Nursing is important in quality and safety of hospital care and in patients' perceptions of their care. We also believe that there is a close association between patient safety, undergraduate nursing students’ learning with nurse staffing levels in Kenya, East Africa. The Ministry of Health as well as the Ministry of education does not yet support changing nurse workforce standards for teaching medical institutions. There are a lot on staffing issues in research that could be applied in Kenya and staff would be interested in a staff-understandable review of what has been discovered to establish the relationship between nurse workload and nurse-sensitive patient safety outcome indicators, staffing issues on the effect of workload on patient outcomes or staff outcomes, how this relates to undergraduate nursing students clinical experience. The Workload/assignment might mean the number of patients that a staff member can care for and complete all care safely, while safe would mean avoiding injuries to patients from the care that is intended to help them. Generally nurse managers ought to implement staffing processes that align staff skills and competencies with prioritized patient needs supported on a shift-to-shift basis. A fair and balanced patient assignment increases nurse satisfaction in their daily work. I would like to conduct such a study if I got some way of going about it. I wonder if I would get anything new. Which angle seems unique?
Simon - a good question - but a very tricky one to answer. The debate over staff-patient ratios has raged for a number of years now - with no clear or universal consensus to emerge. It's never as simple as 'How many nurses a needed to care for how many patients?' There are as many as 100 different factors that have to be factored in - and situations are never static - so no one formulae can suit any one situation all of the time. That's why some countries have it and some don't. Here in New Zealand, for instance, there is no national formulae. Some parts of - say Australia and the US have mandatory staff-patient ratios - but different states adopt different models - while others don't have a model at all.
One of the factors that can be part of the formulae can be staff preceptorship with students etc. That said, student nurses are not part of the formal staff rota in most cases. They are seconded to placements mostly in an 'observational' capacity - so cannot be included in the ratio themselves. Personally, I would argue that the 'general' issue of staff ratios has been covered so much by now, with no definite outcome, that further studies are not encouraged. You might have a different spin on it here - if say you interviewed student nurses experiences of working with preceptors/mentors etc where ratio systems were in place - or you could do a comparative study of students experiences working in environments with and those without.
From the perspective of nursing staff: nurse patient ratios create safe, sustainable working environments. I don't know if a study has been done on nurse burnout or nursing caregiver fatigue with higher ratios. considering patient acuity can more accurately determine the workload. 6 low acuity patients are much easier to manage and creates less work stress for the nurse than 6 total care patients. Balancing the acuity of the assignment evens the workload and reduces risk of something being missed or med errors of the nurse with a high acuity assignment.
From the perspective of nursing education: if a nurse has to heavy an assignment she cannot effectively mentor a student. Having a student to guide with an overly heavy workload creates additional stress and distraction and may increase risks such as those mentioned above.
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