Nurse to patient ratio


Nurses with their expertise in patient care and clinical methods are the backbone of a healthcare system, however in recent times nursing education has not been given enough importance due to which the quality and quantity of nurses has depleted at a concerning rate.


Nurse to patient ratio plays an important role in providing patients with quality healthcare, it can be considered as the ratio of nurses available to the number of patients admitted. The notion of an optimal level of nurse staffing is somewhat controversial because there is no one-size-fits-all approach to assessing staffing levels.

One of the challenges faced by managers responsible for staffing is finding a way to understand the influence of the multiple factors that make up each individual care environment which are likely to differ across organizations and countries.

To determine nurse staffing levels, managers need to understand the underlying determinants which are patient factors (patient nursing need according to acuity and dependency levels), ward factors (patient throughput) and nursing staff factors (number and skill level).

NPRs are typically expressed in two ways: the number of nurses working per shift or over a 24 hour period divided by the number of beds occupied by a patient over the same time period; or the number of nursing hours per patient bed days (NHPPD). There are other more complex approaches to measure nurse staffing requirements but there is no single recommended approach.

A higher level of nursing staff indicates more nurses (or higher proportion of nurses) for assigned patients. Lower nurse staffing is defined as fewer nurses (or lower proportion) for the number of assigned patients.


Burnout among Registered Nurses has been a great concern within the healthcare system and has been reported in many hospitals. Nurse Burnout has been defined as a chronic response to work-related stress comprising three components or dimensions: emotional exhaustion, depersonalization, and personal accomplishment. The purpose of this research was to analyze the nurse-to-patient ratio to determine how it affects the psychological, mental, emotional health and the nurse overall productivity in the workplace.

Burnout Syndrome has been a significant issue in the work environment and its occurrence has grown substantially by 60%-70% over the past decades. One of the most common definitions of Nurse Burnout has been a chronic response to work-related stress comprising three components or dimensions: emotional exhaustion, depersonalization, and personal accomplishment.

The minimum nurse-to-patient ratio in hospitals and ambulatory units has been recommended as 1:6 in medical-surgical units and behavioral units, 1:4 in step-down, telemetry, or intermediate care units and for non-critical emergency rooms, 1: 2 for Intensive Care Unit or trauma patients and post-anesthesia units, and 1:1 for every patient under anesthesia

As financially debilitating as the costs of empty nursing positions have been for healthcare organizations, those nurses experiencing burnout who do not leave their positions had an even larger financial liability as the loss of motivation has led to a lack of patient care and mistakes resulting in the hospital or other healthcare facility facing a possible liability situation. Up to 63% of preventable errors fell in the nursing sector, many attributed to lack of attention or performance from Burnout Symptoms.

The nature of this occupation places nurses into situations where they are often unprepared to handle due to lack of training, ability, support, resources or knowledge; leading to a high level of internalized anguish.


Decision-making about nurse staffing could be enhanced if operational research techniques were brought into mainstream nurse staffing research. There are also opportunities for further research on a range of nurse staff planning aspects: skill mix, nursing work other than direct patient care, quantifying risks and benefits of staffing below or above a target level, and validating staffing methods in a range of hospitals.