Critical Care Outcomes And Nurse Work Environment: An Article Analysis

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Critical Care Outcomes and Nurse Work Environment: An Article Critique
Meghan B. den Hartog
Missouri State University

Critical Care Outcomes and Nurse Work Environment: An Article Critique
“The Critical Care Work Environment and Nurse-Reported Health Care-Associated Infections” is an article on a retrospective, cross-sectional study. The four authors associated with this article are highly credentialed and work in either a critical care or educational setting or both. The study herein addresses a possible relationship between nurse-perceived critical care work environment and the nurse-perceived incidence of healthcare-associated infections (HAIs).
Critique of the Introduction
The introduction of the article is concise
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The study was approved by an institutional review board, and informed consent was obtained by implication when the survey participants returned the surveys. Bias was addressed by follow-up surveys for initial nonparticipants and, while not addressed directly by the article, the participant’s rights do not appear to have been violated.
The data itself was collected from surveys obtained in 2007, the American Hospital Association Survey and the Practice Environment Scale of the Nursing Work Index (PES-NWI). The PES-NWI is a validated assessment tool that addresses staffing, nurse engagement, nurse-physician communication, nurse education, and leadership availability and competence (Kelly et al., 2013). Critical care work environments for each hospital were classified by the PES-NWI score as “better, mixed, or worse” (Kelly et al., 2013, p. 484). The sample included 320 hospitals in four states and involved 3,217 nurses. While this is a very large sample, generalizability may be an issue in regard to the 46 other states that were not
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First, despite the large and relatively diverse sample, the generalizability is questionable. Further studies involving a wider spread of the population are needed. Second, while the assessment tools used are credible, reliability of the data is also called to question. Actual numerical data collected on the incidence of HAIs is needed to support the subjective data collected by the surveys. Despite the questionable areas of this study, it does indeed start a conversation about nurse work environment and patient outcomes. This is an aspect of American healthcare that warrants investigative research, especially in critical care

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