RegisteredNursing: Relationship between Nurse Staffing and Patient Safety


Registerednurses have the knowledge and skills that increase their ability todeliver quality health care. The process of registering nurses andgiving them certificates before they can practice ensures that theyhave adequate academic and professional requirements. Nurses who havegone through the process of registration play an important role inaddressing the pressing challenge of medical errors. The recruitmentof an additional registered nurse reduces cases of medical error andpatient mortality rate by 4.3 %. Additionally, a decrease innurse-patient ratio is associated with a decline in cases ofreadmission, hospital-based infections, and failure-to-rescues. Theeffectiveness of registered nurses in helping patients is attributedto the fact that nurses spend more time with their clients than anyother category of health care professionals. This allows nurses toidentify any changes in health condition of the hospitalizedpatients, thus addressing medical issues before they develop intochronic diseases.

Keywords: Registered nurses, patient safety, medical errors, nurseshortage, readmission.

RegisteredNursing: Relationship between Nurse Staffing and Patient Safety

Registerednurses play critical roles in providing and coordinating the deliveryof health care, patient, and public health education. The role ofregistered nurses extends beyond the ill persons since they areexpected to provide emotional support and advice to the familymembers of the patients (Shekelle, 2013). Apart from academicqualifications (including the bachelor’s degree or a diploma),nurses are required to have a license before they can startpracticing. Although registered nurses are qualified to deliverhealth care services to patients, nearly all states require them towork under the supervision of or in collaboration with physicians.The large base of knowledge to evaluate, plan, and intervene toenhance the health, prevent the occurrence of diseases, and impartclients with the coping skills help nurses play a significant role inincreasing patient safety.


Therelationship between the nurse-staffing and patient safety has becomean area of interest to scholars and researchers. The stakeholders inthe field of health are interested in understanding the role ofnurses in enhancing patient safety, quality of care, and reducing therate of death of patients shortly after discharge. According toShekelle (2013) about 2 % of the patients who are discharged afterundergoing surgery die within the first 30 days after theirdischarge. This challenge is attributed to the lack of adequatenursing care and an increase in medical errors, both of which resultsfrom the shortage of registered nurses in the affected health carefacilities. About 19 % of the medications given to patients in healthcare facilities with a shortage of registered nurses are in error,which lowers the survival rate of patients (Frith, Anderson, Tseng &ampFong, 2012). This makes the relationship between nurse-staffing andpatient safety a health issue worthwhile studying.

Nursestaffing and patient safety

Severalstudies have been conducted to determine the role of registerednurses in enhancing the safety of patients. Registered nurses enhancepatient safety and reduce the mortality rate by increasing the numberof hours that patients are in contact with qualified health careproviders. According to Shekelle (2013) recruitment of one registerednurse for every 1,000 inpatient days is significantly related to adecline in mortality rate of hospitalized patients by 4.3 %.Registered nurses spend more time with patients than physicians,which imply that the earlier have a better chance to understand thehealth needs of patients and detect significant changes that requireadjustment in the medication. In addition, registered nurses increasethe level of patient safety by acting as a link between clients andphysicians. This is because the close contact between nurse andpatients help them detect any changes in disease progression andnotify physicians before the illness can reach the chronic stage(Shekelle, 2013). Therefore, an increase in the number of registerednurses protects patients from chronic illnesses, enhances recovery,and reduce mortality rate.

Roleof registered nurses in reducing medical errors

Therate of change in the number of cases of medical errors is one of thekey indicators of quality of care that is offered by specific healthcare facilities. Although patients are served by health professionalswith different specialties, registered nurses play a cardinal role inlowering the rate of medical errors. An increase in the number ofregistered nurses is positively associated with a decline in cases ofadverse outcomes. Hiring of additional registered nurses reduces theburnout of the current body of nurses, which increases their abilityto deliver quality care. According to Cirpili, Kelly, Aown, Browar,Delaney, Hanrahan &amp Repique (2012) an increase in the number ofregistered nurses is positively associated with a decrease in therate of infection, failure-to-rescues, and the length of hospitalstay.

Moreover,a 20 % decline in the nurse-patient ratio is associated with adecrease in medical errors by 18 % (Frith, Anderson, Tseng &ampFong, 2012). The findings suggest that a higher proportion ofregistered nurses provide one of the most viable solutions to theissue of medication errors. Although the cost of hiring additionalregistered nurses may increase the cost of delivering care, everyhealth care facility that offers patient-centered care should be ableto find the optimum patient-nurse ratio in order to minimizeincidents of adverse treatment outcome.


Acomprehensive nurse training program equips registered nurses withskills that help them play a critical role in enhancing patientsafety and reduce medical errors. The issue of a decline in patientsafety is attributed to an increase in the ratio of registered nursesto patients. A high nurse-patient ratio is an indication of ashortage of health care professionals. Registered nurses play themost important role in enhancing patient safety because they spendmore time with their clients than any other category of health careprofessionals. This enables registered nurses to monitor patients`progress and discovers new medical problems before they advance tochronic stages. By reducing the nurse-patient ratio, health carefacilities are able to lower cases of nurse burnout, which increasethe ability of the current body of nurses to provide health care toall clients. Therefore, the role of registered nurses in the healthcare industry cannot be ignored.


Cirpili,A., Kelly, A., Aown, T., Browar, J., Delaney, K., Hanrahan, P., &ampRepique, R. (2012). APNA position statement: Staffing inpatientpsychiatric units. Journalof the American Psychiatric Nurses Association,18 (16), 17-22.

Frith,H., Anderson, E., Tseng, F. &amp Fong, A. (2012). Nurse staffing isan important strategy to prevent medication errors in communityhospitals. NursingEconomics,30 (5), 288-294.

Shekelle,G. (2013). Nurse-patient ratio as a patient safety strategy: Asystematic review. Annalsof International Medicine,158 (5), 404-409.