1st article
Clinical Question Section/Description of the Problem
This analysis is conducted by the National Consumer Voice for Quality Long-Term Care and reviews federal data regarding the health of the residents. It examines the negative consequences of the understaffing of these facilities.
The issues have been worsened by two factors: the COVID pandemic and the lack of long-term ombudsmen and state regulators. The former emphasized the severity of the situation even further, as the disease and various co-occurring health issues claimed multiple lives.
Significance of The Problem in Terms of Patient Outcomes
Understaffing has resulted in several issues for the patients, including isolation, neglect, and improper safety conditions. By considering the acquired data, one can review the ways in which investing in more employees could help. Some of the problems that proper funding can aid overcome are underpayment, stressful working conditions, and improper training. In addition, the lack of adequate measures in infection control and prevention can be solved with an increase in monetary support.
As the Government Accountability Office reports, in the period of time between 2013 and 2017, 82% of nursing homes were deficient in those aspects (White House, 2022). The article accentuates some of the consequences residents had, such as severe weight loss and higher depression rates. Data from the Centers for Medicare and Medicaid Services is used for this research.
Moreover, the film depicts some of the measures that are currently being taken to improve the situation. That way, many lives will be saved, and there will be higher chances of positive health outcomes for nearly 1.1 million nursing home patients.
PICOT Question
- P = senior members of the society
- I = how is the patient safety culture in nursing homes implemented
- C = compared to care homes for older people
- O = be of assistance in enhancing safety
- T = for the period of patients’ stay in nursing homes
The Purpose of the Paper
The purpose of the paper was to review the data that was acquired during the pandemic. That way, the team could review the statistics related to the shortage of staff and the consequences for the residents and their families. Having analyzed this information, they offer solutions and describe the measures that should be taken and the ones that are currently being implemented to solve this problem.
Levels of Evidence
Identify the Type of Question Being Asked
The question being asked is, “What are the consequences of understaffing in nursing homes?” The type of this question is meaningful, as it considers the patients’ experiences and concerns.
The Best Type of Evidence to Answer That Question
The question asked in this study can be answered by qualitative analysis. The goal is to review the impact – the improvement or deterioration of the quality of nursing due to the shortage of staff in nursing homes. This can be assessed by collecting information related to the matter. It will provide context, explain the importance of the problem, and specify the measures that can be taken to prevent further deterioration of the situation. Thus, this information can be used to improve outcomes and care in nursing homes.
Search Strategy
List of Search Terms and Results
The search strategy applied in this study contained such words as “nursing home,” “staff shortage,” and “consequences.”It was important to avoid outdated sources and the ones that reviewed the matter outside of the US. The use of professional websites helped ensure that the gathered information would be relevant. This led to the discovery of the following file: The Consumer Voice. (2022). Inadequate Staffing During the COVID-19 Pandemic. National Consumer Voice.
2nd article
Clinical Question Section/Description of the Problem
COVID-19 has drawn extra attention to the problems and disparities in healthcare, causing multiple debates and discussions. The following study reviews the correlation between COVID-19 deaths, understaffing in nursing homes, medicaid users, racial and ethnic minorities.
There is an implication of injustice in the situation, as it is stated that the latter three groups were more severely affected by the pandemic than the other ones. The study suggests reviewing crucial facility characteristics as well, as they may mean the difference between possible positive and negative outcomes.
Significance of The Problem in Terms of Patient Outcomes
The groups depicted in the study (elderly people, racial and ethnic minorities) are at risk of COVID and similar conditions. Due to immune and physical functions, they are disproportionately affected by the disease. The disparity among ethnic minorities and Medicaid users is another crucial feature, as they represent the highest numbers of COVID cases.
According to the ethnic research dataset, the share of adults that are at risk of COVID stands at 34% for American Indian/Alaska Natives, 27% for black, and 23% for Native Hawaiian. White people’s share was 21%, and Hispanic people’s share was 20% (Kaiser Family Foundation, 2018).
Better care ensures better health outcomes and decreases mortality statistics. The data gathered from nursing homes in Connecticut, NHC and LTCFoc help comprehend all of the features of the issue. By understanding the nature of understaffing and all of its underlying issues, it is easier to find a solution to the problem.
PICOT Question
- P = senior and minority groups
- I = extent of the patient safety during the COVID pandemic
- C = compared to patients’ well-being in nursing homes
- O = be of assistance in enhancing patients’ well-being
- T = for the period of patient’s stay in nursing homes
The Purpose of the Paper
The paper aims to analyze the correlation between COVID deaths, racial and ethnic minorities, Medicaid users, and quality of care. Moreover, the study emphasizes how it affects underprivileged groups, as fatalities are significantly more common among them. It explains how nursing homes with more staff members and better medical assistance can decrease the number of negative outcomes and the measures that can be taken during a crisis similar to the one caused by the pandemic.
The discussion assesses the role of registered nurses, their staffing, and their correlation to COVID cases. Moreover, the study explains the severity of disparities in such deaths and the defining features of nursing quality of care.
Levels of Evidence
Identify the Type of Question Being Asked
The question being asked is, “What is the correlation between ethnic and racial minorities, registered nurses, quality of care, nursing home residents, and COVID-19 deaths (cases)?” The type of question being asked is the prognosis, as it requires an explanation of possible causes for the patient’s illness or the likelihood of them developing an illness.
The Best Type of Evidence to Answer That Question
The following article employs a cohort study, which is used to examine participants of elderly and minority demographics. In order to do so, a cross-sectional analysis of the Connecticut COVID cases, connecting them with other files and the statistics regarding coronavirus deaths, was conducted. With the help of multivariable two-part models, it has been revealed that there may be a correlation between nursing home features and the COVID mortality rate.
Moreover, data from NHC has been obtained to analyze such characteristics as safety and health outcomes, medicaid users, ratings of the quality of care, and the staffing level of registered nurses. The two required variables were found with the help of the LTCFoc website. The first variable is the number of racial and ethnic minorities among residents. The second one was a facility-level case mix, with its index being calculated by using acuity scores.
Search Strategy
List of Search Terms and Results
The search was conducted by using such words as “registered nurse,” “quality of care,” “Medicaid,” “nursing home,” and “residents.”It was necessary to search for contemporary data from professional websites and exclude those that were conducted on samples outside of the US. As a result, the following article has been found: Li, Y., Temkin-Greener, H., Shan, G., & Cai, X. (2020). COVID‐19 infections and deaths among Connecticut nursing home residents: Facility correlates. PubMed Central (PMC).
Conclusion
In conclusion, the problem of the treatment of the elderly and minorities in healthcare remains a severe issue. The COVID pandemic proved this point by emphasizing how people of age and ethnic and racial minorities were more prone to the disease. The possible solution concerns Medicaid users, the number of which is significantly lower among minorities. Other possible solutions for these adversities are higher staffing of nursing homes and better training programs.
Understaffing in nursing proves to be a serious issue, especially when medical institutions face such disparity as the COVID pandemic. Isolation and neglect, two of the negative impacts of deficient staffing, can lead to depression and weight loss. One of the root causes of understaffing is the lack of funding. With sufficient monetary support, nursing could be improved in the areas of training and safe working conditions.
References
Li, Y., Temkin-Greener, H., Shan, G., & Cai, X. (2020). COVID‐19 infections and deaths among Connecticut nursing home residents: Facility correlates. PubMed Central (PMC). Web.
The Consumer Voice. (2022). Inadequate Staffing During the COVID-19 Pandemic. National Consumer Voice. Web.
Kaiser Family Foundation (2018). Low-income and communities of color are at higher risk of serious illness if infected with coronavirus. Web.
White House (2022). Fact sheet: Protecting seniors by improving safety and quality of care in the nation’s nursing homes. Web.