NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Name

Capella university

NURS-FPX 8045 Doctoral Writing and Professional Practice

Prof. Name

Date

Synthesis of Evidence Highlighting a Practice Gap

Nursing shortages represent a critical gap in healthcare practice, notably at Lima Memorial Hospital (LMH), where they directly threaten patient safety. Recognizing and addressing these gaps is essential for designing effective quality improvement strategies. This assessment critically examines the nursing shortage as a pivotal practice gap by integrating findings from recent scholarly research to enhance understanding and guide interventions.

Review of Key Research Articles

Recent studies underscore multiple dimensions of the nursing shortage problem, reinforcing the necessity for focused solutions. Tamata and Mohammadnezhad (2023) conducted a meta-analysis revealing that poor workforce planning, ineffective policies, inadequate nurse training, and unfavorable work environments significantly contribute to high nurse turnover rates. Their review, spanning over a decade of research, highlighted that 10.4% of studies linked insufficient training for newly recruited nurses as a major factor exacerbating shortages.

Peutere et al. (2024) explored the consequences of understaffing, finding a 20% increase in inadequate nurse staffing associated with a 1.05-fold higher risk of patient mortality, demonstrating the dire implications of nursing shortages on patient outcomes. Similarly, Suprapto et al. (2023) emphasized the role of staff development programs in improving nurse job satisfaction. Their quantitative study reported nurses who underwent training were 1.79 times more satisfied, which correlated with enhanced quality of care.

Lasater et al. (2021) investigated the impact of excessive nurse workloads due to understaffing, reporting a 16% increase in patient mortality linked to increased nurse stress and emphasizing the critical need for appropriate nurse-to-patient ratios. Wei et al. (2023) further analyzed how nurses’ engagement and job satisfaction influence retention, with 59.4% of respondents expressing substantial job satisfaction, thus supporting nurse retention efforts that mitigate shortages.

Critical Analysis of Selected Studies

The persistent nursing vacancies and understaffing challenges are well-documented across the literature. Tamata and Mohammadnezhad (2023) utilized the Johns Hopkins Evidence-Based Practice Model (Category 1) in their systematic review, highlighting that poor policy frameworks and lack of nurse training directly lead to increased burnout and turnover. Their rigorous data synthesis bolsters the credibility of these findings and underlines the need for strategic workforce planning.

Peutere et al. (2024), employing a longitudinal register-based approach (Category 3), examined the linkage between nurse staffing deficits and patient mortality. Their mixed-effects survival model analysis, based on administrative hospital data, offers robust evidence on how nursing shortages translate into worse patient outcomes, including extended hospital stays and increased deaths.

In addressing workforce sustainability, Suprapto et al. (2023) used an analytical observational design (Category 3) to demonstrate that professional development and supportive work environments significantly enhance nurses’ job satisfaction and retention, which in turn improve care quality. Their findings advocate for continuous training and organizational support to maintain nursing capacity.

Lasater et al. (2021) focused on the effects of nurse workloads and staffing ratios on patient safety using multilevel logistic regression models (Category 3). Their findings strongly support legislation mandating safe nurse staffing ratios to reduce adverse patient outcomes and lower hospital costs.

Wei et al. (2023), guided by Convergent Care Theory and employing a quantitative correlational design (Category 3), explored how nurse engagement and satisfaction affect turnover intentions. Their conceptual model revealed that positive workplace culture and teamwork improve job satisfaction and care quality, reducing nurses’ intent to leave.

Synthesis of Literature Using MEAL Framework

Collectively, these studies reveal multifactorial contributors to the nursing shortage at LMH, including policy deficiencies, inadequate training, heavy workloads, and poor working conditions (Lasater et al., 2021; Peutere et al., 2024; Tamata & Mohammadnezhad, 2023). Effective interventions highlighted include professional development, supportive organizational culture, and enforcing appropriate nurse-to-patient ratios to reduce burnout and improve retention (Suprapto et al., 2023; Wei et al., 2023). The integration of various methodologies—systematic reviews, quantitative analyses, and observational studies—provides a comprehensive understanding and validates the need for multifaceted solutions informed by relevant nursing theories and frameworks.

Writing Improvements Based on Feedback

The revised assessment clarifies complex concepts by reducing jargon and improving logical flow using the MEAL (Main idea, Evidence, Analysis, Link) plan for each paragraph. Attention to grammar, sentence structure, and coherence enhanced the overall readability and professionalism. Incorporating feedback on sourcing from reliable databases like CINAHL, PubMed, and Google Scholar strengthened the evidence base. Utilizing Capella Library resources further improved research depth and writing quality.

Conclusion

In summary, the critical evaluation of contemporary literature confirms that the nursing shortage at LMH represents a significant practice gap adversely affecting patient safety. Addressing this gap requires comprehensive strategies encompassing enhanced nurse training, retention initiatives, and supportive workplace policies. Implementing evidence-based actions informed by this assessment can substantially improve patient outcomes and mitigate nursing shortages at LMH.

References

Lasater, K. B., Aiken, L. H., Sloane, D., French, R., Martin, B., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: An observational study. British Medical Journal Open, 11(12), e052899. https://doi.org/10.1136/bmjopen-2021-052899

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Peutere, L., Pentti, J., Ropponen, A., Kivimäki, M., Härmä, M., Krutova, O., Ervasti, J., Koskinen, A., & Virtanen, M. (2024). Association of nurse understaffing and limited nursing work experience with in-hospital mortality among patients: A longitudinal register-based study. International Journal of Nursing Studies, 150, 104628. https://doi.org/10.1016/j.ijnurstu.2023.104628

Suprapto, S., Lalla, N. N., Mulat, T. C., & Arda, D. (2023). Human resource development and job satisfaction among nurses. International Journal of Public Health, 12(3), 1056-1063. https://doi.org/10.11591/ijphs.v12i3.22982

Tamata, A. T., & Mohammadnezhad, M. (2023). A systematic review study on the factors affecting shortage of nursing workforce in the hospitals. Nursing Open, 10(3), 1247-1257. https://doi.org/10.1002/nop2.1434

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Wei, H., Horsley, L., Cao, Y., Haddad, L. M., Hall, K. C., Robinson, R., Powers, M., & Anderson, G. D. (2023). The associations among nurse work engagement, job satisfaction, quality of care, and intent to leave: A national survey in the United States. International Journal of Nursing Sciences, 10(4), 476–484. https://doi.org/10.1016/j.ijnss.2023.09.010

Appendix

Citation	Conceptual Framework	Design/Method	Sample/Setting	Major Variables Studied and their Definition	Measurement	Data Analysis	Findings	Appraisal: Worth to Practice
Lasater et al., 2021	Not specified	Observational study, cross-sectional evaluation of multiple data sources including a 2020 nurses survey, Medicare, and American Hospital Association (AHA) data	210,493 Medicare patients aged 65+ hospitalized at research hospitals; 1391 licensed nurses in medical-surgical units; 87 acute care hospitals in Illinois	Patient outcomes (mortality, hospital stay, cost); hospital variables (number of beds, size)	Not specified	Descriptive statistics; STATA; Multilevel random-effects logistic regression; zero-truncated negative binomial regression models	Patient-to-nurse ratios ranged 4.2 to 7.6. Each increase in nurse workload raised 30-day patient death risk by 16%; hospital stay increased 5% per nurse job stress increase.	Strength: Observational cross-sectional study highlights nurse-to-patient ratio importance. Limitations: Underrepresentation of small hospitals; no causal claims. Ranking: Category III Validity: Yes Reliability: Yes Applicability: Yes Overall rank: High
Peutere et al., 2024	Not specified	Longitudinal study	480,000 patients; ~8000 nursing staff from 40 of 44 clinical and surgical units; hospital district of Finland	Relationship between nurse shortage, insufficient nurse experience, and patient deaths	Nurse understaffing measured via payroll-based shift planning data; understaffed days = <90% median nursing hours	Mixed-effects survival models	1.5% hospitalizations ended in death; nurse shortage led to 20% rise in hospital stays and 1.05-fold increase in patient death risk	Strength: Large longitudinal dataset over 7 years. Limitations: No theoretical framework; follow-up only inpatient-focused; limited agency staff data. Ranking: Category III Validity: Yes Reliability: Yes Applicability: Yes Overall rank: High
Suprapto et al., 2023	Nurses’ development model	Quantitative, cross-sectional analytic observational approach	136 nurses from X Makassar Hospital, Indonesia, selected via probability sampling	Independent: training, administrative support, collaboration, HR administration, service culture; Dependent: job satisfaction	Questionnaire (Likert scale) and interviews	Univariate and bivariate analysis, Chi-square test, cross-tabulation	Training most influences nurse job satisfaction; trained nurses 1.79 times more satisfied than non-specialized nurses	Strength: Quantitative research. Limitations: Results not generalizable; multiple instruments may fatigue respondents. Ranking: Category III Validity: Yes Reliability: Yes Applicability: No Overall rank: Moderate
Tamata & Mohammadnezhad, 2023	Not specified	Quantitative descriptive method with PRISMA flow diagrams	Not applicable	Regulatory/planning obstacles, training barriers, nurse stress, burnout, turnover	Qualitative thematic analysis	Thematic analysis, key theme identification	Factors include poor planning, policy, lack of social support, workload, low satisfaction, all contributing to understaffing	Strength: Assists policymakers in addressing nurse workforce deficit. Limitations: Possible publication bias; limited quality control. Ranking: Level I Validity: Yes Reliability: Moderate Applicability: Yes Overall rank: Moderate
Wei et al., 2023	Convergent Care Theory and Conceptual Model	Quantitative descriptive correlational study; nationwide cross-sectional survey of US registered nurses conducted online	900 US registered nurses (specialty certified or not), across the USA	Nurse job satisfaction, perceived quality of care, intent to leave	Utrecht Work Engagement Scale, demographic data, work fulfillment questionnaires	IBM SPSS; independent t-tests, ANOVA, Chi-square, multiple linear regression	79.2% nurses certified; 59.4% high job satisfaction; 82.2% good perceived care; 28.4% intend to leave next year; engagement positively linked to satisfaction and care, negatively to intent to leave	Strength: Correlational study on relevant variables. Limitations: Self-selection bias; online self-report bias; skewed sample; interpretation difficulty. Ranking: Category III Validity: Yes Reliability: Yes Applicability: Yes Overall rank: High