PICOT: Staffing Effect on Patient Outcomes and Healthcare Quality

Background of Study

Inadequate staffing levels and poor patient outcomes are significant concerns for healthcare organizations. The purpose of the first article is to identify the correlation between nursing staff and missed patient care. In contrast, the second essay deals with the propensity of healthcare organizations and the use of the Acuity-Based Staffing (ABS) model on quality outcomes. The link between nurses’ and patients’ health and well-being is complex, and failure to invest efforts in the nursing workforce is recognized as having a profound impact on patient care. Nursing executives are responsible for balancing human resources and clinical outcomes.

The first article’s research question – what are the nursing care assignments most habitually missed in intense clinics grown-up inpatient wards, as detailed by staff or patients or captured in regulatory data? In the second article, the question is – what is the impact of a shortage of nurses on quality in care patients? arises. These questions are related to the PICOT question “For patients with chronic diseases, does inappropriate staffing as compared to appropriate staffing promote poor patient outcomes and healthcare quality?”

Nurse Practice Issue

The result of treatment is influenced by the professional interaction of workers and patients, consisting of qualified consultations of patients by hospital staff on medical behavior issues. The low staffing rates for nurses were associated with higher missed care reports (Griffiths et al., 2018). In other words, neglected care in medical services identified will directly affect the health of patients, especially those with chronic diseases, as they require more extended consideration. Thus, inappropriate staffing leads to poor patient outcomes.

Patients evaluate the social environment as an indicator of the service’s quality. According to Kollman (2019), the patient’s needs should coordinate with the expertise level of the nurturing skills, knowledge, and experience of nurses. Employees’ ability to remove the psycho-emotional load of patients with chronic diseases from the social environment is an indicator of their competence. In this case, the medical staff’s professionalism is most important in providing high-quality treatment service. In contrast to the PICOT focus group, the first article takes a broader scale of patients, and the second article divides patients into three groups during the review. Applying standardized evaluation tools to observe risk factors and the ABS model in nursing practice are the interventions of two studies, whereas the PICOT questions are associated with quality interventions.

Method of Study

The methodology of the first article was based on a comprehensive study and review of the nursing staffing literature. Researches were conducted in CEA, CENTRAL, CINAHL, Embase, HTA, and other literature databases, and sources in journals, documentation from personal libraries, and bibliographies were reviewed (Griffiths et al., 2018). The second article also focused on a systematic review of the literature to recognize staffing (Kollman, 2019). Nevertheless, in the second article, independent reviewers with knowledge of the medical field analyzed the research in three specific ways. In the analysis, patients were divided into three categories of surgical, intensive care, and step down, which made it possible to determine the correlation more accurately.

Griffiths’ article strength is that the study was based on an extensive search strategy, counting numerous healthcare databases. Even though the connection to caregiving work is coordinated, making a causal translation conceivable, the affiliations in these studies come up short to fully explain this relationship. Thus, assigning a low risk of predisposition to the survey does not give a causal elucidation, and the established correlation is not accurate enough.

In contrast, the second article’s strength lies in the fact that it reinforces a significant gap in the evidence of visual acuity-based nursing staff and influences patient outcomes. However, a limitation found in the review of the nursing staff is that models were not thoroughly studied since there were no researches that fully met the criteria of acuity-based staffing. Therefore, numerous resources have resulted in an inability to control mixed variables such as holistic care needs, patients’ changing conditions, nursing workload, and nursing experience level.

Results of Study

Interest in nursing missed care has regularly been based on playing a part as a potential instrument for clarifying quiet security execution and nursing staff levels. The fluctuation of staffing levels contributes to high mortality through missed care (Griffiths et al., 2018). Based on five studies, there is a definite connection between ABS staffing and improved patient outcomes (Kollman, 2019). In addition, the work environment correlated with improved patient outcomes when work conditions were rated higher, indicating an indirect effect on patient side effects.

Given the results of missed care, its prevalence can serve as a marker of the quality of care. Maintaining a satisfactory level of staffing may be a component preventing incidences of missed care. Kollman’s article focuses on the positive impacts of social change through evidence-based guidance, which can be used to manage nursing and overall healthcare spending prudently alongside fiscal responsibility.

Ethical Consideration

The first ethical principle in healthcare is safety because the data identified shows the impact of sufficient nurse staffing on patient outcomes’ safety and quality. The method for achieving these optimal levels in a workforce remains hidden in a myriad of definitions, strategies, models, and inconsistent workload measurement tools (Griffiths et al., 2018). Ratio-based nursing has represented an excellent beginning to help legislate safe minimum staffing levels per patient.

Second, competence and responsibility for the patient’s life are essential. Investigations into avoidable hospital deaths show how neglect by nurses can lead to serious adverse consequences. For example, reports of preventable deaths within clinics indicate that the level of monitoring patients’ vital signs and satisfaction reaction is low (Kollman, 2019). Thus, oversights within the arrangement of primary care have been hypothesized as a component through which nursing staffing levels can impact mortality rates.


Griffiths, P., Recio‐Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., Smith, G. B., Ball, J., & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74(7), 1474-1487. Web.

Kollman, S. (2019). Acuity-based nurse staffing and the impact on patient outcomes [Unpublished doctoral dissertation]. Walden University.

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NursingBird. (2023, August 13). PICOT: Staffing Effect on Patient Outcomes and Healthcare Quality. Retrieved from https://nursingbird.com/picot-staffing-effect-on-patient-outcomes-and-healthcare-quality/


NursingBird. (2023, August 13). PICOT: Staffing Effect on Patient Outcomes and Healthcare Quality. https://nursingbird.com/picot-staffing-effect-on-patient-outcomes-and-healthcare-quality/

Work Cited

"PICOT: Staffing Effect on Patient Outcomes and Healthcare Quality." NursingBird, 13 Aug. 2023, nursingbird.com/picot-staffing-effect-on-patient-outcomes-and-healthcare-quality/.


NursingBird. (2023) 'PICOT: Staffing Effect on Patient Outcomes and Healthcare Quality'. 13 August.


NursingBird. 2023. "PICOT: Staffing Effect on Patient Outcomes and Healthcare Quality." August 13, 2023. https://nursingbird.com/picot-staffing-effect-on-patient-outcomes-and-healthcare-quality/.

1. NursingBird. "PICOT: Staffing Effect on Patient Outcomes and Healthcare Quality." August 13, 2023. https://nursingbird.com/picot-staffing-effect-on-patient-outcomes-and-healthcare-quality/.


NursingBird. "PICOT: Staffing Effect on Patient Outcomes and Healthcare Quality." August 13, 2023. https://nursingbird.com/picot-staffing-effect-on-patient-outcomes-and-healthcare-quality/.