Nurse To Patient Ratio Analysis Paper

Extensive research has shown that there is a correlation between staffing and patient ratio and patient outcomes. Better outcomes particularly are shown with lower patient to nurse ratio. However staffing issues remain an ongoing concern which greatly impacts the safety of the nurse and their patients, and also impacts cost of healthcare. Evidence shows that adequate staffing causes reduction in mortality, nurse burnout and job satisfaction, and reduction in medical errors.

In Adult patients on medical /surgical units, if staffing ratios are maintained at 1 RN to 4 patients will there be a decrease in post discharge Emergency Room visits and readmission rates in the following 10-30 days?

The study by Aiken et al in 2002 revealed that there was a higher chance of nurses experiencing job related burnout in hospitals with high Patient nurse ratios. Further, nurses in institutions which had the highest rates of patient to nurse ratios were twice likely to suffer from dissatisfaction from their jobs. These influenced the decisions of nurses to leave their current jobs and thus creating more staffing problems that would lead to more negative patient outcomes.

In hospitals in the United States, nurses are left to suffer the consequences of short staffing. In response, they are subject to excessive workloads, added stress, and a heightened feeling of anguish which often silences their cries for change. Not only does short staffing affect the nurses, it also impacts the hospital itself. Research has shown that low staffing levels in hospitals has a direct impact on quality of patient care and job dissatisfaction from nurses. In order to satisfy the affected nurses and prevent them from burnout, a solution must be implemented. Supplemental nursing can be the answer to all staffing conflicts if implemented wisely by charge nurses who complete scheduling. Nurses must also raise awareness for the cause

According to Ryan Rahilly the vacancy rate is due to reach 29 percent by 2020. During 1980-2000, the average length of hospitalization decreased from 7.5 days to 4.9, however, there was no increase to staffing levels to help with the increase in patient’s needs. Without significant hospital nurse staffing there will be a lack of positive patient outcomes. Studies also show that hospitals with higher RN staffing have lower rates of the five adverse patient outcomes (UTIS, pneumonia, shock, upper GI bleeds and longer hospital stays). The higher staffing levels also are linked to a 2 to 25 percent decrease in these adverse outcomes. Study shows that hospital deaths are also associated with staffing levels.

The debate on safe and adequate nursing staffing has remained a growing and controversial issue in the health care fields. There is a strong relationship between adequate nurse to patient ratios and safe patient outcomes. A lot of research and evidence –based practices have shown that limited nursing staffing result to a poor quality of care. According to Huston ( Needleman, Buerhus, Mattke, Stwart, and Zelevinsky,2002) “The study of 799 hospitals in 11 states found a higher prevalence of infections, such us pneumonia and urinary tract infections, failure to rescue and shock or cardiac arrest when the nurse’s workload is high”. When patient to nurse ratios increases to unsafe levels, there are higher incidences of medical errors, forced overtime,

I chose to examine research related to the nurse-to-patient ratios and the variety of effects on safety and quality of care. Nurse staffing levels are directly correlated with quality patient care, safety, and nurse satisfaction. Todays nurse has a larger workload due to higher complexity of care, reduced staffing, and increased responsibility (Hughes, 2008). Low nurse staffing levels with an increased patient load leads to a wide array of problems such as medication errors, sentinel events, nurse burnout, reduced patient dissatisfaction, and overall decreased quality of care (Hughes, 2008).

In the three articles, the focus was how nurse to patient ratio has an effect on the quality of patient care. These studies and observations were made from varied locations and though some of the articles provided little data, they all had a similar conclusion. The conclusion that the safety of a patient and quality care can be provided better through a proper nurse to patient ratio which also increases the nurse's job satisfaction.

A nurse-patient ratio is the maximum number of patients a nurse can have at any time during a shift. There are two primary models utilized, while some methods are gaining popularity as research advances. Presently there is no set methodology used to determine ratios. One model is nursing hours per patient per day and the other being mandated ratios. Either model affects patient outcomes, safety, and quality of care. There are advantages and disadvantages to both models. Besides the advantages and disadvantages, hospitals must also look at cost, patient outcomes, satisfaction of nurses and patients, and safety for both. Another model gaining momentum is one based on the acuity level of patients.

The nurse-patient ratio is highly correlated with the risk of burnout. The more patients a nurse has, the more likely it is that he or she will experience burnout. According to McHugh & Ma (2014). “nurses working in hospitals with excessive patient workloads and poor working environments are more likely to be burned out and dissatisfied with their job” (1). Partly because nurses are constantly on their feet attending to patient’s needs. By the end of the day, nurses are not only physically exhausted, but mentally as well. They may also feel as though

All of these outcomes are dependent on the availability of a nurse to assist and monitor their patients continuously throughout the day, which can be difficult when caring for a large patient load. The Minnesota Nursing Accent (2015) also conducted research on the topic of understaffing within hospitals and concluded that a smaller nurse to patient ratio lead to fewer medication errors, fewer medications given late, and shorter hospital stays for patients. Nurses are in control of all medications given, so having a medication error or administering a late medication adversely affects the patient and the issue being treated by the medication. Likewise, Yoder-Wise (2015) reports that having more registered nurses per shift results in a reduction in hospital stay length and less hospital related mortalities. After reviewing current literature on the topic, it is evident that a relationship between understaffed nurses taking on large patient loads and declining patient satisfaction and safety exists.

Cho et al., (2016) recommends a closer relationship with patients will improve safety and quality of care. It also accentuates that, increased nurse -patient ratio decreases time spent with each patient. Consequently, this leads to more works undone and lives lost. Central reason for jeopardizing safety of patients were from inadequate staffing levels. Griffith et al., (2016) proposed that there were significant associations between nurse staffing and post-operative mortality and missed care. It also highlights the significance of decreasing the workload of nurses, mortality from missed care for patients in the Intensive Care Unit and surgical units is nevertheless detrimental. Thus, it is important to recognize the impact of high nurse-patient ratio on the quality care and death rates of Intensive Care Unit patients.

Hospitals are trying to rectify problems without identifying the root cause which actually led to the problem, which is high patient to nurse ratio (Wang, S., Liu, Y., & Wang, L. 2015). In order to address this issue i.e. to minimize the burden on the nurse’s hospital management technique must be reconstructed towards patient-centered care instead of cost control, which would actually will reduce unrealistic expectations from the nurses Wang, S., Liu, Y., & Wang, L. 2015). California RN staffing ratio law is a very good tool that should and can be implemented to lower the burden the nurses, even the Canadian research that is referenced in this paper is based on staffing ratio law. This will not only reduce the pressure on the nurses, but also will lead to high patient satisfaction and more repetitive

Already knowing myself as a shy person, really getting into politics would be a hard obstacle for me to overcome. My position in advocating would be better suited in the background, and not speaking up at committees or hearings. I was once a member of the Florida Keys Nursing Association during my associate school days and I would like to continue in joining a larger scale nursing organization, such as one consisting all of Florida. I am great at research and taking notes, therefore my job would be to attend committees to learn about the newest legislations being addresses. After each meeting I would find out through the internet, library, and word-of-mouth everything there is to know about these new bills and compare them to research already done by myself regarding the nurse-patient ratios. Working with others in my nursing association, I would educate the group on the specifics of each bill and collaborate with my members on the best means of getting our voices heard. I would

One of the many goals of the nursing profession is to provide high-quality, safe patient care. There are many responsibilities that come with a nursing career and when the nurse to patient ratio increases, there is a possibility that it may hinder the safe care that patients deserve, and this may result in negative patient outcomes and level of satisfaction. Staffing is one of the many issues that healthcare facilities face. In many facilities, there never seems to be enough nurses per shift to provide high quality, thorough patient care which often leads to burnt out staff, and frustrated patients and families. This review discusses the findings of quantitative studies and one systematic review that involves patient outcomes in relation to nurse staffing.