What type of design was used?

What type of design was used?

What type of design was used? 150 150 Nyagu

4-2 Discussion: Locating Research

Using your PICO question, search for a relevant primary research article and critique the article for its potential to provide an evidence-based solution. Note that the article you find here can be used in your final project. In your initial post discuss the following:

What type of design was used?
Was the sample size appropriate and was a power analysis used to estimate sample size needs?
If an instrument was used, was the validity and reliability reported on?
What was the statistical or clinical significance of the findings?
If the results are generalizable, how can these findings be used in nursing practice?
Are the best practices of research ethics addressed?
Respond to two of your peers and briefly analyze their articles, commenting on areas where you agree or differ on the findings and why.

To complete this assignment, review the Discussion Rubric document.
Please use already existing PICO question/topic. Thank you. This is an example from a course mate. Please follow format for mine.

PICO Question: How does the low nursing-to-patient ratio compare with the current high nurse-to-patient ratio affect survival and mortality rates of ICU patients?

Locating Research

A primary research article that focuses on the identified topic is “Are high nurse workload/staffing ratios associated with decreased survival in critically ill patients? A cohort study” by Lee et al. (2019). To adequately study the effect of the nursing staffing ratio in the intensive nursing unit (ICU), the researchers conducted a cohort study of 845 adult patients admitted in two multi-disciplinary ICUs that had reported inadequate workload ratio during the patients’ stay in the facility. The research design that was employed is a retrospective cohort study. A retrospective cohort study is a type of observational research in which the investigator examines exposures to suspected risk and protective factors between exposed and non-exposed patients. In this specific study, the researchers wanted to find the effect of increasing nursing staffing in inadequately staffed intensive care units in the survival and mortality rates of the admitted patients.

Considering the patient population and the size of the two ICUs, it can be deduced that the sample of 845 patients admitted over a period of 5 months was a sufficient sample size to use in the study. Technically, a sample size should be 10% of the population, and therefore 845 is a good number in the 34-bed ICUs that admitted patients over the five months (Lee et al., 2017). In this study, no power analysis was done to determine the most appropriate sample size.

The instrument that was used in the study is the Therapeutic Intervention Scoring System (TISS-76). The instrument is very useful in measuring the severity of illness and nursing workload in ICUs (Lee et al., 2017). The validity and reliability of the instrument are not however mentioned.

The study’s findings are practically significant in the clinical setting because they demonstrate how exposing critically ill patients to a lower level of nursing staffing can result in more deaths. Nursing administrators stand guided on the appropriate nurse-to-patient ratios to use in the ICU environment. In the nursing practice, the findings are useful in creating nurse-patient ratios that can enhance patient safety and improve healthcare quality.

In the article, the best practices of research ethics were sufficiently addressed since the researchers sought approval from the institutional review committee (Lee et al., 2017).


Lee, A., Cheung, Y., Joynt, G. M., Leung, C., Wong, W. T., & Gomersall, C. D. (2017). Are

high nurse workload/staffing ratios associated with decreased survival in critically ill patients? A cohort study. Annals of Intensive Care, 7(1), 46. https://doi.org/10.1186/s13613-017-0269-2