Ensuring Safe Nurse-to-Patient Ratios: What You Can Do (2024)

By: Bethany Nock | On: December 1, 2016

Ensuring Safe Nurse-to-Patient Ratios: What You Can Do (1)
Hospital management teams are always on the lookout for methods to trim costs and improve efficiency. Since nurses account for a large percentage of the hospital staff, a frequently used strategy to decrease costs is to reduce the number of nurse labor hours. However, considering the Affordable Care Act (ACA) has placed greater emphasis on value-based care, the appropriate nurse-to-patient ratio is essential to guarantee patients receive the highest quality care.

Traditional nurse staffing systems fail to account for certain variables, resulting in staff shortages and an inability for nurses to spend adequate time caring for their patients. Newer staffing models are more flexible and can be adjusted to fit not only the needs of the entire hospital but also the needs of individual units.

Here are four approaches hospitals can take to ensure safe nurse-to-patient ratios.

1. Create a Formal Staffing Plan

Rigid nurse-to-patient ratios may not be the best solution for your hospital. An alternative is a formal staffing plan, which ensures each patient is cared for by the nurse with the most appropriate skills. A staffing plan is a unit and shift-specific scheduling strategy that supports standardization of care in each department. With an established strategy in place, healthcare organizations can ensure staffing decisions address the most common factors, including: patient acuity; the number of admissions and discharges; and each nurse’s level of expertise.

2. Reduce Turnover by Addressing the Underlying Causes

If an organization is losing staff in a short timeframe, there will inevitably be a staffing shortage, regardless of what other measures are put in place. The most often cited reasons why a nurse decided to leave a hospital are poor working conditions and insufficient wages. To help decrease turnover, hospital management should consider the following:

  • Limiting mandatory overtime
  • Delegating paperwork to other qualified staff
  • Adopting up-to-date technology to improve the workflow
  • Offering competitive compensation commensurate with experience

3. Establish a Staffing Committee

A staffing committee allows hospitals to take a collaborative approach to staffing. Staffing committees are required for healthcare organizations in some states. Even if it is not mandated in your state, a staffing committee is still a good idea. The committee typically provides input on scheduling procedures as well as staffing policies and ensures these standards are consistent across a specific unit or the entire hospital. Having set guidelines in place helps lower the chances of an unsafe nurse-to-patient ratio.

4. Consult the Staff Nurses

Direct-care nurses are on the frontlines of patient care, which means they have the best insight into care delivery and patient flow. While a staffing plan may appear appropriate on paper, the individuals responsible for creating the staffing plan can’t take into account unexpected events such as nurses calling in sick or floating to another unit or increases in admissions. Direct-care nurses can take note of scheduling issues and make suggestions for improved processes.

Appropriate nurse staffing levels have been shown to have numerous benefits including improvements in patient satisfaction, decreased readmissions and reduced nurse fatigue, which has the added benefit of increasing nurse retention. If finding a way to decrease costs is the goal, fewer nurses is not the solution. Any funds saved by having a lower nurse-to-patient ratios will be negated by potential penalties incurred for failing to meet care quality standards.

Ensuring safe nurse-to-patient ratios is an important part of patient-centered care. To learn more about patient-centered care, download our free guide, How Nurses Can Increase Satisfaction through Patient-Centered Care.

Ensuring Safe Nurse-to-Patient Ratios: What You Can Do (2)

Ensuring Safe Nurse-to-Patient Ratios: What You Can Do (2024)

FAQs

How can we improve nurse-to-patient ratios? ›

Here are four approaches hospitals can take to ensure safe nurse-to-patient ratios.
  1. Create a Formal Staffing Plan. Rigid nurse-to-patient ratios may not be the best solution for your hospital. ...
  2. Reduce Turnover by Addressing the Underlying Causes. ...
  3. Establish a Staffing Committee. ...
  4. Consult the Staff Nurses.
Dec 1, 2016

What is the safest nurse-to-patient ratio? ›

The right nurse-to-patient staffing ratio

For example, the nurse-to-patient ratio in a critical care unit must be 1:2 or fewer at all times, and the nurse-to-patient ratio in an emergency department must be 1:4 or fewer at all times that patients are receiving treatment, the law states.

How to ensure patient safety as a nurse? ›

Top 8 Things to Improve Patient Safety
  1. Support a culture of safety. ...
  2. Communicate well. ...
  3. Perform basic care and follow checklists. ...
  4. Engage your patients. ...
  5. Learn from incidents and near misses. ...
  6. Take care of yourself. ...
  7. Follow infection control protocols. ...
  8. Get involved.
Jan 12, 2022

How to ensure adequate staffing? ›

What are the most effective ways to ensure adequate staffing levels?
  1. Assess your current and future needs. ...
  2. Develop a recruitment strategy.
  3. Implement a retention strategy.
  4. Manage your staff performance.
  5. Adjust your staff levels as needed.
  6. Evaluate your staffing outcomes.
  7. Here's what else to consider.
Nov 9, 2023

How to solve inadequate staffing in nursing? ›

9 Effective Strategies to Overcome the Nurse Staffing Shortage
  1. Improve Employee Benefits. ...
  2. Foster a Positive Work Environment. ...
  3. Offer Flexible Scheduling Options. ...
  4. Offer Career Advancement Opportunities. ...
  5. Create Nurse Retention Programs. ...
  6. Strengthen Relationships with Nursing Schools.
Jan 15, 2024

Why are safe nursing ratios important? ›

Appropriate nurse-to-patient ratios are associated with improved outcomes and fewer adverse events, complications and hospital re-admissions.

What is safe staffing in nursing? ›

Safe staffing means that all patients have the attention and care they need because every member of their care team has a safe workload. Safe patient care relies on a team of health professionals. Any plan to address safe staffing must include the whole care team.

Why are hospitals against safe staffing ratios? ›

Despite the benefits and improved working conditions nurses report feeling as a result of the ratios, the California Hospital Association argues that the mandatory patient-to-nurse minimum is ineffective and requires more money and resources to staff, which can become cumbersome for hospitals.

How does inadequate staffing affect nurses? ›

Healthcare facilities that do not keep an adequate number of nurses on duty can jeopardize the safety of their patients. Overworked nurses may suffer from fatigue or burnout which can impair their ability to focus on tasks.

What are the 5 steps to improving patient safety? ›

  • Maintain Patient Room Cleanliness.
  • Practice Proper Hand Hygiene.
  • Develop Optimized Discharge Process.
  • Keep High-Risk Patients Safer With Trained Sitters.
  • Apply UV-C Technology Creatively.

What actions can you take to ensure patient safety? ›

  • Preventing harm and infection control.
  • Hand washing.
  • Hand hygiene.
  • Clean patients.
  • Waste management.
  • Cleaning.
  • Patient identification.
  • Marking the surgical site.

What mistakes should a nurse leader never make? ›

Top Ten Mistakes Nurse Leader Make
  • Failing to deal with performance problems early enough. ...
  • Avoiding a conflict that later escalated. ...
  • Selecting a staff member that was not a good fit for the unit out of desperation. ...
  • Trying to be liked by everyone. ...
  • Taking action without knowing the whole story.
Aug 5, 2021

What are the cons of nursing ratios? ›

By imposing rigid nurse staffing, mandatory ratios can also harm patient outcomes, such as increasing errors, delays, and complications. They can also reduce patient choice, access, and continuity. Its been my experience, that the biggest drawback to mandatory anything is negativity.

What are staffing strategies? ›

Strategic staffing means making sure your organisation has the workforce it needs to deliver its current and planned business objectives. Markets and plans can change. Many organisations have short, medium and long-term strategic staffing plans and review them regularly in context of overall business strategy.

How nurse staffing levels affect patient outcomes? ›

High nurse-to-patient ratios (NTPRs) often means that nurses have too many patients to be able to adequately monitor and provide treatment to each of them. Staffing ratios can vary by department and setting. This can lead to worse patient outcomes, increased job dissatisfaction, and burnout.

Would increasing the nurse to patient staffing ratio improve patient care? ›

Improved Quality of Care

With adequate nurse staffing, patients had: Shorter hospital stays. Less hospital-acquired infections. Fewer ICU admissions.

How can nurses improve patient outcomes? ›

ANA Nursing Resources Hub
  • Understand and Implement Patient-Centered Care.
  • Build a Solid Team Culture.
  • Promote Evidence-Based Practices.
  • Communicate With Clarity and Compassion.
  • Encourage Preventative Care Practices.

What is the best practice nursing staffing ratio? ›

The standard rule of thumb is to have a nurse–patient ratio of 1:4-5 on medical–surgical units, 1:3-4 on intermediate units, and 1:2 in ICUs. State nurse licensure boards, The Joint Commission, and Centers for Medicare & Medicaid Services (CMS) all have standards designed to help ensure adequate nurse staffing.

What are the problems with high nurse to patient ratios? ›

Research has shown that each additional patient assigned to a registered nurse beyond the optimum ratio significantly increases the risk of preventable death, longer stays, readmissions, and unfavorable patient satisfaction. It directly results in less effective care, poorer patient outcomes, and higher costs of care.

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