Article by Zaranko et al. (2022)
Summary of the Article
The objective of the study by Zaranko et al. (2022) is to examine the impact of several nurses and their composition in an organization and the impact it has on in-hospital patient mortality. The study was conducted as longitudinal research based on patient data and nursing staff rostering. The study was conducted in three hospitals in England. The sample comprised 19287 ward day observations on 66923 hospital admissions and 4498 nurses. Thus, the sample size was large enough to provide information representative of the entire population.
In the study, the patient outcome measured was the patient outcome at the time of discharge. The use of this measure was well-informed because the measure is unambiguous and was consistently recorded across wards.
The study indicated a relationship between the number of nurses in the hospital and their level of seniority to patient mortality. The lack of adequate permanent nurses adversely affects patient health outcomes and mortality. Support nurses are not as effective as trained registered nurses. In a bid to address the problem, there is a need for organizations to employ adequate nurses, something that helps in the reduction of in-hospital patient mortality. There is also a need to support registered nurses in their professional growth and progression, enhancing their ability to execute tasks more effectively and address the problem.
Critical Analysis of the Article
The article is recent, as it was published in 2022. The content is also recent, as it documents findings on a problem currently facing health facilities. There has been an increasing challenge to meet the nurse staffing ratio, contributing to limited chances of nurses realizing the desired patient outcomes. Nurse staffing ratio information was based on recent documented data on patient mortality, the number of nurses, and the level of seniority in health facilities.
In the study, the risk of bias has been highlighted. For instance, the study focused only on contemporaneous impacts that are the effects on the same ward day, ignoring that the level of nurses in the previous ward day may also have contributed to patient health or mortality on the next day. The study also links how nurse staffing and patient mortality rates correlate, creating a risk of bias in interpreting the data collected. It is also clear that when patients are very sick and near death, nurses may be increased even though they would have limited ability to cut the mortality of the patient as the article indicates, “it also means that our estimates of the negative impact of RN staffing on deaths may understate the ‘true’ effect.”
In the article, the strongest point is that staffing ratios are also influenced by the level of nurse retention in an organization as indicated it is to engage in “fostering professional growth and progression for RNs and improving the retention of existing staff in clinical practice roles.” Many health facilities employ many nurses, but nurse turnover reduces the nurse-staff ratio, resulting in increased inpatient mortality.
The article’s weakness lies in the fact that the study was based on observation, and hence it was not possible to gather all variables relating to the patient at the time of admission. The article indicates, “This introduces the possibility of omitted variable bias.” There was a need for the researchers to ensure that the assessed correlations on the variables were purely focused on the nurse-staff ratio alone.
Article 2: Article by He et al. (2020)
Summary of the Article
The article’s objective by He et al. (2020) was to investigate the effect of nursing staffing and the risk of nosocomial infections among infants born with very low birth weight. Clinical data were collected from 280 infants born between 2010 and 2020. Regression analyses were conducted on the data. The data assessment was based on the nursing staff responsible for the care of each infant born with low birth weight.
Based on the study, various findings were made. It was noted that each nurse should not be caring for more than four children with low body weight. It was also noted that the rate of in-hospital urinary tract infections of the infants was influenced by the number of nurses tasked with caring for the children. However, the study indicated that besides urinary tract infections, there was no relationship between the level of nurse staffing and the level of infants’ bloodstream infections. The study concludes by indicating that within the neonatal intensive care unit, there is a need to deploy adequate and skilled nurses to prevent cases of urinary tract infections among infants.
Critical Analysis of the Article
The article is recent, as it was published in 2020. The information in the article is also very recent, as it was gathered between 2010 and 2020. It is essential to note that seeking the most current evidence-based practices in nursing is always good. This helps in ensuring that the information gathered and used in care delivery is the information that provides the most optimal health outcomes to the patient.
In the article, there were no cases of bias. This is based on the fact that the inferences made were based on actual data and that scientific methods of analyses, especially regression analyses, were used, eliminating the risk of subjective interpretation of the data. The findings of the study were also well aligned with the research objectives. The elimination of bias in the study makes the study findings more reliable. The article does not contain discriminatory language, as all the language used aligns with the right terms in nursing.
The strongest point in the article is that developing the right staffing policy will help reduce hospital infections among infants ‘incidence of nosocomial infections and increase the survival rate of very low birth weight infants.’ This is true since an adequate number of nurses will be tasked with taking care of the patients. It will also ensure that the nurses have the right skills and follow the right care delivery procedures, which will boost the patient’s health outcomes. It is essential to note that in care delivery, nurses face many patients needing care. Having a low number of nurses in the facility reduces their ability to deliver adequate care, which may result in omissions contributing to in-hospital infections.
The weakness of the article is that many other scholars do not support the study’s findings. The article indicates, “presently, there is no domestic research on the relationship between nurse staffing and nosocomial infection in very low birth weight infants.” The implication is that validating the findings may not be possible until more studies are conducted on the topic. Despite this, the study was based on a very relevant topic: nurse staffing. Nurse staffing remains a challenge in contemporary health facilities, and it is a challenge that should be fully addressed if the patient health outcomes and nurses’ ability to deliver care with a high level of satisfaction is to be attained.
References
He, Li, Huang, C., Jia, X., Xie, J., & Yang, H. (2020). Study on the relationship between nursing staffing and nosocomoial infection in very low birth weight infants. Journal of Biosciences and Medicines 8(1), 179-186
Zaranko, B., Sanford, N., Kelly, E., Rafferty, A., Bird, J., Mercuri, L., Sigsworth, J., Wells, M., & Proper, C. (2022). Nurse staffing and inpatient mortality in the English National Health Service: A retrospective longitudinal study. BMJ Qual Saf 1(1), 1–10.
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