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Determining the path to safe nurse-to-patient ratios and quality outcomes: a shared governance approach
Dissertation   Open access

Determining the path to safe nurse-to-patient ratios and quality outcomes: a shared governance approach

Kimberly Michelle Morrison
Doctor of Nursing Practice (D.N.P.), Drexel University
28 Jun 2021
DOI:
https://doi.org/10.17918/00001508
pdf
Morrison_Kimberly_DNP_20212.09 MBDownloadView

Abstract

Nurses Work environment Nursing services--Administration Nurses--Job satisfaction
Background: The rapidly increasing mean age of the population and looming nursing shortage have left many organizations challenged to create and promote healthy work environments (HWEs), including safe nurse-to-patient ratios (NPRs). Inadequate NPRs are associated with increased rates of burnout, job dissatisfaction, and intent to leave among nurses. Evidence supports engaging nurses in developing staffing plans with adequate NPRs to improve patient outcomes and nursing turnover rates. Purpose: Create the structure for a shared governance approach to staffing that facilitates the collaboration of direct care nurses and organizational leaders in developing dynamic, cost effective staffing models that support safe NPRs and HWEs. Methods: A workgroup consisting of organizational leaders and direct care nurses worked collaboratively to develop the structure of a staffing council informed by current evidence, experience, and organizational culture to support the development of adequate NPRs and HWEs within a 10-week timeframe utilizing evidence-based project management and a Gannt chart. Results: A completed evidence-based council charter that supported shared decision making between leadership and direct care nurses, incorporated anticipated guidelines included in proposed staffing legislation, was delivered within the designated timeframe and received approval from Chief Nursing Officer for implementation. Conclusion: Utilizing a shared decision-making model to create the structure of a staffing council engaged direct care nurses and organizational leaders in creating a collaborative approach to staffing that will support the creation of dynamic and cost-effective staffing models that promote safe patient care and HWEs for nurses.

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