Nursing Shortage and Patient Outcomes: A Literature Review

Literature Evaluation Table
Student Name:
Summary of Clinical Issue (200-250 words):
Nursing shortage is a global problem that faces the nursing profession. In the U.S, recent evidence reveals that more than 1 million
nurses are needed to feel the gap in nurses and to adequately cater for the needs of all patients. There are myriad numbers of reasons
that are associated with nursing shortages. Lack of potential educators and high turnover are the key reasons why nursing shortage is
prevalent. Various researches have also indicated that increase in aging population, aging workforce and most importantly nurse
burnout could worsen the situation. With increased need for care and limited supply of nurses, the working nurses experience
exhaustion and burnout factors which are strongly associated with job dissatisfaction and willingness to leave the profession. The
nursing turnover has in turn increased from 8.8% to 37% over the last five years (Gaffney et al, 2016).
Staffing shortages and increased burnouts also imply the ratio of patient-to-nurses is high. Other adverse effects
including poor quality of care, increased nurses’ slipups and lack of patient satisfaction are also associated with shortage in nurses
(Frith et al, 2012). Thus, the issue of nursing shortage should be addressed at its root level by increasing the staffing ratios in relation
to the number of patients demanding care. This notion is backed by the fact that evidence reveals increasing these ratios will in turn
improve quality of care and reduce medical errors.
PICOT Question:

When caring for acute care patients, 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?
Criteria Article 1 Article 2 Article 3
APA-
Formatted
Article
Citation
with
Permalink
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
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. International Journal
of Quality in Health Care, 27(4),
276-283. Retrieved from
https://academic.oup.com/intqhc/art
icle/27/4/276/2357294
Mark, B. A., & Belyea, M. (2009).
Nurse Staffing and Medication
Errors: Cross Sectional or
Longitudinal Relationships?
Research on Nursing and Health,
32(1), 18-30. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/
articles/PMC2628558/
How Does
the Article
Relate to
the PICOT
Question?
Shows the relationship between nurse
staffing and patient outcomes.
The paper seeks to understand
whether nursing staffing is
associated with reduced medication
errors.
Illustrates the relationship between
nurse staffing and medication errors
in acute care settings.
Quantitati
ve,
Qualitative
(How do
you
know?)
Quantitative study. A systematic review
and meta-analysis.
Quantitative study involving a
cross-sectional survey with more
than 300 participants.
Quantitative study. Uses primary
data from medical surgical units.
Purpose
Statement
To examine the relationship between
nurse staffing levels and nurse sensitive
patient outcomes in acute specialists
units.
To identify reasons for medication
administration errors and why they
are underreported.
To examine the relationship
between change in nurse staffing
and change in medication errors
over 6 months in 284 general
medical-surgical nursing units.
2

Research
Question
What is the relationship between nurse
staffing levels and nurse sensitive patient
outcomes in acute specialists units?
What are reasons for medication
administration errors?
What is the relationship between
change in nurse staffing and change
in medication errors?
Outcome Reduced mortality and medication
errors.
Medication administration errors. Increased nurse staffing and patient
safety outcomes.
Setting
(Where did
the study
take
place?)
Conducted an online search in nine
electronic databases.
Three university hospitals in three
South Korean provinces.
Acute care hospitals with at least 99
licensed beds that were accredited
by The Joint Commission.
Sample 35 articles from 3429 articles met
inclusion criteria. 175,755 patients from
six studies were used in the meta
analysis.
312 hospital nurses 284 general medical-surgical
nursing units in 145 hospitals.
Method Systematic review and meta-analysis. A cross-sectional survey design. Experimental, longitudinal, causal
modeling design.
Key
Findings of
the Study
Higher staffing levels were associated
with reduced mortality, medication
errors, infections and better patient
recovery.
Inadequate number of nurses in
each working shift was the main
reason for the occurrence of
medication administration errors.
Increase in nurse staffing was
associated with reduced rates of
medication errors.
Recommen
dations of
the
Researcher
More evidence is required to substantiate
optimal nurse-to-patient ratios.
Nurse-staffing adequacy could be
helpful to prevent medical errors
among nurses.
Staffing-medication errors ought to
be examined within a larger
organizational context than in
isolation.
Criteria Article 4 Article 5 Article 6
APA-
Formatt
ed
Article
Citation
with
Permali
nk
Griffiths, P., Saucedo, A.
R., Chiara, D., Briggs, J.,
Maruotti, Meredith, P., &
Smith, G. B. (2018). The
Association between
Nurse Staffing and
Omissions in Nursing
Care: A Systematic
Gaffney, T. A., Hatcher, B. J., Milligan, R., &
Trickey, A. (2016). Enhancing Patient Safety:
Factors Influencing Medical Error Recovery among
Medical-Surgical Nurses. The Online Journal of
Issues in Nursing, 21(3). Retrieved from
http://ojin.nursingworld.org/MainMenuCategories/A
NAMarketplace/ANAPeriodicals/OJIN/
TableofContents/Vol-21-2016/No3-Sept-2016/
Frith, K. H., Anderson, E. F., Tseng,
F., & Fong, E. A. (2012). Nurse
Staffing is an Important Strategy to
Prevent Medication Errors in
Community Hospitals. Nursing
Economics, 30(5), 288-293.
Retrieved from
https://www.nursingeconomics.net/n
3