Nurse-to-Patient Ratio and Evidence-Based Change Research Paper

Executive Summary

The problem of a high nurse-to-patient ratio (NPR) has been in existence in the U.S. healthcare environment for a while. Combined with a lack of qualified experts in the identified environment, high requirements for the competencies of applicants for a nursing position in U.S. hospitals contribute to an increase in NPR. The observed phenomenon causes a range of problems in the context of modern healthcare. Nurses can be viewed as the most vulnerable population in the identified scenario since a high NPR leads to an increase in the workload and the subsequent threat of workplace burnouts. In addition, the development of mental health issues such as stress and depression is very common among nurses in the American healthcare setting due to high NPR. A reconsideration of the current approach toward distributing roles and responsibilities among nurses combined with a change in the human resource policy may help manage the problem.

Rationale

Addressing the problem of high NPR is crucial to the overall quality of healthcare services. When the number of patients per nurse increases, workload levels become far too high for a nurse to meet their responsibilities adequately (Hayes, Douglas, & Bonner, 2015). Thus, medical errors caused by an increase in the degree of exhaustion among nurses can be seen as one of the primary reasons for studying the issue. In addition, burnouts causing severe consequences such as stress, depression, and the associated issues can be listed among the outcomes faced by nurses working in a high NPR environment (Hayes et al., 2015). Therefore, exploring the issue and providing a solution to the specified situation is critical to both the quality of care and well-being of nurses and patients alike. There is a strong possibility that, with the creation of a compelling approach toward a high NPR, one will be able to reduce the threats to which both patients and nurses are exposed in the identified environment, as well as create the platform for improving the skills of the nursing staff in U.S. hospitals.

Overview

The issue of high NPR currently affects the U.S. nursing setting significantly. The specified phenomenon can be explained by a range of reasons, yet the lack of skills professionals can be seen as one of the primary factors behind the issue under analysis (Neuraz et al., 2015). In addition, increasing the number of nurses within a particular hospital setting would imply a steep rise in spending, which most hospitals cannot afford (Hayes et al., 2015). Therefore, a range of American healthcare organizations faces the issue of understaffing (Twigg, Gelder, & Myers, 2015). The phenomenon might seem barely noticeable at first, yet its long-term outcomes are drastic.

It would be wrong to claim that no solutions have been located so far. For example, a suggestion for training newly hired staff members so that they could obtain the knowledge and skills necessary to meet patients’ needs has been made (Aiken et al., 2014). However, implementing the provided idea will also require impressive investments for training sessions. Therefore, it is essential to address the problem of high NPR immediately. Unless managed appropriately, the problem will grow out of proportions, causing a steep increase in patient mortality levels and depression and burnout rates among nurses (Hayes et al., 2015). Consequently, the reconsideration of the current approach toward staffing, as well as the management of roles and responsibilities and the promotion of education among nurses, is overdue.

Change Theory Explanation

The adoption of Kotter’s 8 Steps as the platform for analyzing and managing the issue can be deemed as a sensible choice since the identified change theory helps not only introduce alterations to a nursing environment but also cement them. The theoretical framework has been in existence for quite a while, warranting its significance for promoting improvements in an organization (George, MacDonnell, Nimmagadda, Murphy, & Dollase, 2015). As its title suggests, the model consists of eight steps that help encourage change and institutionalize it successfully (Neuraz et al., 2015). Thus, it is expected that Kotter’s Model will help address the issue of high NPR.

The Goodness-of-Fit Model shows that Kotter’s 8-Step framework is quite valid as a means of encouraging change in the context of a nursing setting (Aiken et al., 2014). According to a recent report, the Goodness of Fit of Kotter’s 8 Steps helps introduce every factor leading to successful change into the realm of a hospital, including employee management, leadership, timing and development, reward and recognition, culture, politics, and information systems (Karnouskos, 2015). The report points to the fact that, in the default model, the Goodness of Fit reaches 0.817, which is a rather impressive result indicating that the framework must be applied to encourage change.

Analysis and Commentary

When considering the effects of high NPR on the overall state of healthcare in the U.S., one must mention that the identified phenomenon has caused a significant decrease in the overall quality of care and the probability of a positive patient outcome. Furthermore, the high NPR has contributed to an increase in the levels of mortality among patients. The identified effects require a thorough analysis and the creation of the tool that will lead to successful change.

In addition, the existing NPR affects the quality of care significantly. Causing a sharp drop in service efficacy, it creates the environment in which recovery takes more time. Furthermore, the threat of medical errors rises in the specified setting. Being exhausted by the number of responsibilities and the amount of information that they have to process, nurses are likely to make mistakes that will ultimately lead to a drop in the quality of care. A change in the approach toward managing human resources in a healthcare setting will help resolve the problem.

References

Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R.,… McHugh, M. D. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383(9931), 1824-1830.

George, P., MacDonnell, C., Nimmagadda, J., Murphy, J., & Dollase, R. (2015). Designing interprofessional education curriculum using multiple conceptual frameworks. Annals of Behavioral Science and Medical Education, 21(1), 9-13

Hayes, B., Douglas, C., & Bonner, A. (2015). Work environment, job satisfaction, stress and burnout among haemodialysis nurses. Journal of Nursing Management, 23(5), 588-598.

Karnouskos, S. (2015). Effective change management in modern enterprises. Stockholm, Sweden: Linnaeus University Print.

Neuraz, A., Guérin, C., Payet, C., Polazzi, S., Aubrun, F., Dailler, F.,… Schott, A. M. (2015). Patient mortality is associated with staff resources and workload in the ICU: A multicenter observational study. Critical Care Medicine, 43(8), 1587-1594.

Twigg, D. E., Gelder, L., & Myers, H. (2015). The impact of understaffed shifts on nurse‐sensitive outcomes. Journal of Advanced Nursing, 71(7), 1564-1572.