see below

4 pages plus referfences

For this assignment, you will re-review your three articles selected from your week 2 and 4 assignment. Then, you’ll write a paper on the following (be sure to include the content from your previous papers in weeks 2 and 4, updating with feedback from your instructor).

For each of the three articles, please discuss the following in your paper:

· Research design of the study

· Threats to external/internal validity

· Potential legal/ethical issues within the article

· Data analysis (be sure to elaborate on this more from your paper in week 4, providing specifics about the results)

· Implications for evidence-based practice and how this article could be used to make an evidence-based change

· Conclusion/summary of the evidence

References

Dechawatanapaisal, D. (2018). Nurses’ turnover intention: The impact of leader-member exchange, organizational identification and job embeddedness. Journal of Advanced Nursing, 74(6), 1380-1391. 

Nurses’ turnover intention: The impact of leader‐member exchange, organizational identification and job embeddedness

Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—a 10-element onboarding program intervention. SAGE Open Nursing, 3, 2377960817697712.

Stalpers, D., de Brouwer, B., Kaljouw, M., & Schuurmans, M. (2015). Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: A systematic review of the literature. International Journal of Nursing Studies, 52(4), 817-835. 

https://doi.org/10.1016/j.ijnurstu.2015.01.005

Running head: EBP PROJECT 1

EBP PROJECT 10

EBP Project

Student Name

Institution Affiliation

EBP Project

Reducing patient suffering while providing medical care is a perennial concern for nurses. Although relieving patients’ physical and mental pain is undoubtedly a top priority for nurses, existing models of practice fail to account for the necessary precautions that must be taken to avoid causing more suffering to patients and their loved ones throughout the provision of care. The shortage of nurses, especially with a high ratio of a single nurse attending five patients at a time, makes it unbearable for patients needing immediate attention to relieve their pain. Increasing the number of nursing staff is a significant intervention that ensures that patients receive immediate attention in relieving their pain without much waiting. Assessing and treating pain are two areas where nurses frequently struggle. The research found that nurses’ inability to answer questions about pain treatment correctly was independent of their level of education, and more education and exposure makes them more competent in service delivery (Stalpers et al., 2015). Improving emergency room pain evaluation and management practices raises the bar for eradicating actual pain felt by patients. Having enough nurses in the hospital facility reduces the ratio and makes it possible for the nurses to cooperate in assisting the patients in patient management for quality care.

Article 1:

Dechawatanapaisal, D. (2018). Nurses’ turnover intention: The impact of leader-member exchange, organizational identification and job embeddedness. Journal of Advanced Nursing, 74(6), 1380-1391. Nurses’ turnover intention: The impact of leader‐member exchange, organizational identification, and job embeddedness

The article discusses about the challenge of turnover rate among the nurses in the healthcare setting. Three factors are highlighted as the main contributors to the turnover: lead-exchange quality, organization identification, and job embeddedness. The study adopts the cross-sectional survey method that facilitates the participants to engage in self-reporting through questionnaires to get to understand the impact that the three factors highlighted causes. The participants of the study are 1966 nurses that are drawn from private hospitals. Self-reporting questionnaire is the instrument used in sourcing the data and is practical in achieving the exercise. The instrument is reliable and valid because the questions are well designed in the questionnaire.

Article 2:

Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—a 10-element onboarding program intervention. SAGE Open Nursing, 3, 2377960817697712.

The article targets reducing the annual nurse turnover rate recorded in hospitals by adopting the 10 element onboarding program intervention that targets strengthening and standardizing the way new employees are welcomed and accommodated. The evidence-based turnover analysis approach is the method used in sourcing data for the source in finding the impact of the 10 element onboarding intervention on the nurse staff. The participants in the reviewed sources and records are nurses, and the instrument used is the existing standardized survey and the review of records that gives detailed data that is reliable and valid to develop a conclusion.

Article 3:

Stalpers, D., de Brouwer, B., Kaljouw, M., & Schuurmans, M. (2015). Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: A systematic review of the literature. International Journal of Nursing Studies, 52(4), 817-835. 

https://doi.org/10.1016/j.ijnurstu.2015.01.005

The article explains about the role that the nurse environment plays in offering quality healthcare services to the patients for a quality outcome. The article’s findings confirmed that there is an association between the work environment for the nurses and patient outcome sensitivity. A systematic literature review is adopted to get information and insight into the relations between the working conditions and patient outcomes. The participants in the study are nurses, and the instrument used is the reviewing of literature to get insight. The method and instruments used are reliable and valid in giving significant results.

Conclusion

The evidence has shown that the nurses’ treatment in the workplace matters in the services that they offer to the patients and also their retention and turnover rates (Stalpers et al., 2015). Employees that enjoy their workplaces remain there for a long and offer quality services to patients. Unfavorable work environment results in an increased turnover rate.

References

Dechawatanapaisal, D. (2018). Nurses’ turnover intention: The impact of leader-member exchange, organizational identification and job embeddedness. Journal of Advanced Nursing, 74(6), 1380-1391. Nurses’ turnover intention: The impact of leader‐member exchange, organizational identification, and job embeddedness
Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—a 10-element onboarding program intervention. SAGE Open Nursing, 3, 2377960817697712.

Stalpers, D., de Brouwer, B., Kaljouw, M., & Schuurmans, M. (2015). Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: A systematic review of the literature. International Journal of Nursing Studies, 52(4), 817-835. https://doi.org/10.1016/j.ijnurstu.2015.01.005

Appendix

Stalpers, D., de Brouwer, B., Kaljouw, M., & Schuurmans, M. (2015). Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: A systematic review of the literature. International Journal of Nursing Studies, 52(4), 817-835. https://doi.org/10.1016/j.ijnurstu.2015.01.005

Article/Reference (in APA format)	Purpose of the Article/Study Question	Variables (i.e.; Independent vs. Dependent)	Study Design	Sampling	Methods	Instrument	Findings/Results
Dechawatanapaisal, D. (2018). Nurses’ turnover intention: The impact of leader-member exchange, organizational identification and job embeddedness. Journal of Advanced Nursing, 74(6), 1380-1391. Nurses’ turnover intention: The impact of leader‐member exchange, organizational identification, and job embeddedness	The purpose of this research was to look into the ways in which leader-member interchange quality, organizational identity, and job embeddedness all affect people’s propensity to leave an organization. The available literature does not provide enough information about this topic.	Dependent variable- Nurses’ turnover intention Independent variable: leader-member exchange, organizational identification, and job embeddedness.	Cross-sectional survey	Convenience sampling	Cross-sectional survey method	Self-report questionnaire	The quality of exchanges between leaders and followers and job embedding were found to be directly related. The impact of leader-member interchange quality on work embeddedness was partially mediated by individuals’ levels of identification with their respective organizations. The analysis also backed the idea that job embeddedness acted as a mediator between organizational identity and turnover intent.
Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—a 10-element onboarding program intervention. SAGE Open Nursing, 3, 2377960817697712.	What are the relevant ways of reducing the nurse staff turnover rate in the hospital setting annually?	Dependent variable- nurse staff turnover. Independent variable- 10 elements onboarding program intervention.	Evidence-based turnover analysis approach	Sources strategically sampled	Standardized exit survey and review of records.	Standardized exit survey.	The study findings showed an abnormally high turnover rate among new hires, that we needed a new onboarding program to better support new hires, and that we needed to work more closely with hospital/unit directors and supervisors to enhance the experience of new hires. To lower yearly hospital and RN staff turnover, we designed and implemented a 10-element program intervention with a heavy emphasis on supporting newly-hired employees. The outcome was a reduction of staff turnover by 14 percent overall and 20 percent among new hires, both of which are statistically significant accomplishments.
The purpose of this study was to conduct a systematic literature review on the associations between the working conditions of nurses and five patient outcomes that are particularly important to nurses.	Dependent variable- patient sensitive outcome. Independent variable- nurse work environment characteristics.	Systematic review design.	Targeted sampling.	Systematic review of literature.	Dutch version of Cochrane’s critical appraisal instrument.	There is an association between the work environment and the nurse sensitive-patient outcomes.

Running head: STAFFING LEVEL 1

STAFFING LEVEL 2

Unsafe Staffing Level

Student Name

Institution Affiliation

Unsafe Staffing Level

Unsafe Levels of Staffing (EBP Problem)

Regarding numerous facets of performance, nurse safety has been a major issue. It’s no longer guaranteed because of the emerging limits that nurses must deal with to protect patients and their bodies. The patient’s and practitioner’s safety is jeopardised because of this condition. This element has degraded in comparison to past years of practise for various reasons (Kurnat-Thoma et al., 2017). When it comes to serving patients in this industry, it has been determined that there are not enough professionals. There are not as many doctors and nurses to go around, so hospitals are straining their staff to the breaking point. As a result, patients are at risk of receiving substandard care that could have a negative impact on their health. As a result, the overloading of clinical instruments reduces one’s proficiency. If sharp things are not handled properly, this condition can spread to other parts of the body. As a result of insufficient nursing workload, it is more difficult to deliver high-quality patient care (Kurnat-Thoma et al., 2017). In units with a low personnel densities, nursing fatigue and a hard work can lead to medical errors, poor care quality, and low patient satisfaction. Nurse staffing has a negative impact on health care in the hospital. In this article, we will create a PICOT question that details the proposed project’s audience, intervention, benchmarks, findings, and timeline.

Significance of Unsafe Levels of Staffing (EBP)

Nurses experience a low staffing level, and this leads to criticism towards healthcare, but it is essential to remember that a complex system and predetermined set of responsibilities must be completed no matter what the staffing level is. To examine the topic from a different angle, consider efficiency and competence. Staffing, it is believed, prevents nurses from performing their tasks effectively and drastically reduces the time they spend with patients. However, the reality of the healthcare system dictates that patient outcomes could be improved if the nursing team’s multitasking and communication strategies are enhanced. The quality of care suffers greatly when communication between providers and patients is compromised, both in quantity and quality. According to Dechawatanapaisal (2018), modern hospitals’ staffing structures prevent nurses from effectively communicating to split workloads and optimize critical processes, two things that would significantly increase the quality of healthcare provided.

The quality of nursing care improves when educators emphasise effective communication techniques more than problems like a shortage of nurses. In order to achieve the best results, nursing procedures should include naturally occurring characteristics of effective communication. As a result, nurses would be able to satisfy the different demands of patients even in low-staff circumstances if communication and training processes were appropriately structured. When the NPR is low, it’s because there aren’t enough nurses to care for everyone. However, the lack of resources is not the fundamental cause of the decline in service quality (Kurnat-Thoma et al., 2017). Many kinds of resources make up a nurse’s toolbox: human resources, informational, infrastructural, and technical resources, to name a few. Digital technology and adequate information databases can, for example, give services such as patient education that do not require a nurse’s presence. In addition, there is often a shortage of infrastructure in place to support exemplary patient care and communication. Since there are no other supporting resources, it can be said that the consequences will be restricted. Stalpers et al. (2015) propose that communication efficacy can be broken down into several components, including culture, language, and a person’s manner. Digital tools and improved communication training can help healthcare providers better manage patient demands and overall communication, reducing redundancies and allowing for a more transparent discussion with the patient. A better quality of life and service is provided to patients by nurses, mostly unaffected by the number of staff members.

PICOT Question

Population

The target population is the inpatient care facility where the patients experience care from different healthcare providers that work as a team.

Intervention

The solution towards addressing the staffing problem of nurses in the inpatient care facility.

Comparison

Inpatients in the acute care units who experienced low nursing staff and failed to adopt solutions as the control compared to the evidence-based intervention in terms of staffing.

Outcome and Time

The nursing outcome is measured based on the infections, length of stay, rate of medical errors and patient fall incidences. The time of measure is seven days.

PICOT Question: “In inpatients in acute care units, does an increased nurse staffing, compared to low staffing rates, improve health outcomes on day 7 of hospitalization?”

Search Strategy

I located the three articles (Kurnat-Thoma et al., 2017; Stalpers et al., 2015; Dechawatanapaisal, 2018) from the SAGE platform and Google Scholar. I will use keywords that include nursing, staffing issues and health outcome. I refined the search to have the

Conclusion

Many factors influence the complexity of nursing care and its results on patients. Such issues as poor service quality and poor patient outcomes do not stem solely from low staffing levels. As long as there is adequate training, communication, and resources, even a small staff can perform all of their duties and establish a rapport with the patients. Though, the patients have the right to get the necessary attention from the nurses by the healthcare facilities meeting the WHO standard ratio of nurses to patients.

References

Dechawatanapaisal, D. (2018). Nurses’ turnover intention: The impact of leader-member exchange, organizational identification and job embeddedness. Journal of Advanced Nursing, 74(6), 1380-1391.

https://doi.org/10.1111/jan.13552

Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—a 10-element onboarding program intervention. SAGE Open Nursing, 3, 2377960817697712.

Stalpers, D., de Brouwer, B., Kaljouw, M., & Schuurmans, M. (2015). Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: A systematic review of the literature. International Journal of Nursing Studies, 52(4), 817-835.

https://doi.org/10.1016/j.ijnurstu.2015.01.005

ted time to complete: 4 hours

Rubric

NU560 Unit 5 Assignment Rubric

Level 5
Demonstrates the ability to construct a clear and insightful problem statement/thesis statement/topic statement with evidence of all relevant contextual factors.

67 pts

Level 4
Demonstrates the ability to construct a problem statement, thesis statement/topic statement with evidence of most relevant contextual factors, and problem statement is adequately detailed

60 pts

Level 3
Begins to demonstrate the ability to construct a problem statement/thesis statement/topic statement with evidence of most relevant contextual factors, but problem statement is superficial.

52 pts

Level 2
Demonstrates a limited ability in identifying a problem statement/thesis statement/topic statement or related contextual factors.

45 pts

Level 1
Demonstrates the ability to explain contextual facts but does not provide a defined statement.

0 pts

Level 0
There is no evidence of a defined statement.

75 pts

Level 5
Organizes and compares evidence to reveal insightful patterns, differences, or similarities related to focus.

36 pts

Level 4
Organizes and interprets evidence to reveal patterns, differences, or similarities related to focus.

32 pts

Level 3
Organizes and describes evidence according to patterns, differences, or similarities related to focus.

28 pts

Level 2
Organizes evidence, but the organization is not effective in revealing patterns, differences, or similarities.

24 pts

Level 1
Describes evidence, but it is not organized and/ or is unrelated to focus.

0 pts

Level 0
Lists evidence, but it is not organized and/ or is unrelated to focus.

40 pts

Level 5
The paper exhibits a excellent command of written English language conventions. The paper has no errors in mechanics, grammar, or spelling.

4.5 pts

Level 4
The paper exhibits a good command of written English language conventions. The paper has no errors in mechanics, or spelling with minor grammatical errors that impair the flow of communication.

4 pts

Level 3
The paper exhibits a basic command of written English language conventions. The paper has minor errors in mechanics, grammar, or spelling that impact the flow of communication.

3.5 pts

Level 2
The paper exhibits a limited command of written English language conventions. The paper has frequent errors in mechanics, grammar, or spelling that impede the flow of communication.

3 pts

Level 1
The paper exhibits little command of written English language conventions. The paper has errors in mechanics, grammar, or spelling that cause the reader to stop and reread parts of the writing to discern meaning.

0 pts

Level 0
The paper does not demonstrate command of written English language conventions. The paper has multiple errors in mechanics, grammar, or spelling that cause the reader difficulty discerning the meaning.

5 pts

5 pts

NU560 Unit 5 Assignment Rubric
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeContent NU560-CO1; NU560-CO3; NU560-CO4		7 5 pts
This criterion is linked to a Learning OutcomeAnalysis NU560-CO1; NU560-CO3; NU560-CO4		40 pts
This criterion is linked to a Learning OutcomeWriting PRICE-I; PRICE-P			5 pts
This criterion is linked to a Learning OutcomeAPA Formatting PRICE-I; PRICE-P	5 pts Level 5 The required APA elements are all included with correct formatting, including in-text citations and references. 4.5 pts Level 4 The required APA elements are all included with minor formatting errors, including in-text citations and references. 4 pts Level 3 The required APA elements are all included with multiple formatting errors, including in-text citations and references. 3.5 pts Level 2 The required APA elements are not all included. AND/OR there are major formatting errors, including in-text citations and references. 3 pts Level 1 Several APA elements are missing. The errors in formatting demonstrate limited understanding of APA guidelines, in-text-citations, and references. 0 pts Level 0 There is little to no evidence of APA formatting. AND/OR there are no in-text citations AND/OR references.
Total Points: 125

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Nursing Paper 1

Nursing Paper Unit 5 Assignment

Janet Johnson

Herzing University

8/14/2022

Stephanie Scovill PhD
109940000000041771
What is the practice problem? There is no problem statement or thesis statement.

Nursing Paper 2

The research design of the study

The research article by Dechawatanapaisal (2018) utilized a survey research design

method. This is a design method in which the primary source of data is a survey. The researcher

makes use of the survey to have a better understanding of the individuals or group of individuals

being studied relative to the topic or the concept of interest. In line with this article, the survey

method ensured that the participants engaged in self-reporting with the help of questionnaires so

that they better understand the impact of the highlighted factors. Kurnat-Thoma et al (2017) on

the other hand employed the evidence-based turnover analysis research design to undertake the

study. The main participants who were involved in the study included the nurses. The third

article by Stalpers et al (2015) employed the correlational research design method in which

relevant literature review studies were reviewed and relevant information collected.

Threats to external/internal validity

Internal validity refers to the extent or degree to which the relationship being tested is

trustworthy. The potential internal threats established from the articles include but are not limited

to; social interaction. The interaction that people have from different groups has a significant

impact on the outcome. For instance, the nurses who are working based on fixed hours are

resentful of the nurses who are working with flexible hours. This significantly impacts the job

satisfaction that employees go through. Another potential internal threat is regression towards the

mean. Employees, and nurses in this case who tend to score very low in the first survey many

times show a better and higher score in the next survey. This is in comparison with employees

who score averagely in the first score.

Stephanie Scovill PhD
109940000000041771
Remember to support your statements with in-text citations.

Nursing Paper 3

External threats to validity, on the other hand, refer to the degree to which study results

can be applied in real-life situations or even to a group of events. The common threat to external

validity is sampling bias. There can be situations in which the sample selected is not the actual

representation of the population to be studied. In this case, for example, the nurses who have

been interviewed might be having pre-determined minds about how they feel about the situation.

This renders them unfit to represent a population sample. Another external threat is the

Hawthorne effect. This is a threat in which the participants selected for the study tend to change

their behaviors after realizing that they are being studied. For instance, the participants might

decide to avoid anxiety-inducing situations because they are conscious of what is being studied.

Potential legal/ethical issues within the article

The potential ethical issues include informed consent. In nursing and health-related

articles, informed consent is a common battle for nurses. Dilemma situations emerge in cases

where the patients together with their children have not been informed fully about the treatment

that they are supposed to go through. There are also issues pointing out that patients are not free

to ask questions yet they are not aware of the implication of the fear of the services they are

about to receive. The second ethical issue is inadequate staffing and resources. This is evident in

the articles that have been presented. The cost of healthcare has been on the rising daily. Patients

and nurses themselves are at great risk when the resources are not enough. This demands a

formulation of very hard decisions.

Stephanie Scovill PhD
109940000000041771
Remember to support your statements with in-text citations.

Stephanie Scovill PhD
109940000000041771
Remember to support your statements with in-text citations.

Stephanie Scovill PhD
109940000000041771

Nursing Paper 4

Data analysis (be sure to elaborate on this more from your paper in week 4, providing

specifics about the results)

The research article by Dechawatanapaisal (2018) established that there three major

contributors to nursing turnover rates are lead exchange quality, organizational identification,

and job embeddedness. According to the results obtained, if these three can be taken good care of

in the organization, then it is evident that turnover rates will be taken good care of. These causes

are majorly engineered by the nature of the management of a facility. Kurnat-Thoma et al (2017)

on the other hand realized that the implementation of an onboarding program can significantly

reduce nurse turnover rates. According to the article, this can be attained through having quality

standards and procedures employees follow to join an organization. If the steps followed are the

right ones, then it is evident that turnover rates will be at their minimum. The third article

revealed that there exists a sensitive relationship between nurses and patients, which plays a role

in employee turnover. The environment that relationship between these two people creates a

robust environment in which other activities in the organization go on very well with minimum

disturbances.

Implications for evidence-based practice and how this article could be used to make an

evidence-based change

Evidence-Based Change (EBP) is a typical process that commences with a simple clinical

question and later goes ahead to finding critically appraising evidence. The article has played an

essential role in establishing a practice change that ought to be changed. The information that has

been provided by the articles gives a solid foundation for the follow up steps, that is integrating

evidence in the clinical expertise as well as patients preferences. Through the article, relevant

Stephanie Scovill PhD
109940000000041771

Stephanie Scovill PhD
109940000000041771

Nursing Paper 5

organizations and bodies are well positioned to implement decisions that will address the

turnover rates. This will collectively bring change. The articles have enhanced the understanding

of internal and external threats as well as possible legal implications which might emerge.

Conclusion/summary of the evidence

In summary, there exists several factors influencing the working nature of the nurses as

well as their relationship with the patients whom they are meant to handle. Other inadequacies

that patients meet in town do not solely come from inadequate staffing of the nurses and their

high turnover rates. However, if the staffing issues can be addressed, many challenges faced by

patients would have been addressed. This is because the higher the number of nurses in place, the

better the services that are being offered since patients have more and enough time with the

patients.

Stephanie Scovill PhD
109940000000041771
Remember to support your statements with in-text citations.

Nursing Paper 6

References

Dechawatanapaisal, D. (2018). Nurses’ turnover intention: The impact of leader-member

exchange, organizational identification and job embeddedness. Journal of Advanced

Nursing, 74(6), 1380-1391. Nurses’ turnover intention: The impact of leader‐member

exchange, organizational identification, and job embeddedness

Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and

registered nurse staff turnover—a 10-element onboarding program intervention. SAGE

Open Nursing, 3, 2377960817697712.

Stalpers, D., de Brouwer, B., Kaljouw, M., & Schuurmans, M. (2015). Associations between

characteristics of the nurse work environment and five nurse-sensitive patient outcomes in

hospitals: A systematic review of the literature. International Journal of Nursing Studies,

52(4), 817-835. https://doi.org/10.1016/j.ijnurstu.2015.01.005

https://doi.org/10.1016/j.ijnurstu.2015.01.005

Nursing Paper 7

Appendix

Article/Reference (in APA
format)

Purpos
e of the
Article/
Study
Questi
on

Variabl
es (i.e.;
Indepen
dent vs.
Depend
ent)

Study
Desig
n

Sampl
ing

Metho
ds

Instru
ment

Findings/
Results

Dechawatanapaisal, D.
(2018). Nurses’ turnover
intention: The impact of
leader-member exchange,
organizational
identification and job
embeddedness. Journal of
Advanced Nursing, 74(6),
1380-1391. Nurses’
turnover intention: The
impact of leader‐member
exchange, organizational
identification, and job
embeddedness

The
purpos
e of
this
researc
h was
to look
into the
ways in
which
leader-
membe
r
interch
ange
quality,
organiz
ational
identity
, and
job
embed
dednes
s all
affect
people’
s
propen
sity to
leave
an
organiz
ation.
The
availab

Depend
ent
variable
–
Nurses’
turnove
r
intentio
n
Indepen
dent
variable
:
leader-
membe
r
exchan
ge,
organiz
ational
identifi
cation,
and job
embedd
edness.

Cross
–
sectio
nal
surve
y

Conve
nience
sampli
ng

Cross-
sectio
nal
survey
metho
d

Self-
report
questi
onnair
e

The
quality
of
exchange
s
between
leaders
and
followers
and job
embeddi
ng were
found to
be
directly
related.
The
impact of
leader-
member
interchan
ge
quality
on work
embedde
dness
was
partially
mediated
by
individua
ls’ levels
of
identifica
tion with

Nursing Paper 8

le
literatu
re does
not
provide
enough
inform
ation
about
this
topic.

their
respectiv
e
organizat
ions. The
analysis
also
backed
the idea
that job
embedde
dness
acted as
a
mediator
between
organizat
ional
identity
and
turnover
intent.

Kurnat-Thoma, E.,
Ganger, M., Peterson, K.,
& Channell, L. (2017).
Reducing annual hospital
and registered nurse staff
turnover—a 10-element
onboarding program
intervention. SAGE Open
Nursing, 3,
2377960817697712.

What
are the
relevan
t ways
of
reducin
g the
nurse
staff
turnove
r rate
in the
hospita
l
setting
annuall
y?

Depend
ent
variable
– nurse
staff
turnove
r.

Indepen
dent
variable
– 10
element
s
onboar
ding
progra
m
interve
ntion.

Evide
nce-
based
turno
ver
analy
sis
appro
ach

Source
s
strateg
ically
sampl
ed

Standa
rdized
exit
survey
and
review
of
record
s.

Standa
rdized
exit
survey
.

The
study
findings
showed
an
abnormal
ly high
turnover
rate
among
new
hires,
that we
needed a
new
onboardi
ng
program
to better
support
new
hires,
and that

Nursing Paper 9

we
needed
to work
more
closely
with
hospital/
unit
directors
and
superviso
rs to
enhance
the
experien
ce of
new
hires. To
lower
yearly
hospital
and RN
staff
turnover,
we
designed
and
impleme
nted a
10-
element
program
interventi
on with a
heavy
emphasis
on
supportin
g newly-
hired
employe
es. The
outcome
was a
reduction

Nursing Paper 10

of staff
turnover
by 14
percent
overall
and 20
percent
among
new
hires,
both of
which
are
statistical
ly
significa
nt
accompli
shments.

Stalpers, D., de Brouwer,
B., Kaljouw, M., &
Schuurmans, M. (2015).
Associations between
characteristics of the nurse
work environment and
five nurse-sensitive patient
outcomes in hospitals: A
systematic review of the
literature. International
Journal of Nursing
Studies, 52(4), 817-
835. https://doi.org/10.101
6/j.ijnurstu.2015.01.005

The
purpos
e of
this
study
was to
conduc
t a
system
atic
literatu
re
review
on the
associa
tions
betwee
n the
workin
g
conditi
ons of
nurses
and
five

Depend
ent
variable
–
patient
sensitiv
e
outcom
e.

Indepen
dent
variable
– nurse
work
environ
ment
charact
eristics.

Syste
matic
revie
w
desig
n.

Target
ed
sampli
ng.

Syste
matic
review
of
literat
ure.

Dutch
versio
n of
Cochr
ane’s
critical
apprai
sal
instru
ment.

There is
an
associati
on
between
the work
environm
ent and
the nurse
sensitive-
patient
outcomes
.

https://doi.org/10.1016/j.ijnurstu.2015.01.005

https://doi.org/10.1016/j.ijnurstu.2015.01.005

Nursing Paper 11

patient
outcom
es that
are
particul
arly
import
ant to
nurses.