Systematic Review and Meta-Analysis Research Discussion Paper

Systematic Review and Meta-Analysis Research Discussion Paper

1. The article selected is that by Driscoll et al. (2017), on how nurse-sensitive patient outcomes are dependent on nurse-patient ratios. Some of these nurse-sensitive patient outcomes the researchers looked at were mortality rates, rate of patient falls, pressure ulcer rates, and the rates of hospital-acquired infections (HAIs) such as ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infections or CAUTI. The standard of care provided to patients is determined by the nurse-to-patient ratio. Optimizing the nursing workforce’s skill mix is challenging when there is a nurse shortage (Driscoll et al., 2017). Dall’Ora et al. (2022) claim that poor care results in greater fatality, which is avoidable. The patient acuity, or level of care needed by each patient, must be taken into consideration when calculating nurse-to-patient ratios. Positive nurse-sensitive patient outcomes result from high-quality treatment, but only when the nurse-to-patient ratio is acceptable. Systematic Review and Meta-Analysis Research Discussion Paper
2. A meta-analysis is a subset of systematic review. It is usually the topmost in the hierarchy of evidence together with systematic reviews (Wang et al., 2021). This particular study is a systematic review and meta-analysis. Some of the characteristics that make it a meta-analysis are that it analyzed previous research on the subject extracted from research databases, it specified inclusion criteria that only 35 articles out of the 3,429 retrieved met, and it carried out further statistical analysis to arrive at a more convincing scientific conclusion on the role of staffing in patient mortality in acute specialist units.
3. Indeed the inclusion and exclusion criteria were clearly stated in the chosen article. On page 3 of the article, the inclusion criteria are stated as:

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• The methodology of the study has to be quantitative in nature. Systematic Review and Meta-Analysis Research Discussion Paper
• The study must be published between January 2006 and February 2017 (a span of 11 years).
• The study must be published in English.
• The study must have considered at least one nurse-sensitive outcome indicator such as mortality, medication errors, surgical bleeding, CAUTI, pressure sores, unplanned readmission, cardiac arrest, or shock amongst others.
• The study must have investigated the nurse-to-patient ratios (NPRs) by using one of two methods: nursing hours per patient days (NHPPD) or direct division of the number of nurses by the number of patients over 24 hours or per nursing shift.
• The study must have sampled specialist units such as critical care units and coronary care units with some of the nurses having postgraduate critical care education and certification.
• Studies that included a mixed population.

4. The articles that were included were selected based on an exclusion process. That means those articles that did not meet the inclusion criteria were automatically excluded from the search results obtained.
5. I agree with the approach taken by the researchers. This is because they specified inclusion criteria and searched five reputable databases as is required. The search was driven by carefully chosen search terms. The independent variables were the NPRs and the dependent variables were the nurse-sensitive outcomes. Systematic Review and Meta-Analysis Research Discussion Paper
6. I agree with the conclusions of the researchers in this article. This is because I know from practice that when there is a shortage of nurses in a heavy workload situation, errors and mistakes are bound to happen. Some of these eventually lead to the deaths of patients (Needleman et al., 2019), increasing patient mortality which is a nurse-sensitive indicator.
7. I would apply the implications from this study to my practice in that if I became a nurse leader overseeing a unit, I would motivate, inspire, empower, and listen to my nursing staff. That is transformational leadership (Islam et al., 2018). It would create a psychologically safe workplace and reduce staff turnover.    Systematic Review and Meta-Analysis Research Discussion Paper

References

Dall’Ora, C., Saville, C., Rubbo, B., Turner, L., Jones, J., Griffiths, P. (2022). Nurse staffing levels and patient outcomes: A systematic review of longitudinal studies. International Journal of Nursing Studies, 134(104311), 1-12. https://doi.org/10.1016/j.ijnurstu.2022.104311

Driscoll, A., Grant, M.J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyombwe, T., & Astin, F. (2017). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 17(1), 6–22. https://doi.org/10.1177/1474515117721561

Islam, T., Tariq, J., & Usman, B. (2018). Transformational leadership and four-dimensional commitment: Mediating role of job characteristics and moderating role of participative and directive leadership styles. Journal of Management Development. https://doi.org/10.1108/JMD-06-2017-0197

Needleman, J., Liu, J., Shang, J., Larson, E. L., & Stone, P. W. (2019). Association of registered nurse and nursing support staffing with inpatient hospital mortality. BMJ Quality & Safety, 29(1), 10–18. https://doi.org/10.1136/bmjqs-2018-009219

Wang, X., Zhang, X., Li, Z., Zhong, W., Yang, P., & Mao, C. (2021). A brief introduction of meta‐analyses in clinical practice and research. The Journal of Gene Medicine, 23(5), 1-8. http://dx.doi.org/10.1002/jgm.3312  Systematic Review and Meta-Analysis Research Discussion Paper

Please read the instruction carefully.

Using the Walden Library, locate a peer-reviewed article that utilizes a meta-analysis design and examines a population health topic that interests you. Your article must be a meta-analysis specifically, not just a systematic review.

In 2 pages, not including title page and references, address the following:

Identify your selected article. Explain what characteristics make this a meta-analysis.
Were the inclusion and exclusion criteria clearly stated? How were the articles that were included selected? Do you agree with the researchers†approach? Explain why or why not.
Do you agree with the conclusions? Explain why or why not.
Explain how you could apply implications from the study to your nursing practice. Systematic Review and Meta-Analysis Research Discussion Paper