Introduction
It is important to note that medical errors in intensive care units (ICUs) greatly hinder the quality of care, patient satisfaction, as well as patient safety. Whenever a healthcare service is being provided in such clinical environments, the shortage of nurses can severely impact a wide range of metrics, including hospital-acquired infections. The mental and physical well-being of nurses themselves can further exacerbate the situation contributing to the overall stress and development of disorders among the healthcare professionals. The given literature evaluation will primarily focus on thoroughly viewing the issue through qualitative perspectives.
Therefore, the nursing practice problem of concern is inadequate staffing of nurses in ICUs. The purpose of the research and analysis is to assess whether or not having enough nursing professionals in ICUs contributes to the medical error frequencies, patient infections, and disorders, as well as stress among nurses. Nursing shortage undermines patient safety, reduces the quality of care, increases medical errors and infections, and stresses the nurses.
PICOT Question: Does having enough nurses on staff in the ICU (I) in comparison to not having enough nurses on staff (C) (O) decrease medical errors and infections among patients and stress and disorders among nurses (O) within a year (T)?
Background of Studies
The first qualitative study addresses the problem of addressing nursing shortages through nursing staff differentiation and skill mix. It is significant since it seeks to improve the efficient utilization of nursing professionals by maximizing their competency and skill use. The objective is to “understand how licensed vocational nurses (VNs) and nurses with a Bachelor of Science degree (BNs) shape distinct nursing roles in daily practice” (Van Schothorst–van Roekel et al., 2021, p. 1). The research question: In the nurses’ opinion, what elements affect patient safety? In other words, it is about whether or not nursing teams developing new roles is useful in improving daily nursing hospital practice.
The second qualitative study primarily focuses on the issue of patient safety factors from the nurses’ perspective. The significance is manifested in the fact that nurses’ view of the problem can reveal the underlying frameworks under which the professionals operate.
The purpose of the study is to identify the insights as well as the areas to work on when educating nurses on patient safety. The key objective is to “describe nurses’ perspectives on factors affecting patient safety” (Pazokian & Borhani, 2017, p. 76). The research question: Which nursing duties are shaped by the differences between licensed vocational nurses (VNs) and nurses with a Bachelor of Science degree (BNs)? Thus, it is about whether or not nurses’ perception and perspective of ‘Organizational-Based Factors’ and ‘Patient-Centered Care’ reflect the patient safety policies.
How Do These Two Articles Support the Chosen Nursing Practice Problem
The first article will be used to answer the PICOT question by revealing how the new BN nursing roles progressively become integrated into the existing frameworks. Essentially, they are ingrained in new nursing routines, organizational routines, and structural arrangements through an experimental process of action and appraisal by nurses (Van Schothorst–van Roekel et al., 2021). There are no intervention groups since the nurses are studied demographically as well as on the basis of their educational level and type. The comparison groups in the article are four wards, such as neurology, oncology, pneumatology, and surgery (Van Schothorst–van Roekel et al., 2021). The PICOT question will focus on nurse staffing in ICUs, which is why there is no significant overlap between groups of interest, but the insights on shortage-related issues are still relevant.
The second article will be used to answer the PICOT question by highlighting patient safety issues, such as insufficient nursing staffing. There is no intervention group since the study merely describes and analyzes the nurses’ perspective on the patient safety issue. The comparison groups include ICU, CCU, and post-CCU wards, which makes them highly relevant to the PICOT question group, which is comprised of ICU nurses as well (Pazokian & Borhani, 2017). Thus, both studies provide valuable insight into the impact of nursing shortage on nurses’ performance, with the second article having more utility due to its focus on ICU environments.
Method of Studies
The method used in the first article is an ethnographic case study conducted in Dutch hospitals. The key advantage of such a methodological framework is its ability to extract valuable data from a different healthcare context, but case studies can have limited applicability. The second article uses semi-structured interviews and their corresponding transcripts to analyze them in accordance with the conventional content analysis approach. Its benefit is comprehensiveness in understanding the nurses’ perspective in-depth, but it still remains subjective by design. Therefore, the qualitative nature of the studies will need quantitative data to improve the precision and accuracy of findings, such as identifying the match between nurses’ perception with hours worked or medical errors made (González-Gil et al., 2021). The latter makes it important to use a variety of reliable and valid evidence to draw plausible conclusions.
Results of Studies
The first article found that BNs play a crucial role in coordinating the flow of patients between different floors, while VNs typically contribute more to organizing care at the level of the individual patient. There was no difference between VNs and BNs regarding the complexity of care they provide. Both have the knowledge and experience to care for patients with extensive medical requirements. The article revealed how the new BN nursing roles progressively got integrated into new nursing routines, organizational routines, and structural arrangements.
The second article found that nurses’ job satisfaction, motivation, and, ultimately, patient safety are all impacted by staffing levels. Therefore, the key outcome is that staffing levels impact patient care. The findings indicate that “patient-centered care improves healthcare outcomes and improves the quality of care” (Pazokian & Borhani, 2017, p. 78). The nurses are collectively concerned about the treatments’ safety without the addition of new issues, which primarily refer to hospital-acquired infections. Other considerations involve patients’ individual characteristics, organizational infection control, and sufficient staffing.
The implications of the two studies in nursing practice are that nursing professionals across a wide range of contexts are acutely aware of the negative effects of understaffing on patients’ as well as nurses’ well-being. Both studies identify that sufficient staffing is essential to ensure that patients are treated safely and effectively. They additionally conclude that there is no alternative replacement to sufficient staffing of nurses, which implies that the issue is more categorical in the nursing practice context.
Ethical Considerations
It is important to state that the two ethical considerations include voluntary participation and confidentiality. The researchers of the first article state that “participants were informed about their voluntary participation and their right to end their contribution to the study” (Van Schothorst–van Roekel et al., 2021, p. 5). The authors of the second article emphasized the confidentiality of the nurses interviewed, and they were given an informed consent letter.
Conclusion
In conclusion, the nursing shortage is a multifaceted problem with a wide range of implications in undermining patient safety, reducing the quality of care, increasing medical errors and infections, and stressing the nurses. The first article provides an in-depth look into the Dutch system of healthcare and how they approach the nursing staffing issue. The second article is more subjective but comprehensive in reflecting the nurses’ perspective on patient safety and staffing.
References
González-Gil, M. T., González-Blázquez, C., Parro-Moreno, A. I., Pedraz-Marcos, A., Palmar-Santos, A., Otero-García, L., & Oter-Quintana, C. (2021). Nurses’ perceptions and demands regarding COVID-19 care delivery in critical care units and hospital emergency services. Intensive and Critical Care Nursing, 62, 102966. Web.
Pazokian, M., & Borhani, F. (2017). Nurses’ perspectives on factors affecting patient safety: A qualitative study. Evidence-Based Care, 7(3), 76-81. Web.
Van Schothorst–van Roekel, J., Weggelaar-Jansen, A. M. J., Hilders, C. C., De Bont, A. A., & Wallenburg, I. (2021). Nurses in the lead: A qualitative study on the development of distinct nursing roles in daily nursing practice. BMC nursing, 20(1), 1-11. Web.