Regulatory and Accreditation

Quantitative Research Article critical review Sandra M. Smith NUR/518 February, 26, 2012 Veta Massey Quantitative Research Article Critique Kalisch, B. J. , & Lee, K. (2011). Nurse Staffing Levels and Team hunt down A Cross-Sectional adopt of Patient wangle Units in Acute C atomic number 18 Hospitals. Journal of breast feeding Scholarship, 43(1), 82-88. Introduction The purpose of this ingest is to explore the circulating(prenominal) research data and use of the Nurse Teamwork Survey to see if hold in mental facultying aims predicts aggroupwork. The importance of teamwork is to achieve a higher(prenominal) take of affected role safety, tonus of bang, job satisfaction, and decrease turnover.A cross-sectional descriptive envision was used with a 2,545 breast feeding supply on 52 units delivering patient care, in quadruple polar hospitals among the Mid- West. The relevance of the turn over is to show that there is an association among quality, safe care, and teamwo rk which overly requires safe runging (Kalisch & Lee, 2011) The title of the article suggests the main variables and the creation in the contain. The abstract concisely and clearly summarize the main occupation, method, and results of the study. The problem set is a lack of understanding between the human descent of workload, teamwork, and take aim of staffing.Literature review The literature review is up- to -date and focused mostly on primary(a) sources. Dates of the literature review range from 1994- 2009. Only one review analyze was over 10 years and six were in the past quintuple years. The review lets a range of comparisons between teamwork and job satisfaction, mortality rate, social skills, and quality of care. What is know is that a higher level of teamwork in the intense care units was found to be related to a decrease in mortality rates (Kalisch & Lee, 2011). Also, a decrease in vacancy rates, and staff turnover was associated with higher level of teamwork.Br ewer (2006) showed that improved teamwork found a fundamental decrease in patient falls. The literature review provides a square(p) base for this study. What is unknown is the blood between workload, staffing levels, and teamwork. Framework The study illustrates a conceptual exemplar which postulates that staffing levels predict teamwork when there is control of the acuteness( CMI) of the patients on the units, the surface of the hospital and the nurse staffing levels( nurse staffing include RNs, LPNs, NAs, and unit secretaries) (Kalisch & Lee, 2009, p. 3). There is a conceptual map, which identifies the variables and relationship that is simple and understandable. The framework was based on the taboocome of the literature review and the effects that staffing levels had on teamwork. The framework does identify the relationships between teamwork and staffing levels to patient outcomes. The framework relates to the body of nursing knowledge in that patient safety and patient pe rception of care delivered in held in high esteem for nurses (Kalisch & Lee, 2011, p. 83).The conceptual framework place the meaning of teamwork by using the Salas, Sims, and Burke (2005) study that identified tail fin important elements of teamwork (trust, team orientation, back up, shared mental model, and team leadership). victimization this conceptual framework its basic foundation, the Nursing Teamwork Survey (NTS) was developed and tried to be used for the psychometric elements. This tribulationing resulted in identifying five different elements of the nursing team that was descriptive. The research questions proposed where asfollows By controlling the CMI and sizing of the hospital, does the level of staffing predict nursing teamwork?By controlling hospital size and CMI, does the level of staffing predict subscales of teamwork (trust, team orientation, back up shared mental model, and team leadership) (Kalisch & Lee, 2011, p. 83)? The aim of the research questions was appr opriate to the study on that they identified the relationship between teamwork and staffing levels. Method The study (Kalisch & Lee, 2011) used a descriptive, cross-sectional design and an appropriate sample was used. The setting was tetrad hospitals within the Midwest of the United. try out characteristics were 60% over the age of 35.The majority of the sample were female (89%) and RNs (70%), and the majority (74%) had at least 2 years find (Kalisch & Lee, 2011, p. 83). The sample group was identified and described and sufficient in size and character. The size of the hospitals were between 300 -900 beds. All units were eligible for inclusion. A lend of 52 beds was the study sample. The sampling staff made up 2,545 respondents. 1,741 were RNs, 41 were LPNs, 502 were NAs, and 191 were unit secretaries. The sample groups were appropriately identified as pertinent to the study question.The NTS was used in this study and was mean to measure nursing teamwork in the inpatient care s etting. The Bartlett test was used to indicate the correlation matrix that showed it not to be an identity operator matrix. The Kaiser-Meyer-Olkin measured the sample adequacy. In this study it was determined to be resplendent at (0. 961). Confirmatory factor compendium also showed that the team work model of five factors belong the data well. A comparative fit index model was 0. 884 with a root mean square misplay of approximation to be 0. 055. The test and retest reliability was good at 0. 92.The trunk of the sentiment showed to be 0. 94 with co-efficient ranging from 0. 74-0. 85. The results of these tests showed a similarity in responses of staff members on the same unit (Kalisch & Lee, 2011). The NTS used was a questionnaire. It contains 33 questions with a Likert-type scaling system. This survey was generated by the literature review and from focus groups with staff members. The staff members are dependent variables within the study, although the hospital size and CMI o f the patients are independent variables. The survey was given to the staff with a time place for responding.The response was anonymous. Staffing data was also obtained by each hospitals database. The nurse staffing indicators include hours per patient day (HPPD), RN hours per patient day (RN HPPD), and skill motley (RNs LPNs, and NAs providing direct patient care). The acuity of the patients was also a factor. The study did ensure comparable data among the four sites. This was done by using the raw data that was provided by the fighting(a) hospitals. The appropriate statistical methods were used in this study and the research questions were also addressed with the groups surveyed. Data collectionThe study was conducted over a four- week stop consonant where data was collected from each facility. The data collection phase included two separate study phases. The first phase was the administration of the survey to the units and the collection of raw staffing data from the hospital s. The NTS was put in an envelope with a letter of explanation about the study. Incentive was given to each act by the addition of a candy bar. The participation was made known to be voluntary. The subjects were to place the completed survey in a locked recession provided on each unit. A pizza incentive was given for units who achieved a 50% return.This incentive was appropriate because the staff had to take time out of their work day to do the study. The second phase, which collected the raw data of HPPD, RN HPPD, CMI, and skill tittup were obtained from each unit prior to the NTS universe administered (Kalisch & Lee, 2011). The collected data was appropriate to the study questions. Statistical data epitome Data synopsis was obtained by the use of the Statistical Package for tender Science version 16. 0. The unit analysis is identified as the patient care unit. The mean score for teamwork level obtained from the NTS was collected and combined to a unit level team score.Stati stical analysis was done to address each question in the study. Appropriate methods were used to analyze the data obtained. preceding analysis involved using frequency, descriptive, and correlation methods that associated with the research question. Correlation analysis was effectively used to address the relationships between hospital bed size, staffing levels, and teamwork (Kalisch & Lee, 2011, p. 85). infantile fixation analysis was done to identify the correlation of staffing levels as it compares to the five subscales of teamwork.One analysis identified HPPD as the high level of predictability of teamwork on the unit. The analysis showed that the higher the skill mixes on a floor and higher HPPD, the greater the predictability of teamwork. The findings of the study are adequately summarized by the use of multiple tables. The findings are describe in a manner that would support evidence-base practice. Discussion The major findings of the relationship between staffing levels a nd teamwork were interpreted and discussed. This study does demonstrate that there is a relationship between HPPD and nursing teamwork.It was also reported that the higher the skill mix the greater level of teamwork. Researcher notes that the use of actual nurse staffing data adds substantial credibility and confidence to the previous findings (Kalisch & Lee, 2011, p. 86). The interpretations of the study appear to uniformly flow with the results. The study does discuss the limitations of the study on that the sample was in only four Mid-Western hospitals. According to Kalisch and Lee (2011, p. 87), team work is to a greater extent difficult to achieve in larger hospitals. The sample does not provide for generalizability of the findings.The study recommends further direct observation studies to measure actual teamwork. Implications The study does discuss the implications of the findings. The results suggest that ensuring adequate staffing is important but also change magnitude the efficiency of the delivery of care by using staff more than effectively. Summary Despite some identified limitations such as generalizability, the study findings appear to have validity and show confidence in the honesty of the results. The study does contribute to meaningful results and evidence applicable in nursing practice and hospital policies regarding staffing.Further study suggested would be to observe larger inward city hospitals with greater levels of skill mix for longer duration of time. References Brewer, B. B. (2006). Relationships among teams, culture, safety, and apostrophize outcomes. Western Journal of Nursing Research, 28(6), 641-653 Kalisch, B. J. , & Lee, K. (2011). Nurse Staffing Levels and Teamwork A Cross-Sectional Study of Patient Care Units in Acute Care Hospitals. Journal of Nursing Scholarship, 43(1), 82-88. Salas, E. , Sims, D. E. , & Burke, C. S. (2005). Is there a big five in teamwork? Small convention Research, 36(5), 555-599.