Nurse understaffing is a complex issue that has a direct influence on patient safety and the consequent adverse events that occur in hospitals. Since there is a correlation between nurse understaffing and poor patient outcomes, there is a need to address the issue as soon as possible. Studies conducted on this topic across different countries showed that in cases of understaffing, multiple treatment errors could occur, including medication mistakes (Kohn, Corrigan, & Donaldson, 2000). These mistakes can lead to further complications and the occurrence of co-morbidities, which will then be treated thus increasing nurses’ workload (Glette, Aase, & Wiig, 2017). Thus, the problem is persistent and cannot be ignored any longer.
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The hospital setting is the most likely environment in which nurse understaffing prevails. Because of this problem, hospitals can experience high rates of patient mortality, overall complications, and co-morbidities such as pressure ulcers, falls, urinary tract infections, and other conditions (Everhart, Neff, Al-Amin, Nogle, & Weech-Maldonado, 2015). In settings where there are not enough professionals to tend to patients, risks of low hospital ratings due to dissatisfaction increase.
Poor hospital management and shortages in available personnel have been identified as the most likely reasons for nurse understaffing. Because of this, researchers have underlined the need for appropriate workload intensity management frameworks as well as models that will increase the amount of educated and skilled nurses who will be hired to work in hospitals. For instance, researchers have proposed a workload management system that defined different diagnoses and connected specific activities linked to those diagnoses. A nursing time per day for each diagnosis can be identified to optimize each process.
The development of a model to optimize nurses’ times for each activity is needed because of the adverse impact of nurse understaffing. According to the study conducted by Twigg, Gelder, and Myers (2015), “for each of the nurse-sensitive outcomes, there was an increase in prevalence for those who were exposed to an understaffed shift, with all ratios being greater than one” (p. 1). Therefore, low nurse staffing levels can influence such factors as patient factors, ward factors, and nursing staff factors (Driscoll et al., 2017). The inability of nurses to provide sufficient care makes it harder for professionals to guarantee recovery and overcome potential health risks.
The problem is significant because of the direct influence on the quality of patients’ lives and the likelihood of their recovery. Patient safety is at risk when nurses do not have time to provide care and address any emerging issues. He, Staggs, Bergquist-Beringer, and Dunton (2016) hypothesized that the increased levels of staffing could contribute to the reduction of such adverse outcomes as falls, pressure ulcers, and other consequences. The increase in nurse staffing levels should be supplemented with increased education and the improved work environment that meets the increasing needs of professionals (Buchan, Seccombe, Gershlick, & Charlesworth, 2017). In addition, such technologies as big data can help hospitals increase their effectiveness and optimize existing processes.
To solve the problem of nurse understaffing, a systematic approach is needed (Bradley et al., 2015). The first step is completing a measurement of the workload by identifying the hours required for addressing each health problem. Second, the better education of nurses will allow nurses to become more knowledgeable and effective in responding to patients’ needs. Third, a comprehensive software system integrated into the workflow will enhance time management. Fourth, raising awareness of the problem is necessary to attract students to the nursing profession and increase the number of nurses in hospitals.
Bradley, S., Kamwendo, F., Chipeta, E., Chimwaza, W., de Pinho, H., & McAuliffe, E. (2015). Too few staff, too many patients: A qualitative study of the impact on obstetric care providers and on quality of care in Malawi. BMC Pregnancy and Childbirth, 15, 65.
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Buchan, J., Seccombe, I., Gershlick, B., & Charlesworth, A. (2017). In short supply: Pay policy and nurse numbers. London, UK: The Health Foundation.
Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., … Astin, F. (2017). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 17(1), 6-22.
Everhart, D., Neff, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2013). The effects of nurse staffing on hospital financial performance: Competitive versus less competitive markets. Health Care Management Review, 38(2), 146155.
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, 1387-1429.
He, J., Staggs, V. S., Bergquist-Beringer, S., & Dunton, N. (2016). Nurse staffing and patient outcomes: A longitudinal study on trend and seasonality. BMC Nursing, 15(60), 1-10.
Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academies Press.
Twigg, D. E., Gelder, L., & Myers, H. (2015). The impact of understaffed shifts on nurse-sensitive outcomes. Journal of Advanced Nursing, 71(7), 1-7.