Sandra M. Smith
February, 26, 2012
Quantitative Research Article Critique
Kalisch, B. J., & Lee, K. (2011). Nurse Staffing Levels and Teamwork: A Cross-Sectional Study of Patient Care Units in Acute Care Hospitals. Journal of Nursing Scholarship, 43(1), 82-88. Introduction
The purpose of this study is to explore the current research data and use of the Nurse Teamwork Survey to see if nurse staffing levels predicts teamwork. The importance of teamwork is to achieve a higher level of patient safety, quality of care, job satisfaction, and decrease turnover. A cross-sectional descriptive design was used with a 2,545 nursing staff on 52 units delivering patient care, in four different hospitals among the Mid- West. The relevance of the study is to show that there is an association between quality, safe care, and teamwork which also requires safe staffing (Kalisch & Lee, 2011) The title of the article suggests the main variables and the population in the study. The abstract concisely and clearly summarize the main problem, method, and results of the study. The problem identified is a lack of understanding between the relationship of workload, teamwork, and level of staffing. Literature review
The literature review is up- to -date and focused mostly on primary sources. Dates of the literature review range from 1994- 2009. Only one review studied was over 10 years and six were in the past five years. The review provides a range of comparisons between teamwork and job satisfaction, mortality rate, interpersonal skills, and quality of care. What is known is that a higher level of teamwork in the intensive care units was found to be related to a decrease in mortality rates (Kalisch & Lee, 2011). Also, a decrease in vacancy rates, and staff turnover was associated with higher level of teamwork. Brewer (2006) showed that” improved teamwork found a significant decrease in patient falls.” The literature review provides a solid base for this study. What is unknown is the relationship between workload, staffing levels, and teamwork. Framework
The study illustrates a “conceptual framework which postulates that staffing levels predict teamwork when there is control of the acuity( CMI) of the patients on the units, the size of the hospital and the nurse staffing levels( nurse staffing included RN’s, LPN’s, NA’s, and unit secretaries)” (Kalisch & Lee, 2009, p. 83). There is a conceptual map, which identifies the variables and relationship that is simple and understandable. The framework was based on the outcome of the literature review and the effects that staffing levels had on teamwork. The framework does identify the relationships between teamwork and staffing levels to patient outcomes. “The framework relates to the body of nursing knowledge in that patient safety and patient perception of care delivered in held in high esteem for nurses” (Kalisch & Lee, 2011, p. 83). The conceptual framework identified the meaning of teamwork by using the Salas, Sims, and Burke (2005) study that identified five important elements of teamwork (trust, team orientation, back up, shared mental model, and team leadership). Using this conceptual framework its basic foundation, the Nursing Teamwork Survey (NTS) was developed and tested to be used for the psychometric elements. This testing resulted in identifying five different elements of the nursing team that was descriptive. The research questions proposed where asfollows: “By controlling the CMI and size of the hospital, does the level of staffing predict nursing teamwork? By controlling hospital size and CMI, does the level of staffing predict subscales of teamwork (trust, team orientation, back up shared mental model, and team leadership)” (Kalisch & Lee, 2011, p.83)? The aim of the research questions was appropriate to the study on that they identified the relationship between teamwork and...