Nursing: Improving Patient Care Outcomes

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Research Critique

The possibility to use the information of the most current research while addressing critical clinical issues is an integral instrument of nurses, clinicians, and managers in their daily workflow. This allows healthcare providers to be updated on contemporary tendencies, therapeutic approaches, standards, and policies, which facilitates making quality medical and managerial decisions and delivering sound patient care. Thus, this paper aims at exploring and summarizing two qualitative articles that address the research question of what is more beneficial: increasing nursing workers or adding more working hours to improve nurses outcomes for patients. In particular, the first article by Cho et al. (2016) is titled Nurse staffing level and overtime associated with patient safety, quality of care, and care left undone in hospitals: A cross-sectional study. The second article by Son et al. (2019) is titled Association of working hours and patient safety competencies with adverse nurse outcomes: A cross-sectional study.

Background of Studies

The Article by Cho et al. (2016)

The purpose of the given study is to examine the correlation between nurse staffing and overtime with nurse-perceived quality of care, care left undone, and nurse-perceived patient safety. The issue that the article tends to address is to determine whether and how nurse staffing and overtime affect the delivery of quality care. The study is significant for the nursing practice since it considers essential hospital characteristics, namely, quality of care, patient safety, and care left undone, and explores the effect of staffing and overtime on them.

The article by Son et al. (2019)

The objective of the article is to reveal the connection between patient safety competencies and the working hours of nurses with adverse nurse outcomes. The question that the authors try to answer is how the number of working hours of nurses influences patent safety. The given study has a profound significance for healthcare providers since it highlights the importance of regulating and controlling the schedule of nurses.

How Do These Two Articles Support the Nurse Practice Issue You Chose?

The two articles are directly related to the PICOT question of what is better for patients outcomes: an increase in the number of nurses or the addition of working hours. The article by Cho et al. (2016) explains that a shortage of working nurses and nursing overtime harm patient safety, the quality of care, and the amount of work done. Likewise, the study performed by Son et al. (2019) confirms that increasing working hours for nurses will bring harmful consequences to patient safety.

The focused groups of the two articles are also associated with those identified in the PICOT question. In particular, the sample size of the study by Cho et al. (2016) comprises nurses of all levels, who worked at inpatient units, including intensive care units, emergency rooms, and medical-surgical units. Regarding the article by Son et al. (2019), the sample size includes the nurses with different education, who are involved in the various clinical departments, such as surgical, intensive care, psychiatry, and emergency in particular. Therefore, in addition to other units, the two studies have nurses that are employed in the emergency department, which is relevant to the conditions of the PICOT question.

Methods of Studies

In the study conducted by Cho et al. (2016), a cross-sectional descriptive design was applied to do a survey that contains answers of nurses of all levels. The inclusion criteria involve nurses who had at least one year of working experience at tertiary care hospitals and had three eight-hour shifts a day. As a result, 364 nurses were enrolled with ages from 24 to 51 years; all participants were women. The second study has a cross-sectional design that used questionnaires of Aikens International Hospital Outcomes Study (IHOS). In contrast to the first article, this study includes diverse nurse characteristics, such as gender, age, highest education, years worked as a nurse, job status, and working unit. The sample size of this study involves 3037 nurses, which is notably larger than in the study by Cho et al. (2016).

Concerning the articles by Cho et al. (2016), the authors of the study manage to conduct a comprehensive survey that involves nurses working in different units of three hospitals. Concerning limitations, it should be indicated that one of the significant drawbacks can be the presence of only one gender, that is, women. Regarding the article by Son et al. (2019), the researchers used a vast sample size that includes over 3000 participants of different gender, education, and job status. One of the limitations is the absence of an age indicator.

Results of Study

The findings of the article by Cho et al. (2016) show that an increase in the number of patients per nurse leads to poor quality of care, failing patient safety, and having care left undone. In addition, regarding these characteristics, the outcomes of nurses who work overtime have appeared worse than the results of nurses who do not work overtime. As to the article by Son et al. (2019), the authors have concluded that nurses working fewer than 40 hours per week have better patient safety competencies than those who work extra hours. Moreover, nurses working over 50 hours a week demonstrated the worst outcome for patients.

Cho et al. (2016) recommend that in hospitals, the managers should provide adequate nurse staffing and working hours to enhance the quality and safety of care and reduce the amount of care left undone. The findings of the article by Son et al. (2019) indicate that there is a necessity to review the policy regarding working overtime in hospitals to prevent the adverse outcomes of nurses. Furthermore, according to the authors, managers of healthcare organizations should implement a system that protects the nurses rights regarding workload and schedule.

Ethical Considerations

Ethical Considerations are determined as critical requirements while conducting scientific research since non-compliance with these principles may lead to the failure of the experiment or survey. In the given two studies, it is worth discussing the further two ethical considerations, namely informed consent and the privacy of information. The first ethical principle implies that an individual consciously, deliberately, and voluntarily, clearly and honestly, gives his agreement for participation in the research. The second principle is closely related to respect for the fidelity and dignity of a participant; that is, the anonymity of respondents must be esteemed and protected.

Regarding the study performed by Cho et al. (2016), it should be indicated that the researchers follow the requirements of voluntary participation since all participants provided written consent. Besides, nurses privately completed the questionnaire by giving answers in sealed envelopes. Concerning the study by Son et al. (2019), the authors also managed to ensure voluntary consent by providing information sheets describing measures to preserve confidentiality, the voluntary nature of participation, and the right of withdrawal. Finally, the participants returned answers in the form of a sealed envelope or box.

In summary, the paper has examined two qualitative articles relevant to the PICOT question of what is more beneficial: increasing nursing workers or adding more working hours to improve nurses outcomes for patients. In particular, the study by Cho et al. (2016) proved that the shortage of nurses leads to an excessive workload, which negatively impacts their performance. Moreover, the two articles firmly do not recommend adding extra hours to the regular schedule since this measure results in inadequate safety and quality of care for patients. Thus, in the context of the PICOT question, increasing clinical staff will be relevant to enhance medical outcomes for patients.

References

Cho, E., Lee, N.-J., Kim, E.-Y., Kim, S., Lee, K., Park, K.-O., & Sung, Y. H. (2016). Nurse staffing level and overtime associated with patient safety, quality of care, and care left undone in hospitals: A cross-sectional study. International Journal of Nursing Studies, 60, 263271. Web.

Son, Y. J., Lee, E. K., & Ko, Y. (2019). Association of working hours and patient safety competencies with adverse nurse outcomes: A cross-sectional study. International Journal of Environmental Research and Public Health, 16(21), 4083. Web.

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