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The Nurse to Patient Ratio Challenge in Ontario

Healthcare facilities in Ontario provide care and support to patients/residents who require assistance with their daily activities due to physical or cognitive impairments. The provision of quality care in these facilities relies heavily on the staffing levels and the “nurse to patient ratio”. However, maintaining an appropriate nurse to patient ratio that ensures patients/residents safety in our healthcare facilities is a significant challenge faced by the industry. One of the primary challenges in maintaining an appropriate nurse to patient ratio in healthcare facilities is the lack of clear guidelines from the CNO, RNAO, RPNAO and ONA. This makes it challenging for healthcare facilities to determine appropriate staffing levels, resulting in variations in the number of nursing staff in different facilities. A common staffing model in LTC facilities is one registered nurse (RN) and three personal support workers (PSWs) looking after 30 residents. While this may appear adequate on paper, it leaves lots of room for patient errors, particularly when dealing with high-needs residents. This staffing level may result in delays in medication administration, inadequate monitoring of vital signs, and insufficient support for residents with mobility issues. The consequences of inadequate staffing levels in LTC facilities can be severe. Inadequate staffing increases the risk of medication errors, falls, pressure ulcers, infections, and other adverse outcomes. These outcomes can have significant physical, emotional, and financial impacts on residents, their families, and the healthcare system. To address the challenges of maintaining an appropriate nurse to patient ratio in Healthcare facilities, several solutions can be considered. One being, collaboration between CNO, RNAO, RPNAO, along with ONA to develop clear guidelines on staffing levels for Ontario's Healthcare facilities. These guidelines could consider the needs of patients/residents in those facilities and ensure that the nurse to patient ratio is adequate to meet those needs. Secondly, a focus for these facilities is to invest in staff training and development to ensure that nursing staff have the knowledge, skill and judgment to provide quality care to patients/residents. This could involve ongoing education and training programs to enhance clinical skills and ensure that nursing staff are up-to-date with the latest best practices. Thirdly, Incorporating a Nurse Lead whose sole responsibility is to continually have a pulse on patient/resident status. In allowing for this implementation within healthcare, the trained Nurse Lead can then alter the number of patients/residents assigned to each Nurse for each shift. When the Nurse Lead adjusts patient/resident ratios, this then allows the Nurse assigned to the patients to have an assignment that allows them to appropriately care for each patient/resident. I have seen this format work in the healthcare setting. Staff felt safe each shift! Patients were cared for! KPI metrics met! Looking forward to healthcare shifting into this model which will increase staff retention, see a rise in patient and caregiver satisfaction and see a system that is focused on #changinghealthcare!

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