Nursing Hours per Patient Day Staffing Method


The paper at hand represents a concise analysis of a research report. One tried to examine the selected study from the point of view of its design, the level of its evidence and the quality of its literature review. The particular focus was put on the estimation of the general validity of the researchers’ findings.

The analysis has shown that the research has a logic structure and provides a profound literature review. The authors rely on credible peer-reviewed sources most of which are relatively update. Meanwhile, the level of the evidence of this research was defined as middle. One has applied a couple of hierarchies in order to define the proper level. According to the first scale, the level can be defined as “level 3”, according to the second scale, one can define the evidence’s level as “fair”.


While analyzing a research report one should lay a particular emphasis on its relevance and validity. The quality of the provided data is of great importance – in fact, its feasibility determines whether the scientific findings can be used for further investigation and study. Among the principal components comprising a successful research, one should necessarily point out a logical design, a valid evidence base and peer-reviewed literature. Thus, the following paper is aimed at analyzing the selected research report focusing on the aspects mentioned above.

Article’s Summary

Research Design

The report under discussion covers the problem of the implementation of the nursing hours per patient day method and the interconnection between the nursing-sensitive outcomes and the skill mix within the framework of this method. The authors point out that the relevant research focuses on the public hospitals of Western Australia and studies a period of four years (Twigg, Duffield, Bremner, Rapley, & Finn, 2012).

Therefore, one might suggest that the main value of the presented data consists in its specificity and the preciseness of the studied object. The authors describe the design of the research as a “retrospective analysis” of the administrative data provided by three Australian hospitals (Twigg et al., 2012, p.2712). One should necessarily note that the research has a logical structure – it covers all the essential aspects: the aim, the methodology and the profound data analysis. One of the distinguishing features of the paper’s design is a special section that provides a comparison between the initial data base and the received findings; thus, emphasizing the novelty of the presented outcomes.

The Level of the Evidence of the Study

In order to determine the level of the evidence of the study one might imply various hierarchies. According to DeVries and Berlet, one of the most efficient estimation methodologies is a five-level scale that was worked out by the Oxford Centre for Evidence-Based Medicine. This scale offers a thorough description of every level for four types of studies (DeVries & Berlet, 2010). As long as the analyzed research bases on the retrospective study, one should define the level of its evidence as Level 3. In order to be referred to a higher level, the following paper should provide a prospective comparative study and a wider statistical base.

In the meantime, Evans provides another hierarchy that suggests analyzing the evidence in the framework of three aspects: effectiveness, appropriateness and feasibility. Instead of five levels, this scale provides only four characteristics: excellent, good, fair and poor (Evans, 2003). Hence, according to this hierarchy, the effectiveness of the research’s evidence is fair as it is represented by the non-randomized controlled trials.

The appropriateness of the relevant evidence can be determined as fair as well as the authors describe a study carried out within the focused groups. Finally, one might assume that the feasibility of the analyzed evidence is also fair due to the descriptive character of the research’s design. Therefore, the general level of the relevant evidence is fair that coincides with the third level that was estimated according to the previous hierarchy. One might suppose that the middle level of the evidence is determined by the narrow focus of the research and the retrospective character of the provided analysis.

Summary and Critique of the Literature Review

One of the principal advantages of the analyzed research is the valid literature base. Thus, the authors suggest a thorough literature review that shows that they rely on the peer-reviewed sources. The number of articles is significant taking into account a moderate size of the study itself. As a consequence, one might suggest that the researchers tried to consider various points of view in order to perform a relevant analysis of the targeted problem. Whereas the majority of the sources is relatively new, one can still come across a couple of articles and papers that date back to the end of the twentieth century.

Another considerable benefit of the analyzed literature review is that the researchers mainly rely on the primary sources. Most of the enlightened insights belong to a particular scientist that describes them in a peer-reviewed article. Some specialists believe that the prevalence of primary sources defines a valid research (Evidence Based Medicine: Levels of Evidence, 2015). Therefore, one might conclude that, on the whole, the literature base looks rather update and credible.

Reference List

DeVries, J.G., & Berlet, G.C. (2010). Understanding Levels of Evidence for Scientific Communication. Foot & Ankle Specialist, 3(4), 205-209.

Evans, D. (2003). Hierarchy of Evidence: A Framework for Ranking Evidence Evaluating Healthcare Interventions. Journal of Clinical Nursing, 12(1), 77-84.

Evidence Based Medicine: Levels of Evidence. (2015). Web.

Twigg, D., Duffield, C., Bremner, A., Rapley, P., & Finn, J. (2012). Impact of Skill Mix Variations on Patient Outcomes Following Implementation of Nursing Hours per Patient Day Staffing: a Retrospective Study. Journal of Advanced Nursing, 68(12), 2710-2718.