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Nursing Understaffing: Research Critiques

The problem of the lack of qualified nursing staff in clinical work is an urgent issue that is often raised. Based on the results of the previous studies and reviews, this gap poses a threat to patient safety and reduces care outcomes due to the inability to provide comprehensive medical care. To address this problem and create the necessary conditions for the productive activities of personnel, an evidence-based practice change may be developed and proposed. As a rationale, existing findings from scholarly journals will be utilized. The implementation of the plan is an objective measure aimed at expanding the number of nursing staff in hospital departments and helping to reduce stress and burnout among staff, as well as increase patient safety.

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Background of the Evidence-Based Practice Change

When analyzing available academic sources, one can note that the problem of imbalance in the nurse-patient ratio is acute. The proposed PICO question considers the possibility of hiring more employees per room as more effective than the strategy of hiring LPN staff exclusively. This proposal is justified because, according to Falk and Wallin (2016), who assess the implications of the shortage of nursing staff in intensive care units, the lack of employees affects care quality negatively. Nursing practice is difficult and tedious, particularly when dealing with severe cases, for instance, in oncology or emergency departments. Consequently, expanding staff may help to distribute responsibility among employees and provide them with more opportunities to pay attention to each patient. As Gardenier, Sosnowski, and Apold (2017) note in their qualitative study, the issue of personnel shortage should be addressed at the national level, and relevant legislation is to regulate specific ratios. Accordingly, the goal of this practical intervention is to look for opportunities to increase the number of junior medical staff to improve patient safety and the quality of care provided.

Steps of the Evidence-Based Practice Change

To determine the relevance of implementing a plan for expanding nursing personnel in a particular medical unit, first, it is essential to assess the current ratio and determine the load on staff. In case the number of employees is significantly lower than the required norm, this will be an occasion to engage additional specialists. The next step is to find employees with basic nursing education who would be ready to start working. Since the intervention involves staffing at the expense of nurses without degrees, this activity is unlikely to be problematic. The main emphasis is to be placed on increasing the number of personnel per room to reduce the burden on individual employees and distribute responsibilities more equitably.

Next, it is essential to determine a list of stakeholders whose opinions will be taken into account when evaluating the results of the intervention. As interested parties, employees, the management of the department and the clinic, as well as patients and their families, will be applied. The interpretation of the results of the intervention will be conducted based on staff feedbacks on changes in the mode of operation and their satisfaction with the new conditions. Also, patient opinions will be reviewed to obtain a comprehensive picture of the productivity of the change plan. In case the program proves its effectiveness, its results may be disseminated to the medical community as a relevant strategy that can help improve patient safety and reduce the burden on nursing staff.


The implementation of the evidence-based practice change aimed at balancing the nurse-patient ratio is an urgent measure in the context of a shortage of nurses. This intervention can improve patient safety and reduce the burden on nurses. The plan can be implemented in several stages with a preliminary assessment, intervention, and subsequent analysis of the results. In the case of improved care outcomes, the results may be disseminated as a valuable guideline among the medical community.


Falk, A., & Wallin, E. (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. Web.

Gardenier, D., Sosnowski, B., & Apold, S. (2017). Should there be laws mandating nurse practitioner/patient ratios? The Journal for Nurse Practitioners, 13(7), 460-461. Web.

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