Nursing

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.

ANSWER

Literature Review

Introduction

Nurses have experienced challenges with long working hours, influencing their performance and job satisfaction. When the long working shifts are combined with overtime, there are consecutive shifts day and night, leading to the risk of burnout and fatigue that may influence patient care. The long working hours and shifts have put nurses at risk of short sleep duration and sleep disturbances. Such incidents have led to fatigue-related errors, the risk of injuries, reduced job performance, and poor patient care that might harm the patient. Shift scheduling is one of the most effective interventions to reduce psychosocial and physical stressors among nurses to improve job performance and patient care. This paper aims to evaluate different studies that offer evidence-based research to reflect on shift scheduling on patient care. The literature comparison will give clinical evidence essential in building knowledge to the various stakeholders concerning the importance of shift scheduling in improving patient care. Shift scheduling is a significant intervention since it focuses on the scheduling of the nursing workforce to reduce long working hours that lead to fatigue and medical errors that impact the quality of patient care.

A Comparison of Research Questions

Comparing various studies, it’s evident that shift scheduling offers promising and measurable outcomes to patient care. Most of the studies have focused on working hours and patient safety among hospital nurses. Stimpfel, Fatehi, and Kovner’s (2020) research question focused on the relationship between sleep duration and patient safety among registered nurses. Stimpfel, Sloane, and Aiken’s (2012) research question was the link between nurses’ shift length and outcomes in terms of burnout and job discontent. Smith-Miller et al., (2014) research question focused on how long shifts and work-related fatigue influence patient safety. Son, Lee, and Ko’s (2019) research question also focused on the link between working hours and patient safety. Abd-El-Aziz and Wahab’s (2019) research question focused on how the work schedule affects patient safety and nurse satisfaction.

Alsharari et al., (2021) research question focused on the impact of night shift rotations on nursing performance and patient safety. Dall’Ora et al., (2020) research question focused on how the long-hour shifts affect the quality of care. Dall’Ora and Dahlgren (2020) did not rely on a research question but a hypothesis that shows how absence or presence of shift work is not merely damaging to the well-being and health of nurses but also how the shifts are organized in terms of overtime, shift length, permanent and rotational schedules.

A Comparison of Sample Populations

To weigh the strength of the evidence provided, it’s essential to examine the sample populations. Stimpfel, Fatehi, and Kovner (2020) focused on community and healthcare settings across the U.S. Stimpfel, Sloane, and Aiken (2012) focused on hospitals in New Jersey, California, Florida, and Pennsylvania. Smith-Miller et al., (2014) aimed at nurses in acute care settings. Son, Lee, and Ko (2019) targeted three tertiary care hospitals in South Korea. Abd-El-Aziz and Wahab (2019) relied on a 1-Day Surgeries Hospital, Nasr City, Cairo. Alsharari et al. (2021) relied on a survey in public hospitals.

Dall’Ora et al., (2020) focused on hospitals in 12 European countries. Dall’Ora and Dahlgren (2020) on nursing articles that used varying designs, methodologies, and samples to highlight the central role of nursing shift work and its impact on patient safety. Research in this special issue of shift scheduling has relied on different sample populations that have been used to examine the impact of nurse shift lengths on patient safety.

A Comparison of the Limitations of the Study

Most of the studies have relied on methodological techniques that offer data that is not generalizable, thus leading to research bias. Ideally, generalizability refers to the extent to which the results of the research studies reflect results that can be reflected in the real world. However, the results of most of the studies can be applied only to a very specific or narrow population which leads to poor generalizability. The studies have failed to use the right sample size, sampling techniques, and procedures that will enable the studies to offer more generalizable information. Therefore, there was a need for the studies to conduct research with a representative sample that will allow the findings to be generalized across other people, situations, and stimuli. There was a moderate strength of evidence from the studies on the significance of shift scheduling to improve patient care. This is because the studies failed to rely on highly valid and strong study designs that would evaluate the effectiveness of shift scheduling to improve patient care.

Conclusion and Recommendations

Evidence-based studies allow the evaluation of research in a manner that the effectiveness can be understood. Using evidence-based studies was effective in finding the response to the PICOT questions. The research questions focused on the impact of shifts on nurses’ performance and patient care. The sample populations varied, but the studies offered valid pieces of evidence and proof that there is a need for effective shift scheduling to eliminate long working hours and improve nurses’ job satisfaction which will result in improved patient care. The studies offered similar results on the significance of implementing shift scheduling to improve patient care. Further studies should focus on more precise research, especially in the various hospital units, to understand how the shift schedules can be implemented to solve the issue of long shifts among hospital nurses. The researchers should also ensure that the findings of the studies are generalizable in order to allow effective application of the intervention in hospitals to improve patient care.

References

Abd-El-Aziz, N. A., & Wahab, E. A. (2019). The relationship between staff nurses’ satisfaction with their schedule and patients’ satisfaction with the quality of care. Egyptian Nursing Journal, 16(3), 147.

Alsharari, A. F., Abuadas, F. H., Hakami, M. N., Darraj, A. A., & Hakami, M. W. (2021). Impact of night shift rotations on nursing performance and patient safety: A cross‐sectional study. Nursing Open, 8(3), 1479-1488.

Dall’Ora, C., Griffiths, P., Emmanuel, T., Rafferty, A. M., Ewings, S., RN4CAST Consortium, … & Schoonhoven, L. (2020). 12‐hr shifts in nursing: Do they remove unproductive time and information loss, or do they reduce education and discussion opportunities for nurses? A cross‐sectional study in 12 European countries. Journal of clinical nursing, 29(1-2), 53-59.

Dall’Ora, C., & Dahlgren, A. (2020). Shift work in nursing: closing the knowledge gaps and advancing innovation in practice. International Journal of Nursing Studies, 112, 103743.

Smith-Miller, C. A., Shaw-Kokot, J., Curro, B., & Jones, C. B. (2014). An integrative review: fatigue among nurses in acute care settings. JONA: The Journal of Nursing Administration, 44(9), 487-494.

Son, Y. J., Lee, E. K., & Ko, Y. (2019). Association of working hours and patient safety competencies with adverse nurse outcomes: a cross-sectional study. International journal of environmental research and public health, 16(21), 4083.

Stimpfel, A. W., Fatehi, F., & Kovner, C. (2020). Nurses’ sleep, work hours, patient care quality, and safety. Sleep Health, 6(3), 314-320.

Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509.