Exploring Leadership and Management Approaches to Nurse Turnover- Impact on Quality of Care and Patient Safety
Leadership and management are key aspects of nursing practice. Leadership entails influencing people towards the achievement of set goals. Management involves a series of steps: planning, organizing, staffing, directing, and controlling. This paper discusses nurse staffing ratios, their influence on delivering appropriate healthcare services, and how to uphold professional standards. Furthermore, it identifies the impact of leaders and managers in the nursing profession on nurse staffing ratios and leadership styles and describes qualities needed to maintain professionalism.
Selected Issue, Setting, and Impact on Patient Safety
Nursing staffing ratios are an important aspect of the healthcare sector. The nurse-to-patient ratio is regarded as the most critical part of health care delivery. These ratios indicate the number of patients that one nurse serves. A low nursing-staff ratio implies that the nursing staff attends to a huge patient population (Haryanto, 2019). Nursing-to-patient ratios should be optimized to ensure that one nurse serves a small population of patients. The optimized ratios differ depending on the department. The optimum ratio of nurses to patients in the critical care unit should be less than or equal to 1:2 (Chowdhury & Chakraborty, 2020). The optimum ratio in the emergency department should not exceed 1:4 for nurses and patients, respectively (Tamata et al., 2021). According to Tamata et al. (2021), the ratio recommended in the general wards is approximately 1:5 for nurses and patients, respectively.
The lack of optimized nursing staff ratios remains a global problem. Poor nursing-to-patient ratios have negative implications on patient care. Ratios higher than the optimized nurse-to-patient ratios indicate that nurses attend to a large population of patients: nurses have to work long-hour shifts, causing staff burnout. This increases the likelihood of medication errors occurring in the healthcare setting (Chowdhury & Chakraborty, 2020), increasing patient morbidity and mortality rates. According to Zhang et al. (2018), studies indicate that a nurse-to-patient ratio of 1:6 in the emergency department increased patient deaths by approximately 6.9%.
The lack of optimized ratios lowers the nursing staff’s morale. Job dissatisfaction hurts the quality of service delivery. Decreased quality of service delivery can be attributed to the huge workload caused by unoptimized ratios or lowered morale. Long working hours and lack of day-offs create fatigue which compromises the quality-of-service delivery (Zhang et al., 2018). Nurses are likely to prioritize specific patients at the expense of others. This impedes the delivery of holistic nursing care services to individual patients. Accordingly, healthcare institutions are likely to experience prolonged patient hospital stays. Prolonged stays have a negative financial impact on the patient and the hospital’s reputation. Therefore, nursing staffing ratios should be optimized to improve the quality-of-service delivery, reduce medication errors and improve patients’ quality of life.
Professional Standards of Practice to Rectify the Issue or Maintain Professional Conduct
The American Nurses Association (ANA) has set up principles and standards that can be used to address the problem of nurse staffing ratios. All nurses in all healthcare settings must play a role in matters concerning nurse staffing (Stievano & Tschudin, 2019). Applying this principle will enable the nurse to participate in formulating policies that uphold optimized nurse-to-patient ratios. ANA stipulates that nurse staffing differs based on the unique task (McClendon & Hurwitz, 2019). Applying this principle will ensure that various departments in healthcare institutions optimize their nursing staff to promote efficient and quality service delivery. ANA directs nurses to be flexible and embrace teamwork (McClendon & Hurwitz, 2019). In this context, nurses should be willing to adjust to low nurse staffing changes. They should be prepared for long-hour shifts and reduced day-offs. They should embrace teamwork with other healthcare providers to ensure that the quality of service delivery is not compromised.
According to McClendon & Hurwitz (2019), the standards of professional practice established by ANA require the nurse to plan, implement and evaluate. This is useful in the cases of low nursing staffing ratios. In this context, the plan should focus on fulfilling the needs of individual patients. This entails scheduling activities to avoid timewasting, further worsening the problem. Communication is the other essential aspect. Nurses should establish open communication with patients and the hospital administration. This will enable them to inform the administration of their grievance and how it affects their perform