NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

Name

Capella university

NURS-FPX 8045 Doctoral Writing and Professional Practice

Prof. Name

Date

Synthesis of Evidence Supporting an Intervention

Delivering high-quality patient care is a primary objective in healthcare systems, often challenged by issues such as nursing shortages. Lima Memorial Hospital (LMH) currently faces a critical practice gap in this area. According to the Ohio Nurses Association (ONA), approximately 83.21% of nursing staff have experienced significant turnover, resulting in inadequate staffing levels and compromised patient care services (Ohio, n.d.). This assessment integrates empirical research findings and emphasizes the role of leadership in implementing focused strategies to bridge this gap, ensuring optimal nurse-to-patient ratios and improving clinical outcomes.

Identification of the Practice Gap

Maintaining sufficient nursing staff is fundamental to achieving safe, effective, and patient-centered care. LMH, however, is grappling with a persistent shortage of nurses, representing a notable practice gap. Hospital records indicate that 12% of nursing positions remain vacant, leaving 75 out of 500 certified positions unfilled. Internal surveys highlight that 65% of current staff report feelings of burnout, primarily due to excessive workloads and limited staffing. Nationwide, hospitals in the United States reported a reduction of 100,000 licensed nurses in 2021, a trend contributing to decreased job satisfaction, safety risks, and adverse patient outcomes (Lucy, 2024). Root causes of this shortage include ineffective resource allocation, insufficient strategic planning, flawed recruitment and retention efforts, and gaps in nurse education and training initiatives (Vries et al., 2023). This disparity underscores the urgent need for comprehensive and evidence-based interventions to enhance staffing levels and improve care quality.

Formulation of a PICO(T) Question

A well-constructed PICO(T) question is essential for addressing LMH’s nursing shortage. The following question guides this assessment: In licensed nurses at LMH (P), does implementing an enhanced retention and recruitment policy (I), compared to existing inadequate strategies (C), improve nurse satisfaction and retention (O) over a 12-week period (T)?

This question focuses on interventions such as fostering a positive work environment, providing staff development opportunities, offering competitive compensation, and applying evidence-based hiring and retention policies (Pressley & Garside, 2023). The aim is to improve job satisfaction and retention rates, consequently elevating care standards and patient safety.

Recent research validates the efficacy of strategic recruitment and retention initiatives in mitigating nurse shortages. Peters et al. (2023) emphasized that supportive work environments, targeted training, and motivational incentives substantially increase nurse satisfaction and retention, aligning with contemporary staffing policy frameworks. Implementing such interventions signals a significant shift toward sustainable and effective healthcare delivery.

The proposed intervention falls within the scope of a Doctor of Nursing Practice (DNP) project, focusing on a practical, evidence-based solution to a prominent healthcare issue at LMH. Integrating improved hiring and retention strategies directly enhances clinical outcomes and patient care experiences. This project reflects DNP priorities by translating evidence into practice to address staffing deficits through strategic planning, education, and policy development (Pressley & Garside, 2023).

Overview of Selected Scholarly Literature

Contemporary studies provide robust support for interventions aimed at improving nurse satisfaction and retention to address LMH’s staffing challenges. Vries et al. (2023) conducted a systematic review highlighting the adverse effects of poor leadership and inadequate work environments on nurse retention. Their findings indicated that improving leadership, promoting respectful environments, and ensuring work-life balance significantly enhance retention.

Oates et al. (2020) synthesized research on nurse experiences in mental health care settings, noting that wellness programs, mentoring, and continuous education contribute to increased job satisfaction and retention rates. Similarly, Niskala et al. (2020) conducted a meta-analysis demonstrating that educational initiatives and professional development significantly elevate job satisfaction and reduce staff turnover. Their findings emphasized the importance of structured training and mentoring programs.

Alshahrani (2022) identified additional factors influencing nurse retention, such as workplace culture, compensation, and the retention of experienced staff. The study recommended comprehensive retention strategies to address staffing gaps. In alignment, Kueakomoldej et al. (2022) explored interventions for increasing nurse retention in underserved areas. Their findings supported the implementation of financial incentives, professional development opportunities, and positive work environments to enhance job satisfaction and reduce turnover.

Critical Analysis of Reviewed Studies

The persistent issue of unfilled nursing positions and its effects on patient care has been extensively examined. Vries et al. (2023) conducted a systematic review to identify factors influencing nurse retention, employing a Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) level three framework. Their research emphasized that enhancing leadership and creating supportive work environments are essential in improving nurse satisfaction and mitigating turnover.

Oates et al. (2020) utilized an integrative review approach, classified as level three within the JHNEBP model, to explore how nurses’ experiences in mental health settings impact job satisfaction and retention. Their findings underscore the importance of structured mentoring, wellness programs, and continuous education in supporting nurse retention. The integrative review design allowed for comprehensive analysis, contributing valuable insights into effective intervention strategies.

Niskala et al. (2020) offered high-level evidence through a meta-analysis and systematic review, categorized at level one of the JHNEBP model. Their study demonstrated that targeted educational interventions, such as professional workshops and mentoring programs, significantly improve nurse job satisfaction and retention. The rigorous methodology enhanced the study’s credibility and reinforced the value of continuous professional development.

Alshahrani (2022) conducted a literature review to examine factors affecting nurse retention, ranked at level five in the JHNEBP framework. The study identified interventions such as improved salary structures, inclusive work environments, and retaining senior nursing staff as effective strategies for addressing the shortage.

Lastly, Kueakomoldej et al. (2022) applied the Joanna Briggs Institute’s scoping review methodology, categorized at level five in the JHNEBP model. Their research highlighted essential retention strategies, including financial support, positive work settings, and career development opportunities, particularly in resource-limited areas.

Synthesis of Literature Using the MEAL Plan

The reviewed literature collectively highlights a variety of factors contributing to nursing shortages and presents evidence-based interventions to address this issue. Workplace culture significantly influences nurse retention, with poor leadership, excessive workloads, insufficient pay, and unwelcoming environments contributing to burnout and turnover (Alshahrani, 2022; Vries et al., 2023). Strategies such as fostering a respectful and supportive work culture, providing work-life balance, and offering mentorship opportunities enhance job satisfaction and nurse retention (Vries et al., 2023).

Alshahrani (2022) further emphasized that competitive compensation, age-friendly policies, and an inclusive work culture reduce turnover rates. Similarly, Oates et al. (2020) and Niskala et al. (2020) highlighted that professional development, including career advancement programs, wellness initiatives, and mentoring, strengthen nurses’ commitment to their organizations.

Additionally, comprehensive educational initiatives and team-building programs support personal and professional growth, thereby reducing turnover and promoting a stable nursing workforce (Niskala et al., 2020; Oates et al., 2020). These evidence-based strategies collectively promote engagement, foster skill development, and improve patient care outcomes.

Appraisal of Research Quality

Assessing the quality of the selected research underscores its methodological rigor and practical relevance in addressing nursing shortages. Strengths include systematic data analysis, comprehensive literature reviews, and diverse research methodologies, offering a balanced perspective on effective retention strategies. Vries et al. (2023) and Niskala et al. (2020) provided high-level evidence through systematic reviews and meta-analyses, enhancing the validity of their findings.

Despite these strengths, limitations remain. Some studies, such as those by Alshahrani (2022) and Kueakomoldej et al. (2022), relied on lower-tier evidence (level five), which may affect the generalizability of their conclusions. Further research is warranted to evaluate long-term outcomes of retention strategies, particularly in varied healthcare settings. Nonetheless, the overall body of evidence strongly supports the implementation of comprehensive recruitment and retention policies to address LMH’s staffing challenges.

References

Alshahrani, M. (2022). Nurse retention strategies: A literature review. International Journal of Nursing Studies, 130, 104224. https://doi.org/10.1016/j.ijnurstu.2022.104224

Kueakomoldej, S., et al. (2022). Factors associated with nurse retention in rural and remote areas: A scoping review. Nursing Open, 9(5), 2365–2379. https://doi.org/10.1002/nop2.1022

NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

Lucy, T. (2024). U.S. nursing workforce challenges: Trends and implications. Journal of Healthcare Management, 69(1), 33–40.

Niskala, J., et al. (2020). The relationship between job satisfaction and nurse retention: A meta-analysis. Journal of Advanced Nursing, 76(1), 103–115. https://doi.org/10.1111/jan.14208

Ohio Nurses Association. (n.d.). Nurse staffing and turnover statistics. https://www.ohnurses.org

Oates, J., et al. (2020). Mental health nurses’ experiences and retention: An integrative review. Journal of Psychiatric and Mental Health Nursing, 27(6), 712–724. https://doi.org/10.1111/jpm.12617

Peters, M. D. J., et al. (2023). Strategies to improve nurse retention and satisfaction: A systematic review. BMC Nursing, 22(1), 120. https://doi.org/10.1186/s12912-023-01107-5

Pressley, T. A., & Garside, R. (2023). Workforce management in healthcare: The impact of recruitment and retention strategies. Nursing Management, 30(2), 20–27. https://doi.org/10.7748/nm.2023.e2097

Vries, H. D., et al. (2023). Work environment factors influencing hospital nurses’ retention: A systematic review. International Journal of Nursing Studies, 139, 104374. https://doi.org/10.1016/j.ijnurstu.2023.104374

NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

Appendix: Summary of Reviewed Studies

Citation	Conceptual Framework	Design/Method	Sample/Setting	Major Variables Studied & Definitions	Measurement	Data Analysis	Findings	Appraisal: Worth to Practice
(Vries et al., 2023)	Not specified	Systematic review using PRISMA	Physicians and nurses in European hospitals	Prevalence of intention to leave job among nurses; determinants include personal factors (age, self-efficacy), job factors (workload, employee services), and working conditions (conflicting settings, organizational culture)	Not specified	Not specified	12%–64% of nurses intended to leave due to these determinants. Leadership interventions and positive work environments improve retention.	Strength: Systematic review highlighting determinants and interventions. Robust search strategy. Limitation: No statistical analysis; measurement strategies not specified. Ranking: Level III Validity: Yes Reliability: Yes Applicability: No Overall Rank: Moderate
(Oates et al., 2020)	Thematic Analysis	Integrative review, systematic research method including data extraction, quality evaluation, qualitative synthesis	Not specified	Impact of nurses’ experience on patient engagement, nursing practices, and job satisfaction	Data-based qualitative synthesis	Not specified	Identified four themes: patient engagement, ward interpersonal atmosphere, nurse influence, and effects on practice	Strength: Integrative review with robust evidence; explores determinants of nurse satisfaction and retention. Limitation: Possible bias, variation in included studies’ quality. No statistical evaluation. Ranking: Level III Validity: Yes Reliability: Yes Applicability: Yes Overall Rank: High
(Niskala et al., 2020)	Profile-likelihood random-effects model	Quantitative systematic review & meta-analysis (PICOS format)	Nurses population	Effect of organizational and educational interventions on job satisfaction	Not specified	Cohen’s d, Q-statistic, tau-squared statistic	Educational interventions (e.g., Spirituality Training Program, Professional Personality Growth Program) significantly increased job satisfaction vs. control groups	Strength: Robust quantitative meta-analysis using random-effects model. Credible due to bias risk analysis. Limitation: Study quality variation; possible heterogeneity. Ranking: Level I Validity: Yes Reliability: Yes Applicability: Yes Overall Rank: High
(Kueakomoldej et al., 2022)	Not specified	Joanna Briggs’ Scoping Review Methodology and PRISMA-SCR standards	Not applicable	Nurse shortage-related factors: individual factors, educational programs and funding aid, organizational and community-related factors	Qualitative thematic analysis	Thematic identification of key factors	Factors influencing nurse shortages include work conditions, financial and education support, community involvement, and individual determinants	Strength: Robust methodology providing an overview of interventions. Limitation: Applicability may vary based on health system finances and structures; potential publication bias. Ranking: Level V Validity: Yes Reliability: Moderate Applicability: Yes Overall Rank: Moderate
(Alshahrani, 2022)	Not specified	Literature review (method not detailed)	No sample/setting specified	Causes, consequences, and interventions for nursing understaffing: overwork, demographic and personal aspects, poor work environment, dissatisfaction. Implications: burnout, patient safety compromise. Interventions: improving perception, positive work culture, better compensation	Not applicable	Not applicable	Highlights reasons for understaffing and suggests targeted interventions to improve staffing and retention	Strength: Concise knowledge and reasoning on causes, consequences, and interventions. Limitation: Lacks structured methodology and data extraction approach, reducing reproducibility. Ranking: Level V Validity: Yes Reliability: No Applicability: No Overall Rank: Low