Qualitative Research Critique And Ethical Considerations

Background

In the article “Nurse staffing and patient outcomes in critical care: A concise review”, the author, Daleen Aragon Penoyer, conducted a study that reviewed previous studies to find a link between patient outcomes and nurse staffing. The study showed that the patients who are severely affected by an illness demand more nurses, especially the highly skilled ones. However, these demands are not met in some places due to short nurse staffing. It is imperative to increase the number of nurses employed so that patients’ satisfaction can be achieved. The study is significant to nursing as it will help determine if the previous problems in nurse staffing have been eliminated or not, which will help determine the solution for the persisting problems. The objective of this study was to extensively research previous works done on the same topic to find an authentic link between patient outcomes and nurse staffing. The significance of this study is that it provides data collected from the research already done and provides an unbiased view of the results. The research questions posed by the researcher in this study are as follows:

• What is the association between patient outcomes and nurse staffing?
• How does nurse staffing impact the patients who are in critical care?
• Is the staffing in intensive units adequate at local levels? (Penoyer, 2010)

Aiken et al. conducted a study called “Patient Satisfaction with Hospital Care and Nurses in England: An Observational Study”. The study was done to observe the views of the patients about hospitals and their confidence in the abilities of the nurses who were responsible for taking care of them. Many patients and their families showed dissatisfaction by reporting that the hospitals had inadequate nursing staff, making getting proper care difficult. This also resulted in deaths that could have been prevented if there had been skilled staff present at that moment. The objective of this study was to find the relevance behind this claim by researching the healthcare policies and finding the reason behind the inadequacy in nurse staffing. This study is significant as it is researching both parties involved to find the root cause of patient dissatisfaction and nurse shortage. By finding the root of the problem, it can be eliminated so that patient outcomes can be better. The research questions of this study are as follows:

• What is the relation between patients’ experience with care and their confidence in hospital staff?
• What is the relationship between patients’ experience with care and their beliefs about whether there were sufficient nurses in the hospitals?
• Do lesser nurse workloads and conducive nurse work environments lead to less missed nursing care?
• What is the relationship between less missed nursing care and patients’ experience with their care? (Aiken et al., 2021)

Relation Of These Studies With The PICOT Question

The PICOT question in the previous study was: “Will patient care improve by limiting the number of patients a nurse can take care of in critical care units?” Penoyer’s study answers this question as this study analyzes the relationship between patient outcomes and nurse staffing. This study is directly related to the PICOT population, that is, the patients under critical care. This study researched the reasons behind the nurse staffing and the way it affected the patients’ outcomes by evaluating similar studies conducted in the past. The study evaluated the effects of nurse staffing in critical care units and found that it harms the health of the patients and sometimes leads to mortality. The researcher recommended that the gap between nurse staffing and demand be closed so that patient outcomes can be achieved.

The study conducted by Aiken et al. answers the PICOT question by focusing on patients’ views about hospital care, especially the care provided by nurses. The reason behind the inadequate care was researched, and it was identified as poor staffing practices. This study brings substantive proof that short staffing can adversely impact patients by gathering their opinions first and then tracing a clear line to the problem. The study further recommends better healthcare policies so that the problem of short-staffing can be solved.

Method Of Study

Before exploring the methods employed by the studies, a brief explanation of qualitative research is necessary as both studies employ it. Qualitative research focuses on the “Why” of the problem and seeks truth by conducting in-depth research on the problem. In nursing, qualitative research focuses on the experiences of the patients and nurses, as well as chronic illnesses and experiences. Penoyer used nursing literature between the years of 1998 and 2008. This literature was used to find the studies that focused on patient outcomes and nurse staffing conducted in critical care units. Irrelevant and redundant articles were ignored, but the works referenced in relevant articles were also reviewed. The experiences of patients and nurses were also analyzed to find a common problem that was causing these negative experiences. The strength of this study was that it analyzed the data extensively; however, the limitation of this study was that it only focused on the previous works, and no new research was conducted for comparison.

The method employed by Aiken et al. was to first gather patients’ experiences, which were collected through surveys and interviews. These were then analyzed to determine the common problem causing patient dissatisfaction. The reason was determined to be inadequate care provided by the nurses. A group of nurses was interviewed, and through their experience, it was determined that short staffing not only affected the patients but also harmed the nurses. This was due to nurse burnout, which was caused by inhumane work conditions. The strength of this study is that it uses unique data that was not available before, allowing the researchers to conduct extensive research on the topic. The limitation of this study was that some variables needed to be omitted, and there was a possibility that these variables could have contributed to the study’s results.

Results Of Study

The results yielded by Penoyer’s study concluded that there is a relationship between nurse staffing in the intensive care unit and patient outcomes. The study by Aiken et al. provided results that proved that there is a strong relationship between patients’ perceptions of hospital care and missed nursing care. This is, in turn, related to poor staffing and poor hospital work environments. Both studies imply that if adequate nurse staff is employed, then patient outcomes can be improved.

Ethical Considerations And Conclusion

Penoyer used existing data in the study, so no ethical boundaries were breached. Aiken et al. interviewed patients and nurses, so there was an ethical dilemma of identity, which the group solved by keeping the identities of participants anonymous. Through analysis of these studies, it can be concluded that if the nurse staffing is done properly, then the patient outcomes can be drastically improved. This will also prevent deaths that could have been avoided, and it will also improve the working conditions of the nurses, who also need to be healthy both mentally and physically to provide proper care.

References

Aiken, L. H., Sloane, D. M., Ball, J., Bruyneel, L., Rafferty, A. M., & Griffiths, P. (2021). Patient satisfaction with hospital care and nurses in England: An observational study. BMJ Open, 8(1), e019189. https://doi.org/10.1136/bmjopen-2017-019189

Penoyer, D. A. (2010). Nurse staffing and patient outcomes in critical care: A concise review. Critical Care Medicine, 38(7), 1521–1528; quiz 1529. https://doi.org/10.1097/CCM.0b013e3181e47888