Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in t

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Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question

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).

Research Critiques

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.

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in t
Running Header: Nurse Shortage Joseph 1 COVID-19 and the Nursing Profession Jessy Joseph Grand Canyon University Introduction While the importance of a strong public healthcare systems has been highlighted for years, the COVID-19 crisis has added a sense of urgency to these needed reforms. This pandemic has highlighted several fractures within the healthcare system. With these issues gushing in indiscriminately, nurses seem to be at the helm. For instance, shortage of testing and supplies, lack of contact tracing, extended home stays, burnout of nurses, overwhelmed hospitals and managing the crisis using personal protective equipment. Nurses have been frontline in caring for COVID-19 patients, as well as in prevention, education, and other preventative health measures to slow the spread of disease, however with many hospitals facing the issue of under staffing, patient safety and care quality have been questioned. This essay will use two qualitative research articles to emphasize the existing issue of nursing shortage in many hospitals across the country and the subsequent consequences such as overload burnouts, patient safety issues and ethical questions. Summary of studies The two articles that will be elaborated in this essay will be “Effects of nurse work environment on job dissatisfaction, burnout, intention to leave” by Nantsupawat A;Kunaviktikul W;Nantsupawat R;Wichaikhum A;Thienthong H;Poghosyan L and” Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction” by Aiken et al. Although these two articles will be the primary source to subjugate the causes, other resources will be also used for rationale. The first article assesses nurse turnover rate and the contributors of nurse shortage such as job dissatisfaction, poor working environment and intention to leave. This study was conducted in Thailand; however, the research has key findings that are similar many research studies done in the United States. Unlike when these studies were conducted, the world now faces the COVID19 pandemic, and this calls for reforms, especially in the nursing sector ever more. The second article assess “the association between patient-to-nurse ratio and patient mortality, failure-to-rescue (deaths following complications) among surgical patients, and factors related to nurse retention” (Aiken et al.). Both these articles address the issues of nurse shortage, the consequences of it and how it affects patient safety as well as care. PICOT After understanding the causes of nurse burnout and consequent shortage, should futhering nursing enrollment be a solution to combating the issue rather than retention in the U.S healthcare system? Both these articles use qualitative research methods that includes cross-sectional analysis of surveyed data collected from nurses in the U.S and a foreign country. Both these research studies describe the predictors of nurse shortage and burnout while describing how this affects the quality of care provided to patients. Additionally, the intervened group are nurses who have faced chronic burnout at workplaces and their comparisons would be nurses from the second research study that admit having a lower nurse-to-patient ratio prevents job dissatisfaction, burnout and lower failure-to-rescue rate for patients admitted with high risks. Method of studies Conventionally, both the studies used cross-sectional surveys of their randomly selected samples. The first survey collected data from “1351 nurses working in 43 inpatient units in five university hospitals across Thailand. The participants completed the Practice Environment Scale of the Nursing Work Index, the Maslach Burnout Inventory, and measures of job dissatisfaction and intention to leave. Logistical regression models assessed the association between work environment and nurse-reported job dissatisfaction, burnout, and intent to leave” ( Nantsupawat et al.). These surveys were designed to measure several predictors of nurse turnover. The second research analyzed data from “10 184 staff nurses surveyed, 232 342 general, orthopedic, and vascular surgery patients discharged from the hospital between April 1, 1998, and November 30, 1999, and administrative data from 168 nonfederal adult general hospitals in Pennsylvania” (Aiken et al.). As mentioned earlier, both these methods were practical but had several limitations. These research articles provide support for the predictors of nurse turnover and the subsequent undermined quality of care, however both these studies were conducted in a time when COVID19 didn’t exist. The results of the studies can help create reformations but might not be prevalent to the current needs of the healthcare system. Results of the studies and Ethical consideration. Results from the first study measured that after adjusting an additional patient per nurse, there was about 7% increase in patient mortality (i.e, increase in the likelihood of dying within 30 days of admission) and a 7% increase in the odds of failure-to-rescue. Furthermore, an additional patient per nurse caused 23% increase in odds of job dissatisfaction and burnout. As for the second research, though many numbers were not disclosed, the results mentioned “Nurses working in university hospitals with better work environments had significantly less job dissatisfaction, intention to leave, and burnout.” (Nantsupawat et. Al.). Additionally, the studies didn’t hinder with any ethical standards of conduct, was truly based on opinions from practicing nurses. However, the measures also indicated that surveys conducted in high-risk patient sector such as those after surgery might have been a stressful environment to begin with, thus a lower nurse-to-patient ratio alone cannot provide for improvement for the patient mortality rate. Conclusion The COVID-19 pandemic has made clear that our care delivery systems are fractured and lack an effective, coordinated response to population health crises. Nurse shortage issue must be handled with high priority as nurse burnout and turnover rates can greatly affect the healthcare system during the pandemic. A solution to this issue would be hiring more new grad nurses thus funding would not be an issue and hence reduce the patient-to-nurse ratio. Nurses have a unique perspective on and expertise in managing infectious disease outbreaks, mitigating health inequities, addressing social drivers of health, and designing innovative, patient-centered care delivery models. These capabilities are critical now, more than ever to reforming a better health care system. is the most important profession that contributes to the overall growth of health and will tinue to exist as it is, thus it is important to continuously monitor its impact and growth. References: Aiken LH;Clarke SP;Sloane DM;Sochalski J;Silber JH;. (n.d.). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12387650/ Nantsupawat A;Kunaviktikul W;Nantsupawat R;Wichaikhum OA;Thienthong H;Poghosyan L;. (n.d.). Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27882573/
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below. PICOT Question Revise the PICOT question you wrote in t
QUANTITATIVE RESEARCH CRITIQUE PAPER JESSY JOSEPH GRAND CANYON UNIVERSITY Introduction Nurses are among the essential careers today since it involves saving lives and promoting the overall wellbeing of society. Thus, without appropriate nursing practices, even economies would not grow without healthy people. However, nurses are exposed to different challenges while at their duty of work which affects not only their performance but also productivity. The current problem affecting nurses not only in the US but also in other parts of the world is nursing shortages. This has led to the present practitioners being overwhelmed with work and having to work overtimes. This leads to job exhaustion and burnouts since the workloads for the already existing nurses is high. Some states have developed regulations about the nurse-to-patient ratio, which may not be practical due to inadequate finances and licensed nurse shortages. For this paper, I will be analyzing two Quantitative articles which have explored the issues of nursing shortages and how they have overwhelmed the existing practitioners and which interventions may be assumed. I will further analyze the importance of teamwork and how it can reduce burnouts in instances where nurses are overwhelmed by work. The core aim of these articles is to understand what may be implemented to improve job satisfaction of the licensed nurses and how burnouts may be reduced due to increased workloads. This paper will give the background information of the two studies, the study method, results and outcome comparison. The background of the study The authors of the two articles conducted a quantitative analysis method when trying to solve job dissatisfaction, high nurse turnouts rated and burnouts that arise from nursing shortages and increased patients who require urgent and holistic care. The first article was authored by “Montgomery, A., Spânu, F., Băban, A., & Panagopoulou, E. in 2015.” Who have explained burnout to be psychological reactions which arise when a person’s characteristics are blended with their jobs? Satisfaction at the job can be solved by communication, accuracy and efficiency; thus, promoting communication will ensure the quality of care increases gradually. This research used a JD-R approach to understand hoe burnouts affects the overall performance of nurses, especially on their team working skills. The aim of this research was testing the results of increased workloads, depersonalization and emotional exhaustion among professional nurses. The research question was “does the job demand have any effect on emotional exhaustion and depersonalization. The subjects sampled include 24 therapists, nurses, social workers and patient care assistants to evaluate their satisfaction, safety and efficiency. The second study was developed by Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J. in 2015. to understand and evaluate the patient and family-centered use of SIBR “bedside interdisciplinary bedside rounds” when careering for the elderly patients. The problem addressed how nursing satisfaction affects retention and leads to improved communication between patients and their colleagues. The research question was “does communication, workloads and organizational demands improve teamwork and job satisfaction?” How this study supports nursing practices Gausvik, C., in 2015 indicates that for nursing practices to be successful, communication, teamwork, proper nurse to patient ratio is essential. Additionally, improvement of communication among interdisciplinary teams is crucial in facilitating and improving the hierarchical orders. It also ensures coordination and ideas are flowing from all team members, thus promoting satisfaction. This study is essential in answering my PICOT question about how the nursing shortage problem can be solved despite the current issue, where we have a few registered nurses all over the US. Teamwork can ensure that the few available nurses can distribute various activities evenly between themselves. Additionally, interdisciplinary rounds have positive impacts on job satisfaction despite people being positively overwhelmed. Nurses will be able to raise their opinions, questions and concerns during the rounds based on their working conditions or how culture in a hospital may be adjusted to make them more satisfied. My project on the shortage of nurses is highly related to the research carried about on the group used for bedside nurses. According to Montgomery, A., in 2015, several stressors will keep affecting nursing practitioners due to increased need for holistic care, high healthcare costs, implementation of regulations etc. however, this can be partially solved through team working where nurses will rarely get stressed when working together while supporting one another. Thus; the articles are essential in helping me answer my PICOT question which engaging various medical experts in trying to reduce burnouts resulting from many assigned responsibilities. This article understands the importance of team working and improved communication. The methods of study Montgomery, A., in 2015applies a correlational design to understand how different variables are related throughout the study. Some variables include nurse’s workload, burnouts, emotional and organization demands. The researchers then try to investigate whether increasing one variable will reduce the other one through correlational designs. Based on the results, the correlation was positive since teamwork was positively related to nurses being engaged. The major limitation of applying this method is that causation is not shown. On the other hand, Gausvik, C., in 2015 applies an experimental design to understand the effects of communication on one’s satisfaction, thus reducing the turnout rates. This design is being called true experimentation since its aim is understanding the causes and consequences of a single variable in the study. The core benefit of this method is that it is simple and straightforward. The weakness is that the researcher has to follow the set ethical protocols keenly. The results of the study According to a study by Montgomery, A., in 2015, it was established that there is a positive correlation between job demand and burnouts. Additionally, there was a negative correlation between burnouts and team working among the members. Based on the two articles’ regression analyses, it was established that organizational and emotional demands had a high priority in determining the vigor. 96% of the participants accepted that nurses working as teams reduced job dissatisfaction levels and burnouts. While in Gausvik, C., in 2015 when answering about communication, nurses argued that it was essential in improving teamwork and satisfaction. 85% of Nurses also agreed that the most reasons for leaving their jobs included; overwhelming jobs, high nurse to patient levels, burnouts and poor communication. However, team working was essential in alleviating the problems faced compared to working alone, according to the details collected from 38 control and 24 SIBR staff, where 96% of them agreed with the team working. In contrast, 100% agreed that bedside rounds increased their levels of job satisfaction. The outcome comparison My expected result anticipated outcome is that the bedside nurses working as a team often experience lower dissatisfaction and burnout compared to those that have implemented a to-do list or fixed schedule. This implies that despite the number of registered nurses being relatively lower, appropriate communication channels can eliminate burnouts and other challenges nurses face. The results from the two analyzed articles are aligned to my thoughts since proper communication and teamwork is an essential sept in reducing nurse’s distress. This further implies that the hospital management should develop steps to improve communication while addressing the nurse to patient ratios, enhancing the overall nurse and patient satisfaction, thus increasing the hospital’s reimbursement from ACA. Conclusion In conclusion, working as a healthcare practitioner requires a highly ethical, moral resilient and hardworking individual. Nurse’s emotional state highly determines whether a patient will heal or not. Additionally, almost every hospital is understaffed due to low numbers of licensed nurses, leading to increased workloads among the current practitioners. References Montgomery, A., Spânu, F., Băban, A., & Panagopoulou, E. (2015). Job demands, burnout, and engagement among nurses: A multi-level analysis of ORCAB data investigating the moderating effect of teamwork. Burnout Research, 2(2-3), 71-79. doi:10.1016/j.burn.2015.06.001 Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J. (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, and understanding of care plan and teamwork as well as job satisfaction. Journal of Multidisciplinary Healthcare, 33. doi:10.2147/jmdh.s72623

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