Nurse Staffing Issues & Evidence Based Practice Discussion. Qualitative Critique Paper Nevada State College | School of Nursing The purpose of this assignment is to apply evaluative criteria to one qualitative research article. Writing and grading criteria are posted for the paper and should be reviewed before writing the paper. To complete the assignment, the group will need: 1. Retrieve one qualitative research study that relates to your PICO question 2. Outline for Qualitative Critique Paper (below) 3. APA Style manual 4. Research textbook to use as rationale for analysis Specific guidelines for the assignment are as follows: 1. Retrieve one qualitative research study that relates to your PICO question 2. Critique the article, using the outline below. The content of the paper should answer all of the questions within the criteria. Use the textbook to justify your analysis. 3. Write a scholarly paper, formatted in APA style, double spaced, 10-12 pitch font, with 1-inch margins. Do not include an abstract. Proper referencing must be used within the paper and in the reference list. Plagiarism guidelines must be followed. The paper is to include a title page, section headings, page numbers, references, citations within the paper, and a separate reference page. Correct grammar and spelling are important, as is clarity of writing. This is to be a scholarly scientific paper. 4. The paper should not exceed 6 pages, including the title page and reference page. Content beyond 4 pages of content will not be graded. Students may submit to SMARTHINKING for editing assistance or work with the NSC Writing Center. 5. Submit electronic copy via Canvas drop box. Only Word documents are accepted; do not submit a PDF or an Apple pages document. 6. Submit a pdf copy of the article selected for review 7. Evaluation of the assignment will be based on the grading form found in this document. 8. Papers must be submitted by due date for full credit. If illness or an emergency prevents a student from meeting deadlines, the instructor must be notified before the deadline. There will be a 50% grade reduction for late papers, received within 24 hours after the due date and time. Students will receive a grade of “0” for any assignment that is over one day late or for plagiarism. Qualitative Critique Criteria A. Phenomenon 1. What is the phenomenon? 2. Is the significance of this topic documented in the literature review at the beginning of article? B. Purpose and Method 1. NURS 451 NSC Nurse Staffing Issues & Evidence Based Practice Discussion

Nurse Staffing Issues & Evidence Based Practice Discussion. What is the study purpose? Is it clearly stated? Where? 2. Describe the specific qualitative method used in the study. 3. Is the study purpose consistent with the specific qualitative method? Cite textbook as rationale. C. Literature review 1. Summarize the existing body of knowledge in the literature review, as it relates to the phenomenon of interest. 2. What gap in knowledge is identified in the lit review? D. Sample 1. What makes participants credible? How were they selected? List inclusion/exclusion criteria. 2. Was data saturation given as rationale for sample size? Compare rationale with textbook. 3. How were participants’ rights protected? Are IRB approval and consents mentioned? E. Data collection and analysis 1. What procedures were used to gather data? Are the data collection procedures consistent with the method? Compare with textbook. 2. What steps were used to analyze data? Is the data analysis procedure consistent with the method? Compare with textbook. F. Results 1. Summarize the findings (themes) of the study. 2. Were the findings justified by data (quotes)? Do the findings tell a complete story? (give rationale) G. Implications for Practice 1. What implications for practice are discussed by the researcher? 2. Do the findings have transferability or implications for your own nursing practice? What do you think? Qualitative Critique Grading Form Area Potential Points A. Phenomenon (10%) 3. What is the phenomenon? 5 4. Is the significance of this topic documented in the literature review at the beginning of article? B. Purpose and Method (15%) 4. What is the study purpose? Is it clearly stated? Where? 5. 6. Describe the specific qualitative method used in the study. Is the study purpose consistent with the specific qualitative method? Cite textbook as rationale. C. Literature review (10%) 3. Summarize the existing body of knowledge in the literature review, as it relates to the phenomenon of interest. 4. What gap in knowledge is identified in the lit review? D. Sample (15%) 4. What makes participants credible? How were they selected? List inclusion/exclusion criteria. 5. 6. 5 5 5 5 5 5 How were participants’ rights protected? Are IRB approval and consents mentioned? 5 What steps were used to analyze data? Is the data analysis procedure consistent with the method? Compare with textbook. F. Results (10%) 3. Summarize the findings (themes) of the study. 4. 5 Was data saturation given as rationale for sample size? Compare rationale with textbook. E. Data collection and analysis (10%) 3. What procedures were used to gather data? Are the data collection procedures consistent with the method? Compare with textbook. 4. 5 Were the findings justified by data (quotes)? Do the findings tell a complete story ? (give rationale) 5 5 5 5 Earned Points Comments G. Implications for Practice ( 10%) 3. NURS 451 NSC Nurse Staffing Issues & Evidence Based Practice Discussion

Nurse Staffing Issues & Evidence Based Practice Discussion. What implications for practice are discussed by the researcher? 4. Do the findings have transferability or implications for your own nursing practice? What do you think? H. Paper formatted in APA style (20%) 1. References cited in text per APA style NOTE: Check Turn-It-In score to avoid plagiarism due to failure to credit sources appropriately. 2. References cited in reference list per APA style 3. 4. Headings, page numbers, and other formatting appropriate. Max 6 pages Including title and reference pages. Content beyond 4 pages of content will not be graded. Spelling, grammar, writing style scholarly and clear. TOTAL 5 5 5 5 5 5 100% Running head: QUALITATIVE CRITIQUE Qualitative Critique (Example Paper) Michael Johnson Nevada State College, School of Nursing 1 QUALITATIVE CRITIQUE 2 Qualitative Critique (Example Paper) Phenomenon The study, “Addressing health disparities of lesbian and bisexual women: A grounded theory study,” addresses encounters between lesbian and bisexual (LB) women and their healthcare provider (Johnson & Nemeth, 2014). Women who are LB encounter numerous barriers to equitable healthcare services, such as lack of quality care and discriminatory healthcare settings. The significance of this topic is well documented at the beginning of the article. Literature Review Women who are LB experience numerous barriers to equitable healthcare, which presumably leads to disparities in health and healthcare. Barriers include lack of quality care from providers and systematic discrimination from healthcare systems. As a result, women who are LB underutilize routine health screenings, including Pap smears and tests for sexually transmitted infections. Also, women who are LB experience higher levels of negative outcomes, such as obesity and cardiovascular disease (Johnson & Nemeth, 2014). The authors stated that the gap and reason for conducting this study was the fact that “few published research studies have addressed health services for LB women” (Johnson & Nemeth, 2014, p. 636). Purpose and Method At the end of the background section, the authors stated that “understanding health care services from the perspective of LB women is integral to addressing health care inequities and health disparities” (Johnson & Nemeth, 2014, p. 636). However, the authors did not explicitly state that this was the author. They should have made it more apparent to the readers that this was the purpose of the study. QUALITATIVE CRITIQUE 3 The authors used grounded theory as the qualitative method. Grounded theory is used when a researcher wants to discover the process of something. The data for this method is mainly gathered through interviews (Schmidt & Brown, 2019). Using grounded theory in Johnson and Nemeth’s (2014) study was appropriate because they collected data through qualitative interviews to understand how LB women experience healthcare delivery systems. NURS 451 NSC Nurse Staffing Issues & Evidence Based Practice Discussion

Nurse Staffing Issues & Evidence Based Practice Discussion. Moreover, the article included a model of the process LB women go through when seeking healthcare services. Sample The inclusion criteria for this study was “self-identifying women between the age of 18 and 24 who identified with a sexual orientation other than heterosexual (e.g., lesbian, bisexual, queer), and reported using health services during their adulthood” (Johnson & Nemeth, 2014, p. 636). The article did not list exclusion criteria. The article does not state how the participants were selected other than that they all lived in the southwest United States. In terms of credibility, the authors screened interested participants to ensure they met inclusion criteria. No other details about credibility were included in the article. The study included nine participants. The authors stated that data were saturated after the seventh interview but conducted two more interviews to ensure no more codes emerged. Their definition of data saturation was, “when no new codes or themes were found” (Johnson & Nemeth, 2014, p. 637). This rationale matches with the textbook, which states that data saturation is when no new information is obtained and repetition of information is consistently heard (Schmidt & Brown, 2019). The authors received institutional review board approval from Medical University of South Carolina. Participants were required to read a statement of research and then provide QUALITATIVE CRITIQUE 4 verbal informed consent (Johnson & Nemeth, 2014). The authors did not provide any additional details on how participants’ rights were protected. Data Collection and Analysis The authors conducted semi-structured, in-depth telephone interviews to collect the data. Also, the authors used an interview guide to conduct the interviews. The interviews were audiorecorded and then professionally transcribed. After the interview, the authors collected demographic information from the participants (Johnson & Nemeth, 2014). These data collection strategies are appropriate for the grounded theory method (Schmidt & Brown, 2019). Data analysis of the transcribed interviews was conducted in a software program called NVivo 10.0. The authors describe a multistep approach: 1) open coding, which is a process of reading transcripts and assigning labels to sections, 2) grouping open codes together using the constant comparative method, 3) using the grouped codes to create focused codes, and 4) using the constant comparative method to group the focused codes into final themes (Johnson & Nemeth, 2014). This data analysis procedure is similar to that described in the textbook, which emphasizes the importance of using the constant comparison approach (Schmidt & Brown, 2019). Results This study identified six themes that were sorted into an explanatory framework that sequences the progression of participants through their healthcare experiences. The three phases included: 1) pre-interaction, 2) health care interaction, and 3) outcomes. Under the preinteraction phase, the themes were seeking health care and expectations. Under the health care interaction phase, the themes were disclosure of sexual orientation and moment of truth (provider QUALITATIVE CRITIQUE 5 attributes). Under the outcomes phase, the themes were proximal outcomes and health outcomes (Johnson & Nemeth, 2014). The authors provided numerous quotes to justify each theme. The final themes within the context of the healthcare model are logical and linear. The themes and participants’ quotes do a good job of telling a complete story. I am able to understand the process that women who are LB go through when seeking healthcare services. Implications for Practice There is a section of the paper dedicated to discussing the implications for policy and practice. The authors emphasized the importance of removing practice- and policy-level barriers to LB women receiving quality healthcare. NURS 451 NSC Nurse Staffing Issues & Evidence Based Practice Discussion

Nurse Staffing Issues & Evidence Based Practice Discussion. Also, the authors discuss the lack of health outcome data available on LB women and recommend that policymakers and healthcare institutions should collect this data (Johnson & Nemeth, 2014). Yes, I think the findings in this study are transferable to my own nursing practice. I am going to encounter patients who are lesbian, gay, bisexual, or transgender in my practice. I should have a basic level of knowledge about the needs of these populations and be able to effectively communicate with them. Moreover, I should be cognizant of the attitude I portray through my verbal and non-verbal communication when interacting with patients who are lesbian, gay, bisexual, or transgender. These are the main findings from Johnson and Nemeth’s (2014) study that are applicable to my own nursing practice. QUALITATIVE CRITIQUE 6 References Johnson, M. J., & Nemeth, L. S. (2014). Addressing health disparities of lesbian and bisexual women: A grounded theory study. Women’s Health Issues, 24(6), 635-640. Doi: 10.1016/j.whi.2014.08.003 Schmidt, N. A., & Brown, J. A. (2019). Evidence-based practice for nurses: Appraisal and application of research (4th ed.). Burlington, MA: Jones & Bartlett Learning. International Journal of Nursing Studies 52 (2015) 1300–1309 Contents lists available at ScienceDirect International Journal of Nursing Studies journal homepage: www.elsevier.com/ijns Nurse staffing issues are just the tip of the iceberg: A qualitative study about nurses’ perceptions of nurse staffing Catharina J. van Oostveen a,b,*, Elke Mathijssen a,c, Hester Vermeulen a,b,d a Department of Quality Assurance & Process Innovation, Academic Medical Centre, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands Department of Surgery, Academic Medical Centre, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands c Clinical Health Sciences, Faculty of Medicine, Utrecht University, P.O. Box 85500, 3584 CG Utrecht, The Netherlands d Amsterdam School of Health Professions, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands b A R T I C L E I N F O A B S T R A C T Article history: Received 25 April 2014 Received in revised form 30 March 2015 Accepted 2 April 2015 Objective: To obtain in-depth insight into the perceptions of nurses in the Netherlands regarding current nurse staffing levels and use of nurse-to-patient-ratios (NPR) and patient classification systems (PCS). Background: In response to rising health care demands due to ageing of the patient population and increasing complexity of healthcare, hospital boards have been implementing NPRs and PCSs. However, many nurses at the unit level believe that staffing levels have become critically low, endangering the quality and safety of their patient care. Methods: This descriptive phenomenological qualitative study was conducted in a 1000bed Dutch university hospital among 24 wards of four specialties (surgery, internal medicine, neurology, gynaecology & obstetrics and paediatric care). Data were collected from September until December 2012. To collect data four focus groups (n = 44 nurses) were organized. Additionally, a total of 27 interviews (20 head nurses, 4 nurse directors and 3 quality advisors) were conducted using purposive sampling. The focus groups and interviews were audiotaped, transcribed and subjected to thematic analysis. Results: Nurse staffing issues appear to be merely the ‘tip of the iceberg’. Below the surface three underlying main themes became clear – nursing behaviour, authority, and autonomy – which are linked by one overall theme: nurses’ position. In general, nurses’ behaviour, way of thinking, decision-making and communication of thoughts or information differs from other healthcare disciplines, e.g. physicians and quality advisors. This results in a perceived and actual lack of authority and autonomy. NURS 451 NSC Nurse Staffing Issues & Evidence Based Practice Discussion

Nurse Staffing Issues & Evidence Based Practice Discussion. This in turn hinders them to plead for adequate nurse staffing in order to achieve the common goal of safe and high-quality patient care. Nurses desired a valid nursing care intensity system as an interdisciplinary and objective communication tool that makes nursing care visible and creates possibilities for better positioning of nurses in hospitals and further professionalization in terms of enhanced authority and autonomy. Conclusions: The perceived subservient position of nurses in the hospital appears to be the root cause of nurse staffing problems. It is yet unknown whether an objective PCS to measure nursing care intensity would help them communicate effectively and credibly, thereby improving their own position. ß 2015 Elsevier Ltd. All rights reserved. Keywords: Inter-professional relationships Nurse staff hospital/organization & administration Qualitative research Professional autonomy Personnel staffing and scheduling Personnel staffing and scheduling information system/classification Professional practice Safety Quality of healthcare Workload * Corresponding author at: Department of Quality Assurance & Process Innovation, Surgical Department, Room G4-141, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. Tel.: +31 20 5664577. E-mail address: c.j.vanoostveen@amc.nl (C.J. van Oostveen). http://dx.doi.org/10.1016/j.ijnurstu.2015.04.002 0020-7489/ß 2015 Elsevier Ltd. All rights reserved. C.J. van Oostveen et al. / International Journal of Nursing Studies 52 (2015) 1300–1309 What is already known about the topic? Patients in hospitals with high workload, caused by low nurse-to-patient ratios, experience higher mortality rates. High workload has a significant impact on nurses’ job satisfaction and ability to innovate. What this paper adds The position of nurses appears to be crucial for nurse staffing: lack of autonomy leads to nurse staffing problems. Nurses perceive a patient classification system to be an ‘autonomous staffing aid’, helping them to communicate across disciplines and have their work valued by others. Dutch nursing organizational model should move from a ‘functional model’ to a ‘professional model’ to support nurses’ work and capacity for innovation. 1. Introduction Nurses represent the single largest group of healthcare professionals in hospitals, and nursing care consumes a substantial proportion of hospital costs (Aiken et al., 2012; Hurst, 2010; Welton et al., 2010). Therefore, it is important that nurses’ time is used efficiently and effectively (Hurst, 2010). Cost containment demands and budget restraints underscore the need for adequate nurse staffing to ensure high-quality care in the most economical way (Welton et al., 2010). Ideally, the demand for care and personnel staffing match perfectly and influence patient outcomes positively (e.g. nurse-sensitive outcomes and adverse events) as well as personnel outcomes (e.g. job satisfaction and absenteeism). However, nurses have reported that their staffing levels are inadequate to provide high-quality care (Aiken et al., 2002; Sochalski, 2001). Indeed, nurse staffing levels and patient outcomes are positively correlated (Aiken et al., 2002, 2014; Kane et al., 2007), while in hospitals with high patient-to-nurse ratios (NPRs), higher mortality and failure-to-rescue rates (Aiken et al., 2002, 2014; Kane et al., 2007) are reported. Furthermore, nurses are more likely to suffer from burnout experiencing high workload (Aiken et al., 2002; Rafferty et al., 2007). The economic formula to match the demand for care to nurse supply was found far from simple in clinical practice (Fasoli and Haddock, 2010). This explains the many staffing models used on the patient interaction, health care organization, and policy levels. The NPRs in California are an example of a nurse staffing model on the policy level. In 1999, Ca …NURS 451 NSC Nurse Staffing Issues & Evidence Based Practice Discussion