*Paraphrase and change/add more information to these 3 articles Article OneArticle TwoArticle ThreeResources:The article, “The Effect of Nurse-to-Patient Ratios on Nurse-sensitive Patient Outcomes in Acute Specialist Units: A Systematic Review and Meta-analysis” is published by Driscoll et al. (2017). In this article, there was a systematic review of the provision of high quality care in acute hospitals. It’s aim was to have an updated review of evidence surrounding nurse staff levels on patient outcomes. It was published to understand the association between nurse staff levels and nurse-sensitive patient outcomes in this setting. The meta-analysis of 175,755 patients, from six different studies, showed a correlation between a higher nurse staffing level and a decreased the risk of in-hospital mortality by 14% (0.86, 95% confidence interval 0.79-0.94) (Driscoll et al., 2017). It concluded that nurse-to-patient ratios influenced patient outcomes and can reduce in- hospital mortality. It was said that additional studies should be conducted to offset the paucity and weakness of the lack of research surrounded this area. We need this information because patient safety is a priority, and we must have adequate staffing to accommodate their needs.The article, “The Relationship Between Understaffing of Nurses and Patient Safety in Hospitals?A Literature Review with Thematic Analysis” is published by Glette et al. (2017). The purpose of this article was to increase knowledge on the understaffing of nurses and any consequence this imposes on patient safety. They concluded that poor staffing increases the risk of mortality, also adverse conditions like pressure ulcers, DVT (deep vein thrombosis), and other related hospital infections. It was also found that understaffing relates to implications pertaining to lack of time nurses could give each patient, lack of quality care, and they faced challenges in safely administering medication. Six of the studies published found a direct link of understaffing affecting patient safety, not caused by direct harm, but increasing their risk for harm later on. Four studies concluded that lack of proper staffing lead to poor quality of care. This includes nursing tasks such as: patient communication, skin/oral care, documentation, and decreased response time to patient alarms and mobilization. 30.39% of nurses reported moderate or poor quality of care, and patient communication was not prioritized in about 39.5% of the shifts. Skin care and back rubs, 24.0%, was frequently reported as undone as well as oral hygiene 19.3% of the time. This impacts patient care and healing time, and also the patients’ ability for self-care and satisfaction was negatively associated with understaffing.The article, “Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review” is published by Hall et al. (2016). The objective of this review was to determine if there was an association between healthcare professionals’ wellbeing and being burned out, in regard to patient safety. It was concluded that poor wellbeing and moderate to high levels of burnout were associated with poor patient safety outcomes, such as medical errors. But due to the lack of prospective studies reduced the ability to determine causality. The article mentions that there is a growing concern in the US over caregiver shortages. This could be due to population increases, increase in chronic diseases, and increased life expectancy. Out of the articles that the study was conducted, over half (59.3%) found that poor wellbeing- depression, anxiety, job stress, mental health issues, distress- was directly associated with poorer patient safety. And the majority of studies found that being burned out, more errors were associated with it (70%). A similar percentage of studies found irrefutable evidence between wellbeing and error (88.9% of studies) as those for burnout and error (83.3%), which indicates the importance of both variables. We need this information to deliver quality care, and the care must be safe. These findings show us that staff wellbeing plays a major role in patient safety. We should take this information and implement a work environment that embodies staff wellbeing and protects them against burnouts.Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyombwe, T., & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 17(1), 6-22.https://doi.org/10.1177/1474515117721561Glette, M. , Aase, K. and Wiig, S. (2017) The relationship between understaffing of nurses and patient safety in hospitals?A literature review with thematic analysis. Open Journal of Nursing, 7, 1387-1429. https://doi.org/10.4236/ojn.2017.712100Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. B. (2016). Healthcare staff wellbeing, burnout, and patient safety: A systematic review. PLoS One, 11(7). https://doi.org/10.1371/journal.pone.0159015Health ScienceScienceNursing NUR 300

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