Nurse Staffing Article Critique Questions
Question 1: Introduction
The authors of this article have various nursing qualifications that make them competent to carry out an investigation on the given topic. Sung-Hyun Choo is a registered nurse with a doctoral degree in nursing. Barbara A. Mark is a registered nurse with a doctoral degree in nursing, and he also possesses the Fellows of the American Academy of Nursing (FAAN) qualifications. George Knafl has a doctoral degree in nursing, Hyoung Eun Chang is a registered nurse with a Masters degree in Public Health, and Hyo-Jeong Yoon is a registered nurse.
The current study is an empirical quantitative research that examines how nurse staffing and experiences of patients are related as well as how missed nursing care affects this relationship. The variables in the study therefore are; nurse staffing, experiences of patients, and missed care by nurses. The study population comprises of patients, nurses, and nurse managers.
The purpose of the study is to assess the relationship between experiences of patients and nurse staffing and to find out the mediating impact that missed care has on this relationship. The researchers have used a correlational study design to carry out their research. The study is based in South Korea. A total of 208 patients and 362 nurses have been sampled from 23 treatment units in six health care facilities in the region.
Nurse staffing has been measured based on the manner in which patients and nurses perceive nursing adequacy as well as on patient-to-nurse ratios. Experiences of patients has been measured using the occurrence of adverse events, the way patients communicate with nurses, and on how patients rate the health facilities. The researchers have used the MISSCARE Survey-Patient that contains three domains to measure missed care as reported by patients.
There are two key findings in this study. First, the researchers have found that there is a significant relationship between patients’ perceptions of nurse staffing adequacy and patients’ experiences as well as missed care as reported by patients. Second, missed nursing care as reported by patients mediates the relationship between experiences of patients and nurse staffing.
Question 2: Research Problem and Purpose
The problem statement for this study states that, “In light of the increasing emphasis on patients’ perceptions and experiences, research on the relationships among nurse staffing as assessed using empirical and perceptual measures, patient-reported missed care, and patients’ experiences is expected to enhance our understanding of how nurses and nursing care contribute to patients’ experiences (p. 348).”
The purpose statement of the study states that, “The purposes of this study were (a) to examine the relationship of nurse staffing, as measured by nurse-perceived and patient-perceived staffing adequacy as well as by the patient-to-nurse-ratio, with patient experiences, and (b) to determine the mediating effects of patient-reported missed care on the relationship between nurse staffing and patients’ experiences (p. 348).”
This study is significant in the sense that, it will help the health facilities in South Korea to understand how patients perceive nurse staffing as well as the main factor that contributes to missed nursing care. This study is relevant to nursing because its findings will help health care organizations to learn that patients’ experiences can be improved and missed care can be reduced by providing appropriate nurse staffing.
The study is feasible to conduct because the researchers possess the right expertise to carry out the research. In addition, the subjects that the researchers can use in the study are readily available, and the health care facilities from where the study participants can be obtained are easily accessible.
Question 3: Review of the Literature
The three major topics listed in the review of literature include; the relationship between nurse staffing and patient outcomes, the effect of missed care on nursing quality and patients’ outcomes, as well as the measurement of nurse staffing.
Two models have been identified in the review of the literature. The first theoretical model assumes that negative patient outcomes and high rates of missed nursing care are attributed to inadequate nurse staffing. The second model states that patient’s experiences, as well as the way patients perceive missed care, are directly affected by nurse staffing.
The review of literature perfectly describes current knowledge of the research problem because it describes what other researchers have written about the study topic as well as the gaps that new studies should fill. In addition, the review if literature has mainly focused on articles published between 2008 and 2016.
The studies reviewed in the review of literature have been summarized based on the way they address the relationship between nurse staffing and patient outcomes, as well as in the way they describe the association between missed care and nursing quality. The studies have also been summarized based on the way they describe how nurse staffing should be measured.
Question 4: Study Framework
The authors have explicitly described the study’s framework and their description leaves no doubt to the reader. This description can easily be followed by someone else who did not conduct the study.
The important concepts found in the study’s framework include the samples used in the study and how they have been obtained, the measures that have been used to study the performance of variables, the methodology used to collect data, as well as how the collected data has been analyzed.
The framework presents the relationship among the major concepts of the study. For instance, the data collection process indicates how information has been obtained from nurse managers, nurses, and patients that were selected at the sampling stage.
Question 5: Research Objectives, Questions, or Hypotheses
This article has clearly stated the study objective which also serves as the study purpose. However, the researchers have not pointed out clearly whether there are specific research questions or hypotheses being addressed.
The article’s objective states that, “The aims of this study were to examine the relationships between nurse staffing and patients’ experiences, and to determine the mediating effects of patient-reported missed care on the relationship between nurse staffing and patients’ experiences (p. 347).”
Question 6: Variables
The major study variables are nurse staffing, experiences of patients, and missed care as reported by patients. Out of the three variables, one of them is an independent variable and two of them are dependent variables. The independent variable is nurse staffing while the dependent variables are experiences of patients and missed care as reported by patients. The performance of the dependent variables is determined by the nature of nurse staffing.
The conceptual definitions of the major variables have been provided in the study. Nurse staffing has been defined by the number of nurses, patients’ experiences have been defined by patient outcomes, while missed care has been defined by the timely responses to care that patients receive from nurses.
The operational definitions of major variables are explained in the methods section. Nurse staffing has been defined by patients’ perception of staffing adequacy. Patients’ experience has been defined by hospital rating, adverse events, and communication. While missed care as perceived by patients has been defined by basic care and communication.
The author has not identified any extraneous variables used in the study. Demographic variables such as age, gender, and sex of participants have not been specified in the study.
Question 7: Research Design
The research design used in the study is correlational design. This is because the researchers are trying to investigate the relationship between dependent and independent variables as well as how that relationship is affected by one of the dependent variables.
The correlational study design perfectly matches the study objective because it allows the researcher to examine how nurse staffing and experiences of patients are related as well as how missed nursing care affects this relationship. Its effectiveness is answering the research questions and hypotheses have not been explained because the researchers have not clearly stated the questions and hypotheses that are being addressed by the study. Since the study purpose in this research is the one that acts as the study objective, it can be concluded that correlational research design provides a means to examine the study purpose.
The study includes interventions and this is evidenced by the use of a number of specific measures to examine the performance of variables. For instance, missed care as reported by patients has been examined by using domains such as basic care and communication between nurses and patients. Pilot study findings have been used to design the major study because the researchers have relied on previous study findings to organize their study framework.
Question 8: Strengths and Weaknesses
One of the strengths of the study lies in the use of a large sample size that helps the researchers to minimize bias. The other strength of the study lies in the manner in which the researchers have used a correlational study design that helps them to examine the relationship among variables.
The main weakness of the study is that the findings may not be generalized because the researchers have focused their study in health facilities in Korean context alone without integrating what might happen in other countries. In addition, other patient characteristics which have not been adjusted in the study might have contributed to the observed patient experiences.
Cho, S., Mark, B. A., Knafl, G., Chang, H. E. & Yoon, H. (2017). Relationships between nurse staffing and patients’ experiences, and the mediating effects of missed nursing care. Journal of Nursing Scholarship, 49(3): 347-355.
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