N515-PE – Inadequate Staffing in Healthcare Facilities Essay

N515-PE – Inadequate Staffing in Healthcare Facilities Essay

Inadequate Staffing in Healthcare Facilities

Inadequate staffing is a problem that persists in Healthcare facilities across the United States. The effects of understaffing are far-reaching and have the potential to cause devasting consequences such as medical errors, patient falls, medication errors, infections, and death. The lack of adequate nurse staffing can result in longer lengths of stay, patient dissatisfaction, and higher readmissions (Lee, Cheung, Leo, Leung, & Hung, 2017). In this paper, we will examine how inadequate staffing affects patient outcomes, potential solutions to this problem, and discuss the best staffing guidelines as evidenced by research N515-PE – Inadequate Staffing in Healthcare Facilities Essay.


Impact on Nursing and Patient Outcomes

            Most healthcare providers are aware that safe staffing greatly impacts the safety and quality of patient care. So, one might ask why so many healthcare organizations allow their facilities to operate with unsafe nursing ratios. There is ample research that identifies the effects/outcomes of unsafe staffing practices, but not much research that provides answers to the question of why it’s allowed to happen. Could the answer be that healthcare organizations are reluctant to admit that they allow this practice to take place despite knowing the potential consequences? N515-PE – Inadequate Staffing in Healthcare Facilities Essay.  According to the article Unsafe staffing ratios, national healthcare systems have become overwhelmed with enormous health care debt, increasing the incidence of chronic illness, and the common misuse of many healthcare services which has led to major budgetary restrictions being put in place to prevent further damage to the system. While the need for some restrictions is necessary, it is vital that organizations set standards for adequate staffing.

In 2012 the Affordable Health Care Act was introduced.  It contained a component that was aimed to reduce readmission rates by penalizing hospitals that had excessive readmission rates among Medicare recipients (Hugh, Berez, & Small, 2013).  The goal of this component was to reduce readmission rates by offering incentives to hospitals that had good quality and low readmission rates. Hugh et al. (2013) stated that a reduction in readmission rates was highly dependent upon having adequate nurse staffing to ensure proper discharge planning, care coordination, and patient education N515-PE – Inadequate Staffing in Healthcare Facilities Essay. The study went on to reveal that hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to other similar healthcare facilities with lower staffing.

A study conducted by Linda Aiken Ph.D., RN, Penn State concluded that for every additional patient a nurse cared for, patients were at a 7% greater risk of dying within 30 days of admission, and there also was a greater risk of failure to rescue in an acute situation.  Also, numerous other studies have shown that patient’s suffering an acute cardiac arrest, or other life-threatening illnesses were more likely to survive in hospitals and other medical facilities that had adequate nurse staffing ratios.  Additionally, research has found that healthcare facilities with appropriate staffing ratios consistently scored higher on patient satisfaction surveys (Learner, 2013).

Potential Solutions to Address Inadequate staffing

             A possible solution to inadequate nurse staffing is setting mandatory nurse to patient ratios.  However, this is a highly controversial move. There has been an ongoing debate for years as to whether mandatory staffing rations hurt or help inadequate staffing. Proponents of mandatory staffing ratios argue that mandated ratios decrease nurse burnout, staff turnover, decreases patient mortality, and preventable mistakes to name a few. Those who are opposed to mandatory staffing ratios argue that “minimum nurse-to-patient ratio laws impose steep fiscal costs on hospitals and allow them little say in regards to staffing decisions”(Jenkins, 2018, p. 221).  They also raise cause for concern that if mandatory ratios are put in place, beds may be unavailable to patients seeking medical care because there is not an adequate amount of nurses according to necessary ratios available to staff beds. N515-PE – Inadequate Staffing in Healthcare Facilities Essay. Although both sides present clear and compelling arguments, the focus must clearly center on what’s best for the patient.

Best Staffing Guidelines as Evidenced by Research

            In 2004, California became the first state to impose laws requiring a mandatory nurse to patient ratios in hospital settings.  Since that time, many other States have expressed the need to have mandatory minimum ratios, but few have actually put laws into place.  “Research clearly shows that inadequate staffing can lead to higher costs and quality of care problems” (“Inadequate Staffing,” “n.d,” para. 3). Thus, leaving us to wonder why laws have not been enacted in all states to protect not only patients but nursing staff as well. Solutions exist to nurse staffing challenges in these times of qualified nursing shortages. They include optimizing existing staff, creating a balance of permanent and contingent staff, and better forecasting of anticipating staffing needs (Wolf, Perhats, Delao, Clark, & Moon, 2017) N515-PE – Inadequate Staffing in Healthcare Facilities Essay.


            In conclusion, whether you are a proponent or opponent of a mandatory nurse to patient ratios, I believe it is safe to say that all parties involved realize that change needs to take place.  As healthcare continues to grow and evolve, finding ways to protect the patient and staff should continue to be a relevant topic of conversation.  As nurse staffing improves, patient outcomes will continue to improve N515-PE – Inadequate Staffing in Healthcare Facilities Essay.


Hugh, M., Berez, J., & Small, D. (2013, Oct). Hospitals with Higher Nurse Staffing had Lower Odd of Readmission Penalties then Hospitals with Lower Staffing. Health Affairs, 32(10). https://doi.org/10.1377/hlthaff.2013.0613

Inadequate Staffing Harms Quality and the Bottom Line. (“n.d”). Retrieved 05/21/2019, from www.amnhealthcare.com N515-PE – Inadequate Staffing in Healthcare Facilities Essay

Jenkins, D., (2018). Inadequate Staffing: Patient Safety in Today’s Healthcare Market Place: A Four-Part Series. Retrieved from www.allnurses.com

Learner, S., (2013, Apr. 9). Can Cash-Strapped Health Boards Afford to Ignore Safe Staffing Levels? Nursing Standard, 27(31), 12-3. Retrieved from www.americansentinel.idm.oclc.org

Lee, A., Cheung, Y., Leo, J., Leung, C., & Hung, W. (2017, May). Are High Nurse Workload/Staffing Ratios Associated with Decreased Survival in Critically Ill Patients? A Cohort Study. Annals of Intensive Care, 7(1). https://doi.org/10.1186/s13613017-02692

Wolf, L., Perhats, C., Delao, A., Clark, P., & Moon, M. (2017, Mar,1). On the Threshold of Safety: A Qualitative Exploration of Nurses Perceptions of Factors Involved in Safe Staffing Levels in Emergency Departments. Journal of Emergency Nursing, 43(2), 150-157. https://doi.org/10.1016/j.jen206.09.003 N515-PE – Inadequate Staffing in Healthcare Facilities Essay

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