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. Research question: Does greater than 6 to 1 patient/nurse ratio decrease nurse satisfaction scores as opposed to less than 7 to 1 patient/nurse ratio? PICOT question: In the acute care setting, what is the effect of a higher nurse to patient ratio on quality of care, compared to a lower nurse to patient ratio?

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. Research question: Does greater than 6 to 1 patient/nurse ratio decrease nurse satisfaction scores as opposed to less than 7 to 1 patient/nurse ratio? PICOT question: In the acute care setting, what is the effect of a higher nurse to patient ratio on quality of care, compared to a lower nurse to patient ratio?

Introduction

Burnout has been rousingly becoming a crucial problem amongst the health care professionals and the same has been associated with a decline in the occupational well-being as well as a rise in illness, turnover and absenteeism. With respect to burnouts, the nurses have been identified to be more vulnerable, especially amongst the emergency nurses, as it is characterized by overcrowding, unpredictability as well as continuous hostility with a varied range of traumatic events, injuries and diseases (Adriaenssens, De Gucht, & Maes, 2015). Intensive care is one of the most resource-intensive forms of the medical care because of the severity of the illness of the patients who are cared for in the units with high levels of staffing. Shortage and inadequacy of the nursing jeopardizes the quality of care and patient safety in hospitals. Therefore, it is important to determine the factors that would reduce burnouts amongst the nurses, thereby enhancing the quality of the care provided to the patients. In the following discussions, various literatures associated with burnouts amongst nurses and the importance nursing for critical and emergency care have been explored. Furthermore, survey was also conducted amongst 8 nurses to determine their satisfaction and burnouts, using the PICOT scale and the information from it has been evaluated in the following discussion as well.

Comparison of Research Questions

With respect to the current research study, the research question that has been pursued is “Does greater than 6 to 1 patient/nurse ratio decrease nurse satisfaction scores as opposed to less than 7 to 1 patient/nurse ratio?”, with the PICOT question being “In the acute care setting, what is the effect of a higher nurse to patient ratio on quality of care, compared to a lower nurse to patient ratio?”. When compared with different literatures that have conducted studies in the area of gaining understanding regarding burnouts and satisfaction level of the nurses, it can be said the questions for the current study has been appropriate. For instance, the research objectives of Adriaenssens, De Gucht, & Maes (2015) had been exploring the prevalence of burnouts amongst emergency nurses, and identification of specific determinants of burnouts amongst them. These research objectives imply that higher patient/nurse ratio has the ability of increasing dissatisfaction and burnouts amongst the nurses and the current study had attempted to determine the same. Similarly, the study conducted by Jarrar, Rahman, & Shamsudin (2015) had also aimed at determining the impact of patient to nurse ratio on the quality care and patient safety in the surgical and emergency wards. As can be identified, the research aim of the study by Jarrar, Rahman, & Shamsudin (2015) is in coherence with the PICOT question of the current study, evidencing that the research questions for the current study are suitable.

Comparison of the Sample Populations

For the current research study, a sample population of 8 nurses working on the night shifts have been considered. Of these 8 nurses, 4 nurses had been responsible for less than 7 patients, while the other 4 had been responsible for more than 7 patients. Although the sample population is low, it can be considered significant as they represent two different populations in equal manner. With respect to the study conducted by Smith, Morin, & Lake (2018), a sample size of 233 nurses were considered as the study was extensive. In the similar manner, study that was conducted by Jarrar, Rahman, & Shamsudin (2015) also had taken under consideration 652 nurses for their study that had ranged from 12 different private hospitals. These studies may imply that a large sample population may be more reliable as opposed to a small population, however, it would also depend on the nature of the study and the availability of time and resources.

Comparison of the Limitations of the Study

With respect to the current study, the major limitation has been the time and resource constraint that had resulted in the selection of such small sample population. Similar limitations have also been observed in other studies. It is evidentiary that most of the studies encounters certain limitations through the course of its progress. For instance, the study that was conducted by Arkin, Lee, McDonald, & Hernandez-Boussard (2014) had encountered the limitations that included the database being utilized to be observational based and therefore, did not comprise of any risk adjustments being made. Furthermore, the study lacked the variables for race that affected the study’s ability of extrapolating the findings on diverse general populations. Similarly, there is a lack of diversity in the population in the current study due to the limited si