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 Substantiating a Practice Gap

Nursing shortages are significant practice gaps in health settings, including Lima Memorial Hospital (LMH), which compromise patient safety. Identifying and addressing practice gaps is crucial for developing targeted quality improvement initiatives. The assessment focuses on the critical review of practice gaps related to nursing shortage. Assessment intends to provide comprehension and interventions by combining recent studies.

Identified Scholarly Articles

Recent research has exhibited diverse facets of the practice gap related to nursing shortage, substantiating the need for targeted interventions with a selection of five research articles. Tamata and Mohammadnezhad (2023), conducted research exhibiting a significant association between inadequate planning, policy, nurses’ training, poor workplace environment, and nurses’ high turnover. The meta-analysis by authors of articles over 10 years highlighted a significant increase in nurse shortage due to barriers; 10.4% of articles showed that an absence of training for fresh nursing recruits significantly contributes to the nursing shortage. Following this, Peutere et al. (2024), investigated the issues and challenges associated with constrained nursing staff, revealing patients’ danger of mortality and outcomes in hospitals.

The longitudinal register-based research indicated disturbing patterns, with a 20% rise in inadequate nurse staffing linked to a 1.05-fold higher risk of patient death. Suprapto et al. (2023), performed a quantitative study using an analytical observational strategy, underlining the importance of staff development training in boosting nurses’ job satisfaction. The statistical test synthesis showed an association between training and reduced nurse shortage, with nurses being 1.790 times more satisfied, enhancing care quality. Training improved the nurses satisfaction and improving their skills to offer efficient care.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Nursing shortages and excessive nurse workloads are related to decreased patient safety and higher medical expenses. An observational study indicated a 16% rise in fatality among patients with rising nurses’ job stress, emphasizing the necessity of optimal patient-to-nurse ratios. Lasater et al. (2021), investigated the influence of nurses’ hard workloads caused by understaffing on patient safety, emphasizing the danger associated with an inadequate patient-to-nurse ratio and the necessity for a nursing staffing policy.

Wei et al. (2023), explored nurses’ commitment to work to investigate connections, job fulfillment, and care quality, emphasizing the nursing shortage issue. Through quantitative analysis, they discovered elements impacting nurses’ job fulfillment and intention to leave, with 59.4% reporting significant job satisfaction, leading to nurse retention. The research offers evidence to substantiate the practice gap of the nursing shortage, underlining the necessity for tailored approaches to boost patient outcomes and quality care provision.

Critical Review of Selected Research Articles

The gap due to vacant positions of nurses to fulfill the needs of patients and the challenges contributing to the understaffing issue have drawn attention to current literature. Tamata and Mohammadnezhad (2023), conducted a meta-analysis and systematic review to examine the factors influencing the nursing staff deficit and its effect on nurses, falling under category one of the Johns Hopkins framework. Through the formation of accessible evidence, covering retrospective cohort studies and observational studies, the researchers discovered that poor policy or planning causes and a lack of nurse training correlate significantly with an increase in nurse exhaustion and turnover. The rigorous method of data analysis strengthens its validity and reliability, offering strong evidence for the optimization of variables causing nurse turnover and understaffing to improve efficient medical provision.

The concern of nurse shortage and insufficient nursing job expertise or experience, which affects the risk of mortality in hospital patients, is a significant research question. The researchers present a complete analysis of the research using a longitudinal register-based study, examining the evidence for the association between nursing shortage and poor patient outcomes, including mortality. Peutere et al. (2024), critically evaluated existing studies utilizing the Johns Hopkins technique, which falls into category three. Using mixed-effects survival models researchers investigate the current discussion about the relationships between nurse insufficient staff, limited nurse job expertise, and patient death threats, with the goal of determining if these connections are justified.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

The study integrates data from diverse sources, including hospital administrative data, to provide a deeper understanding of the complex relationship between nursing shortage and poor patient outcomes, which leads to extended hospitalization and mortality. By addressing numerous perspectives and issues by comparing prior studies associated with nursing understaffing and patient safety, the authors provide vital insights into the current debate over nurses’ deficiency and patient safety concerns.

Growing importance of professional development training among nurses is crucial to overcoming nurse shortage challenges. The study by Suprapto et al. (2023) intended to improve human resources and educate nurses on developing human capital metrics that influence patient and nurse fulfillment. They conduct quantitative research using an analytical observational approach to examine the influence of training on job satisfaction.

The study complies with category three of the Johns Hopkins approach. Using Likert scale surveys and interviews, the authors advocate for approaches that consider training, leadership assistance, and communication to boost nurses’ satisfaction and retention. Suprapto et al. illustrated the necessity of establishing training tools, arguing for advanced studies, and offering a relaxing workplace to retain or optimize nurses’ abilities for efficient nursing care. The study shows the necessity of fostering skilled nurses with improved job satisfaction and boosting care quality by underlining the significance of the analytical observational approach.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Understanding the link between nursing shortages and patient outcomes, the authors urged for a strategy that retains patient-to-nurse ratios while enhancing treatment quality and lowering costs. Lasater et al. (2021), using an observational study method, aimed to investigate the relationship between increased nurse workloads caused by understaffing and patient mortality and the duration of stay and medical cost for hospitals. Using multilevel random-effects logistic regression models, the authors offered concise information about nursing ratios that vary from 4.2 to 7.6 patients per nurse. Using the Johns Hopkins methodology, this study comes in category three. The data on nurse-to-patient ratios exhibits an extensive approach to evidence gathering and analysis, which improves the data’s accuracy and emphasizes the importance of establishing suitable nurse-to-patient ratio policies.

Nurses’ involvement at work, job happiness, and intention to leave are critical metrics of hospital performance. Lowering intent to leave and improved satisfaction mitigate the nursing shortage. In the health setting, Wei et al. (2023), investigated the impact of nurses’ satisfaction and engagement in enhancing hospital performance and solving understaffing. The authors underlined the explicit study question: “What is the association between nurses’ job participation, fulfillment, the perceived level of services, and intention to quit job?” Using Convergent Care Theory, the authors highlight elements that impact nurse engagement and work fulfillment.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Workplace culture and teamwork lead to enhanced nurses’ job satisfaction, which is linked to increased job engagement and care quality. The authors utilized a conceptual model founded on the theory and existing literature. The model included four structures: work involvement, job fulfillment, standard of care, and intention to leave. Using the Johns Hopkins practice, this research fits into category three because it used a quantitative descriptive correlational design. The study inspires further discourse by highlighting limitations like bias in self-selection and additional research suggestions. The evidence table based on the critical appraisal of five articles is mentioned in the appendix.

Literature Synthesis Using MEAL Plan

The study selected for appraisal offers helpful knowledge of nursing staff issues, including strategies to address the reported nursing shortage practice gap at LMH. The selected articles explore factors contributing to the nurse shortages, including poor policy, lack of funding planning, absence of training, inadequate nurse-to-patient ratio policy, heavy workload, and poor workplace setting (Lasater et al., 2021; Peutere et al., 2024; Tamata & Mohammadnezhad, 2023). Each article provides valuable information on aspects of approaches to address the nurse shortage, ranging from the impact of nurse development training to strategies improving nurses’ job satisfaction and reducing intention to leave, in improving care quality and addressing the nurse shortage issue.

Retention strategies include supportive organizational culture, collaboration, and offering skill development training (Suprapto et al., 2023; Wei et al., 2023). The adequate nurse-to-patient ratio legislation causes less nurse burnout, enhanced job satisfaction, and nurse retention. Consequences of a poor ratio, including compromised patient safety and insufficient care services, are outlined in articles (Lasater et al., 2021). The studies utilize several approaches, such as meta-analyses and systematic reviews, quantitative analyses, and observational studies, to address the problem question; the inquiries are based on theoretical frameworks relevant to nursing shortage challenges, such as Convergent Care Theory, which guide the authors’ investigation of the reported practice gap. Each study has thorough data collection and analysis, offering findings that result in a comprehension of the practice gap in hospitals.

Writing Feedback

The writing syntax was cleared and refined to make the content more explicit and understandable based on input from the previous assessment. Feedback was critical in making potentially tricky concepts more accessible to comprehend by minimizing the usage of jargon. The feedback helped refine the material in each paragraph, making it easier to establish a consistent framework and clear linkages across the review. The comments assisted with content organization, ensuring that information was given logically and there was cohesion.

The logical sequence of assessment and cohesiveness were improved by employing a MEAL plan for each paragraph. The writing quality indicators were achieved, and writing skills were enhanced by employing comments to correct grammar and apply appropriate sentence structures. The feedback also emphasized the importance of searching trustworthy databases like CINAHL, Google Scholar, and PubMed for relevant articles, reinforcing the evidence basis of the assessment. Utilizing the Capella Library’s online resources improved research and advanced our writing level. Standards for quality were strictly followed after incorporating the writing feedback, indicating enhanced writing skills.

Conclusion

In conclusion, the critical appraisal of current research resources has offered an in-depth understanding of the practice gap due to the nursing shortage at LMH. The critical review of articles reveals that closing this gap requires a diverse approach that includes aspects such as nurse training, retention strategies, and developing a positive workplace. Employing targeted actions based on the knowledge gathered from this assessment can bring significant enhancements to patient safety by overcoming the nursing shortage 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%2Fbmjopen-2021-052899

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, 104628–104628. 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