Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.
Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.
The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).
In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.
The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.
Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.
Proposed Evidence-Based Practice Change
Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Quantitative and Qualitative studies
Quantitative and Qualitative studies
Instructor Full Name
Quantitative and Qualitative studies
The qualitative study by Cho & Han (2018) aims to establish whether there is an association between the work environment of the nurse to the individual’s behaviors that promote their health and the impact it brings to their performance. The research uses a qualitative cross-sectional design to collect data from the nurses through a questionnaire. The indicators measured were the quality of nurse performance, the quality of the work environment, and health promotion behaviors. The research is significant with its findings that justify the impact of quality nurse leadership on nurses’ health responsibility. Nurses with more convenient and proper staffing have better work spirit and high-quality performance.
Another qualitative research by Van Bogaert et al. (2017) uses an explanatory type of sequential design with different phases. The qualitative study analyzes the qualitative data based on the semi-structured interviews and another qualitative analysis to interpret the results. The research used practice environments and work characteristics to estimate the chances of occurrence of burnout, followed by the establishment of the nurse’s experience with the workloads. The key themes evident are that interdisciplinary collaboration, communication, and the nurse’s teamwork are essential to balance the workload that exists. Nurses’ workload has a significant impact on patients since nurses focus less on patients and the changes that occur in patients.
In the quantitative research by Haegdorens et al. (2019), the improved nursing staff is highly likely to cause a reduction in mortality rates in hospitals. The research applied the stepped wedge form of randomized research, which enabled them to acquire feedback from patients admitted to various wards and conducted composite mortality measures for the unexpected and expected feats in the hospitals. The research checked on regular four-month patient admission across wards and the number of nursing hours spent with the patients. According to the research, there is a high association between the staffing levels of the nurses and the mortality rates, such that high staffing caused a reduction in mortality rates.
Finally, the quantitative study by Huang et al. (2021) studied the prevalence of poor sleep qualities among nurses working on shifts and the effects of the shifts lengths on their outcomes. The research variables were expressed by using median and interquartile ranges to discover the association between these shifts and the sleep in nurses. A total of 1246 nurses participated with consent, although only 686 were involved in the analysis. Poor sleep was reported in many of the nurses. Increasing the supply of more fresh nurses and allocating more resources were recommended as the proper methods to solve the problems and impacts caused by long shifts and night shifts.
How the Findings Relate to the Nurse Problem Issue
PICOT QUESTION; does the level of nurse staffing affect the quality outcomes among the patients and nurses comparing nurses who have many workloads compared to those with small workloads in one month?
The picot question highlighted above is a combination of the quantitative and the qualitative research findings, and in different ways, the resources provided for reference provide answers to different approaches. Haegdorens et al. (2019), in their quantitative research, confirm that, indeed, nurse staffing is highly relatable to the rates of mortality in the healthcare organization. They establish that the higher the nurse staffing levels, the lower the chances of mortality in those hospitals because the work environment is made friendly, and the patient outcomes become quality in patients and surgical wards within the healthcare facility. This study is concurrent to the picot question and indicates the effects of proper nursing staffing on the level of patient outcomes. In many instances, increased mortality indicates poor hospital conditions, such that a reduction in mortality indicates that the efficacy of care delivery increased with higher staffing levels.
In their quantitative study, Huang et al. (2021) indicate that the nurses who perhaps stay at work for quite long hours and those who serve night shifts have sleeping problems associated with injuries. However, the main recommendation in this research is that when the number of nursing staff is increased, and more resources are allocated for the patients and nurses, then the impacts of night shits will reduce. Their findings show that quality outcomes are higher in nurses whenever the staffing is at a better level.
The study by Cho & Han (2018) relates the nurse staffing; levels and the type of outcomes expected among the nurses and patients. According to the finding, the nurses who work with colleagues in environments where staffing is at a reasonable level, there is a high chance of developing more quality outcomes for their patients(). That will reduce the chance of mortality because the quality outcome recorded is higher. These findings answer the cost question that nurses who work in sufficient environments do not experience poor health outcomes or patient outcomes, hence the need to adopt high-level staffing.
Finally, Van Bogaert et al. (2017) compare nurse participants in medical, surgical, and maternal wards. They indicate that the lengthy and demanding workloads in the facilities impact the quality outcomes of nurses on a negative dimension. The nurses could experience exhaustion such as headaches and ineffectiveness hence extending the impact to poor outcomes in the patients. The research used in this context is directly related to the PICOT questions. Although the research methodologies and findings may seem different, the baseline is that nurse staffing affects the outcomes of nurses and patients. Higher staffing levels have had better outcomes than lower levels of nurse staffing.
Methods of Study
In the first two qualitative types of research, Cho & Han (2018) use a cross-section design, whereby information was gathered through questionnaires distributed to 432 nurses. While the variable measured was the quality of performance of the nurses, their work environments, and individual behaviors that promote health. While Van Bogaert et al. (2017) used a sequential research design focused on sei structured interviews of the nurses. Although initially quantitative, the research was qualitatively curated in subsequent stages. Nurses involved in patient care on various units were involved, and data was analyzed using descriptive phenomenology. Haegdorens et al. (2019) study the impacts that rapid response infrastructure cause on patient morbidity. The data collected focused on mortality, unexpected death rates, and unplanned administration of ICUS and CPR. Huang et al. (2021) used a particular cross-sectional survey that maintained self answered questionnaires with information about shifts that were asked and related to the nurse’s staffing and outcomes. The methods are different in their design and the information used to conclude. Because while Huang et al. (2021) focus on the impacts of shifts concerning staffing, others, such as Van Bogaert et al. (2017), investigate the outcomes on nurses in terms of burnout and work engagement. All the methods used were quality and only differed in data analysis and focus components of data.
Results of Study
According to Haegdorens et al. (2019), wards with more nursing hours per patient day had lower rates of unexpected deaths. They also have lower CPS or deaths caused by CPR. The NHPPD and hospital mortality rates had a significant inverse relationship. Patient mortality was linked to increased nursing workload, which was linked to fewer nursing staff. Huang et al. (2021) study .’s had a total of 1246 research participants with fully completed questionnaire consent. There were 686 nurses in the study, and their smoking and drug use rates were lower. Hyperlipidemia was more common. Sleeping pills were widely used, but there were no discernible differences in sleep duration or habits. Other researchers had previously discovered that more than half of the nurses slept poorly.
According to Cho and Han, most survey respondents were under 30, and a quarter worked at CCU (2018). Unmarried people account for 44% of survey respondents (Cho & Han, 2018). Burnout was highest in perioperative and general ICUs in this study. These findings confirm the premise that more fatalities increase the stress on nurses because these wards seldom see their patients recover sufficiently to be discharged, so the nurses must devise coping strategies. A poll of female nurses provided more evidence. Adjusting for workplace stress, nursing-related job experience, and social support did not diminish the impact of affective-oriented coping in predicting depressive symptoms (Cho & Han, 2018). Coping training has been shown in studies to minimize burnout. Burnout was also associated with age, marital status, education, and industry experience. Young, inexperienced nurses might explain these findings. Having too many duties increases coping and problem-solving abilities. According to Van Bogaert et al. (2017), organizational results and healthcare quality discrepancies tired 63% of nurses. Cell-level nurse administration predicted job results by 25% to 36%, workload predicted job outcomes by 12-13%, and personal achievement and detachment predicted job outcomes by 20% to 23%. According to the researchers (Van Bogaert et al., 2017). The themes uncovered through theme analysis included everyday practice and workplace structure, cross-disciplinary cooperation, and communication and collaboration. According to Wills & Kelly, (2017), burnout impacts work performance and patient care. When establishing workloads, physical and mental nursing requirements were taken into account. Long and hard shifts resulted in fatigue, headaches, ineffectiveness, a lack of incentives, and despair and depression among nurses (Van Bogaert et al., 2017). These impact both the nurse and patient outcomes within the entire unit.
Concepts serve as a compass for directing the design and execution of research. Researchers are responsible for doing research that is relevant, ethical, and respectful of human rights. First and foremost, ensure that the outcomes are appropriately communicated (Leppink, 2017). Discoveries in the scientific community founded on truth inspire both confidence and credibility. The most significant ethical problems relate to instances of plagiarism and the manipulation of data. Both sorts of studies use their original research and systematic reviews that contain citations. In the second piece of the study, participant identities are kept secret to emphasize confidentiality. The participants’ privacy is protected when the data are anonymized. There was complete agreement among all of the participants on the findings.
An ethical committee must provide its stamp of approval to any study. Under the authority, permission was given to the hospital administration and each intensive care unit participant. Everyone who took part in the study was advised that they might withdraw from the study without anyone finding out about it (Cho & Han, 2018). The most recent publication contained qualitative research approved by both the review panels of each institution and an ethical review board which ensured compliance and effectiveness.
Outcomes and comparison
The PICOT question wanted to answer if nurses’ staffing affects the quality outcomes among the patients and nurses, focusing on the levels of workload that nurses are exposed to. Furthermore, in every study, their outcomes and findings, as well as the conclusion, imply that nurse staffing levels are directly associated with the level of outcome sin patients and nurses. Some researches involve mortality rates. Some involve the quality of sleep, while others involve predictors for burnout and the long shifts, all of which are related to the level of nurse staffing in various hospitals. The anticipated outcome for the PICOT questions have been achieved; from the presented research, there is a direct impact on how staffing is associated with outcomes; for example, hospitals with a higher level of staffing and resource had quality incomes as opposed to those with low staffing and lower resources. Hence, the achievement of the anticipated outcomes and discovering that more resource allocation is directly proportional to an increased number of nurses and leads to quality outcomes among nurses and patients.
Cho, H., & Han, K. (2018). Associations among nursing work environment and health-promoting behaviors of nurses and nursing performance quality: A Multilevel Modeling Approach. Journal of Nursing Scholarship, 50(4), 403–410. https://doi.org/10.1111/jnu.12390
Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: An observational multicentre study. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4688-7
Huang, Q., Tian, C., & Zeng, X.-T. (2021). Poor sleep quality in nurses working or having worked night shifts: A cross-sectional study. Frontiers in Neuroscience, 15. https://doi.org/10.3389/fnins.2021.638973
Leppink, J. (2017). Revisiting the quantitative–qualitative-mixed methods labels: Research questions, developments, and the need for replication. Journal of Taibah University Medical Sciences, 12(2), 97–101. https://doi.org/10.1016/j.jtumed.2016.11.008
Van Bogaert, P., Peremans, L., Van Heusden, D., Verspuy, M., Kureckova, V., Van de Cruys, Z., & Franck, E. (2017). Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: A mixed method study. BMC Nursing, 16(1). https://doi.org/10.1186/s12912-016-0200-4
Wills, J., & Kelly, M. (2017). What works to encourage student nurses to adopt healthier lifestyles? findings from an intervention study. Nurse Education Today, 48, 180–184. https://doi.org/10.1016/j.nedt.2016.10.011
Quantitative and Qualitative studies