Nurse staffing is a highly researched topic, and many studies demonstrated the importance of maintaining a proper patient-to-nurse ratio. For instance, according to the findings of a systematic review by Shin, Park, and Bae (2018), elevated patient-to-nurse ratios are positively correlated with higher nurse burnout and job dissatisfaction rates, as well as lower levels of staff retention. At the same time, the study by Fagerström, Kinnunen, and Saarela (2018) demonstrates that excess nurse workloads increase the incidence of medical errors, patient morbidity, and mortality. All these findings imply that adequate nurse staffing strategies must be implemented to improve the workplace environment and quality of care. Nevertheless, regardless of convincing research evidence and negative experiences of many patients and care providers, a lot of hospitals still fail to keep optimal patient-to-nurse ratios.
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The suggested strategy is based on a five-step learning cycle that comprises the collection of research evidence, internal environment assessment, development of recommendations for short-term and long-term improvement, plan implementation, and evaluation of outcomes. It is valid to say that this approach may be successfully applied in all types of clinical settings.
In my opinion, such long-term strategies as partnering with nursing schools and utilization of online scheduling systems, can provide more sustainable benefits for hospitals in terms of staffing than many of the discussed short-term strategies. Nevertheless, they will likely work best and result in better nurse retention in case hospitals simultaneously strive to enhance their work environments and cultures. Overall, it is pivotal to remember for hospital administrators that the costs of ignoring the problem of increased patient-to-nurse ratios can be much higher than the costs of hiring new staff, investing in their training, and providing sufficient rewards for their work. Thus, it may be recommended for hospitals to start with the implementation of at least one of the most feasible solutions at a time.
Fagerström, L., Kinnunen, M., & Saarela, J. (2018). Nursing workload, patient safety incidents and mortality: An observational study from Finland. BMJ Open, 8(4), e016367.
Shin, S., Park, J., & Bae, S. (2018). Nurse staffing and nurse outcomes: A systematic review and meta-analysis. Nursing Outlook, 66(3), 273-282.