Causes of the Nursing Shortage: Literature Evaluation

Change Topic: The nursing shortage is caused by the increase in the demand for nurses that the available supply cannot meet. Some of its major causes are aging and the rise in the number of patients requiring treatment.

Criteria	Article 1	Article 2	Article 3	Article 4
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	Fagerström, L., Kinnunen, M., & Saarela, J. (2018). BMJ Open, 8(4), 1-10.	Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K., BMC Health Services Research, 19(1), 1-9.	Jarrar, M., Rahman, H., Minai, M., AbuMadini, M., & Larbi, M., The International Journal of Health Planning and Management, 33(2), 464-473.	MacPhee, M., Dahinten, V., & Havaei, F., Administrative Sciences, 7(1), 1-17.
Article Title and Year Published	Nursing workload, patient safety incidents, and mortality: an observational study from Finland, 2018	The impact of nurse staffing levels and nurses education on patient mortality in medical and surgical wards: a multicenter observational study, 2019	The function of patientcentered care in mitigating the effect of nursing shortage on the outcomes of care, 2018	The impact of heavy perceived nurse workloads on patient and nurse outcomes, 2017
Research Questions (Qualitative)/Hypothesis (Quantitative)	What is the relationship between daily workload per nurse and different types of patient incidents and mortality?	Do staffing levels and nurses education affect patient mortality in medical and surgical wards?	Does patient-centered care help in mitigating the adverse effects of nursing shortages in patient outcomes?	What are the impacts of heavy perceived workloads on patient and nurse outcomes?
Purposes/Aim of Study	The study intended to show how workload per nurse negatively affects different patient outcomes like mortality.	The study intended to show how staffing, education for nursers and mortality of patients relate.	The study intended to show how patient-centered care is significant In preventing adverse effects resulting from the shortage of nurses.	The intention is to explore the effect of job and task-level workloads on nurses and how it affects adverse patient care outcomes.
Design (Type of Quantitative, or Type of Qualitative)	A qualitative Observational study based on the standard patients-to-nurse ratio.	A qualitative retrospective observational longitudinal study.	A qualitative descriptive, crosssectional study.	A quantitative cross-sectional correlational study.
Setting/Sample	The program was conducted in four acute care hospitals in Finland. Data were obtained from 36 units in the facilities.	It was conducted in 14 medical and 14 surgical wards in 7 Belgian hospitals.	The program was carried out in 12 private hospitals.	Web-based Survey data from a province-wide sample of all RNs and LPs direct care nurses in four large health authorities in Canada.
Methods: Intervention/Instruments	RAFAELA, a nursing intensity and staffing system, was used in the measurement of daily Nursing workload.	A Control group of stepped wedge randomized control trials was used. It excluded pregnant patients and children below 17 years.	Questionnaire were used to collect data from nurses.	Both patients and nurses (Participants) were subjected to the survey.
Analysis	Statistical analysis using logistic regression models whereby daily level workloads per nurse were estimated with assumed optimum outcomes.	Analysis was carried out statistically using SPSS as the tool. It involved the Kruskal Wallis test, linear mixed models, and Linear regression was employed afterward.	Statistical analysis that involved Hayes process macro-regression to determine patient-centeredness with hospital staff.	Statistical analysis using hierarchical logistic regression and hierarchical ordinary list squares regression.
Key Findings	The study determined that heavy nursing workloads above optimum level increase the risk for adverse outcomes and mortality.	Nurses who are more educated can handle more workforce and hence reduce the pressure on staffing.	Patientcenteredness helps to mitigate the negative associations of nursing shortage on the outcomes of care and mortality.	Low nurse staffing increases workload and risks adverse patient outcomes.
Recommendations	Nurse managers should use available resources optimally through efficient allocation, which ensures successful clinical governance and leadership.	The education levels for nurses should be improved to enable the handling of increased workload and hence reduce mortalities.	The culture of patient-centeredness should be instilled to deliver quality and safer care to patients and hence reduce mortality.	Healthcare administrators should organize effective work plans with specific nurse allocations to ensure equal distribution and improve outcomes.
Explanation of How the Article Supports EBP/Capstone Project	Is useful since it presents information using an evidence-based system on how heavy workloads affect outcomes.	Is useful because it presents a strategy for estimating the optimal staffing levels using ward-level data and a strategy for addressing the nursing shortage in education.	Supports EBP by providing a guide for nursing leaders and hospital managers on how to maintain adequate staffing and also ensure patient-centered care is instilled.	Supports EBP because it provides strategies for healthcare administrators on how to address different levels of workloads and ensure equal distribution.

Criteria	Article 5	Article 6	Article 7	Article 8
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	Maresova, P., Prochazka, M., Barakovic, S., Barakovi Husi, J., & Kuca, K., Healthcare, 8(2), 1-16.	Mar, M., Bartosiewicz, A., BurzyDska, J., Chmiel, Z., & Januszewicz, P., International Nursing Review, 66(1), 9-16.	Mincer, J., Reuters.	Kurnat-Thorma, E., Ganger, M., Peterson, K. & Channell, L., SAGE Open Nursing.
Article Title and Year Published	A shortage in nurses is a case study from a selected region in the Czech Republic and international context, 2020	A nursing shortage a prospect of global and local policies, 2018	Short on staff: Nursing crisis strains U.S. clinics, 2017	Reducing Annual Hospital and Registered Nurse Staff, 2017
Research Questions (Qualitative)/Hypothesis (Quantitative)	What is the cause of nurse shortage in Hradec Kralove?	Is nursing shortage a prospect of global and local policies?	Is the United States facing a nursing shortage problem that threatens the quality of care?	Can the 10-element program reduce the annual Hospital and registered nurse turnover?
Purposes/Aim of Study	Explores the lack and need of nurses in the Hradec Kralove Region of the Czech Republic, and also the entire country.	The intention is to address the cause of the nurses shortage in Poland and other countries of the world.	The article explores the problem of nursing shortage in the United States and its outcomes.	The article addresses the question with a focus on staffing figures by applying a quantitative research approach.
Design (Type of Quantitative, or Type of Qualitative)	The study applies quantitative approach by obtaining information from public storages and it also uses interviews.	Literature review that relied on past publications.	The study employs an investigative method by examining various healthcare amenities.	The study employs a quantitative approach.
Setting/Sample	The study was carried out on nurses in healthcare facilities in the Hradec Kralove region which is found in the Czech Republic as well as in the whole country.	The study was carried out in Poland by literature search based on inclusion criteria and nursing policy.	Across the United States with some facilities are selected as representatives.	The study was carried out in Washington DC on a public hospital.
Methods: Intervention/Instruments	It entailed the obtaining of information from communal sources/catalogs. Interviews were also used.	Literature search on national listings and strategic documents and international reports.	The intervention entailed the exploration of available evidence to represent opinions.	The intervention entailed the application of a 10-element program to carry out the onboarding process of employees.
Analysis	Analysis depended on indications from inclinations resulting from predominant refrains.	It depended on repeated refrains.	Analysis depended on themes resulting from different indications.	The analysis was based engaged levels examination and proportions.
Key Findings	Lack of potential educators, increased demand for health services, and nurse burnout are some of the factors contributing to the nursing shortage.	Poor recruitment, ineffective planning, and improper allocation of available nursing resources are major causes of shortages.	In the united states, there is a shortage of nurses, and hospitals are forced to hire inexperienced nurses, increase the salaries of present nurses.	The program was an effective and reduced turnover by 7%.
Recommendations	Offering flexible retirement plans and encouraging many students to pursue nursing as a carrier will reduce the risk of nurse shortage.	Social security agendas for nursing policy should be implemented.	An effective strategy is necessary to curb the problem of nurse shortages.	All medical facilities should employ the program in maintaining their staff.
Explanation of How the Article Supports EBP/Capstone	It is useful since it provides policies and strategies that help in mitigating the problem of nurse shortages.	It supports the Capstone project through the provision of strategies for preventing the shortage of nurses.	It is useful because it will help in exploring the problem of nurse shortage experienced in the US.	It supports EBP by providing strategies for improving the nurse-patient ratio and nurse retention.

References

Fagerström, L., Kinnunen, M., & Saarela, J. (2018). Nursing workload, patient safety incidents, and mortality: an observational study from Finland. BMJ Open, 8(4), 1-10.

Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. (2019). The impact of nurse staffing levels and nurses education on patient mortality in medical and surgical wards: an observational multicenter study. BMC Health Services Research, 19(1), 1-9.

Jarrar, M., Rahman, H., Minai, M., AbuMadini, M., & Larbi, M. (2018). The function of patientcentered care in mitigating the effect of nursing shortage on the outcomes of care. The International Journal of Health Planning and Management, 33(2), 464-473.

Kurnat-Thorma, E., Ganger, M., Peterson, K. & Channell, L. (2017). Reducing Annual Hospital and Registered Nurse Staff TurnoverA 10-Element Onboarding Program Intervention. SAGE Open Nursing, 3. Web.

MacPhee, M., Dahinten, V., & Havaei, F. (2017). The impact of heavy perceived nurse workloads on patient and nurse outcomes. Administrative Sciences, 7(1), 1-17.

Mar, M., Bartosiewicz, A., BurzyDska, J., Chmiel, Z., & Januszewicz, P. (2018). A nursing shortage a prospect of global and local policies. International Nursing Review, 66(1), 9-16.

Maresova, P., Prochazka, M., Barakovic, S., Barakovi Husi, J., & Kuca, K. (2020). A shortage in nurses is a case study from a selected region in the Czech Republic and international context. Healthcare, 8(2), 1-16.

Mincer, J. (2017). Short on staff: Nursing crisis strains U.S. hospitals. Web.

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