Quantitative Research Critique on Nurse-to-Patient Ratios in Acute Care

This article provides a critique of two quantitative research studies on the impact of nurse-to-patient ratios on quality of care and nursing errors in acute care settings. The studies focus on the PICOT question of whether high nurse-to-patient ratios decrease or increase quality of care and nursing errors in patients aged 65 and above over a 10-week time-frame using health assessment tools. The first article examines perceptions regarding medication administration errors among hospital staff nurses in South Korea, while the second article explores the effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units through a systematic review and meta-analysis. The findings suggest that a higher number of nursing staff is associated with a decrease in medication errors and improved patient outcomes.

Running head: HEALTH SCIENCE
HEALTH SCIENCE
Name of the student:
Name of the university:
Author note:

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Introduction:
A research critique is an efficient way that is used in order to accurately reviewing
any kind of research or study in order to highlight both of its strengths as well as its
weaknesses, and the researches applicability for the practice (Cobb, Jackson & Dunlap,
2016). researchers are often observed to be in need of the ability to identify the best existing
practice, and the capability to assess and then the usage of the published articles or research is
acute in accomplishing this (Quinlan, Babin, Carr & Griffin, 2019). Thus, it is an ability
which is required in many situation explanations. The assignment will focus on two
quantitative research articles that has been conducted and is related to the PICOT question
that has been asked. The research studies were conducted focusing on the requirement of
greater nursing staff ratio in a health care setting in order to reduce the chances of medication
administration error and delivery of better health care treatment.
The PICOT question for the assignment is;
“When caring for acute care patients aging from 65 and above, does high nurse-to-
patient ratio compared to low nurse-to-patient ratio decrease or increase quality of care and
nursing errors over a 10-week time-frame using health assessment tools?”
Quantitative Research Critique
Nominated articles:
Article 1: Perceptions regarding medication administration errors among hospital staff
nurses of South Korea
You, M. E., Choe, M. H. Park, G. K., Kim, S. H., & Song Y. J. (2015). Perceptions
Regarding Medication Administration Errors among Hospital Staff Nurses in South Korea.

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International Journal of Quality in Health Care, 27(4), 276-283. Retrieved from
https://academic.oup.com/intqhc/article/27/4/276/2357294
Article 2: The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute
specialist units: a systematic review and meta-analysis
Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., & Astin, F. (2017).
The Effect of Nurse-to-Patient Ratios on Nurse-Sensitive Patient Outcomes in Acute
Specialist Units: A Systematic Review and Meta-Analysis. European Journal of
Cardiovascular Nursing, 17(1), 6-22. Retrieved from
https://journals.sagepub.com/doi/full/10.1177/1474515117721561
Background of Study:
PICOT Question:
When caring for acute care patients aging from 65 and above, does high nurse-to-
patient ratio compared to low nurse-to-patient ratio decrease or increase quality of care
and nursing errors over a 10-week time-frame using health assessment tools?
In article 1, the research question that was asked is that what are the reason behind the
occurrence of medication error. Focusing on the question that was asked, the research aimed
towards identifying the reasons behind the occurrence of the medication administration errors
(MAEs) and also to find out the reason for they being unreported, and to estimate the ratio of
medication administration errors (MAEs) that were actually described among the health care
nurses. The study shows relation with the PICOT question as it provides the understanding on
whether the nursing staffing has any effect on reducing the medication errors (You et al.,
2015).
In article 2, the research question that was asked is that what is the relation among the
nursing staff numbers and the nurse complex patient consequences in an acute health

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specialist unit. The objective of the research was to examine the association between the
nursing staff levels and also to find out the outcomes of the nurse sensitive patient in the
acute health care specialists units. It is relevant to the PICOT question as it provides the
relationship among the nursing staff and the patient results (Driscoll et al., 2017).
Method of Study:
In the two quantitative research studies, the article 1 uses Quantitative study which is
found to involve a cross-sectional survey that involved a population of more than 300
applicants (You et al., 2015). Whereas in the article 2, the method that has been used in is
systematic review and meta-analysis in purpose of gaining information and data concerning
the research PICOT question (Driscoll et al., 2017).
Cross-sectional study is used as a study tool in order to capture information
dependent on the data that has been collected for a precise point in time (Ríos-Risquez &
García-Izquierdo, 2016). It is used is cases of assumption in order to prove or disprove them
and can be used in order to analyse new assumptions or studies (Cho et al., 2015). The
research design though has limitations such as, it does not permit the determination of the
cause and effect (Page et al., 2016). The Meta-analysis and systematic review uses
numerical data and statistics from various different studies in order to obtain any outcome
(Moher et al., 2015). The limitation of these research design is the heterogeneity of the
studies they use in order to asses any conclusion (Dhillon et al., 2016).
Results of Study:
In article1, the key findings that were obtained by the researcher was that insufficient
number of the nursing staffs in every working period according to the study, was the chief
reason behind the manifestation of the medication administration inaccuracies or errors (You
et al., 2015). Where in article 2, the key findings showed that a higher number of nursing

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staff levels were related with the decreased rate of the cases of better patient recovery,
infections, mortality and medication errors (Driscoll et al., 2017).
Implication of a greater number of nursing staff in a health care setting will provide a
better treatment and care for the patients involved and also reduce the chances of occurrence
of any medication or treatment error (Driscoll et al., 2017). In article 1 it states that nursing
staff adequacy is a strategy that will be helpful to decrease the rate of medical errors among
the nurses in greater extent (You et al., 2015). Also, article 2, states that greater number of
evidence is still needed to validate the ideal nurse-to-patient ratios (Driscoll et al., 2017).
Outcomes Comparison:
In article 1 it was found that the research reflected decreased cases of medication
administration error when the nursing staff was in adequate amount, it also showed that
treatment and other health care processes were also done with reduced cases of error
occurrence (You et al., 2015). In article 2, it was found that a decreased rate of mortality and
morbidity and also less cases of medication errors were observed after the implication of
greater number of nursing staffs in a health care setting (Driscoll et al., 2017). The two
research articles that were selected demonstrated an improved and in depth understanding
about the PICOT QUESTION that has been asked in the study.
Conclusion:
Thus in order to conclude, it can be stated that the studies that was performed assisted
the researchers by providing information regarding the importance of the greater number of
nursing staff and its relation with the better health and care providing and also in decreasing
the amount of medication admiration error and better treatment delivery (Olley, Edwards,
Avery & Cooper, 2018). The two article’s outcomes concluded that the greater number of
nursing staff has a major effect in reducing the chances of occurrence of medication

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administration error, and it also helps the health care service to provide a better care and error
free and effective treatment in order to ensure better recovery for the patients (Wynendaele,
Willems & Trybou, 2019). It also showed that encouraging the nursing and health care staffs
regarding the assessment and reporting of error in medication and treatment will improve the
medication administration and also will increase the number of reporting of error in order to
retain a knowledge regarding the improvement in the system (Henderson et al., 2016).

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Reference:
Cho, E., Sloane, D. M., Kim, E. Y., Kim, S., Choi, M., Yoo, I. Y., ... & Aiken, L. H. (2015).
Effects of nurse staffing, work environments, and education on patient mortality: an
observational study. International journal of nursing studies, 52(2), 535-542.
Cobb, P., Jackson, K., & Dunlap, C. (2016). Design research: An analysis and critique.
Handbook of international research in mathematics education, 481-503.
Dhillon, J., Craig, B. A., Leidy, H. J., Amankwaah, A. F., Anguah, K. O. B., Jacobs, A., ... &
McCrory, M. A. (2016). The effects of increased protein intake on fullness: A meta-
analysis and its limitations. Journal of the Academy of Nutrition and Dietetics,
116(6), 968-983.
Henderson, J., Willis, E., Blackman, I., Toffoli, L., & Verrall, C. (2016). Causes of missed
nursing care: qualitative responses to a survey of Australian nurses. Labour &
Industry: a journal of the social and economic relations of work, 26(4), 281-297.
Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., ... & Stewart, L.
A. (2015). Preferred reporting items for systematic review and meta-analysis
protocols (PRISMA-P) 2015 statement. Systematic reviews, 4(1), 1.
Olley, R., Edwards, I., Avery, M., & Cooper, H. (2018). Systematic review of the evidence
related to mandated nurse staffing ratios in acute hospitals. Australian Health Review.
Page, M. J., Shamseer, L., Altman, D. G., Tetzlaff, J., Sampson, M., Tricco, A. C., ... &
Moher, D. (2016). Epidemiology and reporting characteristics of systematic reviews
of biomedical research: a cross-sectional study. PLoS medicine, 13(5), e1002028.
Quinlan, C., Babin, B., Carr, J. and Griffin, M., 2019. Business research methods. South
Western Cengage.

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Ríos-Risquez, M. I., & García-Izquierdo, M. (2016). Patient satisfaction, stress and burnout
in nursing personnel in emergency departments: A cross-sectional study. International
journal of nursing studies, 59, 60-67.
Wynendaele, H., Willems, R., & Trybou, J. (2019). Systematic review: association between
the patient‐nurse ratio and nurse outcomes in acute care hospitals. Journal of nursing
management.