QUALITATIVE RESEARCH CRITIQUE

Qualitative Research Critique

Qualitative Research Critique

Introduction

In 1999, California became the first state to pass legislation mandating minimum nurse-to-patient ratios. Regulations detailing specific ratios by type of hospital unit were released in 2002, with phased-in implementation beginning in 2004 and completed in 2008.

1. State the purpose of the study and identify the problem?

This report presents an analysis of qualitative data from interviews with healthcare leaders about the impact of nurse staffing ratios.

2. Examine the literature review

Twenty hospitals (including public, not-for-profit, and for-profit institutions) representing major geographic regions of California were approached. Twelve agreed to participate; semi structured in-person and telephone interviews were conducted with 23 hospital leaders. Several key themes emerged from the analysis. Most hospitals found it difficult and expensive to find more RNs to hire to meet the ratios. Meeting the staffing requirements on all units, at all times, was challenging and had negative impacts, such as a backlog of patients in the emergency department and a decrease of other ancillary staff. Hospital leaders do not believe that ratios have had an impact on patient quality of care.

In 1999, the California legislature passed Assembly Bill (AB) 394 (California Health & Safety Code, [section] 1276.4) mandating that the state establish minimum nurse-to-patient staffing ratios for acute care hospitals (California State Assembly the California State Assembly is the lower house of the California State Legislature. There are 80 members to the Assembly, representing a relatively equal amount of constituencies, with each district having a population of at least 420,000 citizens. Nursing unions lobbied for this legislation as a means to address concerns about overworked nurses and patient safety. Several studies have shown an association between staffing and patient outcomes (Blegen and Vaughn 1998; Kovner and Gergen 1998; Aiken et al. 2002; Needleman et al. 2002). However, these studies did not identify ratios of nurses to patients that could assist California in setting specific ratios by unit type. Over the next few years, the state's Department of Health Services Department of Health Services may refer to:

* Los Angeles County Department of Health Services

* California Department of Health Services a California state agency sought and received input from health services health services Managed care The benefits covered under a health contract researchers, hospitals, nurse labor unions, and other stakeholders. All parties that have an interest, financial or otherwise, in a firm-stockholders, creditors, bondholders, employees, customers, management, the community, and the government. in developing the specific ratios and regulations (Spetz et al. 2000; Institute for Health and Socio-Economic Policy 2001; California HealthCare Association 2002; Kravitz et al. 2002).

3. Examine the study framework or theoretical perspective

Findings related to nurse satisfaction were mixed. Increased RN staffing improved satisfaction with patient workload, but dissatisfaction with issues of decision-making control (e.g., decisions on when best to take a meal break) were taken out of the nurse's hands to meet ratio requirements. Further research should continue to monitor patient outcomes as other states consider similar ratio regulations. Results of this study will be useful to healthcare managers searching ...