NRS 433 PICOT Question and Literature Search
NRS 433 PICOT Question and Literature Search
NRS 433 PICOT Question and Literature Search
Clinical Problem-Shortage of nurses in the ICU
The increase in the number of patients in need of healthcare has caused crisis in healthcare systems in U.S and the world in general, especially the shortage of nurse workers in the ICU. This challenge is witnessed in many forms. For instance, most healthcare organizations requires that nurses to be assigned four patients to care for at once. However, high acuity may become a problem because it adds burden to the available nurses. The circumstance leads to the shortage of staff; therefore, the charge nurse could face a difficult task. If one nurse calls off from the ICU, the charge nurse is compelled to point someone to cover the shift during their day off. Therefore, she may be forced to give the nurse a total of more than four patients due to the absence of one nurse worker. When this happens, the available nurse becomes overburdened. The nurse workload increases due to the excessive patient care
demands placed on the assigned nurse, which compromises patient care. Nonetheless, the situation raises the occurrence of medical errors. The increasing volume of medical needs among the patients poses different challenges to the nurses including developing back injuries. In addition, due to severe workloads, nurses are frequently obliged to hold urination for extended periods of time, which can lead to urinary tract infections. Furthermore, the nurse workers experience significant stress and emotional damage. When faced with challenges caused by a heavy workload, having adequate nursing staff in the intensive care unit and other departments in a facility is the best solution. It significantly improves the well-being of nurses at work by increasing their job satisfaction and it prevents instances of poor health such as sickness and mortality rates.
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In the ICU departments, does sufficient nurse workers (I) prevent the occurrence of medical errors, infections and stress among patients and nurses themselves (O) within one year (T) compared to inadequate nurse workers (C)?
Population (P) – The target population is the patients in the ICU.
Intervention (I) – Sufficient nurse workers
Comparison (C) – Inadequate nurse workers.
Outcome (O) -Prevents infections, stress, and medical errors among the patients and nurses
Time (T) – The duration is one year.
|APA-Formatted Article Citation with Permalink||Fagerstrom, L., Kinnunen, M., & Saarela, J. (2018). Nursing workload, patient safety incidents, and mortality: An observational study from Finland. BMJ Open, 8(4), e016367 https://www.researchgate.net/publication/324739031_Nursing_workload_patient_safety_incidents_and_mortality_An_observational_study_from_Finland||Nogueira, T. D. A., Menegueti, M. G., Perdoná, G. D. S. C., Auxiliadora-Martins, M., Fugulin, F. M. T., & Laus, A. M. (2017). Effect of nursing care hours on the outcomes of Intensive Care assistance. PloS one, 12(11), e0188241. https://journals.plos.org/plosone/article/file?type=printable&id=10.1371/journal.pone.0188241||Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicentre study. BMC health services research, 19(1), 1-9. https://pubmed.ncbi.nlm.nih.gov/31752859/|
|How Does the Article Relate to the PICOT Question?||The article identifies how nurses’ daily workloads relate to patients’ safety. It reveals that the nurses’ workload increases the health risks among patients. However, a reduced workload reduces the health risks.||It examines the ratio of nurse care hours delivered to patient needs.||It investigates the relationship between inpatient mortality and nursing staff ratios in the surgical and medical wards.|
|Quantitative or Qualitative (How do you know?)||The study is quantitative since the investigators employed an observational study as a research method to collect quantitative data.||This study is quantitative based on the nature of the research’s data.||The research is quantitative because it uses actual data from the selected hospital’s admission|
|Purpose Statement||The study seeks to determine if every nurse’s workload relates to patient safety issues and death.||To compare nursing care indicators with the typical number of nursing hours spent caring for patients in intensive care units (ICUs).||To ascertain how staffing numbers in surgical and medical wards affect patient mortality.|
|Research Question||Do patient safety incidents and mortality connect with individual nurses’ daily workload?||What is the relationship between patient care indicators and the amount of time spent on them during nursing care?||Is in-hospital mortality affected by the mean nursing hours per patient?|
|Outcome||A medical error and mortality likelihood was almost 25% lower if OPC/nurse was below the limit. Compared to the traditional patient-to-nurse measure, a workforce measure based on daily measurements of individual patient care needs and the required NWL (OPC/nurse) was marginally better at forecasting incidents and fatality rates.||Nursing care hours impact the health outcomes among patients.||The investigation determined that a higher nurse staffing level determines the low levels of patient mortality|
|Setting||The study included 36 units from four hospitals in Finland, one of which was a tertiary acute care hospital while the other three were secondary acute care hospitals.||An ICU in one of the private hospitals in Sao Paulo, Brazil||The study was conducted in seven Belgian Hospitals’ Medical and Surgical wards|
|Sample||36 units||The selected hospital’s ICU patients between January 1, 2011, and December 31, 2013||The research involved 34,267 patients admitted to both medical and surgical wards|
|Method||The researchers employed the studying of safety incidents through observation. Also, they are based on collecting information from the reporting system in healthcare institutions.||The researchers based on the daily schedule of the nursing staff and the electronic records system, which provided them with information on the number of nurses working in the surveyed ICU daily and monthly. The investigators then utilized the Generalized Linear Models to analyze it||The research included all admitted patients, excluding children under seven and pregnant women. The researchers employed a randomized controlled trial and conducted an observational study to collect data from the medical and surgical wards.|
|Key Findings of the Study||The increased workload of hospital nurses increases the danger of patient fatalities and safety problems.||According to the study, giving patients additional hours per day decreased the incidences of pneumonia and phlebitis, which are related to using a ventilator.||Understaffing among nurses results in higher patient mortality. The researchers reached this conclusion since there were negative outcomes concerning the nurses’ proportion of hours per patient and mortality rate.|
|Recommendations of the Researcher||Investigators, in this case, recommended that future researchers confirm the study’s findings. It showed a link between the daily workload for each nurse and patient safety issues and mortality.||Health care providers should focus on assessing the hazards which result from inadequate nurse staffing in the ICU because patient safety is impacted massively by the number of nursing care hours. They achieve this goal by including indicators to monitor healthcare services. In essence, there is a need to negotiate nurse staffing and promote patient safety using various indicators that monitor healthcare services.||According to the inquiry, creating a method for calculating the ideal nurse staffing level to provide care for each patient during the proper daily hours is crucial.|
|Article 4||Article 5||Article 6|
|APA-Formatted Article Citation with Permalink||Pazokian, M., & Borhani, F. (2017). Nurses’ perspectives on factors affecting patient safety: A qualitative study. Evidence Based Care, 7(3), 76-81. https://ebcj.mums.ac.ir/article_9382.html||Banda, Z., Simbota, M., & Mula, C. (2022). A qualitative study of nurses’ perceptions of the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi. BMC nursing, 21(1), 1-7. https://pubmed.ncbi.nlm.nih.gov/35650646/||Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M. (2019). Hospital nurse staffing and staff–patient interactions: an observational study. BMJ quality & safety, 28(9), 706-713. https://pubmed.ncbi.nlm.nih.gov/30918050/|
|How Does the Article Relate to the PICOT Question?||The article identifies how different elements, for instance, nurse staffing, affect patient safety.||The study investigates nurses’ perspectives on the issue of heavy workloads in the ICU.||The authors successfully carried out an observational study to comprehend how patients feel about their satisfaction with the care they receive, both when it is high and when it is low.|
|Quantitative or Qualitative (How do you know?)||It is a qualitative study because it used structured interviews during the data collection process||Since interviews are conducted as part of the data collection procedure, the research is qualitative.||The research is qualitative because analyzing the patients’ provided feedback is involved.|
|Purpose Statement||The research seeks to determine nurses’ perspectives on the elements that influence patient safety||To investigate and describe how Malawian nurses perceive the effects of a heavy nursing burden in the ICU.||The study aims to look into how patients engage with nursing and staffing in terms of both quality and quantity.|
|Research Question||What elements, according to nurses, affect patient safety?||What impact do heavy workloads have in ICU nursing?||Is there a link between patient outcomes and high nurse staff?|
|Outcome||Improving nurses’ skills, ensuring adequate staffing, and improving nursing equipment and facilities are key to better health care services.||Because of their heavy workloads, nurses provided patients with subpar treatment, endangering their safety. High workloads also jeopardized the safety of the nurses.||Negative relationships occasionally prevented satisfaction|
(Where did the study take place?)
|Five educational healthcare facilities in Tehran||Queen Elizabeth Central Hospital, Blantyre, Malawi.||England, NHS Hospital
|Sample||The study involved 32 nurses from different units: critical care, intensive care, emergency, gastroenterology, and nephrology.||12 nurses||The research involved 270 patients and 13800 staff members|
|Method||The research involved a qualitative study design involving semi-structured interviews of between 30 and 45 minutes. Before the interviews, the researchers obtained consent from the nurses who participated in the research.||The researchers conducted a purposive sampling to choose research volunteers depending on how long they had previously worked at the hospital. After that, they gave their informed consent. To gather the research data, the researchers then conducted ten in-depth interviews. They used Braun & Clarke’s thematic analysis technique to assess the data after the data collection phase.||The investigators observed the patient outcomes based on varied staff ratios for one year. Then they used regression analysis to analyze the gathered data about the quality of care for patients.|
|Key Findings of the Study||The outcomes for patient safety are enhanced when nurses’ skills are increased, staffing levels are met, and facilities and equipment are upgraded. These actions encourage motivation and job satisfaction.||The excessive nurse workload impacts critically ill patients and ICU nurses. It compromises patient safety and prevents effective care. It also hurts the health of nurses.||From the study, the nurses with at least eight patients displayed poor interaction with them compared to those who handled a lower number.|
|Recommendations of the Researcher||Adequate staffing should be implemented in nursing to prevent stress among them and promote better patient outcomes||Nurse managers and policymakers should concentrate on increasing the number of ICU nurses and implementing various measures to solve the problem of high workloads and the impacts it causes on patient care.||The authors advise looking into why there is a poor relationship between nurses and patients when there is a low staffing ratio.|
Banda, Z., Simbota, M., & Mula, C. (2022). Nurses’ perceptions on the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi: a qualitative study. BMC nursing, 21(1), 1-7. doi: 10.1186/s12912-022-00918-x.
Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M. (2019). Hospital nurse staffing and staff–patient interactions: an observational study. BMJ quality & safety, 28(9), 706-713. DOI: 10.1136/bmjqs-2018-008948
Fagerstrom, L., Kinnunen, M., & Saarela, J. (2018). Nursing workload, patient safety incidents, and mortality: An observational study from Finland. BMJ Open, 8(4), e016367 DOI: 10.1136/bmjopen-2017-016367
Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicentre study. BMC health services research, 19(1), 1-9. DOI: 10.1186/s12913-019-4688-7
Nogueira, T. D. A., Menegueti, M. G., Perdoná, G. D. S. C., Auxiliadora-Martins, M., Fugulin, F. M. T., & Laus, A. M. (2017). Effect of nursing care hours on the outcomes of Intensive Care assistance. PloS one, 12(11), e0188241. doi.org/10.1371/journal.pone.0188241
Pazokian, M., & Borhani, F. (2017). Nurses’ perspectives on factors affecting patient safety: A qualitative study. Evidence Based Care, 7(3), 76-81. DOI:10.22038/EBCJ.2017.24174.1520
For this project, you will develop a PICOT question, which is a type of clinical guiding question. The PICOT question must be related to a problem in nursing practice. Identify six peer-reviewed research articles to support your PICOT question, as shown below. The PICOT question you choose, as well as six peer-reviewed research articles, will be used in later tasks.
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
Use the “Literature Evaluation Table” to complete this assignment.
- Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
- Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
- The PICOT question will provide a framework for your capstone project.
- Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.
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Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment. NRS 433 PICOT Question and Literature Search
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
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 not required to submit this assignment to LopesWrite. NRS 433 PICOT Question and Literature Search
Literature Search and PICOT Question
Issue or Problem of Interest
The hospital, clinics and nursing home facilities are encountering an expanding pace of falls of old patients and this is the issue for this situation. Hence, instructing the older patient on technique they can actualize to diminish falls for a term of one year and a half is the proposed mediation that will help lessen falls with healthcare centers. Qualitative and quantitative investigations will be examined in this paper. The qualitative case study led by Al Tehewy, Amin, and Nassar (2015) and the qualitative investigation led by Pohl et al., (2015) will be broken down. As indicated by the investigation directed by Al Tehewy, Amin, and Nassar (2015), it is imperative to consider receiving measures that will help limit instances of falls and this should be possible my diminishing fall danger of patients experiencing diabetes and hypertension. The qualitative study directed by Pohl et al., (2015) centers around distinguishing proof of the measures that can be received so as to limit rates of falls among olderly patients. The study directed by Pohl et al., (2015) found that older patients are acquainted with information regarding to danger of falls. Therefore, the investigation performed by Pfortmueller, Lindner, Exadaktylos (2014) bolster the way that safety of old patent will be improved if avoidance measures are executed.
Falls among the old can be decreased through executing various measures. These measures should be executed in medical clinics or hospitals with the goal that the safety of patients can be improved. Prevention and identification of the hazard is one of the measures that ought to be executed. Other measure incorporates recognizable proof of embracing innovation in the distinguishing proof of the hazard utilizing technological gadgets. For this situation, sensor alarm innovation system will be utilized to reduce falls in the healthcare facilities.
There is critical need to think of modalities that will help upgrade safety of the old through diminishing fall hazard. As such, the qualitative and quantitative research will assume a basic job during advancement of the effective aversion measures. As per Al Tehewy, Amin, and Nassar (2015), distinguishing proof and aversion of danger of fall is one of the measures that can be actualized. Moreover, old patient inside healthcare settings can be taken through preparation and training programs that will help them know techniques that they can embrace so as to limit falls hazard……
Course Code Class Code Assignment Title Total Points
NRS-433V NRS-433V-O500 PICOT Question and Literature Search 120.0
Criteria Percentage 1: Unsatisfactory (0.00%) 2: Less Than Satisfactory (75.00%) 3: Satisfactory (83.00%) 4: Good (94.00%) 5: Excellent (100.00%)
Summary of Clinical Issue 5.0% A clinical issue is omitted or is not relevant to nursing practice. A clinical issue is partially presented. It is unclear how the clinical issue relates to nursing practice. Significant aspects are missing, or there are inaccuracies. A clinical issue is summarized. The issue generally relates to nursing practice. A clinical issue is presented. The issue relates to nursing practice. Minor detail is needed for clarity. A clinical issue is thoroughly described. The issue relates to nursing practice.
PICOT Question 10.0% A PICOT question is not included. A PICOT question is provided but is incomplete. The PICOT question format is used incorrectly. A PICOT question is provided. The PICOT question format is generally applied. Some information or revision is needed. A PICOT question is provided. The PICOT question format is applied accurately. Some detail is need for support or clarity. A PICOT question is clearly presented. The PICOT question format is applied accurately and presents an answerable and researchable question.
APA-Formatted Article Citations With Permalinks 5.0% Article citations and permalinks are omitted. Article citations and permalinks are presented. There are significant errors in the APA format. One or more links do not lead to the intended article. Article citations and permalinks are presented. Article citations are presented in APA format, but there are errors. Article citations and permalinks are presented. Article citations are presented in APA format. There are minor errors. Article citations and permalinks are presented. Article citations are accurately presented in APA format.NRS 433 PICOT Question and Literature Search
Relationship of Articles to the PICOT Question 10.0% Three or more articles do not relate to the PICOT question. At least two articles do not relate to the PICOT question. The remaining articles provide a small degree of support for the PICOT question. Different articles are needed to provide better support for the PICOT question. At least one articles does not relate to the PICOT question. The remaining articles provide general support for the PICOT question. One or two different articles are needed to provide better support for the PICOT question. Each article relates to the PICOT question. The articles provide support for the PICOT question. Each article clearly relates to the PICOT question. The articles provide strong support for the PICOT question.
Quantitative and Qualitative Articles 10.0% Fewer than six research articles are presented. Four or more articles do not meet the assignment criteria for a quantitative, qualitative, Six research articles are presented. Three articles do not meet the assignment criteria for a quantitative, qualitative Six research articles are presented. Two articles do not meet the assignment criteria for a quantitative, qualitative, or mixed study. Some ability to identify the type of research design used in a study is demonstrated. Six research articles are presented. One article does not meet the assignment criteria for a quantitative, qualitative, or mixed study. A general ability to identify the type of research design used in a study is demonstrated. Six research articles are presented. Each article meets the assignment criteria for a quantitative, qualitative, or mixed study. An ability to identify the different types of research design used in a study is consistently demonstrated. NRS 433 PICOT Question and Literature Search
Purpose Statements 5.0% Purpose statements are omitted or are incomplete overall. Purpose statements are referenced but are incomplete in some areas. Purpose statements are presented. There are minor omissions in some areas, or major inaccuracies. Purpose statements summarized. There are some minor inaccuracies in some. Purpose statements are accurate and clearly summarized.
Research Questions 5.0% Research questions are omitted or are incomplete overall. Research question is presented for each article. The research question has been misidentified or misinterpreted for at least two of the articles. Additional information is needed to fully illustrate the research question for several of the articles. Research questions are presented. The research question has been misidentified or misinterpreted for one of the articles. Some detail is needed to fully illustrate the research question for one or two articles. Research questions are presented. Minor detail is needed for clarity in some areas. Research questions are accurate and capture the fundamental question posed by the researchers in each study.
Outcome 5.0% Research outcomes are omitted or are incomplete overall. Research outcome is presented for each article. The research outcome has been misidentified or misinterpreted for at least two of the articles. Additional information is needed to fully illustrate the research outcomes for several of the articles. Research outcomes are presented. The research outcome has been misidentified or misinterpreted for one of the articles. Some detail is needed to fully illustrate the research outcomes for one or two articles. Research outcomes are presented. Minor detail is needed for clarity in some areas. Research outcomes are accurate and described in detail for each article.
Setting 5.0% The setting is omitted for one or more of the articles. The setting described for three or more articles is inaccurate or incomplete. The setting is indicated for each article. The setting described for two of the articles is inaccurate or incomplete. The setting is indicated for each article. The setting described for one article is inaccurate or incomplete. The setting is indicated for each article. Some detail is needed to fully illustrate the physical, social, or cultural site in which the researcher conducted the study. The settiPLACE THIS ORDER OR A SIMILAR ORDER WITH SUPERIOR NURSING PAPERS TODAY AND GET AN AMAZING DISCOUNT