Nurse-Patient Ratios as a Patient Safety Strategy Assignment

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Nurse-Patient Ratios as a Patient Safety Strategy Assignment

Use this document to complete Part 1 of the Module 2 Assessment, Evidence-Based Project, Part 1: Identifying Research Methodologies

Full citation of selected article Article #1 Article #2 Article #3 Article #4
Shekelle, P. G. (2013, March 5). Nurse-Patient Ratios as a Patient Safety Strategy:A Systematic Review. Annals of Internal Medicine. https://web.p.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=1&sid=cfc25415-acc5-4567-a3a5-a1f70bc0735a%40redis
Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyombwe, T., & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing. https://watermark.silverchair.com/eurjcn0006.pdf? Griffiths, P., Maruotti, A., Saucedo, A. R., Redfern, O. C., Ball, J. E., Briggs, J., Dall’Ora, C., Schmidt, P. E., & Smith, G. B. (2018). Nurse staffing, nursing assistants and hospital mortality: Retrospective longitudinal cohort study. NCBI. Nurse-Patient Ratios as a Patient Safety Strategy Assignment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716358/pdf/bmjqs-2018-008043.pdf Redfern, O. C., Griffiths, P., Maruotti, A., Saucedo, A. R., & Smith, G. B. (2019). The association between nurse staffing levels and the timeliness of vital signs monitoring: A retrospective observational study in the UK. BMJ. https://bmjopen.bmj.com/content/9/9/e032157.long
Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest) I chose this article because this article addresses the importance of proper patient to nurse ratio for safety and better patient outcomes. It is dangerous to work shorthanded with a higher ratio of patients in critical need. An unnecessary number of people die because of the strain of fewer nurses to higher patient ratios. It describes a study that examines the relationship between nurse staffing and patient outcomes/mortality. This review was supported by the Agency for Healthcare Research and Quality, which had no role in the selection or review of the evidence. The assessment of multiple systematic reviews criteria was used to assess the quality of the systematic reviews. Nurse-Patient Ratios as a Patient Safety Strategy Assignment

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I chose this article because this article addresses the importance of proper patient to nurse ratio for safety and better patient outcomes. It is dangerous to work shorthanded with a higher ratio of patients in critical need. An unnecessary number of people die because of the strain of fewer nurses to higher patient ratios. All studies were assessed by the Newcastle-Ottawa scale (NOS) to determine the quality of nonrandomized studies. This tool was designed to facilitate the incorporation of quality assessment into the systematic review. I chose this article because this article addresses the importance of proper patient to nurse ratio for safety and better patient outcomes. It is dangerous to work shorthanded with a higher ratio of patients in critical need. An unnecessary number of people die because of the strain of fewer nurses to higher patient ratios. The potential consequences of nurse staffing shortage show a negative impact on patient outcomes and safety. While Nursing assistants help with maintaining safety, they cannot replace a RN. It is necessary that there is appropriate nurse to patient ratio to ensure patient safety and better patient outcomes. I chose this article because this article addresses the importance of proper patient to nurse ratio for safety and better patient outcomes. It is dangerous to work shorthanded with a higher ratio of patients in critical need. An unnecessary number of people die because of the strain of fewer nurses to higher patient ratios. This article examined the relationship between nurse staffing levels and the objective measure of missed care. Monitoring vital signs is a fundamental component of the “Chain of Prevention”, a tool that describes the processes required to identify and prevent patient deterioration. This study addresses the role of nursing staff and patient outcomes. Short staff leads to missed early signs that a situation is about to go bad. This leads to an increase in mortality.
Brief description of the aims of the research of each peer-reviewed article This systematic review examined the evidence on the effects of interventions aimed at increasing nurse-patient ratios on patient illness and death. The aim is to examine the association between nurse staffing levels and nurse-sensitive patient outcomes in acute specialist units. The objective is to determine the association between daily levels of registered nurse (RN) and nursing assistant staffing and hospital deaths. Misses and delays in nursing care are widely reported because of short staffing. This raises safety concerns and potential harm to the patients. Nurse-Patient Ratios as a Patient Safety Strategy Assignment
Brief description of the research methodology used Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific. This is a quantitative approach because this article used keywords to search databases. Articles from 2009 to 2012 were cited. The search identified 546 titles, and 4 articles that came from reference (text) mining. Titles and abstracts were reviewed and selected if they reported empirical data on the relationship between nurse staffing ratios and mortality or nurse-sensitive outcomes (Keywords in the search bar). I believe this article took a quantitative approach. “The authors used nine electronic databases where articles (in English) were searched from 2006 to 2017 for nurse-sensitive patient outcomes. Odds ratios (ORs) were used as an appropriate effect measure if available. Other effect measures were hazard ratios and risk ratios. In this article, nurse-to-patient ratios were used, these were converted to NPRs by calculating in the inverse ratio”. This is a mixed-method approach. This is a retrospective longitudinal observational study using routinely collected data. “The authors used multilevel/hierarchal mixed-effects regression models to explore the association between patient outcomes and daily variation in RN and nursing assistant staffing, measured as hours per patient per day relative to ward mean”. This article is a mixed method approach. Some resources are based on nurse self-report, observational data and vital signs are recorded with time stamped documentation. Nurse-Patient Ratios as a Patient Safety Strategy Assignment
This is a retrospective observational study of 32 wards in a large acute hospital in the south of England over 3 years (April 2012 to March 2015).

A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected. “The relationship between higher nurse staffing levels and decreased inpatient mortality comes from a longitudinal study in a single hospital. This study accounted for the nurse staffing levels and found decreases in deaths by about 2% to 17%”.

Nurse-Patient Ratios as a Patient Safety Strategy Assignment

This research had some weaknesses. Several studies combined patients from non-specialist units with special units, which may have skewed the results. However, there was a reduction in the rate of nurse-sensitive patient outcomes in patients in an ICU with higher level of nurse staffing”. Noncritical patients did not appreciate the same results. The strengths and limitations of this study: The causal inference does not follow directly from the observed associations, although the longitudinal design with staffing exposures measured at a patient level eliminates many plausible alternative explanations making a causal interpretation much more likely. Additionally, there is a growing body of evidence supporting a causal mechanism: linking low nurse staffing to increased mortality through reduced capacity to observe and intervene to prevent deterioration.
Although the study was conducted a single site, this means the findings were not the result of a “hospital effect”, whereby the observed associations between nurse staffing and outcomes could arise because hospitals with more resources in general also have more nurses. This was a large retrospective cohort study exploring the association between levels of nursing staff in an acute hospital and adherence to a vital sign monitoring protocol. “In contrast to previous studies that relied on nursing staff to self-report missed care, the authors used an objective measure derived from electronically recorded vital signs. This study was limited to a single hospital, and they were only able to partially adjust for other factors that might affect protocol adherence”. Nurse-Patient Ratios as a Patient Safety Strategy Assignment