Appropriate Rn to Patient Ratios

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Critical Issue Paper: Proper Staffing related to Patient Safety Introduction
The appropriate staffing of Registered Nurses is critical in the safety of hospital patients. Nursing shortages, along with major cuts in nursing budgets, have combined to result in fewer nurses at the bedside. This creates a safety hazard for patients, as well as a critical issue in the nursing profession. Nursing and patient outcomes are both highly affected by inadequate staffing. This paper will focus on the necessity for appropriate RN-to-patient ration and the evidence based research that supports the effect this has on patient safety, patient outcomes and the nursing practice. Why is this issue a concern for nursing practice and healthcare delivery? Inadequate staffing and unmanageable workloads place an unnecessary burden on nursing staff members and reduce the quality of care that the nurses are able to provide. Nurses are left fatigued, striving to achieve unmanageable expectations, which in turn affect the delivery of care to the patients. Inadequate staffing is unsafe and is an impediment to giving high-quality care in the hospital. (Garrett, 2008) Nearly every person’s health care experience involves the contribution of a registered nurse. Birth and death and all the various forms of care in between, are attended by the knowledge, support and comfort of nurses. When there are too few nurses, patient safety is threatened and health care quality is diminished. (Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), 2002)

Nurse staffing and individual nurse workload has an absolute measurable impact on patient outcomes such as nosocomial infections, length of stay, medical errors. Garrett noted research finding that adding one additional patient to the nurse’s workload is linked to a seven percent increase in patient mortality within thirty days of admission. In addition, a seven percent increase in the odds of failure to rescue was found....
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