past research with emphasis on workload, using both quantitative and qualitative studies. The researchers highlighted that one of the main challenges in identifying the link between staffing and patient outcomes is that few studies have controlled for the confounding variables. Workload is one such confounding factor, and nurses who are fatigued or overburden with high workload are more likely to face more challenges when addressing patient needs, as they are more likely to encounter patient safety concerns. The demand for nursing and medical services affects patient outcomes, and should be considered in studies of nurse staff and patient outcomes. The review also focused on shift variations to meet patient needs under different circumstances depending on the availability of nurses, and nurse skills mix. The literature reviewed showed that there was increased risk of death when the nurse staffing ratios fell below the target shift. Even as workload in the clinical settings changes over time, the researchers did not address the weaknesses of the studies. The study further highlighted that staffing decisions, should be considered by the management to address patient safety concerns and improve patient outcome. Even as there has been interest on workload, mores studies focusing on nurse staffing and workload would provide more details on how this is linked with patient outcome. The arguments made in the literature review section emphasize the association of nurse staffing on patient outcome, where increasing the number of nurses reduces patient mortality and quality of care. Conceptual/Theoretical Framework The researchers pointed out that surveillance and the utilization of evidence-bas practice are to priorities when intervening and seeking to improve clinical outcomes when addressing nurse staffing problems. There is increased demand for intensive care, while medical workers increasingly work closely together. It is important for the support staff to address patient needs, and the hospital administration should address human resource problems. The ability of support staff to conduct surveillance and intervene when required then increasing the number of staff members and addressing the workload problem is necessary. Surveillance as closed observation by skilled medical practitioners affects the working environment and patient outcome. Quantitative study Trinkoff, A. M., Johantgen, M., Storr, C. L., Gurses, A. P., Liang, Y., & Han, K. (2011)....