Evaluating Nursing Hours Per Patient Day as A Nurse Staffing Measure

Summary

The study by Ari Min and Linda Scott is aimed at evaluating the validity, reliability and limitations associated with nursing hours per day. It also aims at identifying various techniques used in measuring nurse staffing as an important aspect that influences quality of care. Min and Scott do not specify the theoretical framework being used in their research. They used nursing hours per patient day as the technique to measure nurse staffing. The study simply tries to establish the common approaches to measuring nurse staffing in the papers under analysis. The study involved an analysis of seventeen studies conducted across the US. The articles analyzed were retrieved from major databases such as Google Scholar, PubMed and CINAHL. Key terms used in the search for the relevant articles were nurse staffing, validity and reliability. Specific terms were then used to find articles associated with each measure.

This study involved analysis of secondary data collected from articles in databases. Therefore, the researchers did not require formal ethical approval. The major ethical requirement for this study was recognizing the authors of the articles from which information and data was drawn. This study does not have a hypothesis nor a research question. The researchers only state the purposes of the study which are to identify common methods of measuring nurse staffing and evaluating the validity, reliability and limitations of the most common measure.  The study analyzes papers based on researches that applied a number of study designs. Most of these researches applied cross-sectional study that were combined with other research designs such as retrospective, correlational and descriptive.  The study by Min and Scott did not involve collection of primary data from respondents or subjects. Therefore, there is no description of a sampling method or the sample characteristics.

There were no data collection procedures for this study. The researchers have not provided a description of the instruments used in collecting data in each paper. However, they note that most of the data was collected using questionnaires and interviews. Some of the studies also relied on data collected from nursing departments. One of the studies also utilized data from larger databases such as those run by the state or national departments and organizations. Graphical presentations and statistical software was utilized in determining the relationship between variables. Tabulation of the results also helped the researchers in determine the most common trends and characteristics of the findings.

The paper by Min and Scott is an analysis of 27 different studies to determine the most common techniques used in to measure nurse staffing. The study found out that nursing hours per patient day (NHPPD) was used in 9 of the studies, making it the most commonly used measure. Most of the other studies utilized a combination of the measures. Min and Scott also relied on the previous studies in determining the validity and reliability of NHPPD as a nurse staffing measure. According to Min and Scott, data collected from the National Database of Nursing Quality Indicators from 11 hospitals indicate there is consistency in the positive relationship between nursing hours per patient day and positive patient outcomes. This study does not use a hypothesis; therefore, we cannot determine whether it is supported or not. However, the research objectives have been met. The paper clearly explains how NHPPD was arrived at as the most common nursing measure. The researchers also examine previous studies aimed at determining the reliability and validity of the nursing measure. 

Critique

Generally, the findings of this study by Min and Scott (2015) appear credible and if incorporated into practice, can make significant contributions towards the use of various techniques in measuring nurse staffing. The findings of the paper have the potential to make significant contributions towards determination of the validity, reliability and limitations of nursing hours per patient day as a measure of nurse staffing. The evidence presented in this paper can be categorized as IIIB. It offers a systematic review of a combination of quasi-experimental studies. It has reasonably consistent results and the analyzed studies have sufficient sample sizes for the respective study designs. Min and Scott (2015) offer fairly definitive conclusions that are based on a comprehensive literature review that is backed by data from the studies being evaluated.

This paper does not have a review of literature. The writers may have omitted this section because the whole paper is a summary of an analysis of relevant literature. However, the description of the 27 studies analyzed in the paper is clear, concise and supports the findings and conclusions in the paper.  The data used to arrive at the findings and conclusions in this research was collected from a vast sample from 27 different studies. The sample and sub-sample size are not specified.

The studies analyzed by Min and Scott (2015) utilized a number of instrument. The most common instruments for collecting primary data were questionnaires and interviews. However, most of the data was obtained from organizations and government departments. This data is reliable since it is collected for microeconomic business decisions at the hospital level and macroeconomic policy decisions at the state and federal level. Min and Scott (2015) do not mention the validity of the instruments used in collecting primary data. However, there is likelihood that the data obtained from databases is more reliable. There is no proof that the data in this research was analyzed without bias in the previous researches. However, Min and Scott (2015) tabulated the results from the studies being examined in order to determine the common characteristics.

Min and Scott (2015) obtained their data from a number of studies. This means that the sample used in this study is large. However, the process of data analysis mainly included tabulation. There could have been more mathematical analysis and graphical representation of the data. One of the limitations recognized by Min and Scott (2015) is the difference in NHPPD approaches between the study. This difference is brought about by the different types of data available to researchers. Some of the researchers obtained limited data from primary sources while others relied on vast secondary sources such as state or federal government departments.

I can generalize the results and conclusions of this study without hesitation because most of the studies show that quality of care is positively correlated to NHPPD. It is unlikely that cultural factors would interfere with my ability to generalize these findings to my practice. Differences in nursing practice are also unlikely to interfere with my ability to generalize thee feelings. Implementation of the findings of this study will benefit patients since an increase in NHPPD will improve quality of care and safety of patients. The study findings can be categorized as phenomenological.

References

Min, A., & Scott, L. D. (2016). Evaluating nursing hours per patient day as a nurse staffing measure. Journal of nursing management, 24(4), 439-448."