Nursing Knowledge International

Moving Beyond Ratios

It is imperative that nurses react to the issue of ratio-based staffing. Intuitively, we understand the right model incorporates the complexities of staff allocation, financial resources, and patient outcomes. As ratios migrate from California to the national health care stage, it is nurses who must keep the conversation focused on patients, not laws.

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Framing the Debate

This issue of ENK establishes a forum for nurses and health care leaders to present and debate the efficacy of mandated ratio-based staffing. Are ratios a knee-jerk solution driven by alarming reports of the recent past? Or are they the awkward but necessary first steps toward safer working environments and better outcomes? Read More

Moving Beyond Ratios
Guest editors Karole Mourek and Ken Colbert present a series of essays that both defines the issue of ratio-based staffing and sets a course for how nurses can respond to the issue with relevant evidence that incorporates the real-world complexities of patient needs.

Staffing Ratios and Patient Outcomes: Linkage, Legislation, and Logic
> by Karole Schafer Mourek and Kenneth W. Colbert

Comparing Staffing to Outcomes: A Conceptual Framework
> by Karole Schafer Mourek and Kenneth W. Colbert

Comparing Staffing to Outcomes: Model Applications
> by Kenneth W. Colbert and Karole Schafer Mourek

Living with Ratios
California is conducting a live field test on ratio-based staffing for the rest of the world to observe. While anecdotes and initial data are beginning to emerge, two ENK contributors add their voices to our real-time understanding of what nurses and patients are observing here.

A Bedside View
> by Ruth Plumb

Costs & Consequences
> by Roberta Mori

Expanding the Context
Perspectives on ratio-based staffing vary depending on point of view. The CNO sees it differently than the unions, and all could benefit from understanding the performance improvement methodologies that must be brought to bear as part of any fair-minded analysis.

An Executive Viewpoint
> by Richard Hader and Tara Dugan Claudio

A Performance Improvement Perspective
> by Kelly L. Podgorny

The Case for Ratios
> by Greg Perry