Critique: Stone et al (2007) 'Nurse Working Conditions and Patient Safety Outcomes' - Essay Example

The data were collected from the records available in Medicare files as well from their own surveillance study, the latter being designed on the pattern and protocol employed in the National Nosocomial Infection Surveillance System (Stone et al, 2007). The study was designed on the basis of the acute nursing shortage and its impact on hospital environments’, especially intensive care units where the increased workload on nurses has been proven to exert profound negative effect on patient outcomes as demonstrated by evaluative parameters such as ‘Central line associated bloodstream infections (CLBSI), ventilator-associated pneumonia, catheter-associated Urinary tract infections, 30-day mortality, and decubiti’ (Stone et al, 2007).

The authors’ admit in their introductory lines that care in intensive care units is much better in Magnet accredited hospitals rather than in others, the latter being afflicted with adversities like poor organizational climate, low nurse wages’ and excessive overtime, the latter putting undue pressure on working nursing professionals. Patient outcomes are therefore expected to be poorer in non Magnet accredited hospitals. . In the second category, the authors’ included organizational structure of studied institutions’ which included hospital size, level of further teaching at particular institutions, the type of intensive care unit and the nursing case mix (Stone et al, 2007).

Independent variables accounted for in this study included administrative processes/nurse working conditions typified into categories such as organizational climate, staffing, overtime, wages and structures of care. Structures of care were identified by parameters such as profit margin and Magnet status of the institutions included in the study. Dependent variables identifiable in this study are ‘Central line associated bloodstream infections (CLBSI), ventilator-associated pneumonia, catheter-associated urinary tract infections, 30-day mortality, and decubiti’ (Stone et al, 2007).

The study was conceptualized on the basis of this framework. The authors utilized a predetermined design for this study by focusing only on outcomes in elderly patients as according to their observation, the predefined selection criteria for institutions and ICUs selected was fulfilled only by those which had established electronic databases which were suited to data extraction, as per the aim of this study. The shortlisted institutions had to satisfy the criteria of minimum 500 patient days and participation in the CDC database collection protocols as well.

In addition, the authors’ contention that elderly patients’ were prone to adverse effects and complications subject to easy evaluation from case histories and electronic medical records was also reasonable. Data collection was from reputable sources and supervised by site coordinators qualified for obtaining such information. The data was analyzed by computing