Safe Nurse Patient Ratios and Acuity Based Staffing Paper

Nurse shortages and unfavorable nurse-patient ratios are among the challenges facing current global healthcare systems. Professional nurses operate in understaffed departments, a factor that compromises their ability to provide quality care and satisfy ever-changing patient expectations. Many health organizations consider implementing minimum nurse-to-patient ratio policies and acuity-based staffing despite the need to address such challenges. Consequently, this paper summarizes scholarly articles that ascertain the importance of nurse-patient ratio policies and acuity-based staffing for addressing nursing shortages and averting problems such as increased workload and burnout.

Safe Nurse Patient Ratios and Acuity Based Staffing Paper

Annotated Bibliography

(Original work published 1769)

“We then that are strong ought to bear the infirmities of the weak, and not to please ourselves” (King James Bible, 1769/2019, Romans 15:1). This verse presents the importance of bearing other people’s pain and being selfless when caring for the weak. Although the verse does not expound on the term “weak,” it is possible to include patients in this category since they require social, medical, psychological, emotional, and spiritual support to recover and revert to their senses of heath and wellness. As a result, this verse provides selflessness as a fundamental principle that enables people to extend love, care, and emphasize with others.

Undoubtedly, the spiritual worldview of nursing practice endorses love, impartiality, selflessness, and compassion as essentials for alleviating other people’s problems and suffering. When considering the importance of the biblical teachings in current healthcare systems, it is valid to argue that this verse is among scriptures that elaborate on God’s commands to humanity. Therefore, it is useful, credible, and applicable in the current healthcare systems.

In this study, Juvé-Udina et al. (2020) embrace a descriptive research design to compare patient acuity, nursing staffing and workforce, missed nursing care, and patient outcomes in hospital settings. The authors define patient acuity as the intensity of care registered nurses (RNs) provide to meet patients’ safety needs. The researchers consider variables such as staffing networks and patient outcomes.

In this sense, they uphold the importance of staffing planning and sufficient resources for addressing patient acuity. Further, Juvé-Udina et al. (2020 Safe Nurse Patient Ratios and Acuity Based Staffing Paper) conclude that nursing managers play a significant role in pressuring policymakers to address organizational understaffing in general wards to maximize patient safety outcomes and address patient acuity.

Research findings from this study represent the overall situation in healthcare institutions struggling with understaffed departments, nurse burnout, and turnover. Researchers are credible, considering their experiences in various healthcare institutions in Spain. Further, the article provides current and reliable contentions that impact knowledge on the topic.

In this scholarly study, Griffiths et al. (2018) provide findings from a systematic review of quantitative studies regarding staffing and missed care relationships. The authors reviewed journals from reputable sources such as Cochrane Library, CINAHL, Embase, and Medline. They acknowledge that low nurse staffing levels lead to adverse outcomes in hospitals, including increased mortality rates. They conclude that missed care is a profound determinant of nursing staffing adequacy where understaffed nursing departments struggle to meet care quality thresholds.

This study is relevant to the topic since it explains the relationships between nursing staffing adequacy and improved care outcomes. Also, it provides the effects of operating in understaffed nursing departments on patient safety and quality of care. Further, researchers are credible considering their experiences in various faculties in health sciences across different universities in the United Kingdom. Finally, the article is current and peer-reviewed, meaning it has a high internal and external validity level.

McHugh et al. (2021) conducted a prospective panel study to assess the effects of nurse-to-patient ratio policy on staffing levels and patient outcomes. The researchers compared 27 Queensland hospitals with ratio policy and 28 hospitals without nurse-patient ratio policies. The researchers acknowledge that patient outcomes are more favorable in hospitals with better nurse staffing. One of the approaches to realizing better nurse staffing is setting minimum nurse-to-patient ratio mandates.

The researchers reveal that having enough nurses with manageable workloads leads to quality care and improved patient outcomes. Therefore, minimum nurse-to-patient ratio policies are a plausible instrument for improving nursing staffing, producing positive patient outcomes, and assuring return on investment.

This study effectively impacts the topic of safe nurse-patient ratios and acuity-based staffing since it elaborates on the synergies between nurse-patient ratio policies and improved patient outcomes. Also, the research has a high internal and external validity level since researchers rely on data from hospital comparisons to make an informed conclusion.

In this scholarly study, the researchers conducted a systematic literature review using PubMed, Embase, and CINAHL to summarize current evidence on the relationship between patient-nurse ratio staffing method and nurse employee outcomes. The researchers acknowledge global healthcare systems’ challenges, including increased pressure on healthcare expenditure and rising patient expectations.

For instance, current healthcare systems face the need to address challenges such as nursing shortages, workplace stress, financial constraints, and overburdened nurses to fulfill thresholds for quality care. The researchers conclude that various scholarly studies confirm a relationship between the patient-nurse ratio and specific staff-related outcomes.

This study is relevant to the topic since it explains the synergies between the patient-nurse ratio and other variables such as staff-related outcomes, skill mix, and work environment. Herlinde Wynendaele, one of the contributors to this study, is an experienced researcher of the Department of Public Health at Ghent University, Belgium. Therefore, researchers are well-versed in the healthcare sector. Above all, this article is current, peer-reviewed, and logical.

Qureshi et al. (2019) conducted a discrete event simulation to predict the effects of varying nurse-patient ratios to nurse workload and care quality. The researcher contends that hospital managers face a daunting challenge of quantifying the impacts of changing operational policy and technical designs, including nurse-to-patient ratios, on nurse workload and the overall quality of care.

As a result, proper preparedness and planning tools are fundamental in averting uncertainties emanating from changing operational policies such as altering patient-nurse ratios. The researchers conclude that discrete event simulation (DES) can inform active policies and technical design decisions for promoting care quality and reducing nurse workload.

This research article is crucial to the topic since it validates the importance of effective planning and preparedness when altering the operational system to promote quality of care. For instance, embracing a minimum patient-to-nurse ratio will require hospital managers to assemble necessary resources for proper staffing and quantify the impacts of new strategies in reducing nurse workload and promoting care quality.

The researchers scanned literature from peer-reviewed articles and case study reports to overview safe staffing policies in various high-income countries in this research journal. Also, they aimed at identifying reform trends in response to recurring nurse workforce challenges. Safe staffing policies in developed countries include varied aspects such as increasing transparency about staffing decisions, meeting required nurse staff levels based on acuity measurement, and maintaining patient-to-nurse ratio policies. The researchers conclude that safe staffing policies are a practical tool in tackling challenges such as the aging population and nursing shortages amidst the complexities surrounding quality care delivery.

While the researchers recommend safe staffing policies for addressing nursing shortages and other challenges facing global health systems, they present relationships between these policies and variables such as nursing work environment, patient-nurse relationships, and leadership styles. Therefore, this article is relevant to the topic since it elaborates on factors of consideration when embracing safe staffing policies for promoting patient safety and enhancing the quality of care.

In this article, Welton (2017) provides expert opinions on various factors for consideration when measuring acuity and their implications for nurse staffing and assignment. The author contends that hospital managers rely on night shifts to identify staffing needs. However, he describes this approach as flawed since it fails to account for nursing staff shortages during the day. Therefore, he recommends healthcare organizations consider acuity for each patient and the overall acuity mix in an inpatient unit when determining staffing policies to avert the effects of too little and too much care intensity.

This article is relevant to the topic since it validates the importance of measuring acuity for nursing staff and patient-to-nurse assignments to settle on good care intensity. John M. Welton, the author, is a professor at the College of Nursing, University of Colorado, Aurora, meaning he is familiar with current trends in acuity measurement. He provides holistic, valid, and comprehensive contentions the impact knowledge to the topic.

The author presents a case study of Mis Emilie Ricard, a young Canadian nurse who went viral after posting a picture of herself in tears due to nursing shortages at her workplace. Ricard’s case exposed the Canadian healthcare system’s real-life challenges, especially understaffed departments, increased nurse workloads, and burnout. Trueland (2017) compares the situation in a Canadian hospital with various American states to recommend possible response interventions for addressing nursing shortages, workplace stressors, and burnout. As a result, she settles on the Californian model, which encourages legally mandated ratios across all clinical settings.

Although Trueland (2017) presents various challenges of implementing mandated minimum nurse-to-patient ratios, she favors such policies for addressing nurse shortages, burnout, and workplace stress. This study is relevant to the topic since it reflects on a real-life case study of a stressed, exhausted nurse. Therefore, its conclusion relate to the determination of addressing nursing shortages, exhaustion, and burnout. As a freelance health journalist, Jennifer Trueland is well-versed in matters regarding healthcare policies.

Safe Nurse Patient Ratios and Acuity Based Staffing Paper References

  • Griffiths, P., Recio-Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., & Meredith, P. et al. (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal Of Advanced Nursing74(7), 1474-1487.
  • Juvé‐Udina, M., González‐Samartino, M., López‐Jiménez, M., Planas‐Canals, M., Rodríguez‐Fernández, H., & Batuecas Duelt, I. et al. (2020). Acuity, nurse staffing and workforce, missed care and patient outcomes: A cluster‐unit‐level descriptive comparison. Journal Of Nursing Management28(8), 2216-2229.
  • King James Bible. (2017). King James Bible Online.  (Original work published 1769)
  • McHugh, M., Aiken, L., Sloane, D., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals. The Lancet397(10288), 1905-1913.
  • Qureshi, S., Purdy, N., Mohani, A., & Neumann, W. (2019). Predicting the effect of nurse-patient ratio on nurse workload and care quality using discrete event simulation. Journal Of Nursing Management27(5), 971-980.
  • Trueland, J. (2018). How a social media post started a safe staffing revolution: a safe staffing revolution. Nursing Standard33(5), 32-34.
  • Van den Heede, K., Cornelis, J., Bouckaert, N., Bruyneel, L., Van de Voorde, C., & Sermeus, W. (2020). Safe nurse staffing policies for hospitals in England, Ireland, California, Victoria and Queensland: A discussion paper. Health Policy124(10), 1064-1073.
  • Welton, J. (2017). Measuring Patient Acuity. JONA: The Journal of Nursing Administration47(10), 471.
  • 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 Management27(5), 896-917.

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