Description
Part 1. After discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based practice project. Explain how your proposal will directly and indirectly impact each of the aspects.
Part 2. Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction?
Literature Evaluation Table
Student Name: Jessica Mock
Change Topic (2-3 sentences): The impact of nurse shortage on quality of healthcare in primary
care setting. Nurse shortage has a detrimental impact on the quality of care provided in the
primary care settings.
Criteria
Article 1
Article 2
Article 3
© 2015. Grand Canyon University. All Rights Reserved.
Article 4
Author, Journal (PeerReviewed), and
Permalink or Working
Link to Access Article
Bragadóttir, H.,
Kalisch, B. J., &
Tryggvadóttir,
G. B.
https://scholar.go
ogle.com/scholar
?hl=en&as_sdt=
0%2C5&q=Brag
ad%C3%B3ttir
%2C+H.%2C+K
alisch%2C+B.+J
.%2C+%26+Try
ggvad%C3%B3t
tir%2C+G.+B.+
%282017%29.+
Correlates+and+
predictors+of+m
issed+nursing+c
are+in+hospitals.
+Journal+of+cli
nical+nursing%2
C+26%281112%29%2C+152
4-1534.&btnG=
Dellefield, M.
E., Castle, N.
G., McGilton,
K. S., &
Spilsbury, K.
https://scholar.
google.com/sch
olar?hl=en&as
_sdt=0%2C5&
q=Dellefield%
2C+M.+E.%2C
+Castle%2C+N
.+G.%2C+Mc
Gilton%2C+K.
+S.%2C+%26+
Spilsbury%2C
+K.+%282015
%29.+The+rela
tionship+betwe
en+registered+
nurses+and+nu
rsing+home+qu
ality%3A+An+
integrative+rev
iew+%2820082014%29.+Nur
sing+economic
%24%2C+33%
282%29%2C+
95108.&btnG=
DePasquale,
C., & Stange,
K.
https://www.nb
er.org/papers/w
22344
© 2017. Grand Canyon University. All Rights Reserved.
Makam, A. N.,
Nguyen, O. K.,
& Halm, E. A.
https://jamanet
work.com/jour
nals/jamaintern
almedicine/arti
cleabstract/26821
56
Article Title and Year
Published
Correlates and
predictors of
missed nursing
care in
hospitals.
Journal of
clinical
nursing. 2017
The
relationship
between
registered
nurses and
nursing home
quality: An
integrative
review (20082014). Nursing
economic$.
2015
Labour supply
effects of
occupational
regulation:
Evidence from
the nurse
licensure
compact (No.
w22344).
National
Bureau of
Economic
Research.
2016
Shortcomings
of Research
Regarding
Long-term
Acute Care
Hospitals and
Skilled Nursing
Facilities—
Reply. JAMA
internal
medicine. 2018
Research Questions
(Qualitative)/Hypothesis
(Quantitative), and
Purposes/Aim of Study
The article
focused on the
contribution of
the unit,
hospital and
staff features
towards missed
nursing care
responsibilities
in Iceland
hospital set up.
The article
explored on the
relationship
between the
Registered
Nurses and the
Nursing Home
Quality.
The study
aimed to
identify labor
supply of the
occupational
regulation upon
licensing
nursing
services.
The aim of the
study was to
examine
challenges
based on
research for
long-term acute
health units and
proficiency of
nursing skills.
Design (Type of
Quantitative, or Type of
Qualitative)
The study
assumed a
quantitative
cross-sectional
survey.
The study
presumes a
qualitative
approach.
The study used
quantitative
and qualitative
design.
The study used
quantitative
and qualitative
technique.
© 2017. Grand Canyon University. All Rights Reserved.
Setting/Sample
The samples
included
Registered
Nurses and
practical nurses
that is 864,
within 27
surgical, ICU
and medical
units in the
Iceland
hospital.
The samples
included the
role of
Registered
Nurses and
Nursing Home
in the context
of Medicare
beneficiaries.
Methods:
MISSCARE
The study
Intervention/Instruments Survey-Iceland employed an
and Nursing
integrative
Teamwork
review
Survey-Iceland methodology.
Analysis
The study
utilized
correlational
and regression
statistics during
data analysis.
The study
comprised
descriptive
analysis of the
Registered
Nurses and
Nurse Home.
The study
employed data
of over1.8
million nurses
and other
health
employees to
examine
evidence of
labor mobility
upon increasing
Nursing
Licensure
Compact.
The study
portrayed
Long-term
Acute Care
patients
account for
more than
130,000 yearly
admission
which costs
about $5.3
billion
Medicare
expenses.
The study used
comparison
technique
pertaining
nursing roles
upon licensing
their services.
The study used
data
estimations for
examining and
predict the
impact of longterm acute care
(LTACs) and
nursing skills.
The study
entailed
analytical
analysis that
compared the
labor market on
nursing units
upon Nurse
Licensure
Compact.
The study
comprised
analytical
analysis of the
data from the
previous years
and different
health units.
© 2017. Grand Canyon University. All Rights Reserved.
Key Findings
The multiple
regression
testing under
unit role and
staffing
adequacy
depicted 16%
of the missed
nursing duties.
The regression
testing of
model 2 on
nursing
teamwork
indicated 14%
variance on the
missed nursing
responsibilities.
The higher
number of the
Registered
Nurses staff,
the better
nursing quality
due to different
nursing skills.
There was no
evidence of
nursing
mobility after
introducing the
Nurse
Licensure
Compact
initiative.
The study
projected a
decline in the
use of LTACs,
due to
Sustainable
Growth Rate
Act established
in 2013.
Recommendations
The Iceland
hospital should
develop
strategies to
decrease the
missing
nursing care
and solve
staffing and
teamwork
issues.
There is need
for increasing
Registered
Nurses despite
cost
implications to
check on the
quality of the
patient care.
There is need
to educate
nurses the
significance of
licensing their
services to
allow adequate
and
professional
staff.
The need for
regular
research
affecting the
LTCAs and the
immediate
nursing skills
in the health
units.
© 2017. Grand Canyon University. All Rights Reserved.
Explanation of How the
Article Supports
EBP/Capstone Project
Criteria
Author, Journal (PeerReviewed), and
Permalink or Working
Link to Access Article
The article
supports the
Capstone
project by
emphasizing on
the importance
of increasing
nursing staff
and teamwork
oriented patient
care.
The article
seeks to
support the role
of Registered
Nurses in
provision of
quality nursing
care.
The article
emphasizes on
the nursing
services
mobility for
efficiency
within
healthcare
units.
The study
support the
Capstone
project via
focusing on the
challenges
affecting
healthcare units
and nursing
proficiency.
Article 5
Article 6
Article 7
Article 8
Smolowitz, J.,
Speakman, E.,
Wojnar, D.,
Whelan, E. M.,
Ulrich, S.,
Hayes, C., &
Wood, L.
https://www.scie
ncedirect.com/sc
ience/article/abs/
pii/S0029655414
001572
Snavely, T. M
https://go.galeg
roup.com/ps/an
onymous?id=G
ALE%7CA452
050018&sid=g
oogleScholar&
v=2.1&it=r&li
nkaccess=abs&
issn=07461739
&p=AONE&s
w=w
Staggs, V. S.,
Olds, D. M.,
Cramer, E., &
Shorr, R. I.
Veenema, T.
G., Griffin, A.,
Gable, A. R.,
MacIntyre, L.,
Simons, R. N.,
https://link.spri Couig, M. P.,
nger.com/articl … & Larson, E.
e/10.1007/s116 https://sigmapu
06-016-3830-z bs.onlinelibrary
.wiley.com/doi/
abs/10.1111/jn
u.12198
© 2017. Grand Canyon University. All Rights Reserved.
Article Title and Year
Published
Role of the
registered
nurse in
primary health
care: Meeting
health care
needs in the
21st century.
Nursing
Outlook. 2015
A brief
economic
analysis of the
looming
nursing
shortage in the
United States.
Nursing
Economics.
2016
Nursing skill
mix, nurse
staffing level,
and physical
restraint use in
US hospitals: a
longitudinal
study. Journal
of general
internal
medicine. 2017
Nurses as
leaders in
disaster
preparedness
and response—
A call to
action. Journal
of Nursing
Scholarship.
2016
Research Questions
(Qualitative)/Hypothesis
(Quantitative), and
Purposes/Aim of Study
The study
explored the
nursing tasks
for a
Registered
Nurse.
The study
purposed to
identify reasons
for shortage of
nurses in the
United States.
The study
investigated
nursing skills,
staff adequacy
and manual
restraint
employed in
US hospital set
ups.
The study
sought to
identify nursing
leadership
skills in the
disaster
occasions.
Design (Type of
Quantitative, or Type of
Qualitative)
The study was
qualitative in
nature.
The study
utilized
qualitative
design.
The study
assumed
quantitative
and qualitative
design.
The study ha
qualitative
design.
Setting/Sample
The study
sample focused
on the
Registered
Nurses duties
in 16 different
health units.
The study
focused on the
health units in
United States
to examine
stressors
causing
shortage of
nursing
personnel.
The study
focused on the
17 quarters
pertaining
longitudinal
data survey of
the units staff.
The study
examined 14
national
subjects or
concerns to
identify the
level of
preparedness
within nursing
personnel.
© 2017. Grand Canyon University. All Rights Reserved.
Methods:
The study
Intervention/Instruments employed
interview
process to
obtain roles
played by the
RNs in each
health unit.
Analysis
The study used
descriptive
analysis to
reveal different
tasks by RNs.
The study
projected
contemporary
factors in the
population to
lead nursing
skills problems.
The research
primarily
concentrated on
the staffing
level and
nursing skill
mix.
The study
employed
workshop
programmes
courtesy of the
Veterans
Emergency
Management
Evaluation
Center to
exposit the
issue.
The study
employed both
descriptive and
analytical
analysis in
examining the
probable
nursing
shortcoming in
the US
healthcare
units.
The study used
regression
analysis to
model the
quarterly odds
of the units’
restraints in
response to
staff and
nursing skills.
The study
utilized
descriptive and
analytical
analysis to
explain the
national
concerns and
the nature of
nurses’
preparedness.
© 2017. Grand Canyon University. All Rights Reserved.
Key Findings
The RNs in
general
performed nine
functions
including
telephone
triage,
management,
supervision,
leadership,
staff
assessment,
health
coaching, duty
delegation,
medication
reconciliation
and
documentation.
The aging
population,
aging baby
boomers,
inadequate
nursing
graduate and
rise of chronic
infections and
Affordable
Care Act led to
increased
nursing
shortage in the
US context.
The nursing
skill mix had
an inverse
correlation with
the physical
restraint use
especially for
fall prevention.
There was
insignificant
correlation
between the
nursing skill
mix and the
physical
restraint use.
The workshop
programme
aided in
development of
future disaster
management by
nursing
personnel in
the healthcare
settings.
Recommendations
The need to
add RNs roles
based on the
patient
attention
compared to
management
and leadership
objectives.
There is need
to motivate
students to
pursue nursing
courses to
increase the
nursing
personnel in
the United
States.
There is need
to link nursing
skills with their
relevant tasks
in the
healthcare
units.
The need to
equip nursing
personnel with
relevant and
contemporary
disaster issues
in the
healthcare
facilities.
© 2017. Grand Canyon University. All Rights Reserved.
Explanation of How the
Article Supports
EBP/Capstone
The study helps
on determining
the nursing
skills by
Registered
Nurses in
healthcare
units.
The article
back up the
Capstone
project by
emphasizing
the need for
adequate
nursing
workforce.
The study gives
overview of the
nursing tasks
recommended
by their
qualifications.
© 2017. Grand Canyon University. All Rights Reserved.
The article
supports the
Capstone
project by
emphasizing on
the specific
tasks deployed
by the nursing
workforce
especially
during
emergency
situations.
References
Bragadóttir, H., Kalisch, B. J., & Tryggvadóttir, G. B. (2017). Correlates and predictors of
missed nursing care in hospitals. Journal of clinical nursing, 26(11-12), 1524-1534.
Dellefield, M. E., Castle, N. G., McGilton, K. S., & Spilsbury, K. (2015). The relationship
between registered nurses and nursing home quality: An integrative review (2008-2014).
Nursing economic$, 33(2), 95-108.
DePasquale, C., & Stange, K., (2016). Labour supply effects of occupational regulation:
Evidence from the nurse licensure compact (No. w22344). National Bureau of Economic
Research.
Makam, A. N., Nguyen, O. K., & Halm, E. A. (2018). Shortcomings of Research Regarding
Long-term Acute Care Hospitals and Skilled Nursing Facilities—Reply. JAMA internal
medicine, 178(6), 866-867.
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L.
(2015). Role of the registered nurse in primary health care: Meeting health care needs in
the 21st century. Nursing Outlook, 63(2), 130-136.
Snavely, T. M., (2016). A brief economic analysis of the looming nursing shortage in the United
States. Nursing Economics, 34(2), 98-101.
© 2017. Grand Canyon University. All Rights Reserved.
Staggs, V. S., Olds, D. M., Cramer, E., & Shorr, R. I. (2017). Nursing skill mix, nurse staffing
level, and physical restraint use in US hospitals: a longitudinal study. Journal of general
internal medicine, 32(1), 35-41.
Veenema, T. G., Griffin, A., Gable, A. R., MacIntyre, L., Simons, R. N., Couig, M. P., … &
Larson, E. (2016). Nurses as leaders in disaster preparedness and response—A call to
action. Journal of Nursing Scholarship, 48(2), 187-200.
© 2017. Grand Canyon University. All Rights Reserved.
Running head: PICOT STATEMENT
1
PICOT Statement
Jessica Mock
Grand Canyon University- NRS 490
June 9, 2019
PICOT STATEMENT
2
Identification of Clinical Problem
Every health care system involves a primary objective, which is to promote the quality of
life of patients. Every patient expects the best quality of life whenever they go to the hospitals,
which satisfies them with the services offered. However, various issues confront health care
currently, which include long waiting times and delayed diagnosis, ADHD, or any other
dysfunction found in children. The principal aim of the investigation is to carry out an evaluation
and analysis of the child and adult growth Actions plans for Autism Spectrum Disorder to deal
with the issue of long waiting times and delayed diagnosis, ADHD or any other dysfunction.
Evidence-Based Solution
Rutherford et al. (2016) explain as to why professionals offer delayed assessment of
diagnosis of autism spectrum disorders (ASD). The investigation translates the evidence into the
practical application via actions plans for services of ASD. The authors presented an action plan
for child and adult diagnostic group to enhance the quality and efficacy of the process of
diagnostic evaluation. Zheng et al. (2016) point out that various problems need to be covered like
early identification, atypical and typical development, increased government investment,
professional development, and enhanced execution of available regulations. According to
Richards and Vostanis (2004), it is crucial for services of transitional mental health for
individuals with 16 years to 19-years in health district, as comprehended by specialists from
social, mental health, non-statutory services, and education. Besides, Chakroborty et al. (2014)
support the idea that early intervention in certain learning disability (SpLD) leads to the
enhanced outcome and controls comorbidity. This way, the authors give a comparison of
pathways for taking care of children with mental retardation and SpLD before reaching a tertiary
care center (Temper et al., 2017).
PICOT STATEMENT
3
Nursing Intervention, Patient Care, Health Care Agency, & Nursing Practice
For early intervention in specific learning disability (SpLD), Rutherford et al. (2016)
claim that it is crucial to utilize Goldberg’s pathways and MINI-KID for comorbidity to care
instrument. It is necessary to enhance physical exercise for youth with intellectual disabilities, as
it is one of the intervention’s description. Frey et al. (2017) executed an intervention for
initiating, increasing, or maintaining physical activity as well as reporting the efficacy of the
intervention. However, nurses will describe to the patients how to perform various exercises for
individuals with intellectual disabilities. Through the above responses, nurses possess the
potential of influencing positive patient outcomes that could enhance the quality of life of
patients while enhancing the quality of care offered to patients. Besides, nurses should carry out
an evaluation and analysis of adult and child growth Actions plans for Autism Spectrum Defect
to deal with the issue of long waiting times, and delayed diagnosis, ADHD or any other
dysfunction. The objective of nurses is to assist patients to stay a healthy life through
maintaining or strengthening their health activities. Through the above interventions, nurses will
be in a position to execute evidence-based practices in their clinical setting to enhance patients’
health.
PICOT Statement
Can children with mental disabilities have better health outcomes in adulthood if they are
managed upon early detection vs. later detection? Does early intervention truly impact health or
does mental disability have the same result despite the starting point of interventional therapies?
(P) Population: Children with mental disabilities like delayed speech or functions, autism,
ADHD, or any other type of dysfunction in children. Some children might be diagnosed early
and get treatment, and others may not be diagnosed until late childhood or into school age stages.
PICOT STATEMENT
4
Intervention: Depends on diagnosis, level of health disparity, and stage. Enhance physical
exercise for youths with intellectual disabilities; transitional services of mental health for
individuals with 16-years to 19-years in health district; an action plan for child and adult
diagnostic group to enhance the quality and efficacy of the process of diagnostic evaluation.
(C) Comparison: Children who receive early diagnosis and intervention vs. children that go
longer with no diagnosis or delayed diagnosis and delayed responses.
(O) Outcome: Improvement in physical exercise among youths with intellectual disabilities and
medication adherence as well as prevention of long waiting times, and delayed diagnosis.
(T) Time: The outcome of the study will be assessed weekly for eight weeks.
References
Chakraborty, S., Sagar Kommu, J. V., Srinath, S., Seshadri, S. P., & Girimaji, S. C. (2014). A
Comparative Study of Pathways to Care for Children with Specific Learning Disability
and Mental Retardation. Indian Journal of Psychological Medicine, 36(1), 27. Retrieved
from
PICOT STATEMENT
5
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&
db=edb&AN=94741876&site=eds-live&scope=site
Frey, G. C., Temple, V. A., & Stanish, H. I. (2017). Interventions to promote physical activity
for youth with intellectual disabilities. Salud Pública de México, 59(4), 437. Retrieved
from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&
db=edb&AN=124408973&site=eds-live&scope=site
Richards, M., & Vostanis, P. (2004). Interprofessional perspectives on transitional mental health
services for young people aged 16 – 19 years. Journal of Interprofessional Care, 18(2),
115–128. https://doi-org.lopes.idm.oclc.org/10.1080/13561820410001686882
Rutherford, M., McKenzie, K., Forsyth, K., McCartney, D., O, H. A., McClure, I., & Irvine, L.
(2016). Why are they waiting? Exploring professional perspectives and developing
solutions to delayed diagnosis of autism spectrum disorder in adults and
children. Research in Autism Spectrum Disorders, 31, 53–65. https://doiorg.lopes.idm.oclc.org/10.1016/j.rasd.2016.06.004
Temple, V. A., Frey, G. C., & Stanish, H. I. (2017). Interventions to promote physical activity
for adults with intellectual disabilities. Salud Pública de México, 59(4), 446. Retrieved
from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&
db=edb&AN=124408974&site=eds-live&scope=site
Zheng, Y., Maude, S. P., Brotherson, M. J., & Merritts, A. (2016). Early Childhood Intervention
in China from the Families’ Perspective. International Journal of Disability,
PICOT STATEMENT
Development & Education, 63(4), 431–449. https://doiorg.lopes.idm.oclc.org/10.1080/1034912X.2015.1124988
6
Running head: HEALTH AND MEDICAL
The impact of nurse shortage on the quality of care in the primary healthcare facilities
Jessica Mock
Grand Canyon University- NRS 490
June 2, 2019
1
HEALTH AND MEDICAL
2
Introduction
There is need for adequate nursing personnel in every hospital to ensure sufficient health
services to the patients. Nurses are part of the health specialists with necessary knowledge and
competency to handle clients and patients at family level, clinics and even at the hospitals.
Health centers with adequate nursing personnel provide effective healthcare attention to their
patients effectively. The proposed topic will focus on the effect of the nurse shortage on the
hospital patient care a situation in the context US primary healthcare facilities.
Discussion
In the recent past, there has been a shortage of nursing personnel in the US primary
healthcare centers which has adversely affected the patients. Nurses provides variety of
healthcare services to the hospital-based patients in their midst (Veenema et al., 2017). Firstly, it
is the responsibility of the nursing units to ensure medication administration to the patients. For
example, a nurse in charge of an admitted patient will ensure such a patient takes the medication
as per the doctor prescriptions following the exact dose and timeline. The nursing personnel
ensure patient can move freely within the restricted zone in the healthcare in case their admission
allows such movements. Thirdly, it is the role of a nurse to ensure patient takes their meals on
time within the hospital so that they are able to remain healthy. Similarly, in the nursing units, a
Registered Nurse will be part of the leading team which helps in delegating duties regarding
patient care in the hospital premises (Smolowitz et al., 2015). In other words, Registered Nurses
guides in giving directives to the Licensed Practical Nurses to provide health attention to the
patients in the hospital set up. For example, under the supervision of the Registered Nurses,
Licensed Practical Nurses provide healthcare to the mentally challenged patients in the US health
centers (DePasquale & Stange, 2016).
HEALTH AND MEDICAL
3
On the other hand, the witnessed decline in the number of the nursing personnel in the
US primary healthcare facilities threatens the lives of the patients (Snavely, 2016). One of the
main impacts as a result of the shortage of the nurse is lack of workforce to administer patient
medication appropriately. For example, a health canter with nearly fifty admitted patients and
only one or two nurses will compromise their attention to some patient regarding medicine
administration (Dellefield et al., 2015). On the same note, patients who require to movement
either outside or within the hospital may find it hard due to shortage of nurses. Hospitalized
patients will also encounter difficulties during meals time such as breakfast, lunch and dinner
due to lack of sufficient directives from a professional nurse (Bragadóttir, Kalisch &
Tryggvadóttir, 2017). Such a situation may end up worsening the patient health status due to lack
of meals considering their nature of medication. Still, patients in the primary health facilities will
not receive professional health attention due to lack of supervision and monitoring by the
Registered Nurse personnel.
There is a couple of significance linked to addressing the issue of the nursing shortage in
the US primary health facilities. Firstly, adequate nursing personnel will ensure different patients
under their care; take their mediation as per the doctor prescriptions. Secondly, patient including
them restricted in a wheelchair will get a chance to move freely with the hospital via the help of
a nurse or licensed practical nurse. It is worth addressing the problem to ensure only professional
and competent Registered Nurses offer directives in the US health facilities to the patients within
the premises (Staggs, et al, 2016). The health department ought to increase the number of the
nurses including Registered Nurses and Licensed Practical Nurses to curb the limitation of the
nursing personnel in the US healthcare facilities. In so doing, the hospital based patients will
receive sufficient health attention which aligns with their hospital charges.
HEALTH AND MEDICAL
4
References
Bragadóttir, H., Kalisch, B. J., & Tryggvadóttir, G. B. (2017). Correlates and predictors of
missed nursing care in hospitals. Journal of clinical nursing, 26(11-12), 1524-1534.
Dellefield, M. E., Castle, N. G., McGilton, K. S., & Spilsbury, K. (2015). The relationship
between registered nurses and nursing home quality: An integrative review (2008-2014).
Nursing economic$, 33(2), 95-108.
DePasquale, C., & Stange, K. (2016). Labor supply effects of occupational regulation: Evidence
from the nurse licensure compact (No. w22344). National Bureau of Economic Research.
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L.
(2015). Role of the registered nurse in primary health care: Meeting health care needs in
the 21st century. Nursing Outlook, 63(2), 130-136.
Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United
States. Nursing Economics, 34(2), 98-101.
Staggs, V. S., Olds, D. M., Cramer, E., & Shorr, R. I. (2017). Nursing skill mix, nurse staffing
level, and physical restraint use in US hospitals: a longitudinal study. Journal of general
internal medicine, 32(1), 35-41.
Veenema, T. G., Griffin, A., Gable, A. R., MacIntyre, L., Simons, R. N., Couig, M. P., … &
Larson, E. (2016). Nurses as leaders in disaster preparedness and response—A call to
action. Journal of Nursing Scholarship, 48(2), 187-200.
Purchase answer to see full
attachment
Student Name: Jessica Mock
Change Topic (2-3 sentences): The impact of nurse shortage on quality of healthcare in primary
care setting. Nurse shortage has a detrimental impact on the quality of care provided in the
primary care settings.
Criteria
Article 1
Article 2
Article 3
© 2015. Grand Canyon University. All Rights Reserved.
Article 4
Author, Journal (PeerReviewed), and
Permalink or Working
Link to Access Article
Bragadóttir, H.,
Kalisch, B. J., &
Tryggvadóttir,
G. B.
https://scholar.go
ogle.com/scholar
?hl=en&as_sdt=
0%2C5&q=Brag
ad%C3%B3ttir
%2C+H.%2C+K
alisch%2C+B.+J
.%2C+%26+Try
ggvad%C3%B3t
tir%2C+G.+B.+
%282017%29.+
Correlates+and+
predictors+of+m
issed+nursing+c
are+in+hospitals.
+Journal+of+cli
nical+nursing%2
C+26%281112%29%2C+152
4-1534.&btnG=
Dellefield, M.
E., Castle, N.
G., McGilton,
K. S., &
Spilsbury, K.
https://scholar.
google.com/sch
olar?hl=en&as
_sdt=0%2C5&
q=Dellefield%
2C+M.+E.%2C
+Castle%2C+N
.+G.%2C+Mc
Gilton%2C+K.
+S.%2C+%26+
Spilsbury%2C
+K.+%282015
%29.+The+rela
tionship+betwe
en+registered+
nurses+and+nu
rsing+home+qu
ality%3A+An+
integrative+rev
iew+%2820082014%29.+Nur
sing+economic
%24%2C+33%
282%29%2C+
95108.&btnG=
DePasquale,
C., & Stange,
K.
https://www.nb
er.org/papers/w
22344
© 2017. Grand Canyon University. All Rights Reserved.
Makam, A. N.,
Nguyen, O. K.,
& Halm, E. A.
https://jamanet
work.com/jour
nals/jamaintern
almedicine/arti
cleabstract/26821
56
Article Title and Year
Published
Correlates and
predictors of
missed nursing
care in
hospitals.
Journal of
clinical
nursing. 2017
The
relationship
between
registered
nurses and
nursing home
quality: An
integrative
review (20082014). Nursing
economic$.
2015
Labour supply
effects of
occupational
regulation:
Evidence from
the nurse
licensure
compact (No.
w22344).
National
Bureau of
Economic
Research.
2016
Shortcomings
of Research
Regarding
Long-term
Acute Care
Hospitals and
Skilled Nursing
Facilities—
Reply. JAMA
internal
medicine. 2018
Research Questions
(Qualitative)/Hypothesis
(Quantitative), and
Purposes/Aim of Study
The article
focused on the
contribution of
the unit,
hospital and
staff features
towards missed
nursing care
responsibilities
in Iceland
hospital set up.
The article
explored on the
relationship
between the
Registered
Nurses and the
Nursing Home
Quality.
The study
aimed to
identify labor
supply of the
occupational
regulation upon
licensing
nursing
services.
The aim of the
study was to
examine
challenges
based on
research for
long-term acute
health units and
proficiency of
nursing skills.
Design (Type of
Quantitative, or Type of
Qualitative)
The study
assumed a
quantitative
cross-sectional
survey.
The study
presumes a
qualitative
approach.
The study used
quantitative
and qualitative
design.
The study used
quantitative
and qualitative
technique.
© 2017. Grand Canyon University. All Rights Reserved.
Setting/Sample
The samples
included
Registered
Nurses and
practical nurses
that is 864,
within 27
surgical, ICU
and medical
units in the
Iceland
hospital.
The samples
included the
role of
Registered
Nurses and
Nursing Home
in the context
of Medicare
beneficiaries.
Methods:
MISSCARE
The study
Intervention/Instruments Survey-Iceland employed an
and Nursing
integrative
Teamwork
review
Survey-Iceland methodology.
Analysis
The study
utilized
correlational
and regression
statistics during
data analysis.
The study
comprised
descriptive
analysis of the
Registered
Nurses and
Nurse Home.
The study
employed data
of over1.8
million nurses
and other
health
employees to
examine
evidence of
labor mobility
upon increasing
Nursing
Licensure
Compact.
The study
portrayed
Long-term
Acute Care
patients
account for
more than
130,000 yearly
admission
which costs
about $5.3
billion
Medicare
expenses.
The study used
comparison
technique
pertaining
nursing roles
upon licensing
their services.
The study used
data
estimations for
examining and
predict the
impact of longterm acute care
(LTACs) and
nursing skills.
The study
entailed
analytical
analysis that
compared the
labor market on
nursing units
upon Nurse
Licensure
Compact.
The study
comprised
analytical
analysis of the
data from the
previous years
and different
health units.
© 2017. Grand Canyon University. All Rights Reserved.
Key Findings
The multiple
regression
testing under
unit role and
staffing
adequacy
depicted 16%
of the missed
nursing duties.
The regression
testing of
model 2 on
nursing
teamwork
indicated 14%
variance on the
missed nursing
responsibilities.
The higher
number of the
Registered
Nurses staff,
the better
nursing quality
due to different
nursing skills.
There was no
evidence of
nursing
mobility after
introducing the
Nurse
Licensure
Compact
initiative.
The study
projected a
decline in the
use of LTACs,
due to
Sustainable
Growth Rate
Act established
in 2013.
Recommendations
The Iceland
hospital should
develop
strategies to
decrease the
missing
nursing care
and solve
staffing and
teamwork
issues.
There is need
for increasing
Registered
Nurses despite
cost
implications to
check on the
quality of the
patient care.
There is need
to educate
nurses the
significance of
licensing their
services to
allow adequate
and
professional
staff.
The need for
regular
research
affecting the
LTCAs and the
immediate
nursing skills
in the health
units.
© 2017. Grand Canyon University. All Rights Reserved.
Explanation of How the
Article Supports
EBP/Capstone Project
Criteria
Author, Journal (PeerReviewed), and
Permalink or Working
Link to Access Article
The article
supports the
Capstone
project by
emphasizing on
the importance
of increasing
nursing staff
and teamwork
oriented patient
care.
The article
seeks to
support the role
of Registered
Nurses in
provision of
quality nursing
care.
The article
emphasizes on
the nursing
services
mobility for
efficiency
within
healthcare
units.
The study
support the
Capstone
project via
focusing on the
challenges
affecting
healthcare units
and nursing
proficiency.
Article 5
Article 6
Article 7
Article 8
Smolowitz, J.,
Speakman, E.,
Wojnar, D.,
Whelan, E. M.,
Ulrich, S.,
Hayes, C., &
Wood, L.
https://www.scie
ncedirect.com/sc
ience/article/abs/
pii/S0029655414
001572
Snavely, T. M
https://go.galeg
roup.com/ps/an
onymous?id=G
ALE%7CA452
050018&sid=g
oogleScholar&
v=2.1&it=r&li
nkaccess=abs&
issn=07461739
&p=AONE&s
w=w
Staggs, V. S.,
Olds, D. M.,
Cramer, E., &
Shorr, R. I.
Veenema, T.
G., Griffin, A.,
Gable, A. R.,
MacIntyre, L.,
Simons, R. N.,
https://link.spri Couig, M. P.,
nger.com/articl … & Larson, E.
e/10.1007/s116 https://sigmapu
06-016-3830-z bs.onlinelibrary
.wiley.com/doi/
abs/10.1111/jn
u.12198
© 2017. Grand Canyon University. All Rights Reserved.
Article Title and Year
Published
Role of the
registered
nurse in
primary health
care: Meeting
health care
needs in the
21st century.
Nursing
Outlook. 2015
A brief
economic
analysis of the
looming
nursing
shortage in the
United States.
Nursing
Economics.
2016
Nursing skill
mix, nurse
staffing level,
and physical
restraint use in
US hospitals: a
longitudinal
study. Journal
of general
internal
medicine. 2017
Nurses as
leaders in
disaster
preparedness
and response—
A call to
action. Journal
of Nursing
Scholarship.
2016
Research Questions
(Qualitative)/Hypothesis
(Quantitative), and
Purposes/Aim of Study
The study
explored the
nursing tasks
for a
Registered
Nurse.
The study
purposed to
identify reasons
for shortage of
nurses in the
United States.
The study
investigated
nursing skills,
staff adequacy
and manual
restraint
employed in
US hospital set
ups.
The study
sought to
identify nursing
leadership
skills in the
disaster
occasions.
Design (Type of
Quantitative, or Type of
Qualitative)
The study was
qualitative in
nature.
The study
utilized
qualitative
design.
The study
assumed
quantitative
and qualitative
design.
The study ha
qualitative
design.
Setting/Sample
The study
sample focused
on the
Registered
Nurses duties
in 16 different
health units.
The study
focused on the
health units in
United States
to examine
stressors
causing
shortage of
nursing
personnel.
The study
focused on the
17 quarters
pertaining
longitudinal
data survey of
the units staff.
The study
examined 14
national
subjects or
concerns to
identify the
level of
preparedness
within nursing
personnel.
© 2017. Grand Canyon University. All Rights Reserved.
Methods:
The study
Intervention/Instruments employed
interview
process to
obtain roles
played by the
RNs in each
health unit.
Analysis
The study used
descriptive
analysis to
reveal different
tasks by RNs.
The study
projected
contemporary
factors in the
population to
lead nursing
skills problems.
The research
primarily
concentrated on
the staffing
level and
nursing skill
mix.
The study
employed
workshop
programmes
courtesy of the
Veterans
Emergency
Management
Evaluation
Center to
exposit the
issue.
The study
employed both
descriptive and
analytical
analysis in
examining the
probable
nursing
shortcoming in
the US
healthcare
units.
The study used
regression
analysis to
model the
quarterly odds
of the units’
restraints in
response to
staff and
nursing skills.
The study
utilized
descriptive and
analytical
analysis to
explain the
national
concerns and
the nature of
nurses’
preparedness.
© 2017. Grand Canyon University. All Rights Reserved.
Key Findings
The RNs in
general
performed nine
functions
including
telephone
triage,
management,
supervision,
leadership,
staff
assessment,
health
coaching, duty
delegation,
medication
reconciliation
and
documentation.
The aging
population,
aging baby
boomers,
inadequate
nursing
graduate and
rise of chronic
infections and
Affordable
Care Act led to
increased
nursing
shortage in the
US context.
The nursing
skill mix had
an inverse
correlation with
the physical
restraint use
especially for
fall prevention.
There was
insignificant
correlation
between the
nursing skill
mix and the
physical
restraint use.
The workshop
programme
aided in
development of
future disaster
management by
nursing
personnel in
the healthcare
settings.
Recommendations
The need to
add RNs roles
based on the
patient
attention
compared to
management
and leadership
objectives.
There is need
to motivate
students to
pursue nursing
courses to
increase the
nursing
personnel in
the United
States.
There is need
to link nursing
skills with their
relevant tasks
in the
healthcare
units.
The need to
equip nursing
personnel with
relevant and
contemporary
disaster issues
in the
healthcare
facilities.
© 2017. Grand Canyon University. All Rights Reserved.
Explanation of How the
Article Supports
EBP/Capstone
The study helps
on determining
the nursing
skills by
Registered
Nurses in
healthcare
units.
The article
back up the
Capstone
project by
emphasizing
the need for
adequate
nursing
workforce.
The study gives
overview of the
nursing tasks
recommended
by their
qualifications.
© 2017. Grand Canyon University. All Rights Reserved.
The article
supports the
Capstone
project by
emphasizing on
the specific
tasks deployed
by the nursing
workforce
especially
during
emergency
situations.
References
Bragadóttir, H., Kalisch, B. J., & Tryggvadóttir, G. B. (2017). Correlates and predictors of
missed nursing care in hospitals. Journal of clinical nursing, 26(11-12), 1524-1534.
Dellefield, M. E., Castle, N. G., McGilton, K. S., & Spilsbury, K. (2015). The relationship
between registered nurses and nursing home quality: An integrative review (2008-2014).
Nursing economic$, 33(2), 95-108.
DePasquale, C., & Stange, K., (2016). Labour supply effects of occupational regulation:
Evidence from the nurse licensure compact (No. w22344). National Bureau of Economic
Research.
Makam, A. N., Nguyen, O. K., & Halm, E. A. (2018). Shortcomings of Research Regarding
Long-term Acute Care Hospitals and Skilled Nursing Facilities—Reply. JAMA internal
medicine, 178(6), 866-867.
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L.
(2015). Role of the registered nurse in primary health care: Meeting health care needs in
the 21st century. Nursing Outlook, 63(2), 130-136.
Snavely, T. M., (2016). A brief economic analysis of the looming nursing shortage in the United
States. Nursing Economics, 34(2), 98-101.
© 2017. Grand Canyon University. All Rights Reserved.
Staggs, V. S., Olds, D. M., Cramer, E., & Shorr, R. I. (2017). Nursing skill mix, nurse staffing
level, and physical restraint use in US hospitals: a longitudinal study. Journal of general
internal medicine, 32(1), 35-41.
Veenema, T. G., Griffin, A., Gable, A. R., MacIntyre, L., Simons, R. N., Couig, M. P., … &
Larson, E. (2016). Nurses as leaders in disaster preparedness and response—A call to
action. Journal of Nursing Scholarship, 48(2), 187-200.
© 2017. Grand Canyon University. All Rights Reserved.
Running head: PICOT STATEMENT
1
PICOT Statement
Jessica Mock
Grand Canyon University- NRS 490
June 9, 2019
PICOT STATEMENT
2
Identification of Clinical Problem
Every health care system involves a primary objective, which is to promote the quality of
life of patients. Every patient expects the best quality of life whenever they go to the hospitals,
which satisfies them with the services offered. However, various issues confront health care
currently, which include long waiting times and delayed diagnosis, ADHD, or any other
dysfunction found in children. The principal aim of the investigation is to carry out an evaluation
and analysis of the child and adult growth Actions plans for Autism Spectrum Disorder to deal
with the issue of long waiting times and delayed diagnosis, ADHD or any other dysfunction.
Evidence-Based Solution
Rutherford et al. (2016) explain as to why professionals offer delayed assessment of
diagnosis of autism spectrum disorders (ASD). The investigation translates the evidence into the
practical application via actions plans for services of ASD. The authors presented an action plan
for child and adult diagnostic group to enhance the quality and efficacy of the process of
diagnostic evaluation. Zheng et al. (2016) point out that various problems need to be covered like
early identification, atypical and typical development, increased government investment,
professional development, and enhanced execution of available regulations. According to
Richards and Vostanis (2004), it is crucial for services of transitional mental health for
individuals with 16 years to 19-years in health district, as comprehended by specialists from
social, mental health, non-statutory services, and education. Besides, Chakroborty et al. (2014)
support the idea that early intervention in certain learning disability (SpLD) leads to the
enhanced outcome and controls comorbidity. This way, the authors give a comparison of
pathways for taking care of children with mental retardation and SpLD before reaching a tertiary
care center (Temper et al., 2017).
PICOT STATEMENT
3
Nursing Intervention, Patient Care, Health Care Agency, & Nursing Practice
For early intervention in specific learning disability (SpLD), Rutherford et al. (2016)
claim that it is crucial to utilize Goldberg’s pathways and MINI-KID for comorbidity to care
instrument. It is necessary to enhance physical exercise for youth with intellectual disabilities, as
it is one of the intervention’s description. Frey et al. (2017) executed an intervention for
initiating, increasing, or maintaining physical activity as well as reporting the efficacy of the
intervention. However, nurses will describe to the patients how to perform various exercises for
individuals with intellectual disabilities. Through the above responses, nurses possess the
potential of influencing positive patient outcomes that could enhance the quality of life of
patients while enhancing the quality of care offered to patients. Besides, nurses should carry out
an evaluation and analysis of adult and child growth Actions plans for Autism Spectrum Defect
to deal with the issue of long waiting times, and delayed diagnosis, ADHD or any other
dysfunction. The objective of nurses is to assist patients to stay a healthy life through
maintaining or strengthening their health activities. Through the above interventions, nurses will
be in a position to execute evidence-based practices in their clinical setting to enhance patients’
health.
PICOT Statement
Can children with mental disabilities have better health outcomes in adulthood if they are
managed upon early detection vs. later detection? Does early intervention truly impact health or
does mental disability have the same result despite the starting point of interventional therapies?
(P) Population: Children with mental disabilities like delayed speech or functions, autism,
ADHD, or any other type of dysfunction in children. Some children might be diagnosed early
and get treatment, and others may not be diagnosed until late childhood or into school age stages.
PICOT STATEMENT
4
Intervention: Depends on diagnosis, level of health disparity, and stage. Enhance physical
exercise for youths with intellectual disabilities; transitional services of mental health for
individuals with 16-years to 19-years in health district; an action plan for child and adult
diagnostic group to enhance the quality and efficacy of the process of diagnostic evaluation.
(C) Comparison: Children who receive early diagnosis and intervention vs. children that go
longer with no diagnosis or delayed diagnosis and delayed responses.
(O) Outcome: Improvement in physical exercise among youths with intellectual disabilities and
medication adherence as well as prevention of long waiting times, and delayed diagnosis.
(T) Time: The outcome of the study will be assessed weekly for eight weeks.
References
Chakraborty, S., Sagar Kommu, J. V., Srinath, S., Seshadri, S. P., & Girimaji, S. C. (2014). A
Comparative Study of Pathways to Care for Children with Specific Learning Disability
and Mental Retardation. Indian Journal of Psychological Medicine, 36(1), 27. Retrieved
from
PICOT STATEMENT
5
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&
db=edb&AN=94741876&site=eds-live&scope=site
Frey, G. C., Temple, V. A., & Stanish, H. I. (2017). Interventions to promote physical activity
for youth with intellectual disabilities. Salud Pública de México, 59(4), 437. Retrieved
from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&
db=edb&AN=124408973&site=eds-live&scope=site
Richards, M., & Vostanis, P. (2004). Interprofessional perspectives on transitional mental health
services for young people aged 16 – 19 years. Journal of Interprofessional Care, 18(2),
115–128. https://doi-org.lopes.idm.oclc.org/10.1080/13561820410001686882
Rutherford, M., McKenzie, K., Forsyth, K., McCartney, D., O, H. A., McClure, I., & Irvine, L.
(2016). Why are they waiting? Exploring professional perspectives and developing
solutions to delayed diagnosis of autism spectrum disorder in adults and
children. Research in Autism Spectrum Disorders, 31, 53–65. https://doiorg.lopes.idm.oclc.org/10.1016/j.rasd.2016.06.004
Temple, V. A., Frey, G. C., & Stanish, H. I. (2017). Interventions to promote physical activity
for adults with intellectual disabilities. Salud Pública de México, 59(4), 446. Retrieved
from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&
db=edb&AN=124408974&site=eds-live&scope=site
Zheng, Y., Maude, S. P., Brotherson, M. J., & Merritts, A. (2016). Early Childhood Intervention
in China from the Families’ Perspective. International Journal of Disability,
PICOT STATEMENT
Development & Education, 63(4), 431–449. https://doiorg.lopes.idm.oclc.org/10.1080/1034912X.2015.1124988
6
Running head: HEALTH AND MEDICAL
The impact of nurse shortage on the quality of care in the primary healthcare facilities
Jessica Mock
Grand Canyon University- NRS 490
June 2, 2019
1
HEALTH AND MEDICAL
2
Introduction
There is need for adequate nursing personnel in every hospital to ensure sufficient health
services to the patients. Nurses are part of the health specialists with necessary knowledge and
competency to handle clients and patients at family level, clinics and even at the hospitals.
Health centers with adequate nursing personnel provide effective healthcare attention to their
patients effectively. The proposed topic will focus on the effect of the nurse shortage on the
hospital patient care a situation in the context US primary healthcare facilities.
Discussion
In the recent past, there has been a shortage of nursing personnel in the US primary
healthcare centers which has adversely affected the patients. Nurses provides variety of
healthcare services to the hospital-based patients in their midst (Veenema et al., 2017). Firstly, it
is the responsibility of the nursing units to ensure medication administration to the patients. For
example, a nurse in charge of an admitted patient will ensure such a patient takes the medication
as per the doctor prescriptions following the exact dose and timeline. The nursing personnel
ensure patient can move freely within the restricted zone in the healthcare in case their admission
allows such movements. Thirdly, it is the role of a nurse to ensure patient takes their meals on
time within the hospital so that they are able to remain healthy. Similarly, in the nursing units, a
Registered Nurse will be part of the leading team which helps in delegating duties regarding
patient care in the hospital premises (Smolowitz et al., 2015). In other words, Registered Nurses
guides in giving directives to the Licensed Practical Nurses to provide health attention to the
patients in the hospital set up. For example, under the supervision of the Registered Nurses,
Licensed Practical Nurses provide healthcare to the mentally challenged patients in the US health
centers (DePasquale & Stange, 2016).
HEALTH AND MEDICAL
3
On the other hand, the witnessed decline in the number of the nursing personnel in the
US primary healthcare facilities threatens the lives of the patients (Snavely, 2016). One of the
main impacts as a result of the shortage of the nurse is lack of workforce to administer patient
medication appropriately. For example, a health canter with nearly fifty admitted patients and
only one or two nurses will compromise their attention to some patient regarding medicine
administration (Dellefield et al., 2015). On the same note, patients who require to movement
either outside or within the hospital may find it hard due to shortage of nurses. Hospitalized
patients will also encounter difficulties during meals time such as breakfast, lunch and dinner
due to lack of sufficient directives from a professional nurse (Bragadóttir, Kalisch &
Tryggvadóttir, 2017). Such a situation may end up worsening the patient health status due to lack
of meals considering their nature of medication. Still, patients in the primary health facilities will
not receive professional health attention due to lack of supervision and monitoring by the
Registered Nurse personnel.
There is a couple of significance linked to addressing the issue of the nursing shortage in
the US primary health facilities. Firstly, adequate nursing personnel will ensure different patients
under their care; take their mediation as per the doctor prescriptions. Secondly, patient including
them restricted in a wheelchair will get a chance to move freely with the hospital via the help of
a nurse or licensed practical nurse. It is worth addressing the problem to ensure only professional
and competent Registered Nurses offer directives in the US health facilities to the patients within
the premises (Staggs, et al, 2016). The health department ought to increase the number of the
nurses including Registered Nurses and Licensed Practical Nurses to curb the limitation of the
nursing personnel in the US healthcare facilities. In so doing, the hospital based patients will
receive sufficient health attention which aligns with their hospital charges.
HEALTH AND MEDICAL
4
References
Bragadóttir, H., Kalisch, B. J., & Tryggvadóttir, G. B. (2017). Correlates and predictors of
missed nursing care in hospitals. Journal of clinical nursing, 26(11-12), 1524-1534.
Dellefield, M. E., Castle, N. G., McGilton, K. S., & Spilsbury, K. (2015). The relationship
between registered nurses and nursing home quality: An integrative review (2008-2014).
Nursing economic$, 33(2), 95-108.
DePasquale, C., & Stange, K. (2016). Labor supply effects of occupational regulation: Evidence
from the nurse licensure compact (No. w22344). National Bureau of Economic Research.
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L.
(2015). Role of the registered nurse in primary health care: Meeting health care needs in
the 21st century. Nursing Outlook, 63(2), 130-136.
Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United
States. Nursing Economics, 34(2), 98-101.
Staggs, V. S., Olds, D. M., Cramer, E., & Shorr, R. I. (2017). Nursing skill mix, nurse staffing
level, and physical restraint use in US hospitals: a longitudinal study. Journal of general
internal medicine, 32(1), 35-41.
Veenema, T. G., Griffin, A., Gable, A. R., MacIntyre, L., Simons, R. N., Couig, M. P., … &
Larson, E. (2016). Nurses as leaders in disaster preparedness and response—A call to
action. Journal of Nursing Scholarship, 48(2), 187-200.
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