Analysis of Nursing Staff Shortage and Workload in Healthcare

This report investigates the global challenge of nursing staff shortages and its direct impact on workloads within clinical settings. It examines the multifaceted factors contributing to this shortage, including recruitment issues and demographic shifts. The report analyzes several peer-reviewed articles, exploring research questions, methodologies, and key findings related to nurse staffing levels, patient safety, and the quality of care. The analysis covers various aspects, such as the correlation between nursing workload and patient safety incidents, the impact of staffing levels on mortality rates, and the effect of workload on nurses' professional development and patient satisfaction. The report highlights the consequences of staff shortages, including increased workloads, potential for reduced quality of care, and the need for effective strategies to address these challenges. The findings emphasize the importance of adequate staffing and the need for healthcare organizations to implement strategies to mitigate the negative effects of nursing shortages. The report also provides recommendations for healthcare organizations to address these issues, including improved staffing and support for nursing staff.

Running head: SHORTAGE OF NURSING STAFF AND WORKLOAD
HOW SHORTAGE OF NURSING STAFF LEADS TO MORE WORKLOADS IN CLINICAL
SETTINGS
Fardowsa Osman
Grand Canyon University
December 14, 2019

1SHORTAGE OF NURSING STAFF AND WORKLOAD
Nursing shortage is a global challenge facing the healthcare industry in all countries around the
globe. Factors that contribute to staff shortage are multifaceted and related to the structural
problems that affect the way healthcare organizations higher the nurses. This is related to the
reduced number of nurses being recruited in nursing institutions and the increased population
that is happening in all states of America (Kaur & Gujral, 2017). The outcome of this problem
has been attributed to many challenges in the practice that lead to reduced quality of the staff.

2SHORTAGE OF NURSING STAFF AND WORKLOAD
Criteria Article 1 Article 2 Article 3 Article 4
Author, Journal
(Peer-Reviewed),
and
Permalink or
Working Link to
Access Article
Duffield, C., &
O’brien-
Pallas, L.
Australian
Health
Review, 26(1),
192-199.
https://
opus.lib.uts.edu.au/
bitstream/
10453/4514/1/200300
0980.pdf
Fagerström, L.,
Kinnunen,
M., &
Saarela1, J.
BMJ Open,
8.
https://
bmjopen.bmj.com/
content/bmjopen/
8/4/
e016367.full.pdf
Griffiths, P.,
Maruotti,
A.,
Saucedo,
A. R.,
Redfern,
O. C.,
Ball, J.
E.,
Briggs,
J., . . .
Smith, G.
B. BMJ
Quality
Safety,
5(3).
https://
qualitysafety.bmj
.com/content/
qhc/
Kaur, N., &
Gujral,
H. K.,
6(5), 23-
26.
Journal of
Nursing and
Health Science.
https://
pdfs.semanticsc
holar.org/
c497/60fdffe81
afe22f1c0d2d29
58c67d52cb815
.pdf

3SHORTAGE OF NURSING STAFF AND WORKLOAD
28/8/609.full.pdf
Article Title and
Year Published
The causes and
consequences of
nursing shortages: a
helicopter view of the
research. (2013).
Nursing workload,
patient safety
incidents and
mortality: an
observational
study from
Finland. (2018).
Nurse staffing,
nursing
assistants and
hospital
mortality:
retrospective
longitudinal
cohort study.
(2018).
Work Load On
Nurses And It’s
Impact On
Patientcare.
(2017).
Research
Questions
(Qualitative)/Hy
pothesis
(Quantitative),
and
Purposes/Aim of
Study
To present an
overview of the
interlinking factors
that cause nursing
shortages.
To investigate the
correlation
between daily
workload of nurses
to patient safety
incidents and
patient mortality.
To determine the
association
between
registered nurse
levels and
nursing assistant
staffing in
reducing
mortality rate.
To study the
role of staffing
levels in quality
patient
outcomes.
The research
aimed at finding
the answers to
the questions
like what is the
impact of
nursing
workload on the

4SHORTAGE OF NURSING STAFF AND WORKLOAD
care of patients,
what is the level
of satisfaction
among the
nursing staffs,
what is the level
of workload in
the nursing
staffs in
different
hospitals. The
final objective
was to find a
conclusive
statement and
recommendatio
ns regarding the
problem of
nursing
workloads on
various
hospitals.
Design (Type of
Quantitative, or
The study design The study design Quantitative A qualitative

5SHORTAGE OF NURSING STAFF AND WORKLOAD
Type of
Qualitative)
used for this
overview study can
be described as
qualitative.
used both
qualitative and
quantitative
designs.
study design was
used for this
study.
study design
was adapted for
conducting this
study.
Setting/Sample There was no specific
sample size
mentioned in the
study. The study
setting was natural
setting.
The study setting
was 3 secondary
acute care hospital
and a tertiary acute
care hospital. The
sample can be
considered as 36
units from all
those hospitals.
The study was
done in a
hospital setting
involving
different wards.
The sample size
was 138133
patients who
were adult per
age.
The study
setting was
natural for this
study and the
sample that
were used in
this study was
previous studies
and the size of
the sample was
not mentioned
in the article.
Methods:
Intervention/
Instruments
Various previous
studies were
reviewed in order to
examine four aspects.
Those aspects are
“Nursing workforce
characteristics”,
The nursing
resources,
incidents of patient
safety and the
mortality rate of
the patients along
with the nursing
The study was an
observational
study that was
done by using a
longitudinal and
retrospective
approach. The
The secondary
data that are
obtained from
the previous
study articles
were subjected
to direct

6SHORTAGE OF NURSING STAFF AND WORKLOAD
“Workload and work
environment”,
“Organizational
structures and
management
systems” and “Impact
on staffs and patient
safety”.
intensity in the
patients were
measured on a
daily basis for
almost one year.
data required for
this study
regarding the
staffing of the
nurses and the
patients were
collected from
various
databases mainly
from the
administration
department of
the hospital.
After that all
those data were
subjected to
measurement in
order to
determine the
primary outcome
of patient death
and the level of
staffing in the
assessments in
order to find the
answers to the
research
questions.

7SHORTAGE OF NURSING STAFF AND WORKLOAD
nurses.
Analysis The analysis of the
data for this study
was performed using
a manual approach.
The analysis of the
data was done by
using the
RAFALA system
and various
statistical methods
were used.
The analysis was
done in order to
determine the
associative effect
of the nursing
staffs and the
patient death by
using the mixed
level
hierarchical/
multilevel mixed
effects survival
level. The first
NEWS, the
SHMI risk score
were used in
order to assess
the risks of
patient death.
This study was
also dependent
on the manual
analysis
approach.
Key Findings Different factors
impact service
delivery by nurses.
Odds for patient
safety were 1.24
(95% CI 1.08 to
The results show
that hospital
mortality was
Nursing
workload
affects the

8SHORTAGE OF NURSING STAFF AND WORKLOAD
Most challenges in
the nursing
profession are
retention challenges,
organizational
structure and
sometimes nurse
experience in
managing the
condition.
1.42)
corresponding
estimates for
patient mortality
were 1.43 (95% CI
1.18 to 1.73) and
0.78 (95% CI 0.60
to 1.00). There is
a direct association
between daily
workload per nurse
and patient safety.
4.1% with the
hazard of death
increasing by 3%
for every day
patient
experience of
registered nurse
staffing that is
below the ward
mean. However,
there is no
difference
between
increased or
reduced nurse
levels to
mortality.
quality of care,
patient
satisfaction and
recovery.
Balancing
nursing
workloads
ensures that
there is a
healthy working
environment
thus reducing
burnout and
work stress.
Recommendatio
ns
The healthcare
organization must not
be hiring unskilled
nursing staffs, since
this approach only
provide some
In order to
implement clinical
governance,
successful
leadership and
inviting a desired
The only
recommendation
made in this
study is that in
order to improve
the conditions of
There was no
specific
recommendatio
ns provided in
this study.
Though from

9SHORTAGE OF NURSING STAFF AND WORKLOAD
additional workloads
for the professional
and registered nurses.
outcome, an
allocation of the
efficient resources
is necessary.
nursing staff
shortages the
matter of more
supply of
professional RNs
should be kept in
continuous
focus.
the conclusion
it can be
determined that
keeping a
continuous
track of
workload in
nursing staffs
can prove to be
effective in
lowering the
instances of
stress related
symptoms in
the nurses.
Explanation of
How the Article
Supports
EBP/Capstone
Project
The study examines
various aspects in
order to find the
reasons and the
consequences of
nursing staff
shortage. The study
also recommends a
The purpose of the
study was to
measure patient
safety incidents
and death, hence
an establishment
of the relationship
between the
The outcome for
this study
showed that
there is strong
association could
be found
between the
number of
The research
was important
since it
identified the
relation
between the
nursing
workload and

10SHORTAGE OF NURSING STAFF AND WORKLOAD
few suggestions in
order to improve the
condition.
incidences and the
factors that are
responsible. These
findings will help
in the development
of a better strategy
to invite a desired
outcome.
hospital deaths
and the shortage
of the nurses.
This study is
based on direct
evidences that
suggest the
instances of
patient death can
be lowered if the
problem of
nursing staff
shortage is
addressed
properly.
the quality of
care in the
patient.
The findings in
relation to this
can be used as
evidence while
developing an
improvement
plan addressing
this issue.
Criteria Article 5 Article 6 Article 7 Article 8
Author, Journal
(Peer-Reviewed),
and
Permalink or
Working Link to
Access Article
Maura, Havaei, S.
D., &
MacPhee, F.
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