[SOLVED] NR 449 Week 3 Assignment: Individual Analyzing Published Research Article (IAPRA) Part 1

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Staffing Levels and Patient Safety Sample Paper Chamberlain University NR-449 Evidence Based Practice Staffing Levels and Patient Safety Clinical Question Problem The problem this pa... per seeks to address is the harm brought to patient safety due to low levels of nurse staffing. Specifically, this paper will evaluate the causal relationship between nurse staffing levels and patient mortality rates while inpatient and thirty days post-discharge. Significance of problem in terms of outcomes or statistics According to West et al. (2014) the number of nurses per bed in an inpatient setting is the highest indicator of patient survival when including the staffing levels of other healthcare personnel. Aiken et al. (2014) adds to this assertion by acknowledging a 7% decrease in mortality rates when the nurse’s workload is decreased by one patient. West et al. (2014) state clearly that increased staffing levels decrease workloads and therefore decrease patient mortality. Acknowledging the evidence behind this assertion, it is possible to claim that the opposite conditions will increase mortality rates and have negative effects on patient safety during and following an inpatient hospitalization. Concerning the significance of the problem as it relates to facilities, it is important to acknowledge the concern of financial burdens to the facilities when increasing the number of staffed nurses. Notably, the upfront costs have continued to support the trend of minimal staffing. However, Skekelle (2013) presents a savings-cost ratio whereas the cost of increasing staffing is the assigned cost and life-years saved and productivity are the assigned savings. According to Skekelle (2013), the analysis yielded a benefit-cost ratio of 2.51. Therefore, the cost of maintaining the current level of nurse staffing exceed 2.5 times that of implementing changes to the levels of staffing. Purpose The purpose of this paper is to explore the relationship between unsafe staffing levels and patient outcomes. The present paper is to interpret the two most relevant articles that were presented in the evidence based research into this relationship and to present the details of these studies as they apply to the present inquiry. This will include a discussion of Matrix Table to include the concepts, methodology, participants, instruments, and applicability to the group research. Description of Findings Following the processes of searching and refining, ten abstracts were selected and reviewed. Upon completion of this review, the following two articles were selected and evaluated in the following Matrix Table: Reviewing the articles through the Evidence Matrix aids in the further integrating the findings to support the need for future research. The first study presented by Aiken et al. (2014) utilizes the European study protocol in an observational study of retrospective discharge records as well as surveys completed by 26 516 nursing professionals. The surveys were utilized to determine the level of education and tenure for each of the participants from 300 hospitals as well as the perception of the nursing environment as based on the Practice Environment Scale of the Nursing Work Index. For the mortality rates, the researchers utilized patient characteristics, 43 dummy variables, and 17 comorbidities to account for any external or additional variables. In response to the primary inquiry, the researchers confirmed their claim that an increase in nurses will decrease mortality rates in patients following a common surgery. The second article presents a systematic review that was conducted by Shekelle (2013). The researcher utilized the assessment of multiple systematic reviews (AMSTAR) criteria to assess the literature selected and formally discussed and justified the omissions or additions to this criterion. The researcher additionally notated the scoring of criteria in discussion of each source included in the findings. While there were no formal participants, the researcher effectively produced data regarding the selection of literature to allow for replication in future studies. While the researcher found that the majority of the literature supports a causal relationship between the nurse to patient ratio and the mortality rates, it is noted that the systematic review did not produce sufficient empirical data to initiate a change of practice. Future studies are recommended to include intentional change of nursing staff and data collection pre and post change. Conclusion This paper has served to further establish the credibility and applicability of the selected resources for study. Although both sources . Nurse staffing, medical staffing and mortality in intensive care: an observational study. International journal of nursing studies, 51(5), 781-794. [Show More]

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