
HealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
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View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
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View All ProductsDeliver custom or industry designed product training directly to patient and resident care environments to reinforce proper use.
View All ProductsTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
View All ProductsCreate engaging and impactful learning experiences that meet the unique needs of your acute care staff.
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View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
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View All ProductsHealthcare scheduling software designed to optimize staffing requirements & elevate patient care
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View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
View All ProductsMitigate risk and elevate your quality of care. Improving both clinical and business outcomes starts with a smarter, more integrated approach to regulatory training, continuing education and quality management.
Learn MoreNurse-to-patient ratios have been heavily debated in the healthcare arena for decades, but the most important aspect of the conversation should be remembered: the right providers need to be in place to deliver the best patient care.
Study after study shows that when registered nurses are working in environments where they have a reasonable patient load, are adequately trained for the job, and are given the proper tools to perform their duties, they provide high-quality care to their patients. Contrarily, when the patient staffing ratio is too high, or nurses do not have adequate experience to manage the acuity of certain patients, the safety of patients can be compromised.
Every patient deserves the opportunity to receive quality care. Nurses can only provide that level of patient care when they are given what they need to do the job well. The future success of the U.S. healthcare system relies on solving the complex issue of nurse staffing.
Nurses play a critically important role in ensuring patient safety while providing care. Because they monitor patients for clinical deterioration, detect and report medication errors, identify changes in a patient’s condition, and perform several other tasks, it is essential for them to be responsible for the right number and mix of patients. However, it is a complicated process to determine the proper nurse-to-patient ratio for any given shift or care unit. It requires coordination between nurses and managers, and it is based on numerous factors, including the care setting, patient acuity, and the mix of nurse skills available.
For example, while five patients per nurse may be appropriate in an acute medical-surgical unit, only one or two patients per nurse may be advisable in an intensive care unit (ICU), depending on the acuity of the patient, as noted by the Agency for Healthcare Research and Quality.
Accurately assessing factors such as patient acuity is a key consideration when balancing patient safety, nurse workloads, and equitable staff assignments. Patient acuity systems can help maintain fair nursing assignments by equitably distributing the workload, thereby reducing patient safety risks and improving satisfaction among nurses and patients. Patient acuity also needs to match the competency of the nurse in order to protect patients.
“To close the experience-complexity gap, staffing models should consider nursing competency, patient severity of illness, and safe patient-to-nurse ratios,” stated an article published by Wolters Kluwer. “It is crucial that scheduling and staffing technology solutions have access to patient acuity and nurse competency data in order to recommend safe staffing levels.”
Nurses have a desire to show up for their patients and provide them with the best care possible. Depending on where they are employed, nurses will be required to adhere to a different standard of safe nurse staffing, which will have to do with more than nurse staffing ratios.
Members of the American Nurses Association’s (ANA) Nurse Staffing Task Force defined appropriate nurse staffing as a dynamic process that aligns the number of nurses, their workload, expertise, and resources with patient needs in order to achieve quality patient outcomes within a healthy work environment. Each state and facility manages safe staffing differently, whether it is through legally mandated nurse-to-patient ratios, public reporting systems, or hospital-based staffing committees.
California is the only state that mandates a ratio for all hospital specialties. For example, a nurse in the post-anesthesia care unit may care for two patients at a time. Meanwhile, Massachusetts mandates a ratio of one patient per nurse for ICUs. Exceptions can be made as long as nurses use an acuity tool to determine that a patient is stable enough to be paired. Nine states—Connecticut, Illinois, Minnesota, New York, Nevada, Ohio, Oregon, Texas, and Washington—participate in hospital-based staffing committees to develop staffing plans.
A new regulation drafted by the New York State Department of Health requiring hospitals to assign at least one nurse for every two patients in critical care units was adopted in June 2023 by the department's Public Health and Health Planning Council. It was part of a state law signed in 2021 that mandated hospitals establish clinical staffing committees.
Meanwhile, in August 2020, UI Health of the University of Illinois issued a memo informing its staff of a proposed staffing plan that they submitted to the Illinois Nurses Association. They explained their position that patient acuity‐based staffing plans were the best for patient safety and quality outcomes.
“Staffing by acuity … recognizes the professionalism of our nurses and takes into account each nurse’s education level, expertise, skills, knowledge and experiences,” they wrote in the memo. “It means staffing the right nurse to the right type of patient at the right time. This leads to better health outcomes, more consistent and manageable nursing workloads, higher staff satisfaction and better patient experiences.”
Although each state approaches nurse staffing and ratios differently, the ANA says an increasing body of evidence shows that appropriate nurse staffing contributes to improved patient outcomes and greater patient satisfaction.
Furthermore, researchers from a 2021 study concluded that “improving hospital nurse staffing would likely save thousands of lives per year and that the associated cost would be offset by savings achieved by reducing hospital readmissions and length of hospital stays.” Their analysis found that each additional patient per nurse increased the likelihood of death, length of hospital stays, and chances of being readmitted to the hospital within 30 days.
Ultimately, healthcare facilities must ensure that the most qualified nurses work in the right environment to deliver optimal patient care. If you are eager to improve your staff’s workload while managing rising patient acuity and demand, please contact HealthStream. With our Acuity and Assignment Manager, we can help you use objective clinical charting data to drive staffing decisions and make real-time staffing to demand possible.
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
View All ProductsHealthStream's education helps address diversity, equity, and inclusion within your organization, as well as promoting health equity in the communities you serve.
View All ProductsHealthStream offers professional training and education on how to best optimize your reimbursement process within your healthcare organization.
View All ReimbursementTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ResuscitationIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
View All ProductsLearn more about HealthStream's provider credentialing, privileging, & enrollment solutions for healthcare organizations.
View All CredentialingExperience standardized and centralized healthcare provider credentialing, privileging, and enrollment that is smarter and faster than ever before.
View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
View All ProductsNCQA-certified CVO verification services for initial and re-credentialing files in an overflow or full-service capacity for healthcare organizations.
View All ProductsSearch, review, and add providers into the Epic provider master file with our Epic app integration, Provider Validate.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare scheduling software designed to optimize staffing requirements & elevate patient care
View All ProductsPrecisely align staffing and needed resources to enable efficient patient flow and high-quality, cost-effective patient care.
View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
View All Products