Research Critique On Patient-nurse Staffing Ratio's Effect On Patient Safety And Hospital Mortality Rate.

The PICOT statement will provide a framework for your capstone project. The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

PICO Question: Among the discharged patients, does patient to nurse staffing ratio affect patient’s safety and hospital mortality rate following the completion of study?

To write a critical appraisal that demonstrates comprehension of the research study conducted

Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem.

The background of the study states the clinical problem.  The clinical problem was that patient nurse ratio affects the safety of the patient and the mortality rate of the patients. The main problem is that due to lack of educated nurses the patient outcome is affected or not. The research problem is that if the patient- nurse ratio affects the patient outcome (Aiken, et al., 2011). In the assignment, the method of the study, result of the study and ethical consideration are discussed.

The significance of the study is that in different hospitals the mortality rate is increasing day by day because of lack of educated nurses. The environment of the hospitals is poor and no effective results are seen.

The paper has a clear objective that is to determine the situation under which hospital nurse education, nurse staffing and working environment influences the patient outcome.

• What are the effects of nurse education in developing the patient outcomes?
• How the patient- nurse ratio affects the patient safety?

To answer the research questions, the qualitative study method was appropriate but the quantitative study could improve the quality of the research.

The author has cited the quantitative studies that are not older more than 6 years. The quantitative research helped the study to complete the research as it provided various data to analyze the results of the study.  

The article did not mention the weakness of the study, which make a big gap to analyze the strength and weakness of the article.

During conducting a qualitative research, the study should be made based on a grounded theory. Therefore, the researcher needs to develop a framework to define the finding of the study.

The research study found that the decrease of workload on the nurses fail to reduce the mortality rate. The hospital environment was poor and most of the nurses need training and education. The Bachelor degree of Nursing Science can develop the knowledge of the nurses and develop the patient outcome (Aiken, et al., 2011).

The implication of nursing includes the education of nursing that has increased. Therefore, the environment of the hospitals also develops and the death rate is decreasing

The findings are that the hospitals include training programs for nurses and the knowledge of the nurses are also developing. The mortality rate of the patients needs to be decreased and the patient outcome should be increased.

The Institutional Review Board approved the study. The review of the study has pointed out the strength and weakness of the study that needs to be included. The paper helps to find out that if the nurse- patient ratio is authentic or not and the adequacy of safety of nurses and patients are checked. The patient privacy was protected. The creditability of the qualitative research is maintained. The finding of the research can help a lot in the evidence based nursing that will help to reduce the mortality rate and develop the environment of the hospitals (Aiken, et al., 2011). The researcher may face various during the qualitative research that the researcher may overcome the problem.

Qualitative Study

In the conclusion section, it can be said that the Bachelor degree of Nursing helps the nurses to reduce the mortality and develop the condition of the hospital (Aiken, et al., 2011). In the hospitals, the condition of the environment is developing. Therefore, the developed environment helps to improve the patient outcome and develop the patient safety so that the patient- nurse ration can be maintained.

The article should have critical appraisal that include the systemic review. The systemic review helps to find out the strengths and weaknesses of the article and provide opportunities to the future researchers to study on the topic and develop the findings. However, the critical appraisal of the study will help to search that if the data are authentic and not older than 10 years.

The article helped to know that the bachelor degree plays important role in case of patient care. The knowledge of the degree helps to reduce the failure of rescue and death rate of the patients. The paper showed that the patient outcome has increased in the hospitals with the improving working environment of the hospitals.

The main clinical problem is that the patient mortality can be affected by poor the nurse staffing, education and work environment. Therefore, the patient staff ratio plays an important role in decreasing the patient mortality rate. The strength of the article is that it addressed about the problems. It may affect the patient mortality but it did not describe that how it can affect the patient mortality.

The significance of the study is that the article has showed the nursing characteristics, which are linked with the patient outcome and can affect the patient mortality. In the assignment, the method of the study, result of the study and ethical consideration are discussed. The purpose of the study is to identify the effects of nurse staffing, education and work environment on the patient mortality (Cho, et al., 2015). The purpose of the study has relation with the research questions that is interlinked with research problem.

• What is the effect of work environment, nurse staffing and education on the patient mortality?
• How it can affect the patient mortality?

Quantitative research method helps to find out the answers of research questions that has improved the quality of research.  

For the research, 14 high technology teaching hospitals are selected that has 700 or more beds for the patients (Cho, et al., 2015). The benefit of choosing such huge amount of sample helps the author to collect enough information. This will help to make comparison in better way. However, selecting such huge number of sample size may have some risks.  This can include that risks of the nurse safety and can affect the patients.

Quantitative Study

To conduct the study, the author took consent of the participants (nurses). Therefore, the ethical consideration is followed that is necessary to conduct a research. The author had identified the independent and dependent variables but did not define the variables. The independent variables are the work environment, education and nurse staffing and the dependent variable is the patient mortality.

The author chose quantitative method for the data collection. The patients and the nurses are surveyed for the study.

To conduct a research, minimum six months are necessary to select the topic, collect data, interpret the collected data, and make the study.

To analyze the data, the quantitative data analysis method is used that is the survey. To reduce the research biasness, the nurses and patients are surveyed.

The interpretation of the findings is that the study has identified that risk adjusted model reveals the significance of the nurse staffing, work environment and nurse education.

The author may face various limitations during the research. The researcher may face problem regarding the time. Moreover, the budget is another research limitation. The hospitals may not provide permission to their nurses. Moreover, the nurses also may not agree to provide information regarding their experience and knowledge.

The article provides knowledge about various models like risk adjusted models to describe the nurse staffing, nursing work environment and the nurse education. These models will help in the general nursing practice as this helps to reduce the patient mortality. The knowledge of the models can be applied to the patients who have the higher mortality rate and to the general patients to a specific area of the nursing.

Institutional Review Board has reviewed the study to give approval. It mainly protects rights and responsibilities of research subject for the welfare of the human.  However, the researcher obeyed the rules of federal regulation to conduct the research.

The study has protected the patient privacy with the nurse privacy. In case of conducting a research, the researcher needs to obey the Data Protection Act (1998) that helps to maintain the study authentic. At the time of data collection, the author needs to take the consent of the participants that are maintained.

The ethical consideration of the study was that the author had maintained the data properly and did not hurt the emotion of the patients. The study showed that many of the hospitals have poor work environment that increases the patient mortality (Cho, et al., 2015). Some of the hospitals has strong work environment but lack of experienced nurses.

The thesis statement is very important for the study that states the main purpose of the study. In conclusion, it can be said that the study focuses on the various aspects of various hospitals. The hospitals, which have poor work condition, may have qualified nurses and the hospitals with the strong environmental condition, may need to provide education and training to the nurses for the better outcome that is reduction of the patient mortality rate.

The critical appraisal of the study that is systemic review is necessary for the article. This will find out the major strength and weakness of the study. From the article, information is gained such as the condition of the hospitals at South Korea, the knowledge and experience of the nurses.

References 

Aiken, L. H., Cimiotti, J. P., Sloane, D. M., Smith, H. L., Flynn, L., & Neff, D. F. (2011). The effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical care, 1047.

Cho, E., Sloane, D. M., Kim, E. Y., Kim, S., Choi, M., Yoo, I. Y., & Aiken, L. H. (2015). Effects of nurse staffing, work environments, and education on patient mortality: an observational study. International journal of nursing studies, 535-54.

Harless, D. W., & Mark, B. A. (2010). Nurse staffing and quality of care with direct measurement of inpatient staffing. Medical Care, 659-663.

Lake, E. T., Shang, J., Klaus, S., & Dunton, N. E. (2010). Patient falls: Association with hospital Magnet status and nursing unit staffing. Research in nursing & health, 413-425.

Needleman, J., Buerhaus, P., Pankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. ((2011). Nurse staffing and inpatient hospital mortality. New England Journal of Medicine, 1037-1045.

Shekelle, P. G. (2013). Nurse–patient ratios as a patient safety strategy: a systematic review. Annals of internal medicine, 404-409.