Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research
Evidence-Based Project, Part 1: Identifying Research Methodologies
Full citation Article #1 Article #2 Article #3 Article #4
Griffiths, P., Recio-Saucedo, A., Dall?Ora?. & Ball, J. (2018). The association between nurse staffing and omissions in nursing care: a systematic review. Journal of Advanced Nursing. https://onlinelibrary.wiley.com/doi/full/10.1111/jan.13564
Brooks, J. Margo. B., Linda, Davis, Lawrence. Dierkes?. & Aiken, Linda H. (2019). Association of nurse engagement and nurse staffing on patient safety. Journal of nursing care quality, 34(1), 40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6001747 Griffiths, P., Maruotti, Antenello., Saucedo, A. R., Redfern, … & Smith, G. B. (2019). Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study. BMJ quality & safety, 28(8), 609-617. https://qualitysafety.bmj.com/content/28/8/609
Driscoll, A., Grant, M. J., Carroll, D., Dalton, S…, & 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, 17(1), 6-22. , https://doi.org/10.1177/1474515117721561
Why chose this article and how it relates to the clinical issue of interest
Much research has been conducted on hospital nurse staffing levels and their relationship to patient outcomes. Low nursing staffing in hospitals has been associated with poor results, most notably death. This article investigates missed nurse care as a significant cause of poor patient outcomes. It investigates the link between missed care and nurse shortages and their implications on patient safety. The article also examines whether a lower nurse-patient ratio is linked with higher mortality rates in the clinical setting.
This study scrutinizes the influence of nurse engagement and staffing on clinical outcomes. The literature points out that the IOM initiative to transform the nurse environment has largely focused on specific interventions such as improving Electronic Health Records, check list, and care bundles. The articles confirmed that the intervention to improve nurse environment and adequate staffing has the potential of improving patient safety.
A lower nurse-patient ratio has been linked to an increased mortality rate in the hospital. The research examined whether substituting nursing staff with nursing assistants might help cut hospital death rates.
This study examines the link between nurse-to-patient ratio and inpatient death rate, as well as nurse-sensitive outcomes in acute specialty units. The articles strive to underscore the need for appropriate assessment methods in order to mitigate negative effects and maximize patient outcomes.
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Aims
The study aims are to identify nursing care that is commonly missed in healthcare settings and to provide evidence for a relationship between missed care and nurse staffing.
The article aims to bring forth to the general public important of nurse engagement and staffing on patient safety.
The study aims to prove whether nursing assistants can mitigate the detrimental effects of inadequate RNs in health care.
The study strives to ascertain if a high nurse-patient ratio can reduce the risk of inpatient deaths.
Research Methodology
This study employed a quantitative technique to investigate the relative frequency of missed care across healthcare settings.
This study used a mixed-method approach to assess survey results from thousands of nurses across 599 hospital settings.
This study used a quantitative technique to evaluate the association between staffing levels and mortality rates.
The study employed a quantitative technique to explore the association between NPR and inpatient mortality rate.
Strength of research methodology used.
The research was carried out in accordance with the review approach provided in the NICE guidelines. Only studies which met inclusion criteria were included in the research. Quality was examined using NICE quality appraisal checklist.
Donabedians conceptual model, which provides a platform for analyzing the link between nursing involvement and patient safety, was used in the review. A 51-item questionnaire was used to assess the risk and give a comprehensive approach to responses. The study engaged the services of 599 hospitals from four major states.
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The death rate in individuals exposed to inadequate staffing ratios was effectively measured using SHMI risk score, initial NEWs, and emergency admission. The SHMI was highly predictive of mortality and corresponding risk strata.
The PRISMA and the Newcastle Ottawa scale (NOS) were used in the study to assess the quality of systemic reviews and non-randomized investigations, respectively. Studies that met the inclusion requirements were identified using electronic databases such as CINHLA and custom-made extraction tools.
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General Notes/Comments
The study revealed that there is great association between low staffing and higher incidences of adverse events. However, reports of missing treatment cannot be relied totally to track staff adequacy; further research proving objective measurements is necessary.
The study revealed that effective nurse engagement and good nurse staffing are positively linked to a high patient safety rating. Thus, prospect investments in patient welfare must discourse nurse resources to enrich nursing engagement, as well as staffing ratios.
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The analysis revealed that, while nursing care assistants play an important role in patient safety, they are unable to mitigate the negative implications of RN shortages. This is attributable to a lack of expertise.
Whilst study found that increasing RN staffing reduced inpatient mortality, it did not indicate the ideal number of Nurse-patient ratio to needed to enhance patient outcomes. More research on the liaison between NPRs and nurse-sensitive patient outcomes is merited.
