Understaffing as an issue in a company

Understaffing is a critical issue in nursing today, posing a barrier to better patient outcomes in healthcare facilities. One of the most effective approaches to address nursing's issues is to do appropriate research in order to deliver good medical and therapeutic services. Research provides healthcare professionals with a foundation for enhancing the quality of care provided in their institutions (Frieden, 2014). The following is a review of a nursing research article, explaining how the study's findings apply to nursing. The paper mostly focuses on the fact that increasing nurse-patient ratio in healthcare facilities improves patient outcomes in the long run. This research is important in drawing the attention of stakeholders towards the important aspects in the process of balancing between patient outcomes and minimization of costs.

Background of Study

There are no adequate studies explaining the possible outcomes of altering the staffing model and the labor hours supplied in health centers. According to Hall (2004), studies carried out by the American Nurses Association highlighted the advantages of considering patient acuity instead of showing the impact of changing staffing models on patient outcomes. However, their objective was to determine the effects of different staffing systems on the effectiveness of healthcare services. Cases such as the impact that a model has on costs and patients’ status were not well covered, thereby prompting Hall and her counterparts to conduct a study on the same. Both private and public healthcare providers strive to provide improved quality clinical services to patients at affordable prices while minimizing costs so as to gain larger profits. Staffing models are used to ensure minimization of costs with respect to time taken to respond to a medical emergency, available working hours, and nurse to patient ratio in every health facility. Hall’s study shows how different staffing models lead to various patient outcomes, and consequently, the costs incurred by the healthcare provider.

The objective of the quantitative research was to investigate the impact of various staffing systems on the economic and social goals of healthcare facilities. Social objectives in this case refer to patient outcomes and impact on the surrounding community at large. From the research question the researcher intended to determine how changing the nurse-patient ratio affect patient outcomes. Hall also sought to determine how different staff mixes affect the cost of providing health services. The study is meant to provide relevant information intended to answer the proposed research questions. The information can be used by healthcare administrators to reduce costs of providing medical services and to improve patient outcomes.

On the other hand, the qualitative study of the same aimed at examining the effects of low proportions of low proportions of professional nurses in health facilities. The researcher examines how low nurse staffing ratios impact urinary tract infections, medication errors, wound infections and patient falls. The study examines a few study models and the effect of each of them on this aspect of patient wellbeing. The author looked at how different nursing models impact patient outcomes as well as the implications that nursing staff ratio have on costs incurred by the service provider. The researcher avails information that can be used by stakeholders in identifying the implications of nurse staffing ratios and models on patient outcomes and costs incurred by the facility.

Method of Study

Both qualitative and quantitate analyses were conducted during the study so as to collect data. The qualitative approach involved the use of questionnaires requesting respondents to provide information concerning the staffing of nurses in hospitals and the resulting patient outcomes. The study was conducted in 77 healthcare centers and 19 teaching hospitals in Canada. The staffing framework involved different combinations: registered nurse and registered practical nurse, both registered and registered practical nurse, restricted nurses and unrestricted nurses, and lastly, a combination of all the three mixes. Patient outcomes were measured basing on the failure of these healthcare centers in terms of the prevalence of infections, specifically UTI’s and wound infections. The working hours were based on the utilization of labor in the health facilities. For instance, all inpatient facilities have two types of nursing staff: Unit Producing Personnel (UPP) and Management and Support (M&S).

UPP has direct contact with patients since they offer services such as dressing wounds, administering dosages and the likes, while M&S provides managerial services mostly to their colleagues, thereby ensuring adherence to existing ethical principles in the workplace (Needlemen et al., 2011). The study used UPP working hours to determine the time devoted to patients since the former are their immediate caregivers. Patient acuity was retrieved from hospital records; it was according to different staff mixes with high patient acuity in cases of chronic illnesses and infections. This ensured that the study did not deviate from its main objective, which also involved infections and not chronic illnesses. This research also maintained its relevance by incorporating the use of HLM to determine whether various staffing models influenced the costs incurred by the hospital. HLM consists of two levels; the first level is used to compare one variable’s correlation to any other two, in our case, patient outcome was compared to patient acuity. The second level of the HLM model was applied to compare various staffing models to the patients’ outcomes (Hall 2004).

The researcher also made use of literature review in the study analyzing both quantitative and qualitative studies conducted by various researchers on the same subject. The literature used in this study is brief. However, it is concise and enables the author to build a logical argument on the existence of a gap on information regarding the relationship between nursing models and ratios and patient outcomes and costs incurred by the service provider. The inadequacies of previous studies formed the basis of the logical argument constructed by the author. Through inductive methodology, research questions formulated are sought to be answered by the researcher going to the ‘field’ and collects both primary and secondary data to determine the relationship between different staffing models and patient outcomes.

From a qualitative approach the author attempts to explains how each of the studies gives little information on the research objectives. Therefore, the research conducted by the author was meant to overcome the shortcomings of these previous studies just as mentioned. The demerits found in the literature review is use of sources that are more than 5 years old, thus relevance and currency is challenged. Furthermore, the author does not highlight the weaknesses of her own study. Another misgiving is the failure to develop a framework from the findings of the systematic research whereby qualitative data was obtained from nurse administrators. However, for a qualitative study the information provided can still be reliable since qualitative data is less prone to change as compared to quantitative.

Results of Study

The research established that a strong positive correlation exists between nurse staffing ratios and positive patient outcomes. On the issue of costs, high nurse-patient ratios lead to an increase in costs in the short-run but has positive implications on cost-reduction in the long-run. A health facility with high nurse-patient ratios will incur higher labor costs (Negron & Cohen, 2013). However, the high ratios will lead to better patient outcomes by reducing wound and urinary tract infections, patient falls and medication errors. Once this is done, the facility can be able to attract more clients leading to an increase in revenues.

The findings are important to medical practitioners in managerial positions since they seek improve the effectiveness and efficiency of hospitals. This will also help them meet the changing needs of their clients as nurses will have more time with their allocated patients, hence understanding their health needs better, and consequently, increasing their area of coverage. The findings of this study are applicable to education, research and practice in nursing. There is need for further studies on the shift on nursing resource in reaction to the prevailing changes. Increase in acuity necessitates that the practitioners put in place proactive nursing models that focus on preventive strategies (Anderson et al., 2014; Hall et al., 2004).

Ethical Considerations

There are no specified ethical considerations that were observed in the course of the research. However, the presentation of data and the people involved in the research presents little chances of violation of ethical standards. For instance, the questionnaire was issued to nurse administrators who must understand the ethical implications of their actions due to their experience and the nature of their work. Nevertheless, the researcher should have indicated her adherence to ethical norms to minimize the chances of falsification and fabrication of another researchers’ work. For instance, the scientist should have mentioned that she sought permission from the American Nurses Association to use their findings in another study.


Nursing services are key for any patient, especially for hospitalized cases. Hall’s research aims at determining the implications that nursing models and ratios have on the patient outcomes and the costs incurred by the provider. The research found out that in high nurse-patient ratio has positive implications on patient outcomes and costs in the long run. Emphasize the importance and congruity of the thesis statement. High nurse-patient ratios minimize patient falls, wounds and urinary tract infections and medication errors. These findings are important for nurse educators, researchers and practitioners.


Anderson, D. J., Podgorny, K., Berríos-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L., ... & Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(06), 605-627.

Frieden, T. R. (2014). Six components necessary for effective public health program implementation. American journal of public health, 104(1), 17-22.

Hall, L. M., Doran, D., & Pink, G. H. (2004). Nurse staffing models, nursing hours, and patient safety outcomes. Journal of Nursing Administration, 34(1), 41-45.

Needleman, J., Buerhaus, P., Pankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. (2011). Nurse staffing and inpatient hospital mortality. New England Journal of Medicine, 364(11), 1037-1045.

Negron, B., & Cohen, E. (2013). Back to the Future: A standardized approach to delivering effective Nursing Care. Nurse Leader, 11(2), 52-56.

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