Nurse-to-Patient Ratios: A PICOT Statement

Nurse staffing ratios have become a crucial concern in recent years. Numerous institutions have reported the decrease in nursing professionals’ numbers, arguing that inadequate staffing significantly reduces the quality of care for the patients (Falk & Wallin, 2016). In addition, the nursing personnel often encounter the negative consequences of unsafe staffing, namely increased workload and stress, which lead to higher burnout and shortage rates (Wynendaele et al., 2019). From this perspective, it is crucial to uphold particular nurse-to-patient ratios, ensuring that the clients receive the best possible care and protecting the nurses from the adverse ramifications of understaffing. The current paper discusses a Population Intervention Comparison Outcome and Time (PICOT) statement that encompasses the described problem of safe nurse staffing ratios, developing an approach for researching this issue.

PICOT Statement

  • Population: staff nurses.
  • Intervention: mandatory policies securing adequate nurse-to-patient ratios.
  • Comparison: industrial engineering staffing methods.
  • Outcome: improvement of the patient’s length of stay.
  • Time: one year.

Given the negative consequences of inadequate nurse staffing levels, the current PICOT focuses on practicing nurses. Nurse demographics can vary significantly across populations, including individuals of different ages, races, genders, and other characteristics. However, it appears that inappropriate nurse-to-patient ratios equally affect distinct nursing communities, resulting in the emergence of workplace pressure, anxiety, and decreased performance (Wynendaele et al., 2019). As such, nurses occupying different positions have been shown to exhibit signs of exhaustion and burnout due to unsafe staffing levels, which adversely affects the quality of care and decreases the patients’ possibility of attaining successful treatment outcomes (Shin et al., 2018). In the long term, nursing personnel can demonstrate symptoms of diminished physical and mental health, meaning that it is crucial to ensure the presence of appropriate nurse-to-patient ratios.

The incorporation of mandatory staffing levels is one of the prominent evidence-based practices aimed at upholding an appropriate number of nurses in the hospital. Recent research suggests that local institution policies that regulate the nurse-to-patient ratios are highly beneficial for maintaining high levels of nurses’ job satisfaction, morale, and well-being (Griffiths et al., 2020). These innovations have also been reported to account for decreased patient mortality, drastically improving the quality of care (Griffiths et al., 2016). Furthermore, mandatory ratios are highly corroborated by the law, as they ensure that the nursing professionals are working under safe conditions. Numerous health policies introduced by the government and the American Nursing Association (ANA) advocate for the installment of obligatory measures that control the staffing levels (ANA, n.d.). In this regard, regulating the nurse-to-patient ratios is not only beneficial for supporting health care equity for the nursing personnel but is also highly supported by institutional legislation.

The practice of mandatory policies has been debated by researchers and lawmakers. A small sample of previous studies suggests that incorporating obligatory staffing ratios does not affect the nurses’ job satisfaction levels and barely influences the working conditions (ANA, 2019). Nevertheless, a much larger scope of research demonstrates that mandatory policies can benefit nursing personnel when introduced together with workforce planning systems and appropriate measurement tools (International Council of Nurses, 2019). From this perspective, it becomes possible to determine the perfect staffing requirements, avoiding the use of industrial engineering practices. Although IE activities were previously employed by health care executives, research has shown that these interventions are less efficient in the hospital setting (Qureshi et al., 2019). in comparison, mandatory policies can be highly more productive.

The expected outcome is to improve the patients’ quality of care, ensuring that the individuals are offered the best services during their length of stay. Adequate nurse-to-patient ratios allow the nursing professionals to efficiently distribute their resources and carefully attend to each patient. in the long term, these changes account for the enhancement of health care standards, resulting in the improvement of patient treatment outcomes (Shin et al., 2018). However, to achieve positive results, mandatory policies must be introduced based on credible data about the medical organization and the current staffing levels (Falk & Wallin, 2016). Therefore, it is proposed that one year will be required to fully incorporate the obligatory nurse-to-patient ratios and yield the necessary outcomes.

To support how else management for the nursing personnel discretional to consider the social determinants of health for this population. Recent advancements in nursing science suggest that a variety of data about the nursing community should be considered when applying a specific intervention (Griffiths et al., 2016). Thus, the proposed intervention will be based on the contemporary credible findings from nursing science, applying the epidemiologic genomic and genetic data two develop a mandatory policy that can improve the nurses’ well-being and ensure that the population’s health is protected.

To conclude, the present paper summarizes the PICOT statement for improving the nurse staffing levels, suggesting that the introduction of obligatory nurse-to-patient ratios could highly benefit the welfare of this population. The target of the current intervention is the nursing personnel, which have been reported to become negatively affected by inadequate staffing levels, leading to adverse consequences impacting their physical and mental health. However, mandatory policies might significantly improve the current situation, establishing staff ratios that account for the numbers of nurses available and the patients that require treatment. In comparison with IE strategies, this method is more specific to the healthcare environment and allows for yielding advantageous results.

References

ANA. (n.d.). Nurse staffing.

ANA. (2019). Safe staffing literature review. Web.

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.

Griffiths, P., Ball, J., Drennan, J., Dall’Ora, C., Jones, J., Maruotti, A., Pope, C., Recio Saucedo, A., & Simon, M. (2016). Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development. International Journal of Nursing Studies, 63, 213–225.

Griffiths, P., Saville, C., Ball, J., Jones, J., Pattison, N., & Monks, T. (2020). Nursing workload, nurse staffing methodologies and tools: A systematic scoping review and discussion. International Journal of Nursing Studies, 103.

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.

Qureshi, S. M., Purdy, N., Mohani, A., & Neumann, W. P. (2019). Predicting the effect of nurse-patient ratio on nurse workload and care quality using discrete event simulation. Journal of Nursing Management, 27(5), 971–980.

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.

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