Strength and Limitations of Kalisch and Lee

The study remains consistent, by using the same questionnaire for all the nurses that participate in the study, however, the population used is small, and only from one geographical region, the Midwest. In this case, the results may not necessarily reflect the feelings of those of a different population. Being that teamwork is not measurable; the study does not give any definitive conclusions about the subject. I feel that this was not a strong study, since, as the author says, teamwork is a matter of perception, and cannot be measured. This study would be one that is not easy to replicate. Participation in the study was voluntary, however there was an incentive. People like free food, so those that participated may have done it for the incentive, and not necessarily to give their honest opinion.

In this case, the quality of their answers becomes questionable. In an acute care setting, no two days are similar. The data collection period was four weeks. Census as well as acuity does not stay the same. In heavy census or high acuity days, the work load is more, and if most of the nurses were busy on days like these and are not able to help each other, they may feel like there is less teamwork, thus affecting the results of that particular day. Team work is affected by more than just staffing. To make it seem as though staffing is the only variable that affects team work is not completely accurate. Leadership, communication skills and the work environment are some of the other factors that may affect teamwork. These or any other factors should have been incorporated by the authors.

The study should have been limited to either RN’s or LPN’s, given that these nurses handle different acuities, which affects the results of the study, in that, those with sicker or more patients than the others may be more likely to feel like there is no teamwork. The study should also have been done in the same acuity level. E.g. do a study of medical floors, or ICU’s, to keep the patient populations as similar as possible.