NR 505 Week 5 Research Summary Assignment

NR 505 Week 5 Research Summary Assignment

PICOT Question: 

  1. Designate each P I C O T

Population: Registered nurses in ED

Intervention: Increasing nurse-to-patient ratio and implementing EBP staff scheduling

Comparison: Low nurse to patient ratio and non-EBP staff scheduling

Outcome: Burnout in nurses reduces significantly

Time: Two weeks

NR 505 Week 5 Research Summary Assignment

  1. Write out in the PICOT sentence format: Whether increasing nurse-to-patient ratio and implementing EBP staff scheduling in emergency department reduces burnout in RNs compared to low nurse to patient ratio and non-EBP staff scheduling in two weeks.

Article 1

Full reference for article (APA Format)Chen, Y., Guo, Y., Chin, W., Cheng, N., Ho, J., & Shiao, J. (2019). Patient–nurse ratio is related to nurses’ intention to leave their job through mediating factors of burnout and job dissatisfaction. International Journal Of Environmental Research And Public Health16(23), 4801. doi: 10.3390/ijerph16234801
PurposeThe purpose of the research was to find the impact of changing patient to nurse ratio on burnout syndrome, job satisfaction, and intention to leave thoughts in nurses. 
Research MethodCross-sectional investigation study
ParticipantsThe sample size was 1409 and all were full-time RNs in ED and medical units.
Data CollectionSelf-administered and structured questionnaire were used to collect data from nurses from 2013 to 2014. 
Study FindingsIncreasing patient to nurse ration resulted in higher burnout, intention to leave job, and job dissatisfaction in nurses. 
Limitations (State why the limitations)1. Generalizability is low. 2. Nurses who experienced burnout might have left the health care. 3. Lack of information related to work environment
Relevance to PICOTAs population and aim of the study is similar to the PICOT question, it is relevant. 

NR 505 Week 5 Research Summary Assignment

Article 2

Full reference for article (APA Format)Dall’Ora, C., Griffiths, P., Ball, J., Simon, M., & Aiken, L. (2015). Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open5(9), e008331. doi: 10.1136/bmjopen-2015-008331
PurposeThe purpose is to find the effects of 12h shifts on nurse’s burnout, job satisfaction, and intentions to leave job. 
Research MethodObservational cross-sectional study design
ParticipantsN= 31,625 RNs in surgical or medical units
Data CollectionCross-sectional survey was used to collect data from 31,625 RNs from 2170 surgical or medical units across 12 countries in Europe.
Study Findings12h shift was a result of higher patient to nurse ratio, and it increased burnout and intention to leave job 
Limitations (State why the limitations)The survey design increases bias and researchers did not consider the work place environment as an influencer. 
Relevance to PICOTThere are three similarities to PICOT. They are population, working unit, and the data collection method through survey. 

NR 505 Week 5 Research Summary Assignment

Article 3

Full reference for article (APA Format)Qureshi, S., Purdy, N., Mohani, A., & Neumann, W. (2019). Predicting the effect of nurse–patient ratio on nurse workload and care quality using discrete event simulation. Journal Of Nursing Management27(5), 971-980. doi: 10.1111/jonm.12757
PurposeThe purpose was to find the test the novel discrete event and nurse-focused simulation and predict the effect of nurse to patient ratio on quality of care and workout. 
Research MethodObservational study with simulation analysis
Participants252 nurses from an urban academic healthcare centre in Canada
Data CollectionThe simulator collected the data by checking current nurse to patient ratio and workplace data.
Study FindingsIncreasing nurse to patient ratio increases quality of care, and reduces burnout.
Limitations (State why the limitations)Generalizability is low as sample is not randomized and study fails to gather data through surveys. 
Relevance to PICOTThe study helped in understanding the relationship between nurse to patient ratio and burnout.

NR 505 Week 5 Research Summary Assignment

Article 4

Full reference for article (APA Format)Arkin, N., Lee, P., McDonald, K., & Hernandez-Boussard, T. (2015). The Association of nurse-to-patient ratio with mortality and preventable complications following aortic valve replacement. Journal Of Cardiac Surgery29(2), 141-148. doi: 10.1111/jocs.12284
PurposeTo find the effects of nurse to patient ratio on patient mortality and complications in the Aortic valve replacement
Research MethodCross sectional observational study.
Participants2917 RNs participated
Data CollectionSurvey design and EHRs were used for the data collection
Study FindingsHospitals with nurse to patient ratio of 1/6 or less had 20% less deaths compared to hospitals with nurse to patient ratio of 1/10. 
Limitations (State why the limitations)The study failed to explain causation and bias. 
Relevance to PICOTThere are three similarities to PICOT. They are population, working unit, and the data collection method through survey.

NR 505 Week 5 Research Summary Assignment

Article 5

Full reference for article (APA Format)Kleinpell, R., Ward, N., Kelso, L., Mollenkopf, F., & Houghton, D. (2015). Provider to patient ratios for nurse practitioners and physician assistants in critical care units. American Journal Of Critical Care24(3), e16-e21. doi: 10.4037/ajcc2015274
PurposeThe purpose is to analyze the correlation between nurse to patient ratio in ICU and factors that affect the ratio and care provided. 
Research MethodA descriptive study design
ParticipantsN = 433 including 211 physicians and 222 NPs
Data CollectionOnline or web-based survey was used to collect the data
Study FindingsNurse to patient ratio was 1 to 4 and factors that affected the ratio were severity of care, work pressure, time of the day, and inflow of the patients. 
Limitations (State why the limitations)Convenience sampling resulted in bias and study has low generalizability.
Relevance to PICOTIt is important to understand the factors that affect nurse to patient ratio as it affects care provided and burnout in nurses. 

Article 6

Full reference for article (APA Format)Tubbs-Cooley, H., Mara, C., Carle, A., Mark, B., & Pickler, R. (2019). Association of nurse workload with missed nursing care in the neonatal intensive care unit. JAMA Pediatrics173(1), 44. doi: 10.1001/jamapediatrics.2018.3619
PurposeThe purpose was to analyze the correlation between nurse workload and missed care in NICU unit
Research MethodA prospective design
Participants136 RNs in Pediatric unit participated
Data CollectionQuestionnaire and reporting after each shift were used to collect data from nurses regarding workload and number of missed care events
Study FindingsWorkload to led to high nurse to infant ratio resulting in 34% more chances of missed care. 
Limitations (State why the limitations)The study failed to assign the participants randomly and as a result, bias and causality cannot be explained. 
Relevance to PICOTThe population, study design, and aim of the study are similar to the PICOT. Increased number of patients increases burnout in nurses leading to missed care events. 

Article 7

Full reference for article (APA Format)Leigh, J., Markis, C., Iosif, A., & Romano, P. (2015). California’s nurse-to-patient ratio law and occupational injury. International Archives Of Occupational And Environmental Health88(4), 477-484. doi: 10.1007/s00420-014-0977-y
PurposeThe purpose was to analyze whether the California’s law of nurse to patient ratio has positive effects on the occupational injury and quality of life of nurses. 
Research MethodDifference in differences study design
ParticipantsAll licensed practical nurses (LPNs) and RNs from the database
Data CollectionData from the US Bureau of Labor Statistics and the California Employment Development Department was used. 
Study FindingsCalifornia law resulted in 55.57 fewer occupational injuries and illnesses per 10,000 nurses. 
Limitations (State why the limitations)1. The study did not estimate all standards of errors. 2. Assumptions were used and this results in bias. 3. Reliability of results can be addressed only if assumptions are true. 4. Need longer period of research. 
Relevance to PICOTThe study highlights that nurse to patient ratio reduces quality of life as a greater number of nurses fall ill. This helps in identifying key aspects of occupational effects due to lower nurse to patient ratio. Also, population resembles PICOT population. 

NR 505 Week 5 Research Summary Assignment

Article 8

Full reference for article (APA Format)Liu, Y., & Aungsuroch, Y. (2017). Factors influencing nurse-assessed quality nursing care: A cross-sectional study in hospitals. Journal Of Advanced Nursing74(4), 935-945. doi: 10.1111/jan.13507
PurposeThe research aims to find the correlation between intention to leave, patient‐to‐nurse ratio, work environment, burnout, job satisfaction, and the quality of care. 
Research MethodA cross-sectional study
Participants510 RNs from Chinese tertiary hospitals participated in the study.
Data CollectionQuestionnaires were used to collect data from nurses 
Study FindingsIncreased patient to nurse ratio results in higher burnout, lower job satisfaction, and poor quality of care. 
Limitations (State why the limitations)1. Generalizability is low. 2. Nurses who experienced burnout might have left the health care. 3. Lack of information related to work hours. 4. The sampling method used leads to bias. 
Relevance to PICOTAll the aspects of the study are similar to the PICOT except the time.

Article 9

Full reference for article (APA Format)Tawfik, D., Profit, J., Lake, E., Liu, J., Sanders, L., & Phibbs, C. (2020). Development and use of an adjusted nurse staffing metric in the neonatal intensive care unit. Health Services Research55(2), 190-200. doi: 10.1111/1475-6773.13249
PurposeTo use the nurse staffing prediction-model to evaluate the staffing deviation and its effects on the patient’s outcome.
Research MethodRepeated-measures observational design 
Participants397 nurses caring for 276 054 infants
Data CollectionNICU-level nurse staffing data was collected through EHRs, questionnaire, and reporting. 
Study FindingsThe study highlighted that there is 35% variation in nurse staffing, which results in increased workload and higher infection rates. 
Limitations (State why the limitations)The study used observational design instead of prospective design
Relevance to PICOTThe study highlights the effects of varying nurse to patient ratio on workload and care provided along with patient outcome. 

NR 505 Week 5 Research Summary Assignment

Article 10

Full reference for article (APA Format)Rushton, C., Batcheller, J., Schroeder, K., & Donohue, P. (2015). Burnout and resilience among nurses practicing in high-intensity settings. American Journal Of Critical Care24(5), 412-420. doi: 10.4037/ajcc2015291
PurposeThe study analyzes the effects of high-intensity work settings on nurse’s burnout and resilience levels to create a 2-phase plan to better resilience and reduce burnout. 
Research MethodCross-sectional study
Participants114 RNs from six high-intensity work settings
Data CollectionSix survey tools and questionnaire were used to collect data
Study FindingsIncreased patients per nurse increased stress and fatigue. As a result, burnout levels were high. 
Limitations (State why the limitations)The study did not consider effects of workplace setting, working hours, and time of the day to analyze the effects. The design increases bias and fails to explain causality. 
Relevance to PICOTThe work setting and population represents the nurses in ED work setting of the PICOT. 

References

Arkin, N., Lee, P., McDonald, K., & Hernandez-Boussard, T. (2015). The association of nurse-to-patient ratio with mortality and preventable complications following aortic valve replacement. Journal Of Cardiac Surgery29(2), 141-148. doi: 10.1111/jocs.12284

Chen, Y., Guo, Y., Chin, W., Cheng, N., Ho, J., & Shiao, J. (2019). Patient–nurse ratio is related to nurses’ intention to leave their job through mediating factors of burnout and job dissatisfaction. International Journal Of Environmental Research And Public Health16(23), 4801. doi: 10.3390/ijerph16234801

Dall’Ora, C., Griffiths, P., Ball, J., Simon, M., & Aiken, L. (2015). Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open5(9), e008331. doi: 10.1136/bmjopen-2015-008331

Kleinpell, R., Ward, N., Kelso, L., Mollenkopf, F., & Houghton, D. (2015). Provider to patient ratios for nurse practitioners and physician assistants in critical care units. American Journal Of Critical Care24(3), e16-e21. doi: 10.4037/ajcc2015274

NR 505 Week 5 Research Summary Assignment

Leigh, J., Markis, C., Iosif, A., & Romano, P. (2015). California’s nurse-to-patient ratio law and occupational injury. International Archives Of Occupational And Environmental Health88(4), 477-484. doi: 10.1007/s00420-014-0977-y

Liu, Y., & Aungsuroch, Y. (2017). Factors influencing nurse-assessed quality nursing care: A cross-sectional study in hospitals. Journal Of Advanced Nursing74(4), 935-945. doi: 10.1111/jan.13507

Qureshi, S., Purdy, N., Mohani, A., & Neumann, W. (2019). Predicting the effect of nurse–patient ratio on nurse workload and care quality using discrete event simulation. Journal Of Nursing Management27(5), 971-980. doi: 10.1111/jonm.12757

Rushton, C., Batcheller, J., Schroeder, K., & Donohue, P. (2015). Burnout and resilience among nurses practicing in high-intensity settings. American Journal Of Critical Care24(5), 412-420. doi: 10.4037/ajcc2015291

Tawfik, D., Profit, J., Lake, E., Liu, J., Sanders, L., & Phibbs, C. (2020). Development and use of an adjusted nurse staffing metric in the neonatal intensive care unit. Health Services Research55(2), 190-200. doi: 10.1111/1475-6773.13249

Tubbs-Cooley, H., Mara, C., Carle, A., Mark, B., & Pickler, R. (2019). Association of nurse workload with missed nursing care in the neonatal intensive care unit. JAMA Pediatrics173(1), 44. doi: 10.1001/jamapediatrics.2018.3619

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