While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project.
A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:
1. Title page
2. Introduction section
3. A comparison of research questions
4. A comparison of sample populations
5. A comparison of the limitations of the study
6. A conclusion section, incorporating recommendations for further research
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Capstone change proposal is Staffing shortages in long term acute care hospitals. Resources must be evidence based.
Nurse shortage is one of the primary issues affecting the current healthcare system globally. The demand for healthcare services is increasing while the number of nurses remains constant, thus the nurse shortage. Nurses are forced to work for more hours than the standard 40 hours a week. This indicates that the nurses are likely to have burnout, high levels of work-life imbalance, and a low nurse-to-patient ratio. Apart from the nurses’ effect, the nurse shortage is experienced by patients who may get delayed care, lack of care, and unsafe or ineffective care. According to Farokhzadian et al. (2018), nurse shortage affects the quality of care, especially on safety and timeliness of care. The most affected communities by nurse shortage are the marginalized communities whereby the ratio of nurses to patients is very unfavorable. Various strategies are used in reducing nurse shortages while maintaining the quality of care. Providing room for career advancement among the nurses from marginalized communities is believed to play a significant role in improving the nurse shortage issue. This paper analyzes different literature sources supporting the hypothesis that education to the nurses from marginalized communities improves the healthcare outcomes and the nurse shortage factor.
Comparison of the Research Questions
The research questions from the literature sources have a different focus on the issue of nurse shortage and on how the problem can be alleviated. Abdollahzadeh et al. (2017) seek to establish the effectiveness of various strategies used by nurses to counter workplace incivility, which contributes to the nursing shortage. Haddad et al. (2021) seek to establish the causes of a nurse shortage, while Nagarajan et al. (2021) studied the impact of technology in solving nursing issues. Pakkonen et al. (2021) directly addressed the research question by establishing the impact of educational continuity among nurses for patient-centered care. Raso et al. (2021), Shah et al. (2021), and Weaver et al. (2018) sought to establish the impact of various nurse stressors on the quality of care. The questions thus had a diversified focus of the primary research question on the effectiveness of continuing nursing education in reducing nursing shortage in marginalized communities.
Comparison of the Sample Populations
The sample populations for the literature sources are nurses. The study questions targeted the performance, stressors, and interventions meant to improve nursing care, and thus all articles took data from nurse samples. The systematic reviews identified sources whose sample populations were nurses, and therefore they can be considered to have used nurse samples. The size of the sample is different amongst the studies. The least size of the sample was 38 nurses, while others included sample sizes of more than 5000. This shows that the research results had higher generalizability.
Limitations of the Study
The limitations of the study differed from the research designs. The Meta-analysis studies discussed the limitations of using the suggested research designs, English language, and particular sample sizes. Pakkonen et al. (2021) cite that the biggest challenge was getting research sources to find out the effectiveness of the same intervention to the nursing problem and limitation to only English sources. This was a major problem in establishing the effectiveness of the interventions through comparative analysis. Other studies cited issues such as the sample’s inability to capture the different aspects differentiating the participants. In their research, Nagarajan & Sixsmith (2021) cited that they did not account for the policy implementations for the low and middle-income countries. Thus, the data collected and analyzed was incomplete. Shah et al. (2021) cited several limitations to the study. One of the limitations is that the data collected and findings are through the cross-sectional design limiting causal inference. The researchers also indicated the lack of enough respondents to be a factor that affected the study in achieving the full goals. The research studies focused on different topics and thus the different limitations that affected the research. The cross-sectional studies experienced limitations in getting the desired sample size. The systematic reviews and meta-analyses cited the limitation to the English language in using the sources and differences in the tools of measure or the variables to be major limitations of the studies.
The sources selected for the literature review focuses on numerous topics, and thus the research questions are different. Even though the sources are in one way connected to the literature review PICO question, limited sources are handling the effectiveness of continuing education among nurses, which is then raised by the PICO question. The studies established that burnout, low-level expertise, workplace incivility, and nurse long-working hours contribute to a high level of nurse shortage. Increased levels of education for nurses improve the access and quality of healthcare services which are limited in areas with nurse shortages. Alleviation of the other factors such as workplace incivility and long-working hours would reduce nurse burnout and the intention to leave, affecting healthcare access and quality. Future research should focus on the relationship between salaries and intention to leave among nurses. Other factors such as work incivility, burnout, and long-working hours are regularly discussed as factors that lead to nurse intention to leave that creates shortage. Focusing on salaries would establish whether low salaries contribute to heightened intention to leave.
Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A. & Vahidi, M. (2017). How to Prevent Workplace Incivility: Nurses’ Perspective. Iranian Journal of nursing and midwifery research, 22(2), 157â€“163. https://doi.org/10.4103/1735-9066.205966
Farokhzadian, J., Dehghan Nayeri, N., & Borhani, F. (2018). The long way ahead to achieve an effective patient safety culture: challenges perceived by nurses. BMC health services research, 18(1), 1-13.
Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2021). Nursing Shortage. StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493175/
Makam, A. N., Nguyen, O. K., Xuan, L., Miller, M. E., Goodwin, J. S., & Halm, E. A. (2018). Factors Associated with Variation in Long-term Acute Care Hospital vs. Skilled Nursing Facility Use Among Hospitalized Older Adults. JAMA internal medicine, 178(3), 399â€“405. https://doi.org/10.1001/jamainternmed.2017.8467
Nagarajan, N. R., & Sixsmith, A. (2021). Policy Initiatives to Address the Challenges of an Older Population in the Workforce. Aging International, 1â€“37. Advance online publication. https://doi.org/10.1007/s12126-021-09442-w
Pakkonen, M., Stolt, M., Charalambous, A., & Suhonen, R. (2021). Continuing education interventions about person-centered care targeted for nurses in older people long-term care: a systematic review. BMC nursing, 20(1), 67. https://doi.org/10.1186/s12912-021-00585-4
Raso, R., Fitzpatrick, J. J., & Masick, K. (2021). Nurses’ Intent to Leave their Position and the Profession During the COVID-19 Pandemic. The Journal of nursing administration, 51(10), 488â€“494. https://doi.org/10.1097/NNA.0000000000001052
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and Factors Associated With Nurse Burnout in the US. JAMA Open Network, 4(2). DOI:10.1001/jamanetworkopen.2020.36469. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2775923
Weaver, M. S., Wichman, B., Bace, S., Schroeder, D., Vail, C., Wichman, C., & Macfadyen, A. (2018). Measuring the Impact of the Home Health Nursing Shortage on Family Caregivers of Children Receiving Palliative Care. Journal of hospice and palliative nursing, 20(3), 260â€“265. https://doi.org/10.1097/NJH.0000000000000436