Benchmark: PICOT Statement Final Draft

Benchmark: PICOT Statement Final Draft

Nursing shortage is one of the main problems associated with different healthcare institutions. Nursing shortage often impact the processes geared towards delivery of quality care. Most healthcare institutions cannot achieve the required number of nurses due to the continuous increase in the number of patients as well as lack of required skills among the workforce (Brittain et al., 2020). The provision of high quality, safe and efficient care is imperative in nursing practice. Nurses embrace the use of evidence-based data to make decisions that optimize the outcomes of care. Workplace factors however influence the safety, quality and efficiency of patient care. Shortage of nurses has a negative effect on care outcomes such as safety, quality, and efficiency. Therefore, this paper is a critique of quantitative studies on nursing shortage. Nursing shortage is an issue that affects most of the healthcare organizations in America in the modern world. The American Association of Colleges of Nursing (AACN) reports that the shortage of nurses in the US is anticipated to rise in the next decade due to the aging of the Baby Boomers (Price & Reichert, 2017). The aging of the Baby Boomers will also imply the increased need for care demands, hence, overburdening the already burden healthcare system due to nursing shortage. Shortage of nurses in the US is also attributed to the low capacity of nursing schools that do not produce new nurses to meet the increasing demands.

Research on nursing shortage has been identified as the most significant challenge affecting the delivery of quality care to patients in community health nursing. The shortage of nursing staff affects the performance of the already existing workforce as it results in fatigue, altered attitude, and negative self-perception all of which compromise quality health service delivery to patients (Marć et al., 2019). Nurse leaders have a noble task to respond to the challenge of nurse shortage in a given health facility. Several quality studies have been identified to provide a roadmap in addressing nursing shortage by increasing enrolment of nurses in the health industry. Nurse leaders have a noble task to respond to the challenge of nurse shortage in a given health facility (Sokhanvar et al., 2018). Several quality studies have been identified to provide a roadmap in addressing nursing shortage by increasing enrolment of nurses in the health industry. Of particular interest to this research is on increased enrollment of nurses as an approach to resolve the shortage of the workforce.

PICOT Question: Among community health nurses, what is the impact of increasing enrolment of nurses in resolving the Shortage of nurses other than using the retention strategy in determining the Shortage of nurses affecting the healthcare setting within two years.

Background

There are two qualitative studies and two quantitative studies that were considered in the research process. In other words, several qualitative studies have been identified to provide a roadmap in addressing nursing shortage by increasing enrolment of nurses in the health industry. Of particular interest to this research is on increased enrollment of nurses as an approach to resolve the shortage of the workforce. Qualitative study I, “Scale, Causes, And Implications of The Primary Care Nursing Shortage” by MacLean et al., (2014). Study I focus on the scale, causes, and effects of nursing shortage in primary care. The main nursing problem highlighted in study I is nurse shortage which continues to impact the quality of care delivered to patients. Study I is significant to nursing since it elaborates different strategies on how to manage healthcare processes to enhance quality treatment outcomes amidst the shortage of nurses. The purpose/objective of qualitative study I is to enumerate reasons for high nurse turnover and provide remedies to the problem. It points out the repercussions of nurse turnover in patient-to-nurse ratios and therefore addresses strategies of staffing to meet the need. From qualitative Study I, the main research question is: What are some of the best approaches to enumerate the reasons for high nurse turnover? How can healthcare professionals and policymakers provide remedies to the problem?

The qualitative study II, “Nursing shortage” by Haddad et al., (2020) highlight nursing shortage as one of the main healthcare problems. The aim of the study is to explore the main causes of nursing shortage in the healthcare institutions. The study is significant to nursing because it elucidates the problems related to the nursing shortage. The article aims to explore strategies that care facilities can use to maximize workforce working in the primary care units. The importance of the research article cannot be ignored as it purposes to identify efforts that nurse leaders can undertake as a remedy to nurse turnover. The main research question in the qualitative study II is: What strategies can health leaders undertake to maximize workforce of primary care nurses in a health facility?

The quantitative study I, “The determinants and consequences of adult nursing staff turnover: A systematic review of systematic reviews” by Halter et al., (2017) examines the impact of the nurse shortage in different healthcare institution. The main purpose/objective of the study is to investigate the determinants and the consequences of staff turnover among the adult nurses. The main research question in Quantitative study I is: what are the determinants and consequences of adult nursing staff turnover? For the quantitative study II, “Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews” by Halter, M., Pelone et al. (2017), there is the examination of the evidence-based interventions that can be applied to address the issues of nursing shortage by reducing adult nursing turnover. The main purpose/objective, of quantitative study II is to determine the evidence-based interventions that can be used to address the issues of nurse shortage. The study is significant to nursing because it determines different strategies that can be applied in addressing the nurse shortage which is a critical factor in improving the quality of healthcare delivery. The main research question in quantitative study II is: what interventions can be embraced to reduce adult nursing turnover?

How the articles Support the Nurse Practice Issue

 (Nursing Shortage)

 

Quantitative study I and II, answer the PICOT question in different ways. Quantitative study I provides insights into the determinants of factors that contribute to shortage of nurses and its consequences. The information obtained from Quantitative study I and II provide information about the severity and magnitude of the problem of nursing shortage, hence, increasing the need for the exploration of interventions to address the problem. Quantitative study II provided interventions that are similar to those proposed in my PICOT question. The interventions include the adoption of teamwork approaches in nursing, effective leadership styles, preceptor-based programs, needs-based orientation programs, use of residency programs and expanding the training capacity of nursing education institutions. Qualitative study I and II on the other hand support the PICOT question by focusing on patient-to-nurse ratios as remedies to shortages. The articles point out the challenges of enrollment of nurses and provides optimal results on the benefits of motivation as ways to promote retention of primary care workforce in a health facility. The four research studies identified to support the issue of nurse shortage. In other words, the four articles provide insights into the PICOT question, and as a result, the findings from the articles can be used to answer the PICOT question.

Method of Study

The authors in the two articles, qualitative study I and II, used peer-reviewed literature materials to investigate the aspect of nurse shortage and potential remedies. Even though the articles were based on findings from other studies, they provided evidence of how nursing staff shortages continue to plague the health industry. The methods were also appropriate as they relied on reports from expert opinions to generate ideas on how enrollment relates to retention strategies in addressing shortage of nurses. The weakness of the qualitative study I and II lies in the weaknesses in the evaluation processes; this means that the articles cannot be relied solely upon to guide evidence of practice.

The quantitative study I and II were quantitative systematic reviews. The authors reviewed evidences from previous quantitative studies that examined the factors contributing to nursing shortage, including turnover by adult nurses. The quantitative systematic reviews that the authors performed are associated with a number of benefits as well as limitations. The benefits include the fact that they provide highly reliable and accurate data, addresses specific questions or hypothesis, and guides the identification of best practices in nursing. The limitation of the quantitative systematic reviews lies on the lack of huma subjects and presenting findings that may not be generalizable to a larger population.

Results of the Studies

Qualitative study I pointed out the benefit of interprofessional team interventions to sustain the nursing workforce in a health organization. The literature material also highlights empowerment to nursing staff as avenues to motivate the professionals to remain in their job. The premise increases the desire of nurses to experience high satisfaction which not only reduces burnout but also ensures safety and quality service to patients. On the other hand, qualitative study II reveals that interprofessional teams and improvement of knowledge, skills, and attitudes are approaches to increase nurse enrolment in the primary care workforce to address the shortage. Besides, lack of adequate skills is the primary reason for the nursing shortage and that increasing training provides new approaches to patient care that nurses can utilize to optimize quality health services.

According to quantitative study I, nurse stress and job dissatisfaction, managerial style, and factors that relate to the supervision methods that organizations utilize are some of the determinants to nurse shortage. The study also revealed that the impacts of nurse turnover include reduction in the quality healthcare and economic costs. Quantitative study II revealed that some of the effective interventions that can be embraced include the adoption of effective leadership styles, teamwork approaches, transformational nursing models, preceptor programs, and residency and new gradate internship programs, and establishment of need-based programs for the nurses.

The four studies have various implications in the nursing practice. They enhanced knowledge and practical skills when it comes to the improvement of the problems associated with nursing shortage. The studies provide new knowledge in the nursing practice as well as the steps that can be undertaken to reduce further health complications among the patients due to nurse shortage.

Ethical Consideration

Approval of research studies by the Institutional Review Board (IRB) is one of the ethical considerations to be taken into account to validate the articles. Besides, privacy of patients and other participants in the research need to be respected by researchers who embrace ethical codes of practice. In regard to the study articles, authors received approval from IRB before publishing the materials. Besides, the primary studies took into account the privacy of participants as they remain confidential in the entire report outcomes. Confidentiality of information is another ethical consideration that was particularly considered in the quantitative research processes.

Outcome Comparison

Findings from the four articles indicate that there is the need to address different factors so as to enhance the development of different approaches required in reducing the problem of nurse shortage. One of the anticipated outcomes of my PICOT question is the identification of factors that contribute to nursing shortage in the US. It is expected that the analysis of different sources of information and data will enhance the understanding of the strategies required in reducing nurse shortage. The intervention will be examined to determine whether it minimized the factors contributing to nursing shortage or not. The outcomes of the selected articles compare to my anticipated outcomes. The anticipated outcome of the PICOT question involves the establishment of an effective mechanism of reducing nurse shortage. The outcomes of the four studies provides both the practical and theoretical perspectives in answering the PICOT question.

Proposed Evidence-Based Practice Change

 

The research article, PICOT question, and the proposed nursing practice problem (nurse shortage) all concentrate on the problem of nurse shortage often experienced in the healthcare settings. The four research articles used are essential in answering the PICOT question. The findings from these articles provide comprehensive solution to the PICOT question.

Based on the information provided, developing effective interprofessional collaboration, improving knowledge, attitude, skills of healthcare workers are critical in offering solution to the problem of nurse shortage. In most cases developing an effective interprofessional collaboration is critical in enhancing the operational processes and reducing the problem associated with the nurse shortage.

References

Brittain, S., Ibbett, H., de Lange, E., Dorward, L., Hoyte, S., Marino, A., … & Lewis, J. (2020). Ethical considerations when conservation research involves people. Conservation Biology, 34(4), 925-933. https://doi.org/10.1111/cobi.13464

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. StatPearls [Internet].

Halter, M., Boiko, O., Pelone, F., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). The determinants and consequences of adult nursing staff turnover: A systematic review of systematic reviews. BMC Health Services Research, 17. https://doi.org/10.1186/s12913-017-2707-0

Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews. The Open Nursing Journal, 11, 108–123. https://doi.org/10.2174/1874434601711010108

MacLean, L., Hassmiller, S., Shaffer, F., Rohrbaugh, K., Collier, T., & Fairman, J. (2014). Scale, causes, and implications of the primary care nursing shortage. Annual review of public health, 35, 443-457. https://www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-032013-182508

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage – a prospect of global and local policies. International Nursing Review, 66(1), 9–16. https://doi.org/10.1111/inr.12473

Price, S., & Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: meeting the needs of novice to mid-to late-career nurses throughout their career span. Administrative Sciences, 7(2), 17. https://www.mdpi.com/2076-3387/7/2/17

Sokhanvar, M., Kakemam, E., Chegini, Z., & Sarbakhsh, P. (2018). Hospital nurses’ job security and turnover intention and factors contributing to their turnover intention: A cross-Sectional study. Nursing and Midwifery Studies, 7(3), 133. https://doi.org/10.4103/2322-1488.235640

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Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement 

Revise the PICOT statement you wrote in the Topic 1 assignment.

The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.