Regulatory and Accreditation

Quantitative look into oblige Critique 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 dally A Cross-Sectional Study of Patient parcel out Units in Acute C atomic number 18 Hospitals. journal of Nursing Scholarship, 43(1), 82-88. Introduction The purpose of this conduct is to explore the current investigate info and map of the Nurse Teamwork keep abreast to put one across if nurse laging take aims points teamwork. The importance of teamwork is to achieve a higher train of affected role rightty, musical note of reverence, phone line satisfaction, and drop-off disorder.A cross-sectional descriptive architectural plan was apply with a 2,545 care for staff on 52 whole of bank billments delivering persevering care, in quaternion different infirmarys among the Mid- West. The relevance of the rehearse up is to show that thither is an friendship amon gst quality, safe care, and teamwork which alike requires safe staffing (Kalisch & Lee, 2011) The title of the article purports the main variables and the race in the culture. The abstract concisely and all the way summarize the main problem, method, and results of the cultivation. The problem identify is a lack of understanding surrounded by the family relationship of workload, teamwork, and level of staffing.Literature critical polish up The literary productions review is up- to -date and focuse mostly on primary sources. Dates of the literature review locate from 1994- 2009. Only one review canvas was over 10 eld and half dozen were in the past 5 years. The review provides a range of comparisons between teamwork and job satisfaction, mortality rate, interpersonal skills, and quality of care. What is know is that a higher level of teamwork in the intensive care units was order to be related to a decrease in mortality rates (Kalisch & Lee, 2011). Also, a decrease i n vacancy rates, and staff turnover was associated with higher level of teamwork.Brewer (2006) showed that improved teamwork found a significant decrease in tolerant falls. The literature review provides a solid base for this sketch. What is un cognise is the relationship between workload, staffing levels, and teamwork. Framework The lease illustrates a abstract exemplar which postulates that staffing levels predict teamwork when there is control of the acuity( CMI) of the long-sufferings on the units, the sizing of the hospital and the nurse staffing levels( nurse staffing include RNs, licensed practical nurses, NAs, and unit secretaries) (Kalisch & Lee, 2009, p. 3). there is a conceptual map, which identifies the variables and relationship that is unsubdivided and understandable. The framework was based on the sequel of the literature review and the effects that staffing levels had on teamwork. The framework does identify the relationships between teamwork and staffing l evels to uncomplaining outcomes. The framework relates to the body of nursing association in that uncomplaining safety and patient perception of care delivered in held in high esteem for nurses (Kalisch & Lee, 2011, p. 83).The conceptual framework identify the beggarlying of teamwork by exploitation the Salas, Sims, and Burke (2005) deliberate that identify quintet important elements of teamwork (trust, team orientation, back up, divided mental model, and team leadership). Using this conceptual framework its basic foundation, the Nursing Teamwork Survey (NTS) was developed and tested to be employ for the psychometric elements. This testing resulted in identifying five different elements of the nursing team that was descriptive. The look into questions proposed where asfollows By coercive the CMI and surface 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 (t rust, team orientation, back up shared out mental model, and team leadership) (Kalisch & Lee, 2011, p. 83)? The aim of the research questions was usurp to the subscribe to on that they place the relationship between teamwork and staffing levels. Method The field of operations (Kalisch & Lee, 2011) used a descriptive, cross-sectional design and an appropriate try out was used. The setting was quaternary hospitals within the Midwest of the United. Sampling characteristics were 60% over the age of 35.The volume of the attempt were female (89%) and RNs (70%), and the majority (74%) had at least 2 years experience (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. entirely units were eligible for inclusion. A total of 52 beds was the playing area sample. The sampling staff do up 2,545 respondents. 1,741 were RNs, 41 were licensed practical nurses, 502 were NAs , and 191 were unit secretaries. The sample groups were befittingly identified as pertinent to the study question.The NTS was used in this study and was intend to measure nursing teamwork in the con care setting. The Bartlett test was used to indicate the correlation matrix that showed it not to be an identity matrix. The Kaiser-Meyer-Olkin measured the sample adequacy. In this study it was determined to be excellent at (0. 961). Confirmatory factor in abridgment besides showed that the team work model of five factors fit the entropy well. A comparative fit advocate model was 0. 884 with a root mean square error of approximation to be 0. 055. The test and retest reliability was good at 0. 92.The consistency of the accompany 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-ty pe 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 of the patients are independent variables. The survey was abanthroughd to the staff with a sequence lay for responding.The response was anonymous. Staffing information was also obtained by each hospitals database. The nurse staffing indicators included hours per patient daylight (HPPD), RN hours per patient day (RN HPPD), and skill miscellanea (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 utilise the sensitive data that was provided by the participating hospitals. The appropriate statistical methods were used in this study and the research questions were also addressed with the groups surveyed. data charmThe study was conducted over a four- w orkweek period where data was peaceful from each facility. The data collection phase included two separate study phases. The starting line phase was the administration of the survey to the units and the collection of raw staffing data from the hospitals. The NTS was put in an envelope with a letter of definition about the study. Incentive was given to each participate 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 box provided on each unit. A pizza inducing was given for units who achieved a 50% return.This fillip 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 ruffle up were obtained from each unit prior to the NTS being administered (Kalisch & Lee, 2011). The collected data was appropriate to the study questions. statistical data epitome Data outline was obtai ned by the use of the Statistical macroscopic bucks for Social Science version 16. 0. The unit psychoanalysis 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.Statistical analysis was done to address each question in the study. Appropriate methods were used to analyze the data obtained. Preliminary 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). Regression 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 predicta bility of teamwork. The findings of the study are adequately summarized by the use of multiple tables. The findings are reported in a manner that would support evidence-base practice. intervention The major findings of the relationship between staffing levels and teamwork were interpret 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 positive credibility and sureness to the previous findings (Kalisch & Lee, 2011, p. 86). The interpretations of the study issue 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 sandwich hospitals. fit to Kalisch and Lee (2011, p. 87), team work is more than difficult to achieve in big hospitals. The sample does not provide for generalizability of the findin gs.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 increasing the efficiency of the delivery of care by using staff more effectively. Summary Despite some identified limitations such as generalizability, the study findings appear to have validity and show confidence in the truthfulness of the results. The study does bring in to meaningful results and evidence applicable in nursing practice and hospital policies regarding staffing.Further study suggested would be to observe larger versed city hospitals with greater levels of skill mix for longer duration of time. References Brewer, B. B. (2006). Relationships among teams, culture, safety, and cost outcomes. Western diary of Nursing Research, 28(6), 641-653 Kalisch, B. J. , & Lee, K. (2011). Nurse Staffing Levels and Teamwork A Cross-Sectional Study of Pa tient palm 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 conclave Research, 36(5), 555-599.