Business Plan Improving Nurse to Patient Ratio

Improving Nurse to Patient Ratio Author's Name Institutional Affiliation Improving Nurse to Patient Ratio Executive Summary This is the value enhancement project that will focus on improved quality of care from nurses through revised nurse-to-patient ratio (NPR). By providing better NPR, the hospital will not only improve its staff turnover, but it will also build its relations with its primary customers, or patients. There are various stakeholders who will be affected by this project, including nurses, patients, hospital and departmental administration, and union. The hospital will effectively reduce the staffing costs in the long run by decreasing the costs related to high turnover and staff absenteeism. Value Proposition Like most other professionals who serve health sector, the members of the nursing profession also experience frequent burnout, undergo emotional labor, and have to deal with traumatic experiences of witnessing death and pain in fellow human beings on regular basis. This stress often leads to long-term physical ailments of the staff, increased turnaround, and, in some cases, negligence of duties towards patients. There is no denying that such nursing negligence can lead to severe consequences for the involved patient. Although nurses are helped in these stressful conditions by their training to manage their physical and mental health before looking after their patients, a lower nurse to patient ratio is bound to negatively impact their satisfaction from the job by impacting their ability to apply this training. In the end, such practices harm the interests of the sole stakeholders for whose service the whole system is designed; the patient. There are various customers who will benefit from an increase in a nurse to patient ratio. Customers other than nurses and patients include administration, doctors, and all hospital staff. The stakes of these stakeholders are discussed below. Patients: They often experience less attention to their condition and decrease in empathy. In extreme cases, they have to experience physical harms because of nursing negligence. Nurses: Nurses are the primary customers who are suffering because of the low nurse to patient ratio. In addition to increased physical and emotional stress from this excessive workload, they also face the threat of job loss and criminal charges of malpractice and negligence. Doctors: Physical and emotional stress from nurses also add to the emotional labor of doctors who may have to deal with a hostile staff member or fails to attain required information about the patient. Administration and other hospital staff: Frequent turnovers, high volume of customer complaints, and lack of cooperation from the nurses are a few problems to list. Literature Review Nurse to patient ratio (NPR) has a strong influence over the quality of care a healthcare setting can provide. Understaffing not only harm the interests of staff but also negatively impact the patients and puts the avoidable burden on the whole department. Various outcomes that are associated with the high patient to nurse ratio include poor patient education, improper documentation of drugs and vital signs, lower patient satisfaction, among other patient-related factors. A number of patient per nurse is related to the quality of care provided to the end customers of the healthcare industry, patients. Studies show a correlation between this ratio and nurse-sensitive patient care outcomes (Driscoll et al., 2017). One study focuses on factors, such as failure to rescue (FTR), heart failure, fluid overload, medication error, wound infection, length of stay, mortality, catheter-related urinary tract infection, and unplanned extubation to study the impact of differing NPR on quality of care provided to relevant patients. One key finding of the research is decreasing in in-hospital mortality rate by 14% under optimal NPR. Another study links this ratio with patient satisfaction with higher figure depicting more satisfied patients and vice versa. In addition to linking this ratio with patient satisfaction rate, this research also analyzes the relation between the average length of stay of the patients and nursing hours spent on individual patients. Less nurse-to-patient time allocated to each patient would result in a longer duration of hospital stay. Readmission rate of heart failure patients becomes higher when the quality of care decrease because of the low nurse-to-patient ratio (Magalhães, Dall'Agnol & Marck, 2013). One study links poor documentation from nurses to the fact or excessive workload which, in turn, is attributed to understaffed nursing stations (Shahverdi & Nasiri, 2018). This inefficiency in documenting a patient’s medical history can lead to various mild to intense level issues including improper patient care planning, communication with insurance providers and scheduling and administration of drugs. It should be noted that understaffing is only one of the many reasons which result in poor documentation from the nurses. In the end, the impact of this ratio on the staff’s job satisfaction is uncontested (Teeter, 2014). In fact, satisfaction with the workload is the third biggest factor which determines the level of job satisfaction a nurse might feel in his/her given position. Furthermore, job satisfaction shares a mild correlation with the level of workload a nurse has to bear. In short, optimizing nurse to patient ratio will surely enhance patients’, as well as nurses’, satisfaction. Intended Outcomes and Their Measurement The direct outcome of this development is an increase in the number of nurses per patient. The hospital should define a minimum number to benchmark the number of nurses in any department. An NPR of 1:8 is acceptable among most departments. However, some acute care departments will need a higher ratio. Other indirect expectations from this development include the following key performance indicators. Impact on Staff Turnover Rare: The program will likely result in a 20% decrease in annual staff turnover rate compared to the previous year. This is a rather straightforward measure to evaluate. The decrease in turnover rate will be tracked using human resource data related to this matter. Decrease in Absenteeism: Although those hospitals which present lower nurse to patient ratios often boost lower absenteeism because of stricter rules preventing the staff from taking days off, the ratio of sick days to other reasons of leaves is higher in these hospitals. The program will decrease the volume of absenteeism that results from physical ailments and stress by 10%. Again, the HR department will provide this information for evaluation purposes. Increase in Patient Satisfaction: This measure will look at the subjective responses from the patients. It should be noted that patients’ satisfaction comes from various factors, not just nurse’ diligence and care. However, this satisfaction will increase significantly. The data about patients’ satisfaction can be attained from feedback forms filled by them. Increase in quality of care: It is expected that the program will help in the improvement of nurse-sensitive patient outcomes. Various factors will appear as results including a decrease in complaints of medical errors; shortened hospital stays of the patients; and reduced readmissions. These outcomes will be measured by tracking information from various sources including medical records, patient intake and discharge forms, and feedback from the patients. Other than these quantifiable outcomes, the program will also give non-quantifiable outcomes. Some examples of such outcomes include stress-free and healthy hospital environment, elevated staff morale, and enhanced nurse-patient relations. These outcomes will generally improve the work environment which will ultimately help the hospital in building a positive reputation among clients. Supporting Activities It is apparent from the discussion so far that the hospital needs to recruit additional nurses to improve its nurse-to-patient ra...