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Safety and Quality in Nursing Care

Adam Bennett
11/3/13

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Abstract: This article looks at the effect of a high and low patient to nurse ratio. It looks at
mortality rates related to the ratio and how high ratios can be dangerous to both the patient and
the nurse. It also looks at how some nurses are trying to prevent high patient to nurse ratios.
Safety and Quality in Nursing Care
Nursing is seen as one of the most dangerous jobs that a person can have in todays
society. Nurses are exposed to multiple different types of diseases and illnesses on a daily basis.
Due to this, it is important for nurses to maintain a safe work environment and good nursing
quality for both themselves and their patients. This means that a nurse should be given proper
training in safe procedures for both the nurse and their patient and in quality of care for their
patient. The American Nurses Association (ANA) has published ten guidelines in order to
promote safety and quality of care in nursing. One of the guidelines published by the ANA is
Nurses have the right to work in an environment that is safe and healthy.(American Nurses
Association, 2010) This means that a nurse should be in a working environment where the
proper protection is in place that will protect both the nurse and the patient and it is also an
environment that the nurse feels safe to work in. When some people think about nursing safety in
nursing they think of just disease protection. However, the nurse to patient ratio can also affect
the safety of both the nurse and the patient.
In a recent research article conducted by the U.S Department of Health and Human
Services, it was stated that Hospitals with low nurse staffing levels tend to have higher rates of
poor patient outcomes such as pneumonia, shock, cardiac arrest, and urinary tract infections.
(Stanton, 2013) This shows that due to low staffing there are some nosocomial illnesses and
infections that in some cases could have been prevented. Low staffing is also a health hazard for
the nurse. Many studies have been done and majorities have shown that many nurses obtain
mental burnout quicker than nurses who work in a facility that is not understaffed. Mental
burnout can lead to severe problems for the nurse and the patient. Nurses who are mentally worn

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out are more likely to make mistakes while working. This could lead to potential danger to
patients.
There are many ways in which nurses are trying to prevent having high patient to nurse
ratios. One way is by demonstrating the decrease in mortality rate that is seen when there is a
lower nurse to patient ratio. In a recent study, it was shown that the mortality rates of patients
decreased when the patient to nurse ratio was low. The data shows that when a nurse had 8
patients the average number of the data collected showed that 2.39 patients died where as a nurse
that was caring for only four patients that the number drops to 1.83 patients. (Rothberg,
Abraham, Lindenauer & Rose, 2005) It is impossible to only have a portion of a patient so these
are only the mean numbers from the study. That is one ways in which nurses are using statistical
data in order to prevent high patient to nurse ratios.
Nurses have the right to work in an environment that is safe and healthy is closely related
to the idea of low nurse to patient ratios. This creates a better working environment for the nurse
by decreasing the amount of mental burnout the nurse has which in turn increases job
satisfaction. Also the patient is less at risk for nosocomial infections and errors committed by the
nurse due to mental burnout. It is important to have low patient to nurse ratios in order to create
a healthy environment for the patient and the nurse.

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References
American Nurses Association. (2010). Scope and standards of practice in nursing. (2nd ed., p.
73). siver springs, MD: Nursebooks.org.
Rothberg, M., Abraham, I., Lindenauer, P., & Rose, D. (2005). Improving nurse-to-patient
staffing ratios as a cost-effective safety intervention. Medical Care, 43(8), 785-791.
Stanton, M. (2013, 02 13). Hospital nurse staffing and quality of care.