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Registered Nurse-To-Patient Ratio Analysis

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Registered Nurse (RN) staffing in the hospital setting has direct correlation to nurse-to-patient ratio which has become an ongoing area of concern when it comes to patient outcomes. According to the Center for Disease and Prevention (CDC, 2015) more than one million RN’s work in hospitals, which makes nursing the largest hospital workforce (p.1). In 60% of U.S. hospitals, vacancy rates for RNs have increased since 1999; 14% of hospitals now report a severe nurse shortage (i.e., >20% of positions vacant) (p. 1). The main priority is the safety of both the patient and the nurse. The rise in patient acuity and shortened hospital stay add to the challenges. According to the cdc.gov, “California is the only state with a law governing minimum …show more content…

During each shift assignment the patient’s acuity was not taken into account when the assignment was made by the previous charge nurse. A problem statement and a researchable question are developed. An improvement model, Plan-Do-Study-Act (PDSA), is identified and created as a framework to develop an improved process to assign each nurse to a set number of patients using an acuity ratio. Using a specific framework, a PDSA model (see Figure 1) is created to show the quality improvement model in order to address the nurse-to-patient ratio in order to provide effective and safe …show more content…

The unit consisted of forty private rooms and the breakdown was twenty beds were for BMT and twenty beds for the oncology side. Usually each pod station numbered one through eight consisted of five beds each with a total of eight pod stations. The process when this writer started on the unit was RN’s were assigned five rooms all in numerical order and also next to each other by the charge nurse for that shift. Without this assignment, it would in turn have each RN walking further and not having a consistent assignment. The problem is the acuity level was not a factor. The unit has bone marrow transplants all in the same part of the unit in which acuity level is high and if one patient needs critical care and more nursing time this is in turn is taking valuable time away from other high acuity patients.
Problem and Question
Patients admitted into hospitals are requiring more critical care. This in turn requires a nurse-to-patient ratio that is suitable for the acuity of the patients on the unit in order to provide safe and effective nursing care. The bone marrow/oncology unit needs an optimal staffing model which will assess patient acuity, staffing of RN’s and also unlicensed assistive personnel. Leadership support is required for adequate staffing solutions and will provide the RN’s with an appropriate number along with skills and experience of the nurse

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