Review of the Literature

Reviewof the Literature


Describe Relevance


Wong, C. A., Cummings, G. G., &amp Ducharme, L.

The Relationship between Nursing Leadership and Patient Outcomes: A Systematic Review Update.

The article integrates the relational leadership theory in solving the problem of staffing ratios. It helps in motivating the nurses to facilitate their quality of care and improve the patient outcome


Ball, J. E., Murrells, T., Rafferty, A. M., Morrow, E., &amp Griffiths, P.

‘Care left Undone’ during Nursing Shifts: Associations with Workload and Perceived Quality of Care.

It reveals how a lower nurse staffing ratios results in unethical dilemmas. Hence, the changes in the staffing ratios will most certainly improve the patient outcome and reduce the ethical issues.


McHugh, M. D., Kutney-Lee, A., Cimiotti, J. P., Sloane, D. M., &amp Aiken, L. H.

Nurses’ Widespread Job Dissatisfaction, Burnout, and Frustration with Health Benefits Signal Problems for Patient Care.

It reveals that the lower levels of the staffing ratios will undermine the efficiency of the nurses and the patient outcome.


Muller-Juge, V., Cullati, S., Blondon, K. S., Hudelson, P., Maître, F.,Vu, N. V.,&amp Nendaz, M.

Interprofessional Collaboration on an Internal Medicine Ward: Role Perceptions and Expectations among Nurses and Residents.

It illustrates the way that the interprofessional collaboration solves any of the staffing problems since it facilitates teamwork.

Ball et al. (2013) clarify the ethics of the nurses as they areundertaking their shifts. For instance, right from the start, thearticle reveals that the lower staffing levels will often result inthe worse patient outcomes. In this case, the article decides tohighlight the omissions the nurses make that end up affecting thepatient’s outcome. Based on the ethics consideration, the nursesare expected to prioritize the health and safety of the patients bylooking at each of their needs. Instead, the lower staffing levelshave resulted in the patients suffering, and that has also affectedtheir recovery period. The article clearly aligns with the second SLOthat looks at the ethics of the nurses and also insists on theprotection of the patient. Unfortunately, the nurses often have lesscontrol in such situations since the management is responsible forthe nurse staffing ratios. Hence, the management needs to considersuch scenarios and improve the nurse staffing ratios to reduce anyunethical issues. For instance, a high number of the nurses willensure that they cater for every need that the patients might have(Ball et al., 2013). In the process, they will reduce the omission ofthe quality of care because of the insufficient time. Improving thenurse staffing ratios will be another way of meeting the outcomes ofthe fifth SLO that insists on applying the practice guidelines toimprove the overall care environment. Hence, reducing the unethicalscenarios arising from the reduced nurse staffing levels will beanother way of improving the care environment. It will also improvethe patients’ outcome reduce the mortality rate as well as therecovery period because of the high-quality care.

McHugh et al. (2011) reveal how the lower staffing levels oftenaffect the job satisfaction, burnout as well as frustration that willreduce the morale of the nurses in working. In this article, thescholars illustrate evidence from a population of 95,499 nurses thatshow how they often suffer when exposed to a reduced number ofnurses. In this case, the credibility of the sources and theevidence-based arguments prove that the staffing ratios are animportant part that the hospital should prioritize. The fact thatnearly 95,499 nurses are interviewed and they provide similarresponses show how it is a huge problem that the management shouldcorrect before it escalates. The credible evidence shows that thenurses will clearly suffer because of the lower staffing levels. Inparticular, the article highlights the burnout as one of thechallenges while frustration is another clear issue. The jobdissatisfaction is also another problem that will result from theincreased work that has to deal with a large number of patients. Inthe process, the nurses will even undertake some duties that will notimprove the patients’ outcome since they keep rash decisionsbecause of the less time they have (McHugh et al., 2011). In fact,increasing the nurse-patient ratios will be another way to reduce thedissatisfaction and improve the patients’ outcome. The third SLOalso relates to the fifth SLO since the credible decision making thatis also evidence-based will most likely improve the practice and thecare environment. With the evidence of the burnout anddissatisfaction, improving the staffing levels will ensure that thenurses undertake their activities effectively without any challenges.A higher nurse staffing ratio will favor the patients since they willreceive improved services and that will help them in recoveringquickly.

Wong et al. (2013) show how relational leadership is effective insolving the problems that might arise from the lower level of thenurse staffing ratios. In fact, the article aligns with the first SLOthat insists on integrating theory and clinical judgment in solving aparticular problem. In this case, the relational leadership is atheory that insists on the leader creating better relationships withtheir followers. The paper shows how a better leader should be ableto understand the needs and interests of the other nurses. Besidesunderstanding their needs, the leader should also focus on ensuringthat they are satisfied in undertaking their duties as well. Forinstance, a relational leader will still use the lower nurse-patientratio to improve the patient outcome. A relational leader mightallocate a smaller number of patients to a nurse that has a longershift. On the other hand, a nurse with a shorter shift will have todeal with a large number of patients instead. The arrangement willensure that the nurses work efficiently and that might also help inreducing the burnout and dissatisfaction that they might experience.The relational leadership will clearly help in improving the practiceand care environment as the fifth SLO implies. More importantly, itwill help in various situations even when the hospital experiences alower nurse-patient ratio. By integrating the leadership theory, thearticle shows the various ways in which the nursing might improve thepatient outcome since they are the ones at the risk of sufferingbecause of the reduced quality of care (Wong et al., 2013). All inall, the nursing leadership will clearly influence the patientoutcomes but, only after the interests of the nurses are alsoconsidered. In particular, the relational leadership theoryconsidered how the nurses will work efficiently under the lowerstaffing ratios and still achieve the required patient outcomes.

Muller-Juge et al. (2013) show how the interprofessionalcollaboration in a nursing setting might help in improving thepatients’ outcome. It also reveals that the collaboration helps innurturing teamwork among the nurses. Even if the hospital isexperiencing a lower staffing level ratio, the nurses will use thecollaboration in making their work a bit easier. For instance, anurse and a doctor might exchange ideas on the appropriate way tohandle a specific problem. The knowledge and dissemination will be anappropriate way of handling the issue rather than only one persondealing with it. Teamwork often enhances the service delivery sincethe members are able to solve an issue as a group, and that improvesthe quality of care. The article meets the ideologies that the fourthSLO facilitates. It is clear that the presence of theinterprofessional collaboration will improve the patients’ outcome.Instead, the lack of collaboration increases the chances of humanerror in the decision-making process and the knowledge implementationphase too. The article also aligns with the fifth SLO that states thenurses should implement the practice guidelines to improve the careenvironment. In this case, the interprofessional collaboration is oneway to reduce the nursing inequality and improve the patient outcomeinstead. Hence, the collaboration will facilitate the evaluation ofthe treatment plans and make sure that the team agrees on the bestconcept they will use in solving a particular issue. Thecollaboration also helps the nurses in solving any ethical issues,and they might also find a perfect way of dealing with a givendilemma.


Ball, J. E., Murrells, T., Rafferty, A. M., Morrow, E., &ampGriffiths, P. (2013). ‘Care left Undone’ during Nursing Shifts:Associations with Workload and Perceived Quality of Care. BMJquality &amp safety, bmjqs-2012.

McHugh, M. D., Kutney-Lee, A., Cimiotti, J. P., Sloane, D. M., &ampAiken, L. H. (2011). Nurses’ Widespread Job Dissatisfaction,Burnout, and Frustration with Health Benefits Signal Problems forPatient Care. Health Affairs, 30(2), 202-210.

Muller-Juge, V., Cullati, S., Blondon, K. S., Hudelson, P., Maître,F., Vu, N. V., … &amp Nendaz, M. R. (2013). InterprofessionalCollaboration on an Internal Medicine Ward: Role Perceptions andExpectations among Nurses and Residents. PloS one, 8(2),e57570.

Wong, C. A., Cummings, G. G., &amp Ducharme, L. (2013). TheRelationship between Nursing Leadership and Patient Outcomes: ASystematic Review Update. Journal of nursing management,21(5), 709-724.