Nurse-Patient Ratios and Inpatient Safety Outcomes: Video Script

Hello, my name is… My research proposal is aimed at enhancing inpatient safety through nurse-patient staffing ratios. My PICO(T) question is: In hospitalized adult patients, how does a nurse-to-patient ratio of 1:4 compared to a ratio above 1:6 affect patient safety outcomes such as falls, pressure ulcers, and medication errors within a 30-day hospital stay? To explore this subject, I reviewed three research studies with varying research designs—experimental, quasi-experimental, and non-experimental—that contribute significantly to nursing science and evidence-based practice: Nurse-Patient Ratios and Inpatient Safety Outcomes: Video Script.

For the experimental design, I selected Assaye et al.’s (2022) article, which employed structured nurse questionnaires and retrospective medical record reviews in Ethiopian acute care hospitals. The research demonstrated that greater nurse-patient ratios were associated with significantly more missed nursing care, which in turn increased adverse events, including medication errors, pressure ulcers, and falls. The results strongly support the essential need for evidence-based staffing policy to promote patient safety and prevent harm.

Next, for the quasi-experimental design, I selected an article by Robinson et al. (2021). Their quasi-experiment piloted a proactive primary care model of nurse-led care for frail older people in New Zealand. With a matched comparison group, the trial demonstrated a reduction in mortality and postponed aged residential care admissions. Although not randomized, the design demonstrates the effectiveness of real-world nurse-implemented interventions and shows how a greater nursing presence can contribute to improved care continuity and enhanced outcomes.

Finally, for the non-experimental design, I selected an article by Gramaglia et al. (2021), who conducted a systematic review of non-pharmacological interventions in long-term care. Their study revealed that older residents with depression had improved mental health with regular, attentive nursing care. While not stating ratios specifically, the implication is that only with sufficient staffing is such care feasible on an ongoing and effective basis.

Together, these three studies direct us to how diverse research designs establish a strong scientific basis for promoting safe nurse-to-patient ratios. They inform decision-making in clinical practice and policy alteration, particularly in inpatient settings where safety initiatives are of the utmost priority.

Thank you.

References

Assaye, A. M., Wiechula, R., Schultz, T. J., & Feo, R. (2021). Missed nursing care, nurse staffing levels and patient safety outcomes in low‐income country acute care settings: An observational study. International Journal of Nursing Practice, 28(1). https://doi.org/10.1111/ijn.13031

Gramaglia, C., Gattoni, E., Marangon, D., Concina, D., Grossini, E., Rinaldi, C., Panella, M., & Zeppegno, P. (2021). Non-pharmacological approaches to depressed elderly with no or mild cognitive impairment in long-term care facilities. A systematic review of the literature. Frontiers in Public Health, 9(76), 685860. https://doi.org/10.3389/fpubh.2021.685860

Robinson, T. E., Boyd, M. L., North, D., Wignall, J., Dawe, M., McQueen, J., Frey, R. A., Raphael, D. L., & Kerse, N. (2021). Proactive primary care model for frail older people in New Zealand delays aged‐residential care: A quasi‐experiment. Journal of the American Geriatrics Society, 69(6), 1617–1626. https://doi.org/10.1111/jgs.17064

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Module 3 Discussion: Research Design
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