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What should be considered when utilizing a ratio staffing structure?

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Ratios are a common strategy for staffing plans, particularly in specialty areas of nursing such as the ICU or labor and delivery. Patient units often have a very diverse mix of patients, based on the services provided in the organization and the demographics of the population. This is especially true when you start looking at some of the units which cover a broader spectrum of patients such as the medical/surgical or progressive care units. Critical points to consider if you use a ratio structure include the following:

  • Direct care nurses have input into the plan
  • Individual needs of patients are integrated into the plan
  • Competency of the staff is a consideration, including experience and training
  • Consideration for the technology devices which are a part of the care
  • Inclusion of support services for provision of care

This approach to staffing is much more flexible to the needs of patients and offers the opportunity for changes in technology, as well as change in the condition of the patient which often occurs on a moment's notice.

Pamela Hunt, BS, MSN, RN and Deborah Laughon, RN, BSN, MS, DBA, CCRN