Answer

Nurse to Patient Ratio and the Impact on Patient Safet

Description of the Search Method

            The database, Ebscohost, was used to identify relevant research articles. This database was chosen as it tends to feature various kinds of scholarly materials such as periodicals, reports, books, newspapers, and even academic articles. The keywords used for the research include: Nurse staffing, nurse to patient ratio, and patient outcomes.

            The inclusion and exclusion criteria depended on these keywords and the characteristics of the articles obtained. 1,782 results were obtained from the keywords mentioned above. Unfortunately, all could not be used in the research as some featured slightly different objectives. The first exclusion criteria focused on articles that simply considered advantages of effective nurse staffing. 1,010 articles were eliminated in this step as they did not feature in-depth discussions of how nurse staffing impacted patient outcomes. The second exclusion criteria focused on articles which simply considered nurse staffing ratios without a discussion of how patient outcomes were impacted. Here, a total of 503 articles were eliminated.  The third exclusion criteria focused on articles which were simply considering the factors resulting to positive and negative patient outcomes. These were excluded because the discussions were not sufficient to inform the current study. Thus, 256 articles were eliminated. The fourth step in this exclusion criterion focused on the date of the articles. Those which were older than the year 2000 were excluded. This resulted in a total of 8 articles being eliminated. A total of 5 articles were included in this study. They featured the required characteristics such as in-depth discussions of the relationship between nurse staffing levels and patient outcomes.

Summary of Research Studies Used

            Clarke (2003) conducted an analytical research study on impacts of nurse staffing’s on patient outcomes. It featured a review of literature that focused mainly on the research keyword. Various literatures were analyzed thoroughly before the author compared their given results. All the articles seemed to agree on specific findings. First, Clarke (2003) notes that studies conducted in hospitals with the highest levels of nurse staffing recorded low rates of adverse patient events. On the other hand, studies conducted on hospitals with the lowest nurse staffing levels led to more adverse patient outcomes. Second, Clarke (2003) notes that most researchers suggest that the level of RN nurses and not the assistive personnel, drive this association. This study has strength in that it focuses on a review of primary research articles. However, it would have been better if the research was conducted first hand in a uniform environment.

            Janita et al. (2015) conducted a multilevel research to analyze the association between nurse staffing and patient outcomes in hospitals. Registered nurses were interviewed to get their perspective on what they think impacts their productivity, as well as the patient outcomes. Additional research on the hospitals proved also tried to analyze the levels of adverse patient events and the nurse to patient ratios in these hospitals. Considering their analysis, these authors seem to agree on the fact that registered nurse to patient ratios must be maintained at a significant level if at all better patient outcomes are to be experienced. This is because they noted that negative outcomes were common in hospitals with limited nurse staffing levels. This article’s strength is that it focuses on primary research, thus the audience can see the results and understand.

            Morita et al. (2017) conducted a retrospective cohort study to determine the association between in-patient nurse to occupied bed ratio and in-hospital fractures. It tried to consider the number of hospital fractures in hospitals with a higher nurse to patient ratio, as well as those with a lower nurse to patient ratio. The results indicated that patients experienced less falls and fractures when they had nurses who would actively assist and monitor them. Therefore, these authors concluded that sufficient nurse staffing is important to reduce postsurgical fractures. This study has strength since it features first hand research, as well as the use of additional secondary resources to support the findings.

            Needleman (2015) also conducted a literature review on previously conducted researches relating to nurse staffing. Needleman’s paper considers how nurse staffing levels impact their performance, which is why patient outcomes are also impacted. Considering the various articles analyzed, Needleman (2015) concluded that the nurse staffing level is directly associated with patient outcomes. This means that the higher the staffing level, the better the patient outcomes. This study has strength as it draws arguments from other scholars who studied the issue initially. However, it also has limitations since it does not conduct primary research.

            Weston, Brewer and  Peterson (2012) also conducted a literature review which focused predominantly on analyzing the ANA principles relating to nurse staffing levels. The analysis considered how nurse staffing levels are considered important as they impact patient outcomes. Various suggestions are given on how hospitals may achieve the required nurse staffing level which is expected to lead to a safe, quality care for the patients. This paper has strength in that it is based on the ANA principles for nurses. A weakness, however, may be noted from the fact that research is not first hand.

Internal and External Research Validity

            This research features a high of internal and external validity due to specific reasons. First, internal validity is guaranteed as the results are fully relatable to the independent variable which is the nurse staffing level. Second, the results are not only focused on a specific situation, but also on nurse staffing in general. Therefore, various healthcare institutions can borrow the results to help improve their patient outcomes.