The Importance of Nurse Staffing Ratio and the Role of Nurse Leaders

Running head: NURSING
Nursing
Name of the Student
Name of University
Author’s note

1NURSING
Introduction
Nurses are regarded as one of the principle component of comprehensive healthcare.
Proper nurse staffing helps to impact the ability of the nursing professionals to delivery safe and
quality care under any practice settings. However, the delivery of the nursing care is
multifaceted, the proper determination of the nurse staffing is a complex work and the solution is
not simple (American Nurses Association, 2012). The following paper aims to focus on the
importance of the nurse staffing ratio under the healthcare settings and the role of a nurse leader
in shaping up the nurse staffing ratio while improving the overall quality of care.
Nursing staffing ratios
According to Rogowski et al. (2015), a national survey conducted on the perspective of
the American healthcare system found that the nurse understaffing is one of the greatest threat to
patients’ safety. As per the reports published by the American Nurses Association (ANA) when
the healthcare professionals fail to understand the relationship with the registered nurse (RN)
staffing and patients’ health related outcome, the legislations and rules becomes mandatory
(Rogowski et al., 2015). During 2003, California mandated the minimum RN: patient ratio for
hospitals and subsequently 12 other states also imposed the same law. Following the imposition
on the Medicare and Medicaid Service and subsequent quality improvement initiatives in the
domain of hospital acquired conditions, the nurse staffing ratio in the hospitals of US increased
substantially. During the tenure of 2004 to 2011 the total nursing hours per day in comparison to
the patient population in the general care units of the US hospitals increased by 11.5% and that
of RN per patient day, increased by 22.9% (Rogowski et al., 2015).

2NURSING
Nursing staffing and quality of patients’ care
The study conducted by Griffithset al. (2016)over 10 years under California healthcare
setup stated that it may be intuitive that increased nurse staffing can improve the patients’ care
outcome however, the association between staffing of nurses and associated patients’ health
related outcome is inconclusive. A mate-analysis conducted by McHugh and Ma (2014) showed
that there is a consistent relationship between the high nurse staffing and lower patient mortality
rate of the patient in the ICU. However, the findings in the domain of establishing relationship
between the nurse staffing and other patients’ outcome like accidental fall, pressure ulcers and
urinary tract infections were inconclusive. The quantitative study conducted by He et al. (2016)
showed that there is a prominent association between staffing of nurse and patients’ health
related outcome both in the trend and in the seasonal levels. Kouatlyet al. (2018)showed in their
prospective study that increased nurse staffing ratio was effective in improving certain nurse-
sensitive outcomes but not others in the emergency units.
Professional standards and nurse staffing
According to the ANA (2019), it is the duty of the RN to think critically wile accessing
and analyzing the best available evidences in order to improve the safety and quality of care. The
study conducted by Twigg andMcCullough (2014) showed that increase in the nurse staffing
increases the provision for critical thinking of the nursing professionals by giving scope for
reflective practice. Reflective practice helps to refining the understanding of the clinical priority
of the patients and thereby helping to improve the patients’ health related outcomes. Conducting
comprehensive assessment also falls under ANA professional code of conduct. Increase in the
nurse staffing helps to conduct comprehensive patients’ assessment by reducing the workload
over individual nurse.