The Importance Of Safe Nurse Staffing For Patient Satisfaction

Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).

One can wonder if there is any correlation between patient-nurse ratio and it’s effect on patient safety. In the research conducted by Jack Needleman and his associates (2002), they examined the relationship between amount of care provided by the nurse and compared it to patient outcome. The result showed that the increase amount of time a nurse is able to spend with the patient better the quality of care is. The data for this research was collected from seven hundred and ninety-nine hospitals across eleven states. This covered both medical and surgical patients that were discharged and the data was evaluated the relationship between the time provide to the patients by the nurses and patients’ outcome. As research showed,

For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.

Nursing to patient ratio can have a direct impact on patient safety. Studies have been done that show that these ratios impact patient outcomes and mortality rates when nurses are understaffed and are given a larger patient load than they can handle safely. Nursing education level has also shown to play a role in patient outcomes. Whether they are an unexperienced nurse or the patients are at a higher acuity and require more time for care, these larger ratios can be detrimental to the nursing quality of care that can be provided. These larger nurse to patient ratios can also play a part in nurse burnout leading to medical errors, negative patient outcomes, and higher health care costs in the future.

Nurse-to-patient ratios is not a new topic of debate for all of us who deliver care to patients every day. Only lately it has been a big issue that have caught the attention of many. Demands by the medical community for changes concerning staffing, asking for the government interventions in minimum staffing laws. Registered nurses have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse. (ANA, 2015) .nowadays hospitals are running for profit and the emphasis is not put on job burnout, stress, and endangerment of patients. Nursing shortages is a very pertinent problem, it will be optimum to have laws in place to help with the issue, however meanwhile leadership and management methods to the matter can help to mend the nursing situation and avoid many of the damaging effects of unfitting nurse-to-patient ratios.

With a shortage of nurses, the care and safety of patients may become compromised. The nurses themselves may be having feelings of dissatisfaction, overwhelm and distress. Nurses who may become overwhelmed with the high number of patients may become frustrated and burnt out. And inadequate staff of nurses may lead to a negative impact on the patient’s outcome. The quality of care the patients may receive in facilities with low staffing may be poor.

The research studies reviewed all share a common theme that staffing and patient care make a safe care environment. The patient safety conditions all are enhanced by adequate staffing and nurse retention. Nursing turnover leads to reduced staffing and affects the patient’s outcomes and overall satisfaction. The point of agreement is that nurse staffing and the environment has a positive effect on patient safety, outcomes, and satisfaction.

Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.

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.

Nursing is the powerhouse in the delivery of safe, quality patient-centered care in the healthcare industry. To ensure continued safety of the patient and nursing staff, the issue of inadequate staffing must be addressed. Consequently, patient’s mortality rate has been linked to the level of nursing staff utilized in ensuring an utmost outcome (Aiken, 2011). This paper will outline the issue associated with inadequate nurse to patient staffing ratios in the hospital setting; essential factors such as economic, social, ethical and political and legal affecting the issue will be established; current legislature and stakeholders will be ascertained and policy option, evaluation of bill and the results of analysis will be reviewed.

Additionally, the study found that a high patient to nurse ratio resulted in greater emotional exhaustion and greater job dissatisfaction amongst nurses. Each additional patient per nurse was associated with a 23% increase in the likelihood of nurse burnout, and a 15% increase in the likelihood of job dissatisfaction. Moreover, 40% of hospital nurses have burnout levels exceeding the normal level for healthcare workers, and job dissatisfaction among hospital nurses is four times greater than the average for all US workers. 43% of nurses involved in this study that reported job dissatisfaction intended to leave their job within the upcoming year. (Aiken et al.)

The broad research problem leading to this study is the belief that nursing shortage in facilities leads to patient safety issues. The review of available literature on this topic shows strong evidence that lower nurse staffing levels in hospitals are associated with worse patient outcomes. Some of these outcomes include very high patient to nurse ratio, fatigue for nurses leading to costly medical mistakes, social environment, nursing staff attrition from the most affected facilities. The study specifically attempts to find a way to understand how nurse

Barry Hill (2017) performed studies related to the quality of care that patients receive and what factors are associated with those perceptions. One area that was noted to be of importance and directly related to quality of care provided to patients is staff dissatisfaction and burnout. This study also found that longer shifts contributed to increased amounts of emotional exhaustion leading to decreased quality of care for patients. Addressing staffing needs early and intervening can decrease the amount of nurse burnout and dissatisfaction that is often seen. This study has shown that hiring additional competent nurses reduces medication errors, falls, infections, wounds, and decreases hospital litigation costs, while improving staff morale, patient experience and care, and cost-effectiveness for the hospital.

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.

Staffing deficits pose a direct threat of manifesting negative outcomes associated with the delivery of patient care. Anything or anyone that compromises patient care should be eradicated immediately. This author believes that staffing deficits remain a consistent issue due to lack of solutions that actively address the issue. This author believes that inadequate staffing is a major concern due to the degree of harm it can impose on patients. Adverse events associated with