Relationship Between Nursing Job Staffing Discussion Paper

Relationship Between Nursing Job Staffing Discussion Paper ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Relationship Between Nursing Job Staffing Discussion Paper Assignment Directions Read over each of the following directions, the required Reading Research Literature worksheet, and grading rubric. CCN NR 439 Week 6 Relationship Between Nursing Job Staffing Discussion Paper Complete the required Reading Research Literature (RRL) worksheet (Links to an external site.) . This must be used. (ATTACHED) Required article to use is attached This assignment contains: Purpose of the Study: Using information from the required article and your own words, summarize the purpose of the study. Describe what the study is about. Research & Design: Using information from the required article and your own words, summarize the description of the type of research and the design of the study. Include how it supports the purpose (aim or intent) of the study. Sample: Using information from the required article and your own words, summarize the population (sample) for the study; include key characteristics, sample size, sampling technique. Data Collection: Using information from the required article and your own words, summarize one data that was collected and how the data was collected from the study. Data Analysis: Using information from the required article and your own words, summarize one of the data analysis/ tests performed or one method of data analysis from the study; include what you know/learned about the descriptive or statistical test or data analysis method. Limitations: Using information from the required article and your own words, summarize one limitation reported in the study. Findings/Discussion: Using information from the required article and your own words, summarize one of the authors’ findings/discussion reported in the study. Include one interesting detail you learned from reading the study. Reading Research Literature : Summarize why it is important for you to read and understand research literature. Summarize what you learned from completing the reading research literature activity worksheet. CCN NR 439 Week 6 Relationship Between Nursing Job Staffing Discussion Paper nurse_staffing_and_the_relatio.pdf nr439_w6_rrl_worksheet_3.2020.docx Debra C. Hairr Helen Salisbury Mark Johannsson Nancy Redfern-Vance Nurse Staffing and the Relationship to Job Satisfaction And Retention EXECUTIVE SUMMARY The purpose of this quantitative, correlational research study was to examine the relationships between nurse staffing, job satisfaction, and nurse retention in an acute care hospital environment. Results indicated a moderately strong, inverse relationship between job satisfaction and nurse retention. A weak positive relationship between job satisfaction and nurse staffing was identified. Nurses reported experiencing job dissatisfaction in the past 6 months specifically related to the number of patients assigned. Analysis suggested nurses are staying with their current employer because of the current economic environment. Improving nurse staffing will be necessary when the economy improves to prevent the departure of discontented nurses from acute care facilities. 2004, THE INSTITUTE OF Medicine released a report, Keeping Patients Safe: Transforming the Nursing Work Environment. This report recognized appropriate nurse staffing levels are essential for patient safety. Nurse-patient ratios are a starting point in the discussion of appropriate levels of nurse staffing. Researchers agree patient acuity and skill mix must also be taken into consideration when addressing nurse staffing issues (Tevington, 2011). CCN NR 439 Week 6 Relationship Between Nursing Job Staffing Discussion Paper There is a paucity of research that addresses patient acuity, skill mix, and nursepatient ratios. The American Nurses Credentialing Center (ANCC) Magnet® hospitals are widely recognized for promoting safe and appropriate nurse staffing and generally I N have good patient outcomes (Trinkoff et al., 2010). According to Needleman and colleagues (2011), Magnet hospitals also have lower patient morbidity and mortality rates than non-Magnet hospitals. A 3-year study conducted in a Magnet hospital analyzed over three million patient records. Researchers examined the effect of inadequate nurse staffing on mortality. There was a 6% risk of death for patients when a shift with a nurse staffing shortage of just 8 hours occurred. The literature suggests nurse-patient ratios of 4:1 or less provide the most optimal outcomes for patients (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002; Aiken, Clarke, Sloane, Lake, & Cheney, 2008; Aiken et al., 2010; Needleman et al., 2011; Rosenberg, 2011). DEBRA C. HAIRR, DHSc, MSN, RNC-OB, is Contributing Faculty, College of Health Sciences, School of Nursing, Walden University, Minneapolis, MN. HELEN SALISBURY, PhD, is Assistant Professor, Arizona School of Health Sciences at A. T. Still University, Mesa, AZ. MARK JOHANNSSON, DHSc, MPH, is Adjunct Professor, Arizona School of Health Sciences at A. T. Still University, Mesa, AZ. NANCY REDFERN-VANCE, PhD, RN, CNM, is Associate Professor, College of Nursing, Valdosta State University, Valdosta, GA. 142 NURSING ECONOMIC$/May-June 2014/Vol. 32/No. 3 Health care in the United States is a commodity, and nurses are an expensive budgetary consideration. Health care facilities have the potential to achieve large financial savings by reducing the number of nurses. CCN NR 439 Week 6 Relationship Between Nursing Job Staffing Discussion Paper Despite the evidence, many institutions are unwilling or unable to provide nurse staffing that is supported by the growing body of research (Duffin, 2012; Garretson, 2004). Implementing this one evidence-based practice could have a positive impact on patient outcomes, ultimately decreasing patient morbidity and mortality (Aiken et al., 2002; Aiken et al., 2008; Aiken et al., 2010; Needleman et al., 2011; Shamliyan, Kane, Mueller, Duval, & Wilt, 2009). Positive patient outcomes are not the only benefit from improved nurse staffing. Aiken and associates (2002) examined nurse satisfaction and retention issues. The authors noted that when nurses are exposed to inadequate staffing levels, they leave their positions. Retaining as many nurses in their roles as possible makes fiscal sense for any organization. Costs to an organization to retrain a specialty nurse have been estimated as being as high as $80,000 (Burr, Stichler, & Poeitler, 2011; Tellez, 2012). Not only will patient care and outcomes improve with additional nurses, but also cost savings may result. Aiken and co-authors (2010) suggested a ratio of four patients to one nurse will save each health care organization $60,000 a year. Retaining just one nurse and utilizing the recommended nurse-patient ratios may result in savings of around $140,000 every year. CCN NR 439 Week 6 Relationship Between Nursing Job Staffing Discussion Paper That is just for one nurse retained in his or her position, taking care of four patients on a medical-surgical floor. Extrapolating that number to every medical-surgical floor, in every hospital across the United States, would result in the realization of enormous savings to health care. In the current economy, administrators would not be fis- cally responsible if they did not examine every avenue that could save lives, improve nursing job satisfaction, retain nurses at the bedside, and save health care dollars. Methods Study participants. This quantitative, correlational research study was developed to examine the relationships between nurse staffing, job satisfaction, and nurse retention in an acute care hospital environment. Survey participants were practicing licensed registered nurses with at least 6 months of acute care nursing experience. A consecutive sample was recruited on nursing listserv’s, Facebook, MySpace, and Allaboutnurses.com. Consecutive sampling is a “form of non-probability sampling where survey participants are recruited as they become available” (Portney & Watkins, 2009, p. 865). Inclusion criteria for participating in the survey included (a) licensed as a registered nurse, (b) a minimum of 6 months direct patient care nursing experience, and (c) employed in an acute care hospital. Additional demographic data were collected and included (a) gender, (b) age, (c) academic preparation for initial licensure, (d) highest level of education attained, (e) nursing specialty, (f) if employed in a Magnet hospital, and (g) number of years nursing experience. The research protocol for this study was approved by the A. T. Still University Institutional Review Board. Survey tool. The survey tool is a revision of one of the most widely used tools to assess the clinical nursing environment, the Nursing Work Index (NWI) (Kramer & Hafner, 1989). The NWI consists of 65 items on a 4-point Likerttype scale ranging from 1 (strongly agree) to 4 (strongly disagree). The NWI scale was revised by Aiken and Patrician (2000). The authors used 57 of the original 65 NWI items for the Nursing Work Index- NURSING ECONOMIC$/May-June 2014/Vol. 32/No. 3 Revised (NWI-R). The NWI-R captures organizational attributes that characterize professional nursing practice environments including job satisfaction (Aiken & Patrician, 2000). The NWI-R has four subscales. CCN NR 439 Week 6 Relationship Between Nursing Job Staffing Discussion PaperThe subscale that can be attributed to job satisfaction is the Control Over Practice (COP) subscale. The reliability of the NWI-R survey tool has been previously demonstrated with Cronbach’s alpha of 0.96 for the entire NWI-R, and the subscale COP alpha noted at 0.91 (Aiken & Patrician, 2000). Additional survey questions addressed the survey participants’ current experiences with nursepatient ratios and job dissatisfaction. The participants were asked the following additional questions: How many patients were assigned to you at the beginning of your last shift? Has the number of patients you have been assigned resulted in job dissatisfaction? Have you thought about leaving your current nursing position in the last 6 months due to job dissatisfaction? If this question was answered in the affirmative, an additional question was asked: Has the current economic downturn influenced your decision to stay in your current position? These additional questions were an attempt to gauge the effect that the economy may have on a nurse’s reluctance to change jobs in spite of job dissatisfaction. Data collection. Data were collected via an electronic survey. An explanatory invitation was posted online with inclusion criteria and the link to SurveyMonkey. The link was available for 30 days. Statistical Analysis Data were analyzed using the IBM Statistical Package for Social Sciences (SPSS), version 20. Descriptive statistics were obtained for demographic and NWI-R COP subscale variables. The NWI-R COP data were tested for normality. Percentages and frequencies were also obtained. 143 Table 1. Sample Demographics Correlational analyses for each research question were performed. As ordinal scales were used in this study, and data were not normally distributed, nonparametric statistical analysis was appropriate. Spearman’s Rank Correlation Coefficient Analysis was used to determine whether the predictive variables of job satisfaction and nurse staffing were related to the criterion variables of nurse retention and job satisfaction, respectively. The NWI-R COP was used to measure job satisfaction.CCN NR 439 Week 6 Relationship Between Nursing Job Staffing Discussion Paper An additional retention variable was analyzed. The question was asked if the current economic downturn had affected a decision to stay in a current position. Frequencies and percentages were analyzed. Statistical significance (p) level of the analysis was set at ? = 0.05, two-tailed. Characteristics Gender Age 144 Female Male 9 (12.9) Prefer not to answer 2 (2.9) 6 (8.6) 26-30 12 (17.1) 31-35 10 (14.3) 36-40 7 (10.0) 41-45 8 (11.4) 46-50 9 (12.9) 51-55 9 (12.9) 56-59 6 (8.6) 60 and older 3 (4.3) Diploma 5 (7.1) Associate’s degree 38 (54.3) Bachelor’s degree 23 (32.9) Master’s degree Highest level of formal education Bachelor’s degree in nursing (BSN) 23 (32.9) Other bachelor’s degree (non-nursing) 8 (11.4) Master’s degree in nursing (MSN, MN) 11 (15.7) Other master’s degree (non-nursing) 4 (5.7) Doctor of nursing practice (DNP) 0 (0.0) PhD (nursing) 0 (0.0) 2 (2.9) Medical/Surgical 28 (40.6) Intensive care 11 (15.9) Emergency department 9 (13) Pediatrics 1 (1.4) Surgical services 1 (1.4) Mental health 2 (2.9) Women’s health 7 (10.1) Outpatient services ANCC Magnet status b 10 (14.5) 11 (15.7) 19 (27.1) 6 – 10 years 8 (11.4) 11 – 15 years 7 (10.0) 16 years and greater 25 (35.7) Yes 18 (25.7) No 48 (68.6) Don’t know a (5.7) 22 (31.4) Years of nursing 6 months – 1 year experience 2 – 5 years b 4 Associate’s degree (AD) Other doctoral degree Nursing specialtya Study Sample N (%) 59 (84.3) 19-25 Basic RN education Results Participant characteristics. Of 70 respondents, the majority were female (n=59; 84.3%). The median age of respondents was 36-45 years (n=15; 21.4%). As Table 1 indicates, registered nurse education data revealed that most of the respondents (n=38; 58.3%) had earned an associate’s degree in nursing. Participants holding a master’s degree in nursing were 15.7% (n=11), while those with a non-nursing master’s degree were noted at 5.7% (n=4). No survey respondents reported holding a doctor of nursing practice or doctor in nursing; two respondents (2.9%) reported doctoral degrees in non-nursing disciplines. Nursing experience ranged from 6 months to greater than 16 years. Most of the nurses reported having 2 to 5 years of experience (n=19; 27.1%), or greater than 16 years of experience (n=25; 35.7%) (see Table 1). Nurses working in a hospital with Magnet designation were 25.7% (n=18). Four respondents reported they did not know if their facility held the Magnet designation (5.7%). CCN NR 439 Week 6 Relationship Between Nursing Job Staffing Discussion Paper Specific Attribute 4 (5.7) One participant did not define nursing specialty. American Nurses Credentialing Center NURSING ECONOMIC$/May-June 2014/Vol. 32/No. 3 The first research question explored whether there was a relationship between nurse staffing (nurse-patient ratios) and job satisfaction. Survey participants were asked to quantify the number of patients they had been assigned during the last shift they had worked. The data were not normally distributed. Overall, the reported mean patient assignment for each nurse for his or her last worked shift was 5.6. The range for all respondents was 1:1 to 1:10 or greater (n=63). In Magnet institutions, the mean nurse-patient ratio was 1:5.3 (n=17). Job satisfaction was determined using the COP subscale, which is derived from the NWI-R survey tool (Aiken & Patrician, 2000). Nine participant responses were removed from the COP analysis as there was either no response to all of the subscale questions (n=5) or there was a limited response (n=4). Two additional respondents answered all but one question in the subscale. Data substitution was implemented for these two subjects. The mean of all answered subscale responses was substituted for the missing value. The data for the COP are a sum of all question responses in the subscale, which were normally distributed. Correlation coefficients between nurse-patient ratios and the NWIR COP subscale were examined using Spearman’s rho. A weak positive relationship between COP and nurse staffing was identified, (59) = 0.33, p = 0.01, twotailed. This weak relationship implies there is a relationship between workload and job satisfaction. The second research question explored whether there was a relationship between job satisfaction and nurse retention. Spearman’s rho was used to test the correlation between job satisfaction, using the NWI-R COP subscale, and whether nurses had thought about leaving their position in the past 6 months. The data for this variable were not normally dis- Table 2. Additional Survey Questions Question Specific Attribute Study Sample N (%) Has the number of patients assigned resulted in job satisfaction? Yes/Sometimes 61 (75.4) Has the current economic downturn influenced your decision to stay in your current position? Yes 61 (63.9) tributed. A moderately strong negative correlation was demonstrated, p(59) = -0.43, p = 0.01, twotailed. The null hypothesis was rejected as there was a demonstrated inverse relationship between job satisfaction and nurse retention which indicates as job dissatisfaction increases, the more likely a nurse will think about leaving his or her nursing position. Responses from the additional survey questions are shown in Table 2. The additional questions addressed whether nurses felt job dissatisfaction, which can be attributed to nurse-patient ratios, and was the economy a factor in remaining in their current nursing position. Discussion The COP subscale of the NWIR measures six aspects of professional nurses’ control over their nursing practice. CCN NR 439 Week 6 Relationship Between Nursing Job Staffing Discussion Paper This study suggests there is a problem in the professional nurses’ work environment, which has created job dissatisfaction for many nurses participating in this research. Identifying the issues that create dissatisfaction at work is important. Job satisfaction is the foremost indicator of the likelihood an individual will remain in a position, and is a significant factor in nurse turnover (Brewer, Kovner, Greene, Tukov-Shuser, & Djukic, 2012; Hill, 2011; Larrabee et al., 2003; O’Brien-Pallas, Murphy, Shamian, Li, & Hayes, 2010; Tellez, 2012; Wang, Tao, Ellenbecker & Liu, 2012). NURSING ECONOMIC$/May-June 2014/Vol. 32/No. 3 Nurse turnover is a costly proposition with estimates from $42, 000 for a medical-surgical nurse to $80,000 to hire and orientate a specialty nurse (Burr et al., 2011; Tellez, 2012). Some researchers argue that improving nurse-patient ratios will not result in any cost savings for an organization but will in fact increase health care costs (Buerhaus, 2010; Reiter, Harless, Pink, & Mark, 2012; Tevington, 2011). Salary expenses will increase immediately when an organization adds nursing staff to meet staffing recommendations (Reiter et al., 2012; Welton, 2007). However, a growing body of research suggests long-term savings will be indirect and will occur as nurse retention and patient outcomes improve (Burr et al., 2011; Cho, Ketefian, Barkauskas, & Smith, 2003; Shamliyan et al., 2009). During the recent period of economic upheaval, which began in late 2007, the shortage of nurses has significantly lessened (Staiger, Auerbach, & Buerhaus, 2012). Buerhaus, Auerbach, and Staiger (2009) stated that between 2006 and 2008, there was an increase of 250,000 nursing fulltime equivalents, marking an unprecedented period of growth. This growth was attributed to the recession and the need for nurses to return to the workforce as confidence in job stability waned and the potential for a nurse’s spouse losing his or her job became a reality (Buerhaus & Auerbach, 2011). Nurses are remaining in their positions, older nurses are not retiring, and new graduate nurses 145 are having difficulty finding their first staff nurse position (Tellez, 2012). This study confirms that many nurses are not leaving their current positions because of the uncertain economy, despite declining job satisfaction. This finding is supported by Buerhaus and Auerbach (2011). Limitations and recommendations for future research. The primary limitation for this study was sample size. With over three million nurses practicing in the United States, it is difficult to determine the generalizability of this research to the larger population. CCN NR 439 Week 6 Relationship Between Nursing Job Staffing Discussion Paper The COP subscale is widely recognized as a valid survey tool to measure job satisfaction in a nurse’s professional work environment. The COP is a broad indicator of job satisfaction, and measures many aspects of the work environment that impact a nurse’s job satisfaction. Future research may benefit from the use of a specific tool that addresses nurse staffing issues that are specifically related to nursing job satisfaction. In addition, data collection was a convenience sample collected over 30 days. Further research with a larger sample is indicated to explore the relationship between nurse staffing and job dissatisfaction in the current economic environment. Magnet hospitals have the reputation for providing an improved nursing work environment, which includes decreased patient assignments for nurses. Exploring a comparison between Magnet and non-Magnet facilities may well demonstrate the value the Magnet designation has for a hospital in terms of nurse satisfaction and subsequent retention of professional nurses. Implications for practice. Improving nurse staffing will be necessary when the economy improves to prevent an exodus of discontented nurses. Improving nurse staffing can be a feasible solution for patients, health care facilities, and nurses. Evidence 146 has shown patient outcomes will improve, which will indirectly decrease costs associated with longer lengths of stay, costs associated with hospital-acquired conditions, and medical errors. The mandatory nurse-patient ratio law enacted in California in 2004 has been associated with improved nurse satisfaction (Spetz, 2008; Spetz & Herrera, 2010; Tellez, 2012). Buffington, Zwink, Fink, DeVine, & Sanders (2012) described themes identified by registered nurses for reasons they leave a bedside nursing position. One such theme was workload and staffing. Those same nurses were also asked to identify strategies that would retain them in their bedside nursing role. A key strategy for retaining bedside nurses was identified as improving nurse-patient ratios. Improving nurse staffing will likely improve nurses’ job satisfaction and in doing so will help in keeping needed nurses at the bedside and decrease the likelihood of a new nursing shortage. Conclusion Preventing nurse turnover will decrease the high cost of employing and training new nursing staff. Improving job satisfaction among nurses will be a key factor in retaining experienced nurses at the bedside. The present study has suggested a relationship between job satisfaction and an appropriate patient assignment. Reducing the number of patients a nurse is responsible for during a work shift will improve job satisfaction, improve patient outcome … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10