Purpose
This paper looks to evaluate the impact of the nurse-to-patient ratio in achieving the desirable outcomes. It will analyze the evidence which depicts ways of improving this ratio to improve the quality of care given to patients and meeting their needs. Additionally, the paper will describe the impact of staffing problem to the well-being of the patient and work satisfaction. It will come up with questions which will be used to find the evidence which addresses this issue. Lastly, the paper will describe the strategy which will be employed to locate articles in regards to nurse-to-patient ratio.
Describe the problem
Nurses played a major and a significant role in the provision of primary care to the patient in any health facility with an aim of improving patient’s quality of life, decrease cases of patient mortality and helped patient cope with life after recovery from illness (Zhu et al., 2012). In order to achieve these desirable outcomes, it is critical to put into consideration the number of nurses giving care to a particular population of patients. As such staffing issue is an essential part of the nursing profession since it has a direct impact on quality of safety of service delivery (Joint Commission, n.d.). When the nurses in any facility are under-staff, cases of fatigue, burnout, absenteeism and high staff turnover will be rampant. This is due to increase in the workload which can have a devastating effect on the existing nurses. Thus, this increase in the workload may force some nurses to opt out of the profession. The high turnover will continue to increase the workload and pressure on the remaining nurses; thus, cases of near misses, hospital-acquired infections, and medical errors will rise considerably (Aiken et al., 2011). Additionally, nurses will be forced to concentrate on medical care provision only since there will be no enough manpower to provide holistic care customized to individual patients. Additionally, there will be no enough time to provide comprehensive teaching plan to patients before being discharged from a hospital. Poor discharge plan have the potential of increasing the risk of reoccurrence of the illnesses which were treated before; therefore, cases of readmission will rise (Tubbs-Cooley et al., 2013). Readmissions and hospital-acquired infections are indicators of poor quality of services which have adverse outcomes on the patients. Therefore, it is necessary to increase nurse ratio to patients.
Statistics
According to American Nurse Association (2014), 2% of 4,535 patients in Pennsylvania died after being discharge from the hospital. The major contributor to these deaths is poor patient to nurse ratio. Additionally, American Nurse Association assert that seven lives in every 100 patients who are most likely to die while receiving care will be saved in a well-staffed hospital. This can be achieved if the number of nurses is increasing from the normal four nurses per bed to six nurses per bed (American Nurse Association, 2014). Moreover, studies show that a decrease of 20% of nurses below the recommended number, cases of medical errors are likely to increase by 18% (American Nurse Association, 2014).
Picot questions
In addressing patient to nurse ratio and patient’s outcomes, is an enhancement of nursing continuous education more effective that mandatory nurse–patient ratios regulation in increasing number of nurse and quality improvement in two years?
Type of question asked
• Is advancement in nursing continuous education essential to improving nurse–patient ratios?
• Is nurse leadership critical in improving the number of nurses?
• What is the impact of staff regulation in increasing the number of nurses?
• Do recruitment and training have a significant impact in nurse-to-patient ration?
Search strategy
I will use Google search to find statements from authoritative organizations such as American Nurse Association, Joint Commission, CDC and United States Health Department concerning this issue. I will also utilize Google Scholar to find peer review articles addressing the impact of nurse-patient ratio. Finally, I will use medical databases such as PubMed to find health journals which have been published concerning this staffing issue.
Level of evidence
Evidence Matrix
References
Aiken, L. H., Cimiotti, J. P., Sloane, D. M., Smith, H. L., Flynn, L., & Neff, D. F. (2011). The effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical care, 49(12), 1047.
American Nurse Association. (2014). Safe Staffing Literature Review. Retrieved from http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/NurseStaffing/2014-Nurse-Staffing-Updated-Literature-Review.pdf
Joint Commission. (n.d.). Health Care at the Crossroads Strategies for Addressing the Evolving Nursing Crisis: Strategies for Addressing the Evolving Nursing Crisis. Retrieved from https://www.jointcommission.org/assets/1/18/health_care_at_the_crossroads.pdf
Tubbs-Cooley, H. L., Cimiotti, J. P., Silber, J. H., Sloane, D. M., & Aiken, L. H. (2013). An observational study of nurse staffing ratios and hospital readmission among children admitted for common conditions. BMJ quality & safety, bmjqs-2012.
Zhu, X. W., You, L. M., Zheng, J., Liu, K., Fang, J. B., Hou, S. X., & Wu, Z. J. (2012). Nurse staffing levels make a difference on patient outcomes: a multisite study in Chinese hospitals. Journal of Nursing Scholarship, 44(3), 266-273.
