Introduction
The positive environment for nurse staffing forms an excellent topic for a research project. Quality nursing care and nurse-to-patient ratios are more challenging now than they were a few years ago. A wide range of circumstances influences nurse-to-patient ratios. Concerns about healthcare spending, the aging population of both patients and nurses and competing agendas contribute to this challenge.
According to several studies, the expense of recruiting more nurses will put a strain on hospitals’ finances if state legislators mandate minimum nurse staffing ratios. According to other studies, insufficient nursing staffing can result in patient deaths and medical blunders, leading to increased legal concerns and higher expenditures to compensate for turnover rates. To solve this problem, the healthcare system resorts to the PICOT system, which is designed to facilitate the work of a nurse and avoid risks. The main idea of PICOT implies the mandatory implementation of a policy that would ensure an adequate ratio of nurses and patients (1 RN: 4 patients). They are trying to show the effectiveness of this concept by the example of recruitment for industrial engineering.
Search Methods
Patient safety has become essential due to the increase in the staff of nurses. Many conclusions based on the available data are currently uncertain. Four systematic reviews achieved the goal with specific search parameters, inclusion criteria, and full findings descriptions. Thirty AHRQ papers were found in the PubMed and CINAHL databases between 2002 and 2003 (Neves et al., 2021). The process of gathering data for the review was simplified by the use of databases. This review looked mainly at nursing studies; however, it found few exceptions. Quantitative research was sought to see what affects safe nurse staffing. The research used quantitative methodologies and only current publications was considered for this evaluation.
Strategies
Nursing staffing is a severe concern according to the study’s inclusion criteria. The inclusion method allows one to create an infinite number of research variables. Several papers related nurse staffing to patient outcomes, whereas others expressed diverse opinions. Legislation from the federal and state governments can secure enough workers. Staffing, managerial support, and patient care were highlighted (acuity, patient needs) (Juvé-Udina et al., 2020). Professionally, exclusion rules reduced the number of registered nurses on staff. This study must involve observational methods and questionnaires conducted by or for registered nurses to be considered valid data. Although they work under identical conditions, this group was excluded from the analysis.
Cost-Benefit Analysis
A three-year (2015-2017) long-term longitudinal study was conducted in the department, department, and patient groups of the Swiss University Hospital. Shin et al. (2018) were interested in determining whether shifts with low or high staffing levels of nurses affect mortality. The study involved 55 institutions, 79,893 adult inpatient patients, and 3,646 nurses (Shin et al., 2018). Regression models combined with a staffing model to study the relationship between nurses on duty and mortality rates. However, an increase in mortality risk by 10% was associated with insufficient staffing. Mortality and the number of personnel of other groups had a minor relationship, for example, higher mortality rates were associated with increased unlicensed and administrative workers. According to the results of using this method as an experiment at the patient level, the number of registered nurses employed at work may be associated with death. The key finding was that more registered nurses improved patient outcomes, but fewer nurses had the opposite effect.
Quality of Nursing Care
Another study determined that the qualitative proportion of nurses and patients can be used to improve patient safety. Therefore, certified nurses should not be replaced by any groups where employees without education are present (Cho et al., 2020). It is in line with PICO’s statement, as it adheres to the procedural and consistent implementation of strategies to have a favorable structure for cost-effectiveness analysis and quality selection of medical personnel.
Nurse Burnout
The quality and safety of patient care are directly related to the ratio of nursing staff. The quality of nursing care is directly related to the treatment results of patients in most hospitals. Using this data to study the impact of changing patient-nurse ratios on patient outcomes, nurse satisfaction, and quality of care indicators is exemplary; if so, we will bet on it (Carlisle et al., 2020). Information from the National Press Ganey database showed that the results of this experiment were positive, with daily personnel records associated with this data (Carlisle et al., 2020). In September 2017, the ratio of nurses to patients decreased from 1:1.75 to 1:1.5. Study participants with a high ratio of nurses and patients were more likely to experience burnout.
Staff Turnover
According to research results, widely available indicators can use to monitor nursing staff and results that consider the needs of nurses in nursing departments (Musy et al., 2020). Measurements can provide a new perspective on optimizing the ratio of nursing staff. Staff turnover is essential so as not to overload nurses. This experiment corresponds to PICO’s general idea that the fewer patients per nurse, the more effective their treatment is.
Response
It is essential to analyze the impact of the number of qualified nurses (RN) and their assistants on responding promptly to patients with impaired physiology. The study used data from 32 general emergency departments in England from 2012 to 2015. The study results showed that the level of staffing with qualified personnel, but not assistants, has an impact on the untimely response (Smith et al., 2020). The lower the number of qualified nurses, the higher the risk of patient death during hospitalization.
Generalization of Data and Search for Relationships
A large number of studies on the relationship between the recruitment method and the results of their work need to be evaluated and generalized. Important decisions are made based on the generalization of evidence. A literature search was performed using PubMed and Web of Science databases, and others to analyze the data. Thirty different studies were identified that analyzed several critical results of the staff’s work (Wynendaele et al., 2019). The results confirmed the existence of a relationship between the ratio of patients and nurses and the results of their work. Additionally, according to research, the quality of medical care is influenced by factors such as a combination of skills and working conditions. These studies should become guidelines in the healthcare system in the future.
Comparison of Studies
Each of the eight articles reviewed offers a comprehensive assessment of past research using quantitative methods (data analysis, observation, and survey). Common to all articles is built based on PubMed, Web of Science, and other databases. Similarly, this included assumptions about the limitations of using an approach that never recognizes the need to use the methods of ordinary propositions in their most basic abstraction. The authors of the studies also applied nurses’ analysis in the nursing environment. As an adverse consequence, research processes are limited to the methods used to collect data. The parameters of participants and sample size are narrow in the range of nurses participating in the study.
Some studies have been conducted for a long time, while others have been conducted briefly. It can be assumed that in surveys conducted in an intensive care unit or a long-term care facility, the quality of treatment, and satisfaction of nurses may vary. Each of the researchers collected data for their scientific papers with the help of educational equipment and not just observed them in the field. Registered nurses can focus on more practical nursing procedures when delegating patient care responsibilities to nursing assistants. Each of the articles reviewed confirmed the relationship between the ratio of patients and nurses and some of the results concerning staff. Many other properties need to be considered (for example, working conditions) to guarantee patients the best treatment.
Future Research
According to the authors, scientists should concentrate on unit-level data in the future, combine fresh approaches, and strive to demonstrate comparability between diverse clinical settings and healthcare systems worldwide (Carlisle et al., 2020). It is required to conduct a nurse-to-patient ratio study to find the optimal nurse-to-patient ratio level in terms of nursing outcomes. By using the findings of these studies, hospitals will be able to prevent adverse nurse outcomes and retain nursing staff.
Conclusion
To benefit from the help of supportive personnel, it is vital to divide up the duties of care. There should be a clear separation between direct and indirect care and between personal time and irrelevant costs. In a neurological rehabilitation center in London, these characteristics were used to measure and quantify nurse care hours. Predicting workforce levels based on assignable tasks was done. Examples of indirect care activities include phone calls and documentation. Direct patient care includes monitoring vital signs, administering medications, and healing wounds as a healthcare practitioner. Employee evaluation, lunch breaks, professional development, and other non-work-related tasks can take personal time. For nurses, patient care is a priority, and most of the above actions can be transferred to other competent staff, freeing up the nurse’s time.
References
Carlisle, B., Perera, A., Stutzman, S. E., Brown-Cleere, S., Parwaiz, A., & Olson, D. M. (2020). Efficacy of using available data to examine nurse staffing ratios and quality of care metrics. The Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses, 52(2), 78–83. Web.
Cho, S.-H., Lee, J.-Y., You, S. J., Song, K. J., & Hong, K. J. (2020). Nurse staffing, nurse’s prioritization, missed care, quality of nursing care, and nurse outcomes. International Journal of Nursing Practice, 26(1), e12803. Web.
Juvé-Udina, M.-E., González-Samartino, M., López-Jiménez, M. M., Planas-Canals, M., Rodríguez-Fernández, H., Batuecas Duelt, I. J., Tapia-Pérez, M., Pons Prats, M., Jiménez-Martínez, E., Barberà Llorca, M. À., Asensio-Flores, S., Berbis-Morelló, C., Zuriguel-Pérez, E., Delgado-Hito, P., Rey Luque, Ó., Zabalegui, A., Fabrellas, N., & Adamuz, J. (2020). Acuity, nurse staffing and workforce, missed care and patient outcomes: A cluster-unit-level descriptive comparison. Journal of Nursing Management, 28(8), 2216–2229. Web.
Musy, S. N., Endrich, O., Leichtle, A. B., Griffiths, P., Nakas, C. T., & Simon, M. (2021). The association between nurse staffing and inpatient mortality: A shift-level retrospective longitudinal study. International Journal of Nursing Studies, 120(103950), 103950. Web.
Neves, T. M. A., Parreira, P. M. S. D., Rodrigues, V. J. L., & Graveto, J. M. G. N. (2021). Impact of safe nurse staffing on the quality of care in Portuguese public hospitals: A cross-sectional study. Journal of Nursing Management, 29(5), 1246–1255. Web.
Shin, S., Park, J. H., & Bae, S. H. (2018). Nurse staffing and nurse outcomes: A systematic review and meta-analysis. Nursing outlook, 66(3), 273–282. Web.
Smith, G. B., Redfern, O., Maruotti, A., Recio-Saucedo, A., Griffiths, P., & The Missed Care Study Group. (2020). The association between nurse staffing levels and a failure to respond to patients with deranged physiology: A retrospective observational study in the UK. Resuscitation, 149, 202–208. Web.
Wynendaele, H., Willems, R., & Trybou, J. (2019). Systematic review: Association between the patient–nurse ratio and nurse outcomes in acute care hospitals. Journal of Nursing Management, 27(5), 896–917. Web.