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Discussion Question

Visit South’s online library and review these two articles using this link bellow ( )

  • Connelly, L. M. (2014). Use of theoretical frameworks in research. MEDSURG Nursing, 23(3), 187-188.
  • Green, H. E. (2014). Use of theoretical and conceptual frameworks in qualitative research. Nurse Researcher, 21(6), 34-38.

Next, review the evidence you are collecting for your proposed study. Which theories have others cited? Are you seeing a common theme? Next construct a conceptual map (see p. 133 in your textbook). Use Microsoft Word or Microsoft PowerPoint and include this as an attachment. Be sure you have defined the concepts and included relational statements.

Provide constructive, supportive feedback to your classmates’ posts.

Attach you will find the two paper work that you need to review in order to complete this paper and ald the picture of the 133 book page thanks .

Running head: NURSE SHORTAGE Nurse Shortage in Health Care Institutional Affiliation Problem Statement The United States health care system is experiencing a great demand for health care services beyond the capacity in which they can hold. According to the bureau of labor statistic, there united states have the largest number of health care providers adding to a total of 3million (Darkwa, Newman, Kawkab, & Chowdhury, 2015). Despite this enormous number, there exist a great nurse shortage which has been represented by the increased patient to nurses ration of ten nurses to responsible for providing care for 1000 patients (Van et al,. 2013). With this high nurse patient dependency ratio, research highlights that there is a growing demand for health care professionals where there has been a projection of about 16% growth in the nursing occupation by 2024 (Yang, Hung, & Chen, 2015). Due to this issue patient are experiencing reduced quality health outcomes since the present health care providers are not able to satisfy the needs of the population. As a result, there is an elevating workload for these hospital workforce that lead to reduced patient safety and thus increased incidences of medical errors. In addition, the problem have also increased nurse burn outs and intention to leave the nursing career among the care providers have also escalated. This has consequently led to the increasing challenge. The increased aging population of care providers have significantly contributed to the growing shortage as more nurses are retiring form the job and thus not meeting the demand (Darkwa et al., 2015). However, the increasing number of aging population is experiencing major chronic medical conditions that are consequently demanding for more attention. This therefore have led to the elevation of this problem in the United States. The purpose of the research proposal is to examine the association between nurse shortage and patient health outcomes as well as developing an appropriate intervention to solve this critical issue in the health care system. Research Questions What are the major causes of nurse shortage in the United States health care problem? Is there an association between nurse shortage and patient health outcomes? Which is the most appropriate intervention to reduce nurse shortage in the US health care system? Picot Question For hospital having current number of nurses {P} , how does increasing nursing school capacity to have more qualified nurses in the market {I}, compared to the existing nurse shortage {C} influence the patient outcome [O] over the years {T}. Purpose of the Research There is a nurse shortage in the health care system of the United States. In addressing this issue the researchers will be focused in determining the age, gender and the level of satisfaction of the nurses as the main characteristics. Condition The United States nursing is among the leading job creators in the US economy contributing to over 2.7 million health care nurses. It is projected that form 2014-2024, there will be an increased job vacancy of over 1.3 nursing vacancies (Van et al., 2013) There is reduced number of nursing students enrolling for nursing course and this has created more shortage. In a research by the American journal of nursing about 56 % of all the 756 nursing schools reported to have a great deficit in the holding capacities of the school amounting to 1236 vacancies (Dawson et al., 2014). A significant nurse shortage issue thus exist. Intervention Following this problem in this critical health system an appropriate and long life intervention is desired so as to solve the issue. The government need to increase funding for nursing education which can significantly increase the nursing student enrollment. With increased qualified and skilled nurses within the health care centers patient outcome would greatly be reduced as a result of reduced workload and job satisfaction among nurses. Alternative to the intervention An alternative approach that would also enhance increased patient outcome as well as reduced nurse shortage due because of increased job retention is providing high wages and improving the hospital working environment. Outcome With the development of appropriate intervention to reduce nurse shortages within the nursing environment, patient health outcomes would also be enhanced. This would as well improve provision of quality services since nurses would no longer experience workload leading to burnout. Additionally, it’s expected that nurses would also have job satisfaction and thus serving the health care for a longer period. It is expected that patient safety would also be enhanced due to reduction in incidences of medical errors. References Darkwa, E. K., Newman, M. S., Kawkab, M., & Chowdhury, M. E. (2015). A qualitative study of factors influencing retention of doctors and nurses at rural healthcare facilities in Bangladesh. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-1012-z Dawson, A. J., Stasa, H., Roche, M. A., Homer, C. S., & Duffield, C. (2014). Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies. BMC Nursing, 13(1). doi:10.1186/1472-6955-13-11 Van, K., Florquin, M., Bruyneel, L., Aiken, L., Diya, L., Lesaffre, E., & Sermeus, W. (2013). Effective strategies for nurse retention in acute hospitals: A mixed method study. International Journal of Nursing Studies, 50(2), 185-194. doi:10.1016/j.ijnurstu.2011.12.001 Yang, P., Hung, C., & Chen, Y. (2015). The impact of three nursing staffing models on nursing outcomes. Journal of Advanced Nursing, 71(8), 1847-1856. doi:10.1111/jan.12643
Running head: NURSING SHORTAGE Introduction to a Proposal on Nurse Shortage in US Health Care Institutional Affiliation Background information There is a projection that the United States health care system is going to experience a great shortage of the registered nurses as the health care needs continue to intensify (Yang, Hung, & Chen, 2015). Quality and outcome measurement are valuable methods of determining the influence of nurse staffing and achieving the desired patient outcome goals. A number of effort have been made to improve the capacity of the nursing schools across the US so as to have more students enrolling so as to assist in meeting the increased demand of the elevating demand for health care system. The American Association of Colleges of Nursing has made various cooperation with institutions and policy makers have tried to make this health concern as a global problem. Following a report by the bureau of labor statistics, registered nurse employment was projected to be among the top occupations in terms of growth form 2014-2024 (Robert, 2017). This growth in the health workforce is expected to elevate form 2.6 million in 2014 to 3.1 million by 2024 which will be translated as a 16% increase (Robert, 2017). Further research by the American journal of medical quality explains that nurse shortage is projected to rise around the United States between 2013 -2030 (Nantsupawat, Nantsupawat, Kulnaviktikul, & McHugh, 2014). A report by the institute of medicine on the focus on future of nursing highlighted that there was a need to significantly increase the number of baccalaureate nurses in the health work force to 80% as well as increasing the number of nurse by two (Yang, Hung, & Chen, 2015). There is only 55% of the baccalaureate registered nurses and thus creating a big deficit. In a systematic review performed in the hospital setting, it was identified that increased patient load to a single nurse due to shortage was highly associated with elevated rates of patient readmission. In addition, American journal of nursing highlights that increased patient to nurse ration was greatly linked with rising incidences of nurse burnouts and profound health acquired infections such as urinary tract infection. Significance of the problem With a well proportion number of health care providers within the health care system, there will be reduced number of nurse burn out, reduced job dissatisfaction and finally enhances the health well-being of both the patients and the nurses. As a result of the escalating global nurse shortage, cases of medical errors are regularly being reported. This problem has been contributed by many factors among them being the ageing of the baby boomer generation. Yang, Hung, and Chen (2015) indicated that majority of the health care providers in the United States are aged above 65yeasr and thus approaching retirement age hence creating the shortage. Despite nursing being explained as the fastest growing profession in the US, about 1.2 job vacancies of registered nurses are likely to emerge between 2014 -2022 (Robert, 2017). It is very significant to address this issue and acquire a lifelong intervention to the problem. Measure of addressing this health issue must however focus on preparing more baccalaureate-prepared nurses in order to ensure access to high quality, safe patient care. Increasing the capacity of nursing schools is also very essential as this would at long last increase the number of physicians joining the job market and hence reduce the remedying the shortage. With increased and appropriate number of nurses within the health care systems, patient’s health outcomes will be improved as well as ensuring a positive well-being of the care providers. With nursing care being a primary factor in patient satisfaction and little relief from shortages, nursing leaders are compelled to establish methods of measuring staffing effectiveness. Problem Statement The United States has the highest number of registered nurses of over 3 million nurse though there still exist a great deficit (Yang, Hung, and Chen, 2015). The most significant cause of the is nurse shortage in this great nation is the elevating aging population that has led to more incidences of chronic diseases, there is also a large number of old nurse work force as well as the nursing institutions lack the capacity to satisfy the entire health care center with care providers. With the increased nurse shortage, there have been raise cases of job dissatisfaction which results from stressful working condition brought about by workload. Moreover, the nurses are pressured to leaving the job and find alternative career. Patient safety is another issue of concern that come about by reduced nurse number. In a research conducted by the health service research, it was indicated that a reduced patient to nurse ratio on both medical and surgical units consequently led to low numbers of death (Robert, 2017). According to a study carried out in Canada, it was explained that there were 4.9 fewer deaths per 1,000 patients on intensive care units staffed with a higher percentage of nurses with bachelor’s degrees (Van et al., 2013). In a meta-analysis performed by the agency for health research and quality, it was found that registered nurse reduction plus increased nurses workload posed a significant threat to patient’s quality and safety during acquisition of health services. The main purpose of this research proposal is to examine the association between registered nurse shortage to the patients’ health outcome and wellbeing to the nurses. Research questions What are the main causes of increasing nurse shortage in the United States? Is there a relationship between nurse shortage and patients health outcome and nurse well-being? Hypothesis H0: increased incidences of nurse shortage in the United States health care system is directly associated with poor patient outcome, job dissatisfaction and burnout among health career providers. H1: There is no direct association in deteriorating the patient’s health outcome and job dissatisfaction, nurse burn out with the increasing nurse shortage in the United States health care system. Variables The independent variables will include the patient’s health outcomes, nurse job dissatisfaction and burnout. These variables will be determined by getting the total number of nurses in a hospital and the resultant rate of patient readmission and incidences of medical errors and this will signify the level of patient outcome. For the well-being of the nurses, intentions of the nurses to leave the career coupled with cases of burn out will highlight the level of satisfaction and dissatisfaction for the nurses and thus this will directly be related to patient outcome. The dependent variables that will be examined in the research paper will be the level of nurse shortage. This variable will be examined by determining the total number of nurses that are in a health care center compared to the appropriate number that should be present. This will however give out the nurse deficit. References Nantsupawat, A., Nantsupawat, R., Kulnaviktikul, W., & McHugh, M. D. (2014). Relationship between nurse staffing levels and nurse outcomes in community hospitals, Thailand.  International Journal of Nursing Practice17(1), 112-118. doi:10.1111/nhs.12140 Robert, R. (2017). American Association of Colleges of Nursing | Nursing Shortage. Retrieved from Van, K., Florquin, M., Bruyneel, L., Aiken, L., Diya, L., Lesaffre, E., & Sermeus, W. (2013). Effective strategies for nurse retention in acute hospitals: A mixed method study. International Journal of Nursing Studies, 50(2), 185-194. doi:10.1016/j.ijnurstu.2011.12.001 Yang, P., Hung, C., & Chen, Y. (2015). The impact of three nursing staffing models on nursing outcomes. Journal of Advanced Nursing, 71(8), 1847-1856. doi:10.1111/jan.12643

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