Nurse to Ppatient rRatio

Woodline Augustin

Grand Canyon University

NRS-490

2/17/19

Introduction

The nurse to patient ratio refers to a quantity that helps in describing the total number of patients who have been assigned to each nurse (McHugh et al., 2016). Allocation of patients to nurses are primarily dependent on the needs or acuity of the patients, in relation to nursing care. This assignment will elaborate on a PICOT statement, in relation to nurse to patient ratio.

Evidence Bbased Ssolution

Time and again it has been provend that a greater nurse to patient ratio advances countless expanses of nursing, counting in the quality of care, quality of documentation, and adverse health events. Nurses have been recognized to play an important role in the healthcare settings, thereby calling for the need of implementation of safe-staffing ratios that are mandated by the state (Watson et al., 2016). This in turn ensures the safety of both nurses and patients. According to (Driscoll et al., 2018) higher nurse staffing levels are correlated with decreased mortality, ulcers, medication errors, restraint use, pneumonia, infections, and more patients obtaining percutaneous coronary intervention, and higher aspirin use. Higher ratio has also been linked to poor work environment and reduced likelihood of optimum survival rates among patients.

Nursing Iintervention

With budget cuts, nursing shortage, and hospital downsizing most nurses find it difficult to spend adequate time on each patients. The major interventions should focus on recruiting more nursing professionals and preventing overcrowding of patients, through proper delegation of clients to healthcare personnel. Improving recruitment and retention rates are largely associated with a drastic improvement in nurse to patient ratio (Hairr et al., 2014). Collaboration with multidisciplinary team members, budget allocation, and proper time management skills are also required for improving the ratio. Establishing minimum adjustable number of nurses, including output from direct care nurses and their representatives, taking into account the educational attainment and training of nurses, and following mandatory staffing levels that are enforced by the state legislature are other interventions (Arkin et al., 2014).

Patient Care

Safe staffing creates an impact on the quality and safety of patient care. Low ratio helps in decreasing nurse fatigue, which in turn promotes safety of the patients and increases nurse job satisfaction. Reduction of burnout, comprising of chronic fatigue, insomnia, irritability, and depression allows the nurses to spend more time in caring for all patients, thereby allowing them to focus properly on individual patients. Under poor work environment when nurses have to care for more than one critically ill patient, none of the latter get optimal care services, which in turn violates patient safety and wellbeing.

Research Qquestion

What is the consequence of a high nurse to patient ratio on the quality of care and patient outcomes, compared to low nurse to patient ratio, in acute care settings? See correction below.

In acute care settings (P), does a high nurse-to-patient ration (I), compared to a low nurse-to-patient ratio (C), impact quality of care and patient outcomes (O), over a six-month period (T)?

PICOT Ccomponents

PICOT acts as a mnemonic that helps in describing the different components of a good research question (Abbade et al., 2016). The components of the capstone research question are given below

(P)/Population- Patients admitted to ICU

(I)/Intervention-         Low nurse to patient ratio

(C)/Comparison-        High nurse to patient ratio

(O)/Outcome-   Better patient outcomes and enhanced quality of healthcare

(T)/Time-   3 months

Health Care Agency

According to the AHRQ (2019) excessive nursing workload is a crucial safety issue for both the healthcare personnel and the patients who are admitted to different healthcare organizations. The AHRQ has recognized the fact that missed nursing care is a kind of error related to omission where the much necessary care elements are not accomplished, and this is comparatively common in the inpatient wards. Furthermore, the capstone project will also be based on the California state law that mandates a 11 or 12 nurse to patient ratio in ICUs, depending on patient stability (Leigh et al., 2015).

Nursing Practice

Nurse staffing is a critical factor that helps in the determination of the quality of healthcare services that are delivered in hospitals, and their subsequent impact on patient outcomes. Proper nurse to patient ration will help in reducing rates of errors, thereby lowering the chances of preventable health complications in at-risk clients who are admitted to ICU (Martin, 2015). Another potential implication to practice is the fact that a low ratio will result in positive clinical outcomes, thereby increasing the desire to care for patients, and enhancing job satisfaction.

Conclusion

To conclude, maintaining a low ratio of nurses on a ward, to that of the patients has been associated with an improvement in patient health and wellbeing. Therefore, the PICOT statement for the capstone project will try to determine the impacts that low nurse to patient ratio will have on patient health outcomes.

References

Abbade, L. P., Wang, M., Sriganesh, K., Mbuagbaw, L., & Thabane, L. (2016). Framing of research question using the PICOT format in randomized controlled trials of venous ulcer disease a protocol for a systematic survey of the literature. BMJ open , 6 (11), e013175.

Agency for Healthcare Research and Quality. (2019). Nursing and Patient Safety . Retrieved from https//psnet.ahrq.gov/primers/primer/22/Nursing-and-Patient-Safety

Arkin, N., Lee, P. H., McDonald, K., & Hernandez?Boussard, T. (2014). The Association of Nurse?to?Patient Ratio with Mortality and Preventable Complications Following Aortic Valve Replacement. Journal of Cardiac Surgery Including Mechanical and Biological Support for the Heart and Lungs , 29 (2), 141-148.

Driscoll, A., Grant, M.J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyombwe, T. and Astin, F., 2018. 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), pp.6-22.

Hairr, D. C., Salisbury, H., Johannsson, M., & Redfern-Vance, N. (2014). Nurse staffing and the relationship to job satisfaction and retention. Nursing Economics , 32 (3), 142-147.

Leigh, J. P., Markis, C. A., Iosif, A. M., & Romano, P. S. (2015). California’s nurse-to-patient ratio law and occupational injury. International archives of occupational and environmental health , 88 (4), 477-484.

Martin, C. J. (2015). The effects of nurse staffing on quality of care. MedSurg Nursing , 24 (2), S4-S4.

McHugh, M. D., Rochman, M. F., Sloane, D. M., Berg, R. A., Mancini, M. E., Nadkarni, V. M., … & American Heart Association’s Get with The Guidelines-Resuscitation Investigators. (2016). Better nurse staffing and nurse work environments associated with increased survival of in-hospital cardiac arrest patients. Medical care , 54 (1), 74.

Watson, S. I., Arulampalam, W., Petrou, S., Marlow, N., Morgan, A. S., Draper, E. S., & Modi, N. (2016). The effects of a one-to-one nurse-to-patient ratio on the mortality rate in neonatal intensive care a retrospective, longitudinal, population-based study. Archives of Disease in Childhood-Fetal and Neonatal Edition , 101 (3), F195-F200.

Woodline,

Your paper was well written, and had a nice flow from topic to topic. I appreciate your use of headings to organize your writing.  See my notes throughout your paper and in the right margin. Great topic choice and PICOT. Please contact me if you have any questions or concerns.

Sharon