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Issue of Nursing Personnel Understaffing in Hospitals and Ways to Improve It

Project Summary


The capstone project’s focus is on the issue of nursing personnel understaffing in hospitals and ways to improve it. Staffing describes the number of people employed in a particular establishment. The number of nurses employed and the number of patients in a hospital is taken into consideration when evaluating the metric. The problem of the insufficient amount of medical staff occurs in the US, Europe, and Asia. Aiken et al. (2014) state that the lack of professionals can be connected to the policy of cutting costs by decreasing the number of people employed. However, an essential aspect of these difficulties is the high turnover rate, which is caused by inadequate work conditions.

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Problem Statement

The main issue presented by low staffing in hospitals is the quality of service and its impact on patient outcomes. According to studies by Cho et al. (2015) and Aiken et al. (2014), the nurse-to-patient ratio can influence mortality rates in a healthcare establishment. Moreover, an insufficient amount of nurses can lead to complications during treatments (McHugh, Berez, & Small, 2013; Rogowski et al., 2013). Both infection and readmission rates increase when hospitals do not have enough staff members. Additionally, the factor influences communication quality between the professional and the patient and increases the number of medical errors due to the need to make decisions quickly. Thus, the problem of understaffing is affecting many aspects of the quality of health care provided by an establishment.

Burnout is the primary cause of insufficient staffing rates in US hospitals. The problem presents issues with patient outcomes, as nurses who are affected by burnout, maybe less productive. One way to overcome the factor for medical employees is to increase job satisfaction levels (Van den Heede et al., 2013). The change in the work environment can be carried out by offering excellent employment value propositions (EVPs). Therefore, providing additional benefits to nursing professionals will help increase their motivation and overcome burnout consequences.

Purpose of the Change Proposal

The primary objective of the change proposal is to enhance retention rates among nursing staff in the US. For it, a variety of methods can be tested to determine their effectiveness. This project offers an intervention by examining the efficiency of the proposed solutions. The objective is to identify whether burnout management techniques provided onsite in a hospital setting can help reduce the nurse turnover ratio. The focus is on the issue of burnout as other approaches (such as improving recruitment rates and work conditions) are valid long-term solutions. However, they do not address the adverse effects of a stressful environment, which can cause depression, loss of appetite, and issues with sleep. Therefore, the purpose of the proposal is to determine whether methods that help reduce burnout can be utilized for managing the understaffing problems of a hospital.


The PICOT question summarizes the issue and the purpose of the project. It involves investigating the intervention in a healthcare setting for twelve months. In particular, the question refers to research in intensive care unit nurses as they often work in stressful conditions. The proposed methods are meditation, writing workshops, relaxing massages. A comparison is made between standard burnout management techniques and the proposed approach.

Literature Search Strategy Employed

The primary strategy for the literature search employed for this project focused on examining peer-reviewed articles to find an evidence-based solution to the understaffing issue. The aim was to find productive retention strategies for healthcare organizations. Additionally, works that offer methods for increasing job satisfaction levels were examined. Firstly, the importance of nurse to patient ratio was researched to determine what influence an insufficient number of personnel has on the quality of care.

Then, the primary causes of high turnover rates were reviewed to gain an understanding of which aspects should be addressed in the project. An essential element of the question is the influence of the issue on the mental health of nursing professionals. A small number of studies that focused on interventions were found. Furthermore, the majority of the examined literature stated that are various limitations to their conclusions. The researches do not show the full state of things due to limited population analysis. Moreover, it is not clear whether the studies can be applied in developing nations successfully. More studies that are conducted on larger sample sizes and with consideration of cultural differences are required to gain a full understanding of the problem.

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Evaluation of the literature

An evaluation of the literature was performed utilizing a specified table. Two articles study the relationship between understaffing and patient health outcomes (Falk & Wallin, 2016; Glette, Aase, & Wiig, 2017). Both conclude that the issues have adverse effects on the health of nurses and patients. An article by Hassan (2015) investigates the burnout of nurses who work in pediatrics. The author states that patient safety is compromised when medical professionals experience burnout. According to Henry (2014), exhaustion can be beneficial for oncology nurses; however, the author uncovered no other evidence that supports this claim. Other articles evaluated in this section confirmed the findings. The studies utilized different methods (literature analysis, meta-analysis, retrospective, and descriptive study). Overall, the researchers concluded that nursing burnout and understaffing affect the quality of performance. Additionally, a large number of nursing professionals experience burnout, which is associated with years of experience. Interventions can be utilized to battle the adverse effects of exhaustion.


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

Cho, E., Sloane, D. M., Kim, E. Y., Kim, S., Choi, M., Yoo, I. Y.,… Aiken, L. H. (2015). Effects of nurse staffing, work environments, and education on patient mortality: An observational study. International Journal of Nursing Studies, 52(2), 535-542.

Falk, A. C., & Wallin, E. M. (2016). Quality of patient care in the critical care unit in relation to nurse patient ratio: A descriptive study. Intensive and Critical Care Nursing, 35, 74-79.

Glette, M. K., Aase, K., & Wiig, S. (2017). The relationship between understaffing of nurses and patient safety in hospitals—A literature review with thematic analysis. Open Journal of Nursing, 7(12), 1387-1429.

Hassan, M. B. (2015). Assessment of pediatric nurses’ burnout in Al-Najaf Al-Ashraf city. International Journal of Scientific and Research Publications, 5(10), 732-735.

Henry, B. J. (2014). Nursing burnout interventions: What is being done? Clinical Journal of Oncology Nursing, 18(2), 211-214.

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McHugh, M. D., Berez, J., & Small, D. S. (2013). Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing. Health Affairs, 32(10), 1740-1747.

Rogowski, J. A., Staiger, D., Patrick, T., Horbar, J., Kenny, M., & Lake, E. T. (2013). Nurse staffing and NICU infection rates. JAMA Pediatrics, 167(5), 444-450.

Van den Heede, K., Florquin, M., Bruyneel, L., Aiken, L., Diya, L., Lesaffre, E., & Sermeus, W. (2013). Effective strategies for nurse retention in acute hospitals: A mixed method study. International Journal of Nursing Studies, 50(2), 185-194.

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