evidence-based change proposal
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), and
Permalink 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.
|
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.
|
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 staff
Low 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 ulcers
Seasonal 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 goals
Leaders 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), and
Permalink 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. | 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.
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© 2017. Grand Canyon University. All Rights Reserved.