Clinical question
The picot question is: In addressing patient to nurse ratio and patient’s outcomes, is an enhancement of nursing continuous education more effective than mandatory nurse–patient ratios regulation in increasing number of nurse and quality improvement in two years? To find answers to the above clinical question, the questions that this study will seek to find answers to from various published research studies shall include: whether enhancing nursing continuous education improves nurse-patient ratios and the role of nurse leadership as well as staff regulations in increasing nurse numbers so as to improve nurse-patient ratios.
Description of the problem
Nurses are critical to patient care, basically, because they spend most of the time with patients ranging from carrying out bedside care to administering medicines and care prescribed by physicians and medical doctors. Therefore, nurses to a greater extent determine patient outcomes such as reduction of readmissions, morbidities, and mortalities. However, some challenges exist in most healthcare facilities that impact on the nurses’ ability to provide quality patient care that improves patient outcomes and patient satisfaction. The biggest problem is the issue of nurse-patient ratios; many studies have revealed that nurse-patient ratio is directly linked to quality patient care (Stalpers et al., 2015). Where there are more nurses providing care to fewer patients, the better the outcomes, and vice versa.
Several proposed explanations try to explain this; one is that nurse shortage in a patient care facility means that few nurses hall be available to take care of many patients. As a result, patients will not care due care that meets their different and unique needs. Secondly, understaffing of nurses leads to an increased workload to the few available nurses that in turn cause fatigue and burnout (Stalpers et al., 2015). As a result of this, chances of making medical errors and near misses increases, this negatively impact on the quality of care and subsequent patient outcomes. Therefore, to improve the quality of care and enhance patient outcomes, there is a need to increase nurse-patient ratios.
Significance of the problem
According to Stalpers et al. (2015), many studies have clearly shown that there is a significant relationship between nurse-patient ratio and patient outcomes; therefore, this is an important area that healthcare facilities management should focus so that become useful in their healthcare services and improve patient outcomes. The only most viable solution to this problem is employing more nurses so as to reduce the current prevailing gap between nurses and patients.
Purpose of paper
The purpose of this paper is to interpret and provide a description of the findings of two articles that we identified as the most important to our group topic which is nurse-patient ratios.
Description of findings
The two articles relevant to this study were obtained from Google scholar; they were published in 2012 and 2013. I chose the materials because they have a large sample size in their research. Hence, their findings are reliable and can be used to represent the entire population under the study. Moreover, the articles years of publication is recent thus presents the current status of the problem we seek to address in our topic.
The first article is the one by Tubbs-Colley et al. (2013), the intention of this study was to scrutinize the relationship between nurse staffing ratios in hospitals and rates of readmission for children hospitalized for universal health and surgical problems in four States in America. The method that was used for this particular research was cross-sectional observational study whereby data from three primary sources were analyzed. The participants of the survey were 225 hospitals, 14 194 registered nurses and 90 459 hospitalized children. The instrument employed in this study was random nursing surveys, and the response rate was 91%, this shows that the survey tool is valid and reliable (Tubbs-Cooley et al., 2013). The study found out that children who were treated in hospitals whose nurse to child ratio is 1:4 were less prone to readmissions within 15-30 days after discharge. The findings of this study answer the purpose of the survey which seeks to established relationship of nurse-patient ratios and patient outcomes.
The second article by Zhu et al. (2012) is a multisite study of Chinese hospitals. The primary objective of this study was to determine the association between nurse employment and patient outcomes focus being on different mainland China hospitals. The methods that were used in this study were a four-stage sampling design in which 181 hospitals were considered in the study. In total, 5,430 patients and 7,802 nurses participated in the study (Zhu et al., 2012). The instruments that were used in this study were patient satisfaction measurement and China Nurse Survey. The two are from Hospital Consumer Assessments; therefore, they are valid and reliable instruments for any analytical study. The findings of this study showed that more nurses per patient positively affected essential nursing care as well as patient satisfaction. Consequently, the study found out that quality patient care was significantly evident in hospitals which had more nursing personnel per patient (Zhu et al., 2012). From the study findings, it is clearly demonstrated that the purpose of the study was well answered. The next step for the group would be to conduct a detailed literature review further to ascertain that there is a significant relationship between nursing staff ratios and patient outcomes.
Conclusively, it is visible from the two articles that adequate nursing staff is crucial to the provision of quality patient care. Therefore, to improve patient outcomes, reduce rates of hospitals readmissions, reduce medical errors and missed care, hospital administrators should consider increasing the nurse to patient ratios. By doing this, the workload of nurses will reduce significantly hence nurses will get more time to engage patients on significant discharge preparation so that when patients are finally discharged from the hospital, their likelihood of readmission reduces.
References
Stalpers, D., de Brouwer, B. J., Kaljouw, M. J., & Schuurmans, M. J. (2015). Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: a systematic review of literature.International journal of nursing studies, 52(4), 817-835.
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.
