It is possible to concentrate on the issue of nurse staffing impact on older adults’ health in the context of a certain hospital. Taking into account that health care delivery standards change according to the ever-changing world environment and need to be followed properly, it seems appropriate to consider these two aspects while studying the problem. In this connection, the following research question is to be addressed:
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What is the role of nurse staffing in health care delivery associated with elderly people?
As one of the components of the Transitional Care Model, nurse staffing aims at providing high-quality health care and ensuring the patients’ best outcomes possible. It should be emphasized that scheduling and staffing are usually used as the same issue, yet it is not correct. If the first one implies planning a range of daily activities, then the second embraces the wider area. According to Mensik (2014), nurse staffing refers to “a day-of-operations function in which designated persons assess and determine the shift-to-shift ratio of nurses to patients to ensure adequate staffing on each shift and unit” (p. 2). Thus, nurse staffing involves various significant aspects that need to be considered while analyzing and evaluating the specific situation.
American Nurses Association (ANA) distinguishes between centralized and decentralized forms of nurse staffing. The first one refers to the form when one department manages all the units in the organization. The second one implies the situation when every unit has its own leader who identifies the required level of staffing (Capezuti et al., 2012). Each of the mentioned forms can be employed by the leaders, depending on certain goals and objectives. There are three types of nurse staffing that are as follows: budget-based, nurse-patient ratio, and patient acuity. No model is recognized as the most suitable or useful one as each of them is important and relevant to the modern world. However, it is also recommended to use a combination of these models.
While identifying nurses’ staffing, several components of their performance are to be taken into account. In particular, such issues as planning, implementation, assessment, consultation, coordination, etc. need the precise attention of a leader (Falk, Baiqis, & Kopac, 2013). Therefore, a number of federal and state organizations developed staffing requirements that help to enhance both nurse staffing and patients’ outcomes. For example, the Center for Medicare & Medicaid Services (CMS) provides information for safe and adequate staffing, pointing out that hospitals should hire RNs and vocational nurses as well as other staff to meet the required volume of staffing. Along with the key aim of nurse staffing that was specified earlier in this paper, there are some other factors that may affect it. For instance, a workflow of nurses, patients’ volume, admissions, and other similar obstacles (Cho et al., 2016). Therefore, a leader should employ a consistent approach to ensure adequate staffing.
The role of nurse staffing in ensuring older adults with adequate health care services seems to be underestimated in modern practice. Some scholars such as Zisberg et al. (2014) claim that the lack of nurses and improperly designed nurse staffing lead to the patients’ mistreatment and dissatisfaction. Discussing their research results, Zisberg et al. (2014) suggest that “patients who have a greater need for professional nursing care during an acute hospital stay, perhaps caused by a decline in functional or health status, report greater satisfaction with nursing functions” (p. 650). It should be noted here that the mentioned research was conducted according to the quantitative research design and thus provides accurate numerical information regarding the issue. This means that the role of nurse staffing should be studied in an in-depth manner, leading to some appropriate changes.
Methodology and Design of the Study
The literature review shows that currently there is a shortage of nurses caring for elderly people (Zisberg et al., 2014). The methodology and design of the study focus on a certain set of processes and principles that act as a basis for the prospective research. The study of the role of nurse staffing can significantly improve the level of this shortage by discovering its core reasons. To explore the topic and answer the research question, it seems appropriate to employ the qualitative design of research due to its informative nature (Creswell, 2014). It will be possible to collect, analyze, and interpret the acquired information to make subsequent conclusions and recommendations. The following variables will be studied: perceptions of nurses and patients regarding staffing at a certain hospital and the structure of staffing. It is expected that the research will reveal key tendencies and potential changes in the field of nurse staffing.
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Sampling will focus on elderly patients aged 60 years old or over. For this study, an interview is a cost and time-effective way that is likely to help to collect perceptions and attitudes of the respondents. Following the research standards, the potential participants will be invited to join the project voluntarily. No personal information will be collected either in written notes or audio recordings. Also, the respondents will have knowledge of the point of the research in advance. Furthermore, a properly-developed questionnaire will be used to collect the data. This study will focus on simple random sampling due to its inclusivity. In particular, it allows including various units and participants in the study, thus ensuring its relevance and objectivity. This type of sampling also helps to avoid classification errors.
As for the tools that are necessary to provide the research, it is important to note that the interviews need to be digitally recorded in the form of audio files for further analysis. Any device can be used for this purpose, be it a computer or a smartphone. The questionnaire will be typed and printed for the convenience of the participants. The received results will be analyzed by using electronic means. All the accompanying information will also be printed and offered to the respondents before the interview.
Algorithm of the Study
The study will be conducted in the framework of short interviews and questionnaires. After that, the information will be analyzed and interpreted in the context of the identified problem. Based on the literature review and the results of the study, it will be possible to provide adequate conclusions. The value of this study lies in the fact that the current problem of nurse staffing along with nurse shortage in care for elderly patients needs to be addressed. The results of this study will be beneficial both for nurses and their patients. The prospective studies may involve the following research question: how technology can improve relationships between nurse staffing and quality of care? This is likely to help in exploring the problem in the global context.
Capezuti, E., Boltz, M., Cline, D., Dickson, V. V., Rosenberg, M., Wagner, L.,… Nigolian, C. (2012). Nurses improving care for health system elders – a model for optimising the geriatric nursing practice environment. Journal of Clinical Nursing, 21(2), 3117-3125.
Cho, E., Lee, N. J., Kim, E. Y., Kim, S., Lee, K., Park, K. O., & Sung, Y. H. (2016). Nurse staffing level and overtime associated with patient safety, quality of care, and care left undone in hospitals: A cross-sectional study. International Journal of Nursing Studies, 60(2), 263-271.
Creswell, J. W. (2014). Research design (4th ed.). Thousand Oaks, CA: Sage Publications.
Falk, N. L., Baiqis, J., & Kopac, C. (2013). Elder mistreatment and the Elder Justice Act. The Online Journal of Issues in Nursing, 17(3). Web.
Mensik , J. (2014). What every nurse should know about staffing. American Nurse Today, 9(2), 1-11.
Zisberg, A., Zlotnick, C., Gur-Yaish, N., Admi, H., Sinoff, G., & Shadmi, E. (2014). Functional decline and satisfaction with nursing care among older hospitalized adults. International Journal of Nursing Practice, 21(5), 645-652.