Nursing is a medical discipline that aims to provide quality services to patients via careful management. The number of nurses in a specific hospital has a direct impact on the level and quality of services provided. As a result, the nurse-patient ratio should be closely monitored. This is because a high burse patient ratio ensures that patients receive quality care because there is a consistent patient nurse contact inside the institution. As a result, a high nurse to patient ratio improves the status of the healthcare facility and creates a favorable impression among patients and the general public. As a result, the level of trust among patients increases and so does the number of patient visit to the facility. The kind of patient services being offered has to be affordable for all patients without compromising on quality (Burns & Grove, 2014). However, the ratio in itself is sufficient. Nurses should adopt the Evidence-based-practice approach when caring for patients.
The nurse patient ratio alongside with the incorporation of the Evidence-Based Practice (EBP) framework improves quality and increases quantity. EPB goes hand in hand with nursing practices as the best decision regarding a patient’s health are made by actively comparing it with the available research evidence and patient preference. EBP has been used frequently in most health care facilities. The simultaneous use of working/proved scientific evidence, clinical expertise, and patient preference has made it the best approach in handling complex cases (Overview - Introduction to Evidence-Based Practice - LibGuides at Duke University Medical Center, n.d.). The reason behind this topic is attributed to high mortality rates despite the federal government’s efforts on increasing the number of health workers (Bowser & Hill, 2010). This paper focuses on nurse to patient ratio and the related outcome when using EPB in patient health care by answering the PICOT question. The research techniques are also discussed alongside with EPB.
PICO Question
Does a high nurse patient ratio and the Evidence-based-practice approach improve the quality of services and the number of patient outcomes in medical centers?
Summary of Qualitative Research Critique- Using Feedback
In this section, the concepts are used to help grasp the need of high nurse-to-patient ratio in hospitals. Evidence-Based-Practice methods can be used to best translate and define a patient’s needs in relation to the available practices being used. Qualitative research being inductive in nature is a useful tool in assessing health care systems. However, critiques have shared their thoughts on qualitative methods as well. The fact that it does not analyze the frequencies or data distribution of nurses, makes it dependent on patient feedback only to improve health services. This should not be the cases as nurses also experience a heavy work load.
Background
Nurse-to patient ratio is thought to be the center of a good healthcare facility in many states. A high ratio means that there is adequate supply of labor which means smooth operations and effective care. The admitted patients in chronic illness are constantly in dire need of attention which can only be offered by nurses. The presence of a nurse all time is just an efficient way to ensure that the patient’s needs are taken care of. Nevertheless, in some cases, this is not always true. A high nurse-to-patient ratio does not always ensure quality service at all times. For instance, California was the first state to establish the rule after the policy was passed in 2005. It has been observed that a less nurse-to –patient ratio has helped in improving the patient satisfaction and comfort. This is because a high ratio may lead to congestion in health facilities which may also result in multiple errors. The errors when made lead to fatalities and even death. Therefore a good management system including nurse-patient scheduling and EBP is required. Failure to which there will be high chances of messing up. On the other hand, upon good management a high ratio is admirable. The California Nurses Association confirmed that the high ratio helped improve morale, solved the burnout problem and increased nurse retention. With such benefits, it is hard for health systems to go wrong.
Method of Study
An online research was done on Korean nurses Sung-Cheol Yunb and Sung-Hyun Choa was used show the effect of a high nurse-to-patient ratio. The study which was done in 2009 was comprehensive and justified the positive feedback to the PICOT question.
A survey done on October 2013 showed that some states passed a policy in favor of a high nurse ratio. It revealed that penalties were charged to institutions that were less staffed. The result study section has elaborated on the benefits that were associated with this policy.
Data was collected from an online study done by Health Center and Policy research on December 2015 regarding nurse staffing. The data collected was sufficient to support the fact that a high nurse-to-patient ratio is needed. The matter has been well discussed in the result study section.
Results of Study
The Korean study stated above showed that health facilities that had a higher nurse-to-patient ratio provided a more effective basic care. ICU high staffing was directly linked with less mortality rates and low admittance periods. August 2009 -- found that "hospitals with higher ICU staffing were more likely to fully provide basic care (Clarke, 2009, p. 1094).
According to 2013 survey, the penalties Imposed on policy defaulters were based on the positive results of a high staffing ratio. Enough staffing lead to a good patient coordination and patient education. Understaffed health facilities resulted to poor evidence based coordination techniques which justified a mandatory aggressive policy which was to be followed by all hospitals ("Nurse–Patient Ratios: A Systematic Review on the Effects of...: Journal of Nursing Administration," n.d.).
The results of the survey by Center of Health Outcomes a ratio of one to on, i.e. one nurse to patient, improved the survival rate of chronic ill persons. The health facilities that had minimal nurse participation experienced 16 percent low survivability of chronic patients with cardiac related problems. This justified the need for nurse staffing.
Ethical Considerations
The review focuses on all appropriate methods of staffing; the federal act 42CFR makes it clear that only certified hospitals can take action in practice (Curtin, 2016). All Medicare should have sufficient resources and registered nurses. In line with this staffing should be done in an ethical manner. In that no harm should be done to patients, no inconveniencing patients in regard to the quality of services offered and also reducing or eliminating nurse fatigue. Confidentiality was emphasized in the report and all data is accurate and up to date.
Conclusion
Qualitative methods can form a strong basis for analyzing patient healthcare. It is a requirement for all systems to focus on the welfare of a patient through EBP methods. Hence, the workforce need to be well equipped for this matter.
Summary of Quantitative Research Critique- Using Feedback
A more comprehensive way of dealing with huge numbers of patients in hospitals could be developed. However, in order to determine the appropriate of nurse-to-patient ratio, it is prudent to analyze the current nurse distribution per patient. A certain ratio is standard for a hospital to function smoothly. Most health facilities have subjected their patients in mental harsh conditions. Whereby patients depend on a small number of nurse to attend to them. This can be very stressful and mind disturbing.
Background
The current workload being experienced in most hospitals is inconsiderate of patient safety. It is a global concern that the number of nurses is highly insufficient to cater for the overwhelming patient numbers in health facilities. This has been a result of partial or total absenteeism, excessive workload and lack of qualifications on the nursing part. The cause can be as a result of socio-technical systems that are associated with medication and regular nurse care. Despite the federal government’s actions in restoring an effective nursing ratio, excessive workload has still remained to be a problem.
Method and result of Study
Data collection was obtained from the report presented in 1999 by the Institute of Medicine (IOM). The research showed that approximately 43,000 to 100,000 patients lose their lives as a result of medical errors caused by nurses (Connecticut. Office of Health Care Access, 2000, p. 2). A more related and close comparison was done with the number of deaths cause by AIDS 16,500, accidents 43,455, and Cancer 42,000. This portrayed the healthcare system as reckless and unprofessional. However, IOM proposed an integration of accurate EBP with nursing practices so as to tackle and solve the problem.
Ethical Considerations
There are quite a number of issues related with quantitative research in ethics. Prime among them being the focus on the number of patients by medical practitioners while neglecting duty. In that money and profit making becomes the main agenda while the quality of services is overlooked.
Conclusion
In conclusion, measures should be taken to avoid overworking medical practitioners at the same time ensuring that patients are well taken care of. There is a need for entire medical systems to change the general perception in handling patients. Otherwise more facilities will continue focusing on profits, cutting costs and disregarding Evidence-Based-Practice methods and labor distribution.
Proposed Evidence-Based Practice Change
The Evidence-Based-Practice change needs to be performed and should be according to the following six points. They include the need to acknowledge and accept the failure of the current health system, analyze the negative impacts of the current system, develop a good system, grounding the new changes on future objectives, implement and carefully monitoring the progress of new changes. In line with all this, it is evident that high nurse ratio really solves the patient’s needs and improves on outcome. Therefore, the best action would be for the federal government to train more nurses by subsidizing education, and once they are in practice a thorough check should be conducted by officials regularly in order to improve the quality of services being delivered to patients. By so doing mortality rates would decrease drastically, hence solving the initial problem.
References
Clarke, M. (2009). Nursing research: Ten studies in patient care. International Journal of Nursing Studies, 20(4), 1092-1101. doi:10.1016/0020-7489(83)90020-2
Curtin, L. L. (2016, April). A conversation about the ethics of staffing - American Nurse Today. Retrieved from https://www.americannursetoday.com/conversation-ethics-staffing/
Connecticut. Office of Health Care Access. (2000). Nurse-to-patient ratio study: A report on the current nursing environment in Connecticut hospitals. Hartford, CT: The Office.
Does Mandating Nurse-Patient Ratios Improve Care? | HealthLeaders Media [Video file]. (n.d.). Retrieved from http://www.healthleadersmedia.com/nurse-leaders/does-mandating-nurse-patient-ratios-improve-care
Nurse–Patient Ratios: A Systematic Review on the Effects of...: Journal of Nursing Administration. (n.d.). Retrieved from http://journals.lww.com/jonajournal/ Abstract/2004 /07000/Nurse_Patient_Ratios__A_Systematic_Review_on_the.5.aspx
Overview - Introduction to Evidence-Based Practice - LibGuides at Duke University Medical Center [Video file]. (n.d.). Retrieved from http://guides.mclibrary. duke.edu/c.php? g=158201&p=1036021
