PICOT Question
Given the understaffing of nurses, how does setting a minimum staffing table versus changing the schedule to accommodate nurses’ needs improve patient satisfaction, reduce readmissions, nurse burnout, and hospital stays compared to last year?
Quantitative Studies
Veenstra, M., & Gautun, H. (2021). Nurses’ assessments of staffing adequacy in care services for older patients following hospital discharge. Journal of Advanced Nursing, 77 (2), 805–818. Web.
The work aims to study the adequacy of the staffing of nurses working with elderly patients by the nurses themselves. The study aims to assess the adequacy of staffing care for elderly patients by district nurses. The Norwegian Nursing Organization (NNO) provided email access to all 20,714 NGO members, and the final sample consisted of 1,364 nurses working with the elderly (Veenstra & Gautun, 2021). The method was web-based survey, that was a questionnaire of 32 questions or groups of questions, the passage of which took approximately 15 minutes (Veenstra & Gautun, 2021). An analysis of the results showed large differences in staff assessments regarding the adequacy of the staffing of medical staff. While nearly half of nurses are understaffed overall, a similar proportion of nurses indicated that staffing was adequate, suggesting that staffing is not necessarily considered an issue in all community care services. In addition, the majority agreed that there were too many unskilled nurses in their workplace, which harmed patient satisfaction.
Saaiman, T., Filmalter, CJ, & Heyns, T. (2021). Important factors for planning nurse staffing in the Emergency Department: A consensus study. International Emergency Nursing, 56, 100979. Web.
Although there are models for determining the staffing of nurses in departments, these models do not consider all factors. The authors decided to study the degree of influence of improper staffing of nurses on the quality of medical care. Data was collected using e-Delphi to improve the efficiency of data collection using the Modified Nominal Group (NGT) method. In the first round, the researchers sent letters to selected experts working in the emergency department (N = 74) (Saaiman et al., 2021). A shortage of workers and erroneous nurse scheduling are causing overcrowding, poor quality of patient care, increased hospital costs, poor patient outcomes, and high burnout among nurses (Saaiman et al., 2021). Inadequate staffing of nurses is associated with increased mortality and poor patient experience. Stakeholders and experts agreed that planning for the number of nurses in the emergency department should consider various factors, including hospital, staff, patient, and some additional factors. It will greatly affect the condition of health workers and the quality of patient care.
Min, A., Kim, YM, Yoon, YS, Hong, HC, Kang, M., & Scott, LD (2021). Effects of work environments and occupational fatigue on care left undone in rotating shift nurses. Journal of Nursing Scholarship, 53 (1), 126–136. Web.
Continuously meeting patient expectations is next to impossible, but patient experience and outcomes can be improved and stress reduced by changing the staffing and workload of nurses. This study aimed to investigate the impact of the work environment and occupational fatigue on nursing care. The researchers used data from an online survey from a project investigating associations between work-related factors and nurse and patient outcomes among shift nurses in Korea. Thus, 492 nurses completed the survey, and 488 valid responses were used in the final analysis (Min et al., 2021). Research shows that nurses and administrators may not be fully aware of the health and safety risks associated with shift work and fatigue in healthcare settings (Min et al., 2021). Existing nurse-patient ratio models are based on general nursing departments and do not consider the medical department’s unique nature. Acuity impacts patient safety, and nursing staff should be sized according to both patient acuity and volume.
Vera San Juan, N., Aceituno, D., Djellouli, N., Sumray, K., Regenold, N., Syversen, A., Mulcahy Symmons, S., Dowrick, A., Mitchinson, L., Singleton, G., & Vindrola-Padros, C. (2021). Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: Contrasting guidelines with experiences in practice. BJPsych Open, 7 (1). Web.
Organizations with inflexible or overly busy work schedules can result in the loss of a healthcare worker. The study’s objectives are to assess the applicability of well-being guidelines in practice to identify the unmet needs of medical workers. For analysis, 33 interviews with front-line healthcare workers who were also working at the beginning of the pandemic were selected (Vera San Juan et al., 2021). The result was considered in connection with a rapid review of wellness recommendations developed in response to the COVID-19 pandemic, including 14 strategies (Vera San Juan et al., 2021). Leading organizations focus either on individuals or on the institutional/organizational level. In general, it was noted that the health worker’s mental health and support received more attention. At the same time, healthcare professionals emphasized structural conditions at work, and responsibilities outside the hospital. The scheduling interventions suggested in the guidelines can affect care pathways and reduce worker stress levels.
Keith, AC, Warshawsky, N., & Talbert, S. (2021). Factors that influence millennial generation nurses’ intention to stay. JONA: The Journal of Nursing Administration, Publish Ahead of Print. Web.
A good working environment is directly related to the well-being of the workers. The authors investigate the likelihood of a nurse leaving the workplace in circumstances that do not meet the proper working conditions. The study is a review and analysis of various sources on the balanced work of medical workers. The layoff rate largely depends on the schedule provided by the organization (Keith et al., 2021). It was shown that the more patients are cared for by a nurse, the higher the nurse’s stress, and chronic stress exposure is strongly associated with post-traumatic stress disorder (Keith et al., 2021). Thus, full staffing and a fair distribution of the workload will positively affect the quality of the medical services provided, increasing patient satisfaction.
Min, A., Kang, M., & Hong, HC (2021). Sickness presenteeism in shift and non-shift nurses: Using the fifth Korean Working Conditions Survey. International Journal of Environmental Research and Public Health, 18 (6), 3236. Web.
Backlog refers to necessary nursing activities that have been delayed or not completed due to lack of time during shifts. The researchers wanted to identify the prevalence of sickness presenteeism due to illness and explore concomitant factors. A systematic review found this related to patient satisfaction, quality of care, clinical outcomes, readmission, and mortality rates (Min et al., 2021). The survey included 272 nurses in Korean hospitals, who were overworked for at least one hour for pay (Min et al., 2021). The questionnaire included questions about working conditions, health status, attendance at work due to illness. The study’s main finding was that work breaks, quick returns, sleep disturbance, and health problems all affected health status among shift nurses. Nursing leaders and administrators must prevent this in hospital nurses to maintain property of care and increase productivity.
Moon, D.-J., Han, MA, Park, J., & Ryu, SY (2021). Post-traumatic stress and related factors among hospital nurses during the covid-19 outbreak in Korea. Psychiatric Quarterly, 92 (4), 1381–1391. Web.
Nursing staffing models do not always consider the movement of patients, the minimum and the maximum number of staff, nursing activities necessary to ensure the quality of care. The study recruited 300 nurses who worked in general hospitals during the COVID-19 outbreak. The purpose was to investigate post-traumatic stress and related factors. A total of 36.7% of nurses were at risk for PTSD, and factors associated with PTSD were the work department, nursing staff, and the presence of COVID-19 symptoms (Moon et al., 2021). In any hospital or medical department, proper staffing of nurses at any given time is associated with improved performance, especially lower mortality rates fewer complications. It also improves outcomes, shortens hospital stays, reduces hospital costs, and, most importantly, improves patient satisfaction.
Manzano Garcia, G., & Ayala Calvo, JC (2021). The threat of Covid-19 and its influence on Nursing staff Burnout. Journal of Advanced Nursing, 77 (2), 832–844. Web.
The issue of nurse burnout has become especially relevant recently, with the advent, spread, and development of the COVID-19 pandemic. It is known that the psychological state of a medical worker has a direct impact on the quality of work and threatens the general health of the population. It was needed to investigate the ability to adaptively respond to feelings of distress on an ongoing basis can prevent everyday stresses from escalating into more severe symptoms of burnout, anxiety, and depression. The authors used a sample of more than 700 nurses working in 10 hospitals in northern Spain (Manzano García & Ayala Calvo, 2021). Data on burnout, job demand and resources, and the perceived threat of COVID-19 were collected using an online questionnaire. As a result, it was found that overload, material, human resources, and social support at work were important causes of burnout.
Qualitative Studies
Ansah Ofei, AM, Paarima, Y., Barnes, T., & Kwashie, AA (2021). Staffing the unit with nurses: The role of Nurse Managers. Journal of Health Organization and Management. Web.
Nurses already know that inadequate staffing of nurses and high workloads threaten the quality of care and patient safety. The study used a descriptive method to select 47 nurses and 15 nurse managers for in-depth interviews and further focus group analysis, respectively, to study the practice of preventing deterioration in nurses’ quality of work. (Ansah Ofei et al., 2021). The nurses confirmed their dissatisfaction with the lack of staff in the department, especially in peripheral hospitals. The greatest number of factors influencing job satisfaction for nurses was provided by good care; another important factor had a challenging but doable workload (Ansah Ofei et al., 2021). The dissatisfaction was caused by several factors: feelings of overload or factors that interfere with patient care. Time can be used as a source of motivation for nurses, and nurses should be involved in developing the duty list to ensure that they are met effectively.
Franco, PL, & Christie, LAM (2021). Effectiveness of a one-day self-compassion training for pediatric nurses’ resilience. Journal of Pediatric Nursing, 61, 109–114. Web.
Resilience is an important skill for nurses and other healthcare professionals, especially during a pandemic. The researchers examined the impact of self-compassion, mindfulness, and well-being training on health care worker resilience. Interviews were conducted before, after, and follow-up of 22 nurses who attended the training and 26 nurses who did not attend the training (Franco & Christie, 2021). Intervention participants showed a significant increase in self-compassion, mindfulness, compassion for others. These skills include strategies for coping with difficult emotions through mindful awareness, kind self-talk, and physical gestures (Franco & Christie, 2021). In addition, strategies for managing empathic distress arising from observing another person’s suffering help cope with the possible burnout of nurses at work and improve the quality of patient care. Establishing a minimum staffing level can enable nurses to cope with stress based on their free time practices.
References
Ansah Ofei, A. M., Paarima, Y., Barnes, T., & Kwashie, A. A. (2021). Staffing the unit with nurses: The role of Nurse Managers. Journal of Health Organization and Management. Web.
Franco, P. L., & Christie, L. A. M. (2021). Effectiveness of a one day self-compassion training for pediatric nurses’ resilience. Journal of Pediatric Nursing, 61, 109–114. Web.
Keith, A. C., Warshawsky, N., & Talbert, S. (2021). Factors that influence millennial generation nurses’ intention to stay. JONA: The Journal of Nursing Administration, Publish Ahead of Print. Web.
Manzano García, G., & Ayala Calvo, J. C. (2021). The threat of Covid‐19 and its influence on Nursing staff Burnout. Journal of Advanced Nursing, 77(2), 832–844. Web.
Min, A., Kang, M., & Hong, H. C. (2021). Sickness presenteeism in shift and non-shift nurses: Using the fifth Korean Working Conditions Survey. International Journal of Environmental Research and Public Health, 18(6), 3236. Web.
Min, A., Kim, Y. M., Yoon, Y. S., Hong, H. C., Kang, M., & Scott, L. D. (2021). Effects of work environments and occupational fatigue on care left undone in rotating shift nurses. Journal of Nursing Scholarship, 53(1), 126–136. Web.
Moon, D.-J., Han, M. A., Park, J., & Ryu, S. Y. (2021). Post-traumatic stress and related factors among hospital nurses during the covid-19 outbreak in Korea. Psychiatric Quarterly, 92(4), 1381–1391. Web.
Saaiman, T., Filmalter, C. J., & Heyns, T. (2021). Important factors for planning nurse staffing in the Emergency Department: A consensus study. International Emergency Nursing, 56, 100979. Web.
Veenstra, M., & Gautun, H. (2021). Nurses’ assessments of staffing adequacy in care services for older patients following hospital discharge. Journal of Advanced Nursing, 77(2), 805–818. Web.
Vera San Juan, N., Aceituno, D., Djellouli, N., Sumray, K., Regenold, N., Syversen, A., Mulcahy Symmons, S., Dowrick, A., Mitchinson, L., Singleton, G., & Vindrola-Padros, C. (2021). Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: Contrasting guidelines with experiences in practice. BJPsych Open, 7(1). Web.