NRS 490 Assignment Discussion

NRS 490 Assignment Discussion

The significance of adequate nurse staffing in providing quality care is a major finding that has also been highlighted in a report by the Institute of Medicine. Nurse staffing is an essential aspect of care that determines the nature of patient health outcomes and the quality of care in clinical settings. Currently exiting literature highlights that, inadequate nurse staffing that is primarily characterized by a decreased nurse/patient ratio is strongly associated with poor health outcomes (Cho et al., 2015). Similarly, in a hospital setting with a decreased nurse-patient ratio, a high turnover of patients and nurses and increased life-sustaining procedures, death is likely to occur. A decreased ratio between nurses and patients is a major issue in the American healthcare system that results from a shortage of nursing staff. As noted by Needleman (2015), the shortage in nursing staff has been influenced by a high nursing turnover, an increase in the aging population and an inadequate supply of nurses. NRS 490 Assignment Discussion


Nurse staffing issues that result in a decreased ratio between nurses and patients are a major concern that affects healthcare organizations. It is linked to adverse health outcomes and mortalities. After recognizing this issue, healthcare organizations often implement appropriate measures to improve are quality care and maintain the safety of patients. Numerous factors contribute to the shortage of nursing and ultimately a decreased nurse-to-patient ratio. They include: high nursing turnover, a shortage of qualified nursing professionals and an aging population that is rapidly increasing (He et al., 2016). Since nurses have a preference for working in environments where their efforts are recognized, acknowledged and rewarded, the shortage of nursing staff is still an issue of significance. NRS 490 Assignment Discussion



Problems in nurse-patient ratios are observable in clinical settings when providing care to patients in either inpatient or outpatient units. According to Falk & Wallin (2016), quality indicators are the best tools to assess how a decreased nurse-patient ratio affects patient safety, care quality and health outcomes.

High-Level Description of the Problem

            Significant declines in financial nursing resources alongside the effects brought about by a gradually increasing shortage of nurses have contributed to a decrease in the nurse-to-patient ratio with nurses working longer than expected taking care of patients. According to Griffiths et al., (2014), this does not only compromise the safety and quality of care but also adds to the current shortage through the creation of a working environment that pushes nurses away from he patient’s bedside.

Impact of The Issue

            With the current reforms in the American health sector that are linked to cost- reductions, the least staffing levels are vital to safeguard the safety of nurses’ and patients. However, adequate staffing of nurses is mandatory for improved patient care and retaining nurses. Driscoll et al., (2018) notes that poor nurse staffing does not only endanger the patient safety and  care quality but also drives nurses away from the nursing profession. As the demands for health services continue to grow, it is expected that issues in the staffing of nurses will continue to worsen, making it a priority issue for patients, policymakers’ researchers, healthcare administrators, and nurses.  Noted by

Significance Of The Problem

Inadequate nurse staffing characterized by a decreased nurse-patient ratio increases patients fall risks, preventable medical and medication errors, healthcare-related complications, readmissions, prolonged admissions, and additional healthcare-related costs. Besides, empirical studies have revealed that inadequate nurse staffing (a decreased nurse-to-patient ratio) has a strong association with nurse burnout, emotional exhaustion, job dissatisfaction, and high nursing turnover. Thus, it negatively impacts care quality and compromises the patient safety. NRS 490 Assignment Discussion

Proposed Solution

Implementing a nurse retention program is the best strategy to address this issue since it was identified that a high nursing turnover rate is the major cause of a decreased nurse-patient ratio in the selected organization. Evidence suggests that an effective retention program should ensure a favorable working environment that is primarily characterized by a formal plan for staffing, a staffing committee, opportunities for professional development, shared governance, reduced turnover time, rewards for longevity and excellence and programs for nursing residency (Van Camp & Chappy, 2017). A nurse retention program would also increase the levels of job satisfaction, reduce burnout and promote flexible work schedules amongst nurses, hence reducing the rate of nurse turnover to achieve an adequate nurse-patient ratio.


Cho, E., Sloane, D. M., Kim, E. Y., Kim, S., Choi, M., Yoo, I. Y.,  & Aiken, L. H. (2015). Effects of nurse staffing, work environments, and education on patient mortality: an observational study. International journal of nursing studies52(2), 535-542.

Cho, E., Lee, N. J., Kim, E. Y., Kim, S., Lee, K., Park, K. O., & Sung, Y. H. (2016). Nurse staffing level and overtime associated with patient safety, quality of care, and care left undone in hospitals: a cross-sectional study. International journal of nursing studies60, 263-271.

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., & 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 Nursing17(1), 6-22.

Falk, A. C., & Wallin, E. M. (2016). Quality of patient care in the critical care unit in relation to the nurse-patient ratio: A descriptive study. Intensive and Critical Care Nursing35, 74-79.

Griffiths, P., Ball, J., Drennan, J., James, L., Jones, J., Recio, A., & Simon, M. (2014). The association between patient safety outcomes and nurse/healthcare assistant skill mix and staffing levels and factors that may influence staffing requirements.

Griffiths, P., Ball, J., Drennan, J., Dall’Ora, C., Jones, J., Mariotti, A., … & Simon, M. (2016). Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development. International journal of nursing studies63, 213-225.

He, J., Staggs, V. S., Bergquist-Beringer, S., & Dunton, N. (2016). Nurse staffing and patient outcomes: a longitudinal study on trend and seasonality. BMC nursing15(1), 60.

Needleman, J. (2015). Nurse staffing: knowns and unknowns. Nurs Econ33(1), 5-7.

Van Camp, J., & Chappy, S. (2017). The effectiveness of nurse residency programs on retention: a systematic review. AORN Journal106(2), 128-144.NRS 490 Assignment Discussion


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