Establishing a Safe Nurse-to-Patient Ratio

Healthcare providers always try to improve the quality of their services: to decrease the mortality rate and increase patient satisfaction levels. Moreover, it is also necessary to ensure nurses have enough rest and time for self-care. Otherwise, it would increase the risk of burnout and mental health issues among nursing staff, which, in turn, would affect the quality of patient care (McHugh et al., 2020). The solution is to ensure that each patient receives enough attention and care from their nurse. Thus, in my opinion, establishing a safe nurse-to-patient ratio is a necessary measure.

In some countries or states, this ratio is already mandated by law to control the nurses’ workload. California (the USA), Victoria and Queensland (Australia), Wales, and Ireland are among the areas where the such legislative practice is adopted (McHugh et al., 2020). McHugh et al. (2020) studied the changes in Queensland hospitals’ outcomes among patients in acute adult medical-surgical wards after the minimum ratio was established. According to the new law, the average nurse-to-patient ratio must be at least 1:4 on morning/afternoon shifts and at least 1:7 on night shifts (as cited in McHugh et al., 2020, p. 2). According to the researchers, this ratio contributed to lowering exhaustion among nurses and increasing patient satisfaction with the treatment (McHugh et al., 2020). Thus, I believe that this average nurse-to-patient may be considered safe for acute adult medical-surgical wards.

However, there exists an alternative position that one cannot ignore. In some cases, even a perfectly calculated nurse-to-patient ratio and sufficient nurse staffing can be useless in improving patients’ care and mortality rates. McHugh et al. (2020) noted that for an adequate nurse-to-patient ratio to be efficient, it should be combined with a good work environment. They define it as a sufficient amount of nurses’ autonomy and engagement in decision-making, opportunities for advancement, hospital management’s support, and good relationships between colleagues based on professional respect (McHugh et al., 2020). Paredes et al. (2019) studied outcomes among patients who underwent one of the most complicated surgical operations – pancreaticoduodenectomy – and concluded that the nurse-to-patient ratio did not significantly affect the risk of complications. They found that the number of operation-specific surgeons was the major factor impacting the risk of complications regardless of nursing volume in these cases (Paredes et al., 2019). Therefore, one cannot determine the universally safe nurse-to-patient ratio while considering it separately from other factors affecting nurses’ performance and patients’ outcomes.

References

McHugh, M. D., Aiken, L. H., Windsor, C., Douglas, C., & Yates, P. (2020). Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study. BMJ Open, 10(9). Web.

Paredes, A. Z., Hyer, J. M., Tsilimigras, D. I., Sahara, K., White, S., & Pawlik, T. M. (2019). Interaction of surgeon volume and nurse-to-patient ratio on post-operative outcomes of medicare beneficiaries following pancreaticoduodenectomy. Journal of Gastrointestinal Surgery, 24(11), 2551–2559. Web.