Article critique
The title of the study provides a clear and succinct indication of the issues which will be touched on in the main study. The issues which will be discussed in the study includes nurse staffing, nurse work schedule and patient mortality have been clearly captured. Such a realization provides the reader with a sneak preview of what to expect when they read the study.
Abstract
The abstract of the study provides a clear breakdown of what the reader should expect to see while reading the paper. The problem of the study has been clearly stated as the independent effects which work schedules have on the outcomes of patients (patient mortality). The problem is also captured in the objective section of the abstract. The method employed in the study starts with a cross sectional study design on more than 633 nurses providing their services in acute non-federal hospitals totaling seventy one in number (Trinkoff et al., 2011). The analytic process employed is also discussed in the methodology section. The results section of the abstract present a direct relationship between the burden of the nurses’ work and the patient mortality rates. For instance, pneumonia, abdominal aortic aneurysm, congestive heart failure and acute myocardial infarction deaths were positively correlated with pressing working schedules. As such, the conclusion from the results is that there is a direct relationship between nurse work schedules and patient outcomes.
Introduction
Quoting the statement of the problem from the study, “because the alertness and vigilance required in nursing protocols depends upon having an adequate duration of quality sleep, long work hours can impact nursing care and can increase the potential for error” (Trinkoff et al., 2011) it becomes easy to identify and build a persuasive argument which forms the basis for carrying out the study. The problem is significant to nursing care since it shows the repercussions which may come about as a result of care providers being exposed to long working hours. There is a positive relationship between the methods used and the research problem since the quantitative design is directed towards ensuring that a positive relationship exists between nurse work schedules and patient mortality rates.
Hypotheses or research questions
The hypothesis of the study has clearly stated that in hospitals where adverse working schedules are reported by care providers, the incidences of high mortality rates will be an indication of poor quality care provided to patients. The hypothetical underpinnings of the study are directly related with the study’s conceptual framework of balance theory which states that the performance of an individual is usually affected by excessive job demands.
Literature review
The literature employed in the study process is composed of primary studies most of which were completed less than ten years before this study was done. The issues discussed in the literature review part provide a succinct relationship between nurse work schedules, sleep deprivation, fatigue and nurse illness (Trinkoff et al., 2011). One of the studies posits that the issue of sleep deprivation results in poor psychomotor coordination and impaired vigilance which provides direction for carrying out the new study.
Conceptual/theoretical framework
The Conceptual framework of the study is based on the balance theory which posits that an individual’s work performance is usually affected by excessive demands of their work. By extension, therefore, the effects are on the patient.
Methods
Protection of human rights
This study does not provide the basis for the protection of human participants and as such may compromise the ethical underpinnings which guide research studies.
Research design
The study employed a cross sectional design which is the most appropriate for this situation since data from diverse healthcare settings had to be compared. Comparing the data from the seventy one different hospitals was a crucial step in ensuring easy interpretation of the inferences. The points of data collection were appropriate since hospitals are the areas where nurses work.
Population and sample
The sample used in the study comprised of 633 nurses working in diverse healthcare facilities in the region. This sample was taken through a rigorous process of feeling questionnaires from a nurses work life and health study survey (Trinkoff et al., 2011). The use of a cross sectional design was essential in enhancing the representativeness of the sample.
Data collection and measurement
The data which was collected mainly focused on the key variables which were included in the study. Different methods were employed in the collection of the different types of data used in the process. Information on work schedules was collected from standard shift work index, staffing data from the American hospital association annual survey of hospitals while mortality rates were calculated from the discharge data. As such, the data collected met the reliability and validity tests.
Procedures
The intervention employed consisted of nine RNs from each facility responding to the questions in the survey. As such, all the 633 participants in the study actually participated in filling up the questionnaires. The participants were also adequately trained since all of them had a working experience of more than one year.
Results
Data analysis
All the components making up the variables of the study were analyzed using the Predictive Analysis Software (PASW). Analyses regarding nurses’ working schedules, patient mortality and staffing were done with specific attention to the mean and standard deviation values. The possibilities of multicollinearity issues affecting the final results were addressed by employing GEE modeling thus controlling the confounding variables (Trinkoff et al., 2011). This analytical process served the role of avoiding possible type I and type II errors from the process since the alternative hypothesis was proved.
Findings
The inferences from the study were presented at 95% confidence level and 5% statistical significance level. The results from the study have been presented in the form of tables, percentages and figures which make it easy for comparisons regarding evidence based practice to be made.
Discussion
Interpretation of the findings
The inferences from the study show a direct relationship between the variables presented in the design and the expected results which is patient outcomes. Work schedules were found to have most of the negative effects on patient mortality rates. Poor staffing was also shown to result in nurse exhaustion thus leading to nurse injuries. Such deductions present a causal relationship between the study variables (Trinkoff et al., 2011). The inferences touch on the issue of generalizability since nurses working in these teaching facilities may be well trained than care providers in other facilities.
Implications/ recommendations
The study identifies the effects which improper staffing and poorly planned work schedules have on patient outcomes. The recommendation for this study is ensuring that care providers are presented with 12-hour shifts for them to get enough sleep.
Global Issues
Presentation
The mechanics employed in writing the study focuses on proper organization and critical analysis thereby enabling the reader to have a quick glimpse of the study’s gist. The study does not however employ a CONSORT flow chart since it is not a randomized control trial.
Researcher credibility
The cross section design methodology employed by the researchers in the process indicates that they are well accustomed to the research process which, therefore, enhances the confidence in the results gotten from the study process.
Summary assessment
The findings of the study indicate that the issue of work schedules and staffing levels plays a crucial role in ensuring that patients are able to emerge with positive outcomes from the care they receive. There is the need for healthcare facilities to ensure that the nurse working shifts have been designed in such a way that allows them to have enough sleep.
References
Trinkoff, A. M., Johantgen, M., Storr, C. L., Gurses, A. P., Liang, Y., & Han, K. (2011). Nurses' work schedule characteristics, nurse staffing, and patient mortality. Nursing research, 60(1), 1-8.
