Picot Statement P: Nurses and Nursing.

Nursing leadership and patient outcome

Review of studies and literature that examine the association and relationship between nursing leadership practices and patient outcomes.

O: Evidence suggests relationships between positive relational leadership styles and higher patient satisfaction and lower patient mortality, medication errors, sentinel events, and hospital-acquired infections.

Over three months

Healthcare faces an economic downturn, stressful work environments, upcoming retirements of leaders and projected workforce shortages, implementing strategies to ensure effective leadership and optimal patient outcomes are significant.

The nursing shortage continues to be a serious concern for the healthcare industry as a whole. "According to the Bureau of Labor Statistics' Employment Projections 2012-2022 released in December 2013, Registered Nursing (RN) is listed among the top occupations in terms of job growth through 2022. The RN workforce is expected to grow from 2.71 million in 2012 to 3.24 million in 2022, an increase of 526,800 or 19%" (Rosseter 2014). Although certain fields such as geriatrics and primary care have greater need than others, concerns about high rates of attrition and low rates of entry remain in virtually every sphere of the nursing profession.

Description of the problem

The need for nurses has been spawned by the growing numbers of baby boomers retiring as well as the shift (in an age of cost-cutting) from physicians to APNs and other nursing providers...

However, the numbers of new entrants into the profession are not keeping pace with the need for new providers. Although economic uncertainty has driven some people to shift careers later in life, the numbers of faculty in nursing schools has not permitted there to be sufficient openings to fully address the deficit. "Enrollment in schools of nursing is not growing fast enough to meet the projected demand for nurses over the next 10 years" ("Oncology nursing society position," 2013). Despite "a 3.5% enrollment increase in entry-level baccalaureate programs in nursing in 2009 over the previous year, the increase is not sufficient to meet the projected demand for nurses. According to AACN (2009), U.S. nursing schools turned away more than 39,000 qualified applicants from baccalaureate and graduate nursing programs in 2008 because of insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budgetary resources" ("Oncology nursing society position," 2013).
Nursing shortages are associated with adverse patient outcomes, including an increase in medical errors. "Almost all surveyed nurses see the shortage in the future as a catalyst for increasing stress on nurses (98%), lowering patient care quality (93%) and causing nurses to leave the profession (93%)" (Rosseter 2014). There is also a deficit in nursing leadership which is concerning regarding patient outcomes as well: "nurses prepared at the baccalaureate-level were linked with lower mortality and failure-to-rescue rates. The authors conclude that "moving to a nurse workforce in which a…