Introduction
Leadership relates to a multifaceted procedure of distinguishing a target or goal, inspiring other individuals to act, and offering motivation and support to attain mutually negotiated objectives. In nursing, this conception refers to the practice of managing initiatives that enhance better nursing operations and outcomes (Sfantou et al., 2017). Nurse leaders typically depend on their capacity to inspire and motivate nursing staff and teams in developing high-quality patient care procedures and practices. Leadership and management of healthcare experts are crucial in reinforcing care integration and quality; it improves and enhances healthcare frameworks’ efficiencies and efficacy.
On the other hand, healthcare informatics refers to the incorporation of cognitive, information, computer, and healthcare sciences to aid in the management of healthcare data. Lavin et al. (2015) identify nursing informatics as an informatics subset specific to the nurse’s specialty and duty within a healthcare setting. According to the ANA (American Nurses Association), nursing informatics relates to an academic and professional field that incorporates nursing, informatics, and computer science to convey and manage information, knowledge, and data in practice (Lavin et al., 2015). Nursing and healthcare informatics are growing disciplines within the field of medicine and are continually consolidating evolving and new technology. This paper highlights the role of leadership and informatics in influencing the nurse-to-patient ratio.
Leadership in Nursing
The nurse-to-patient ratio relates to the proportion of nurses on a specific floor, unit, or ward to the number of clients or patients. It refers to the number of nurses allocated to offer care to a patient within a healthcare setting. The higher the expected care acuity, the lower the nurse-to-patient ratio. For instance, according to Sfantou et al. (2017), the typical proportion within the medical-surgical section is 1:6 and for an ICU is 1:2. However, this limit varies as per the hospital setting. For example, the nurse-to-patient ratio within an operating room cannot exceed a single nurse for each patient, whereas a nurse can have up to six patients in a psychiatric ward. Sfantou et al. (2017) further link low nurse-to-patient proportions with a significant reduction in the quality of care provided by workers in a healthcare facility and a surge in care complications.
There is an interconnection between nursing leadership and the nurse-to-patient ratio. Nurse leaders should employ strategies that aim to ensure that their organizations have the appropriate number of staff members to offer quality care to patients. To do so, they typically advocate for the needs of nurses through endorsing a change in policies and appropriate nurse staffing within the healthcare setting. In the nursing field, advocacy refers to an approach that aims to conserve human dignity, provide freedom from pain or suffering, and promote patient equity. Nurse leaders act as information-flow managers and frontline innovators who provide team leadership at care points to enhance better patient outcomes, attain cost savings, and increase satisfaction.
Other strategies nurse leaders can employ to ensure healthcare settings maintain proper nurse-to-patient ratios include:
Developing a formal nurse staffing program: Sfantou et al. (2017) argue that rigid or inflexible nurse-to-patient proportions may not be the most appropriate solution for a healthcare facility and endorses the implementation of a formal staffing plan. According to Sfantou et al. (2017), this approach ensures that patients are cared for by the nursing team with the recommended expertise. A staffing plan is a shift- and unit-specific scheduling methodology that reinforces care standardization in every department. By developing an appropriate staffing strategy, healthcare institutions can ensure that staffing decisions resolve the most typical aspects, such as nurse-to-patient ratios, nurses’ skill level, hospitalization rate, and patient acuity. Nurse leaders should also involve direct-care nurses when developing the plan since they are on the frontline of care delivery. These experts can identify issues related to scheduling and make recommendations for improved procedures.
Minimizing turnover rates by addressing rudimentary causes: Increased turnover incidences can be instrumental in affecting proper staffing and the recommended nurse-to-patient ratio. To address the above-mentioned issue, nurse leaders may consider the following approaches:
- Restricting mandatory overtime
- Delegating paperwork related tasks to other competent staff
- Adopting up-to-date technologies to foster better workflow
- Advocate for the provision of competitive compensation rates commensurate with nurses’ experience
Advocate for the development of a staffing committee: According to Sfantou et al. (2017), a staffing committee allows healthcare settings to adopt a coordinated nurse staffing approach. The staffing commission typically offers input regarding the scheduling of processes, staffing policies and guarantees that these standards are congruent across a particular department or the entire healthcare facility. Implementing a set of guidelines within the institution helps reduce the possibility of an insecure nurse-to-patient proportion.
Technology and Informatics
Technology and informatics can help address the issue of the low nurse-to-patient ratio by providing informed I.T-based solutions that reinforce the evidence-based staffing of nurses. According to Lavin et al. (2015), information technology can help address challenges and issues related to inadequate staffing and low nurse-to-patient proportions through the following processes:
- Information acquisition from several sources of data.
- Data presentation in user-configurable and standardized configurable approaches.
- Sophisticated information mining and processing.
Acquisition of Information from Several Data Sources
Health-related data is currently captured electronically from various sources, and it could be utilized to apprise staffing decisions. Multiple healthcare settings monitor patient flow with regard to transfers, discharges, and admissions electronically. Technology that supports the utilization of the identification badges of staff members as locators via infrared signals is also available. Beds and patients can also be discerned using bar-coding technology and radio frequency identification. Combined with the call light technique, these innovations have the prospective to capture the period a patient demands care, the time to respond and assign a call, the period taken before the cancellation of the call by a nurse, and the call type. Bar-code technology is also being utilized in drug administration and EHRs for nursing documentation. Data from these technologies can help highlight nurse workload, nursing care demand, and possible delays in care provision. Integrated together, this detailed information may encapsulate the real-time demand for nursing services, the available supply of qualified nurses, and the care quality being provided in a particular setting. The above-mentioned aspects are essential components of informed staffing.
Sophisticated Information Mining and Processing
Advanced data mining and data processing approaches that can be implemented to reinforce evidence-based decisions related to nursing staffing are currently being developed. Knowledge evaluation in databases can be performed using several approaches, for instance, NLP (natural language processing) and statistical methodologies. This approach helps to ascertain the deficiencies in the required workforce skills, which consequently impacts nurse-to-patient proportions.
Data Presentation in User-Configurable and Standardized Approaches
Decision support systems are currently being utilized for evidence-based healthcare-related management decisions. This approach facilitates the re-use of accessible information and averts redundant entry of data. Its effective use demands extensive knowledge regarding information technology and clinical nursing administration. Using automated operational data for developing dashboards is an integral approach that enhances proper staffing and addresses low nurse-to-patient ratios. These dashboards can integrate resource utilization and clinical outcome indicators. For instance, web-based actual-time dashboards allow for prototyping or benchmarking strategic functional or operational information such as demands of nurse staffing, credentialing requirements, and quality indicators. Web-based scheduling and staffing systems are among the recent technologies being used to enhance communication among staff nurses and nurse leaders regarding their willingness to work, as well as scheduling availability and needs. Web 1.0 innovations are used to implement web-based staffing and dashboards.
How the Two Concepts Impact Nurses Need to Use High-Level Clinical Judgment
Technology and informatics impact nurses’ need to utilize a high level of clinical judgment by improving processes. The above-mentioned innovation facilitates the gathering, evaluating, and leveraging of health-related data. This, in turn, allows professionals to utilize this data to improve processes, distinguish at-risk patients, advance research, and enhance efficiency in fostering better procedures, including staffing choices, purchasing decisions, scheduling protocols, and clinical operations.
Nursing informatics affects nurses’ capacity to distinguish at-risk patients. To enhance better clinical outcomes, identifying issues sooner than later is essential; however, this may be challenging for several reasons, such as scheduling conflicts. Big data may help facilitate this procedure by providing doctors with a head start in addressing diseases that could be deadly if untreated for an extended period. Technologies such as disease registries can be used to discern at-risk clients. This innovation consists of biometric, pharmacy, and claims data, which helps practitioners ascertain populaces that may be susceptible to specific conditions and unmet clinical needs.
Nursing informatics also enhances efficiency in operations by minimizing procedures and practices.
On the other hand, nursing leadership, particularly transformational management, triggers decreased medication errors, fewer incidences of hospital-acquired infections, and low mortality rates among patients. According to Sfantou et al. (2017), this administrative approach allows patients to receive improved treatment and care, allowing them to survive their misery or ordeal. Collaborative and transformational leadership have also been linked to improved patient satisfaction rates. Appropriate nursing leadership enforces the aspect of individual consideration by allowing nurse leaders to listen to workers’ demands and offer adequate support (Sfantou et al., 2017). Effective leadership also allows nurse leaders to articulate a common vision that encourages nurses to exceed expectations. Furthermore, this concept fosters a nurse leader’s capacity to model nurses’ ethical behavior within the organization, consequently minimizing legal claims.
Emerging Healthcare Initiatives Surrounding the Two Concepts
Nurse leadership plays an instrumental role in sustaining nursing services’ cost-effectiveness, production, and efficiency. This concept is also crucial in empowering nursing while offering care; it offers guidance and support to both healthcare teams and patients. Leadership in nursing is also critical in improving care offered to patients and this, in turn, enhances better patient outcomes. Moreover, it impacts the quality and safety of provided care (Sfantou et al., 2017). Nurse leaders typically prioritize patients’ safety when implementing nursing care approaches, for instance, patient education, infection control, wound care, and medication management.
On the other hand, informatics and technology promote the improved alignment of nursing best practices with clinical care and workflows. Nursing informaticists are usually involved in reviewing clinical workflows, developing new treatment plans, diagnostic approaches, and designing processes. They integrate various care delivery approaches and utilize objective analysis and facts to identify actions that promote value-based and patient-centered care.
This concept also leads to significant improvements in clinical procedures, processes, protocols, and policies. Relevant data can be utilized to compute the success of different procedures, processes, and protocols used in healthcare organizations.
The above-mentioned conception also enhances reductions in medical costs and errors and learning and training based on objective information.
How to Advance Workplace Communication
The following strategies can be employed to advance workplace communication:
The ISBAR handover framework is a standardized communication approach that can be utilized by nurses in healthcare settings to enhance communication. This tool typically structures a conversation into critical aspects during data transfer from a single source to the other. ISBAR helps nurses to develop easy and focused communication in care transition during handover.
Safety huddles refer to a brief interdisciplinary briefing, convoked at a predictable place and period, and centered on at-risk patients. According to Wang et al. (2018), safety huddles encompass agreed actions, are apprised by visual data feedback, and enhance harm reduction. They aid in reinforcing teamwork, improving better patient encounters, and preventing harm.
Bedside reports relate to the change-of-shift records between oncoming and off-going nurses, which occurs at the bedside. Benefits associated with bedside reporting include high patient involvement, better communication, improved comprehension of care, reduced family and patient anxiety, increased nurse accountability, improved teamwork, and interrelationship among nurses, and decreased possibility of errors.
Conclusion
Leadership is the behavior of coordinating and directing the operations or activities of a group of individuals or teams towards a common objective. Informatics in nursing refers to an academic and professional field that incorporates nursing, informatics, and computer science to convey and manage information, knowledge, and data in practice. Nurse leaders advocate for the needs of nurses and employ strategies that aim to address proper staffing. Technology and informatics can help address the issue of poor nurse-to-patient ratios by providing informed I.T-based solutions that reinforce nurses’ evidence-based staffing. Workplace communication can be enhanced by implementing the ISBAR handover approach, safety huddles, and bedside reports.
References
Lavin, M., Harper, E., & Barr, N. (2015). Health information technology, patient safety, and professional nursing care documentation in acute care settings. The Online Journal of Issues in Nursing, 20(2), 1–10. Web.
Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki- Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of leadership style towards quality of care measures in healthcare settings: A systematic review. Healthcare (Basel), 5(4), 1–17. Web.
Wang, Y., Wan, Q., Lin, F., Zhou, W., & Shanga, S. (2018). Interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review. International Journal of Nursing Science, 5(1), 81–88. Web.