University Health Science Research Critique Report

This report presents a comprehensive research critique in the field of health science, meticulously analyzing both qualitative and quantitative studies. The analysis centers around a specific PICOT question, which explores the impact of nurse-to-patient ratios on patient care quality and medication errors in acute care settings, particularly for patients aged 65 and above. The report critically examines four selected articles, summarizing their backgrounds, methodologies, results, and ethical considerations. It highlights the key findings related to nursing staff adequacy, medication error reduction, and the significance of nursing education and training. The critique also compares the outcomes of the studies, emphasizing the implications for nursing practice and patient safety. Furthermore, the report synthesizes the research findings to propose evidence-based practice changes, aiming to improve healthcare outcomes and reduce the incidence of medication errors. The studies reviewed include the effect of nurse-to-patient ratios on nurse-sensitive patient outcomes, perceptions regarding medication administration errors, and the relationships between nurse staffing and medication errors. The report concludes with a discussion on the link between the PICOT question, the research articles, and the identified nursing practice problem, ultimately advocating for changes that enhance patient care and safety.

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 defined as the process of analysing a research paper that will
focus on the limitation and strength of the research study. Research Critiquing is considered
as the systematic method or approach that is primarily used to evaluate the research study and
report the result accordingly (McDonald, 2017). The researchers focus on the best existing
exercise that will highlight the capability of the researcher to assess and evaluate the
explanation of the study. The study will focus on critiquing two qualitative study and two
quantitative study that is associated with the PICOT question. This research study was
conducted based on the necessity of higher nursing staff proportion within a health care
situation to decrease the probabilities of medication error and distribution of improved health
care management and treatment.
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?”
Qualitative Research Critique
Nominated articles:
Article 1: 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.

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.
Article 2: Nurse staffing and medication errors: cross sectional or longitudinal
relationships?
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.
Background of Study
The first article focus on identifying appropriate nursing care that is frequently missed
at the acute hospital setting. The researcher had also focused on determining the association
between the missed care of the patient and the care that is given to the patient in the nursing
staff. The mortality rate was also focused that was majorly affected due to the nursing staff
level and patient outcome (Driscoll et al., 2017). The PICOT question was associated and
linked with the objective of the research as the study provided a detail explanation of the
result that exhibit the low registered nurse staffing associated with missed care that was not
given to the acute inpatient.
In the second article, the researcher has focused on the cause of error or the factors
that lead to error rather than highlighting the steps of error recovery. The researcher had
focused that it is very crucial for the nurse to keep the patient safe and utilize their nursing
practice through effective education and experience. The study focused on the nurses of
medical-surgery background and how their knowledge and experience will help them to treat
the patient effectively and reduce medication error (Mark & Belyea, 2009). The researcher
had concluded that it is very crucial for the nurse to be proficiently trained in order to create a
safe and healthy healthcare system that will also assist in reducing the possibility of
medication error. The significant of the studies are to reduce the occurrence of medication
error in the health care settings, also it demonstrates the association of the nursing staff with
the appropriate nursing care for the patient.

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Methods
In article 1, the researcher had focused on collection of secondary data and hence used
qualitative study method for extraction of relevant information. Literature review and
comprehensive examination was done that would help the researcher to determine if the
interpreted research question is relevant and significant (Driscoll et al., 2017). This data
collection method is based on the primary resources and thus might not be fully acceptable
for an unbiased review of the literature.
In article 2, a descriptive correlational and cross-sectional study was performed that
comprised of 184 participants who were nurses and they evaluated the relationship among the
organizational factors, nurse characteristics and medical-error recovery within the nurses
belonging to medical-surgery background (Mark & Belyea, 2009). The benefit of the study is
that, it helped the nursing staffs to understand the characteristics of the nursing role and its
impact on the medication administration and error occurrence rate in a healthcare setting.
Result
In article 1, the key findings obtained from the study was that lower registered nursing
staff is related with the missed or skipped nursing care within the hospital setting. The
findings exhibited that missed nursing care was primarily due to nursing staff adequacy
(Driscoll et al., 2017). This also shows that the presence of the nurse is also very important in
order to provide better patient outcome. In article 2, the key findings obtained from the study
exhibited that effective nursing education and experience is crucial for correcting the medical
error that will enhance the patient safety and healthcare (Mark & Belyea, 2009). It also
helped to show that medical errors can be reduced by their timely reporting and analysis.
In article 1, the implication of efficient registered nursing staff within the acute care
setting is significant for reducing missed nursing care and efficient knowledge to the
registered nurse will help the nurse to gain knowledge about the factors that result in bad

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nursing outcome and healthcare (Driscoll et al., 2017). The article also shows the effect of the
nursing on the better patient outcome and thus clearly highlighted the relation between the
adequate numbers of nurses with that of patient outcome. In article 2, the implication of
proper nursing education and training of the registered nurse is necessary for improving the
medical recovery of the patient. The factors that result in medical error can be highlighted
and can be used to remove the medical error (Mark & Belyea, 2009). The practice has helped
the nursing staff to develop in their field of practice and enhance the quality of care delivery
to the patients and also decrease the error occurrence rate (Bowdle et al., 2018).
Ethical Consideration
In article 1 and article 2, no such ethical consideration was included by the
researchers.
Outcome Comparison
In article 1, it was evident that the shortage in the nursing staff causes burden to the
other nurses and results in the decrease in the quality care. Thus, there should be adequate
nurses so as to give proper nursing to each patient. Low nursing staff level was also reported
that resulted in missed care and eventually effected the patient care and safety (Driscoll et al.,
2017). Effective communication between the patient and the nurse was also missing that
resulted in absence of effective care. The consequence of missed care that affected the patient
health was elaborated in this study and the outcome exhibited that resulted prevalence rate
might act as the care quality indicator and effective staff management is crucial for maintain
and reducing the medical error. In article 2, the lack of effective education and proper
experience was considered as the factors that resulted in medical error and it was crucial to
overcome the error and focus on medical recovery. The activity of medical-surgery nurse was
crucial in increasing and maintaining the patient safety that will in turn assist the nurse in
creating a healthy and safe healthcare setting that will promote safer nursing practice and

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reduce the medical error too (Mark & Belyea, 2009). The researcher concluded that effective
medical recovery will depend on the education, ability of the nurse to interpret and
understand the issue of the patient, experience of the nurse and locate the factors that will
result in medical error.
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.
International Journal of Quality in Health Care, 27(4), 276-283.
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.
Background of the Study
In article 1, the researcher had exhibited the association between the medication error
and the nursing staff that is significant for policy concern. The lower registered nursing staff
is related with the missed or skipped nursing care within the hospital setting. The findings
exhibited that missed nursing care was primarily due to nursing staff adequacy. There is also
a dependence on the education, training, safe medication and administration of the nurses for
the reduction of the medical errors. In addition to that it also encouraged the nurses to

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identify the problems and to report the same (You et al., 2015). Different factors are
responsible for exhibiting the relationship and the result identified was also inconsistent. The
factors included are diverse analysis unit, different nursing staff measures, diverse methods of
operationalization and conceptualization and different risk adjustment approaches (Mark &
Belyea, 2009). Extensive literature review was conducted that would help the researcher to
understand the relationship in a better way. In the second article, the researcher constructed a
set of research question that would exhibit the relationship between the patient consequences
and number of nursing staff. The primary objective of the study was to evaluate the
relationship between the levels of nursing staff and predict the nurse profound patient
consequences within the healthcare setting (Driscoll et al., 2017). The objective of both the
research article was relevant to the PICOT question as the objective exhibit the association
between the outcome of the patient and nursing staff associates. The significance of these
study is that; it provides the nursing staff with the proper knowledge regarding the
complications and risk factors associated with the medication error. Medication error is found
to effect the development and recovery process of the patient (Berdot et al., 2016).
Method of the Study
In article 1, a longitudinal, prospective and non-experimental study was performed
accompanied with formal modelling design. The study was included as the large and multi-
position organizational study that would help the researcher to explore the association among
the patient outcome, hospital context and organizational and hospital structure and nurse.
Large set of secondary data is collected in this study (You et al., 2015). In article 2,
systematic review method is used in the study associated with meta-analysis method that is
required to gain information and knowledge regarding the proposed PICOT question
(Driscoll et al., 2017).
Result

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In article 1, the researcher had exhibited important finding that will show the factors
leading to medication error and disturbing the nursing-medication error. It was extracted from
the study through structural contingency theory using conceptual model that organizational
structure and context influence the medication error and role of nursing staff is crucial for
effective medication error (You et al., 2015). In article 2, the researcher had exhibited
important finding that will exhibit that increased nursing staff member is associated with
lower or decreased rate of better patient outcome and recovery, medication error, mortality
and infection (Driscoll et al., 2017).
In article 1, significant methodological and managerial implication was highlighted
that would include the perspective of management and methods used in the study (You et al.,
2015). From both the perspective important factors that was extracted as the primary reason
of medication error was highlighted and can be used to reduce the high possibility of
medication error. Hence, implication of better management and nursing procedure was
crucial for reducing the high possibility of medication error. In article 2, the researcher had
stated that higher number of research evidence was still required to completely validate the
effectiveness of nursing and patient association and ratio (Driscoll et al., 2017).
The benefits of both the studies are that, these studies provide the nursing staff with
the idea and knowledge about how the medication error may harm the health and increase the
risk factors for the patient. It also provides the knowledge about how to provide proper
medication administration to the patient in order to avoid any complications (Berdot et al.,
2016).
Outcome Comparison
In article 1, nursing unit characteristics was considered as the factor that will affect
the medication error like average occupancy, method to assist the medication administration
and work uncertainty (You et al., 2015). In article 2, lower level of medication error was seen

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associated with reduced morbidity and mortality rate after higher number of nursing staff
members were recruited within the healthcare setting. In both the articles, the concept of
medication error was highlighted and the factors that respectively effect the upsurge of
medication error was exhibited as the outcome (Driscoll et al., 2017). These practice
enhances awareness regarding the medication error occurrence in the health care
professionals, also it has been observed that the practice has reduced the rate of health care
risk and health complications among the patients.
Conclusion
It can be concluded from the above four research article that greater significance was
given to the concept of medication error and how this medication error is related to the bad
patient health outcome. The relationship between the nursing staff, administration, patient
outcome and medication error was exhibited in both qualitative and quantitative research
study. The strategies that can be used to reduce the medication error and enhance the patient
health outcome by improving the health care delivery of the patient within the healthcare
setting.

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References
Berdot, S., Roudot, M., Schramm, C., Katsahian, S., Durieux, P., & Sabatier, B. (2016).
Interventions to reduce nurses’ medication administration errors in inpatient settings:
a systematic review and meta-analysis. International Journal of Nursing Studies, 53,
342-350.https://doi.org/10.1016/j.ijnurstu.2015.08.012
Bowdle, T. A., Jelacic, S., Nair, B., Togashi, K., Caine, K., Bussey, L., ... & Merry, A. F.
(2018). Facilitated self-reported anaesthetic medication errors before and after
implementation of a safety bundle and barcode-based safety system. British journal of
anaesthesia, 121(6), 1338-1345. https://doi.org/10.1016/j.bja.2018.09.004
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. https://doi.org/10.1177/1474515117721561
Mark, B. A., & Belyea, M. (2009). Nurse staffing and medication errors: Cross‐sectional or
longitudinal relationships? Research in nursing & health, 32(1), 18-30.
https://doi.org/10.1002/nur.20305
McDonald, J. (2017). Queering methodologies and organizational research: disrupting,
critiquing, and exploring. Qualitative Research in Organizations and Management:
An International Journal, 12(2), 130-148 https://doi.org/10.1108/QROM-06-2016-
1388
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/article/27/4/276/2357294

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