Critique of Qualitative Research on Nurse Workload and Patient Outcomes in Intensive Care Units

This critique analyzes a qualitative research study on the impact of nurse workload and nurse-patient ratios on patient outcomes in intensive care units. The study found that high nurse workload and ratios were linked to negative outcomes, and suggests the need for further research and standard tools for assessing nurse workload.

Research Critique
Qualitative Research Critique
Name
Grand Canyon University
Unit
DATE

Research Critique 2
Background of study
The study focused on the negative outcomes experienced at the intensive care units. The
author attributed the rise in ICU related deaths on the workload experienced by nurses.
Limited studies have focused on this issue. Insights from the British association if prenatal
medicine, pointed out on the rise of the incidence related to the case. The rises in cases have
been attributed to high workloads being experienced by nurses in implementing their roles at
the ICU facilities. If this knowledge on nurse’s workload is better understood in the
healthcare arena, ICU related deaths could be reduced significantly. Mitigating on nurse
workload and nurse-patient workload could improve outcomes for the patients, Needleman et
al., 2011.
The author attributed to lack of research in the area focussing on nurse workload and n nurse
patient ration in relation to ICU deaths. Studies undertaken have not focussed on this, further
research undertaken as illustrated have shown inconsistencies. Currently as noted, researches
done have show inconsistencies on nurses staffing issues as outlined, (Hamilton, Redshaw &
Tarnow-Mordi, 2006; Grandi, González, & Meritano, 2010; Pillay, Nightingale. Thus the
author is gearing towards enhanced patient care and reduction in low death rates and
decreased burn out.
The research study adopted an objective inferring on the establishing nurse to patient ratios
and results obtained in ICU units. To achieve this, the study aimed at establishing the
association between the nursing workload and nurse-patient ratios in improving care for
NICU patients, (Aiken et al., 2002).
The outlined aims and objectives of the study are relevant to the study in that it answers the
key focus of the study. The objective assesses two parameters which include nurse-patient
ratio and nursing workload on the negative outcomes at the adult intensive care units.

Research Critique 3
Methods of study
The study adopted a Meta-analysis search for qualitative studies undertaken on the topic of
interest. The study sought to find out studies in medical databases which is the repositories
for allied studies. Further, the study adopted the use of Boolean operators in searching for the
key information needed. Further, the use of STROBE method of study is an essential and
most standard tool for qualitative study.
The data cited in the studies obtained are crucial in answering the research questions. Further
to enhance on the type of data, both qualitative and quantitative information was obtained
from the study. Reports done from organizations such as the British Association of prenatal
medicine was included in the study as a key source of information needed.
In qualitative research, studies undertaken in less than 10 years are often considered and
given priority. However in this study articles published between the year of 1990 and 2010
were included in the study, this portrays the inadequacy of literature information outlining the
inconsistencies of research undertaken. Further analysis of the kind of data received from the
literature review was assessed in the study. Further, the author noted inadequate research
obtained answering the objective if the study. Due to the weakness of the literature research
the study findings no framework was developed.
Study findings
The study included six independent studies. These studies reported a total of 19,570 patients
being nurses at NICU between years 1966-2007 in various countries such as the USA, UK,
and Australia. Further poor health outcomes were reported, these included underweight
infants being noted in three studies while two studies showed that there was registration of
infants at the NICU. Further four studies attributed reported from the NICU when compared
to the nurse-patient ratio as its outcome. One study linked low nurse to patient ratio with the
lower death rate, with suggestions that low handling of delicate infants yields better health

Research Critique 4
outcomes, (Callaghan, Cartwright, O’Rourke, & Davies, 2003), while three studies
established an association with high mortality rate. Other studies attributed adverse health
outcomes emanating from unqualified caregivers, which is a consequence of boosting nurse
to patient ratios.
Further, the findings of these studies implicated nursing practice. A high incidence rate of
19570 infants who were nursed at NICU in a period of 11 years, this indicates the demanding
nature of the work requirements by the nurses in their work profession. The huge workload
offers nurses with a challenging task of offering quality care irrespective of the situations
there are in. However, restrictions are observed on nurse-patient ratios.
The study findings offer crucial knowledge to nurses in various ways. From these studies, it
is evident that there is a need for standard tools for assessing nurse workload due to
observable inefficiencies on credible and legal tools of measuring neonatal workload. Thus
the findings of the studies done show that there is an urgent need for additional research so as
to establish measures which optimize nursing care instead of nurse-specific workload.
Ethical considerations
The studies displayed no indication of establishing any approval of Intuitional Review
Boards. An observed expectation in these cases is the disclosure statement of the authors on
no conflict interest and acknowledgments from the authors who offered supplementary
information to the various studies assessed.
Conclusion
Assessment of the impact of workload and nurse to patient ratio in the improvement of
outcomes at NICU is critical. ICU mortality rates linked to nursing workload and elevated
nurse to patient ratio is alarming. With this trend, the specific influence of the nurses is
paramount. Nurses can play an effective role in ensuring that NICU achieves better health
outcomes, however, extensive research needs o to be undertaken on the association of nurse

Research Critique 5
workload and nurse-patient ratio on improved health outcomes.

Research Critique 6
References
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital
nurse staffing and patient mortality, nurse burnout, and job
dissatisfaction. Jama, 288(16), 1987-1993.
Callaghan, L. A., Cartwright, D. W., O’Rourke, P., & Davies, M. W. (2003). Infant to staff
ratios and risk of mortality in very low birthweight infants. Archives of Disease in
Childhood Fetal and Neonatal Edition, 88(2), F94-F97.
Grandi, C., González, A., & Meritano, J. (2010). Patient volume, medical and nursing
staffing and its relationship with risk-adjusted outcomes of VLBW infants in 15
Neocosur neonatal network NICUs. Archivos Argentinos de pediatría, 108(6), 499-510.
Hamilton, K. E. S., Redshaw, M. E., & Tarnow-Mordi, W. (2006). Nurse staffing in relation
to risk-adjusted mortality in neonatal care. Archives of Disease in Childhood-Fetal and
Neonatal Edition.
Needleman, J., Buerhaus, P., Mattke, S., Stewart, M., & Zelevinsky, K. (2002). Nurse-nurse
staffing and patient mortality, nurse burnout, and job dissatisfaction. Jama, 288(16),
1987-1993.
Pillay, T., Nightingale, P., Owen, S., Kirby, D., & Spencer, A. (2011). Neonatal nurse ratios
and risk of mortality in very low birthweight infants. Archives of Disease in Childhood-
Fetal and Neonatal Edition, 88(2), F94-F97.