Reducing Emergency Department Nurse to Patient Ratios to Reduce Preventable Deaths

Background: Staffing shortages, exacerbated by high turnover rates from staff burnout, have created an unsafe environment for nurses and patients alike, by creating an intensive imbalance in RN-to-patient ratio allocation. Inadequate RN-to-patient ratios have shown an increase in adverse events as well as the length of stay in units, such as the emergency department. Objectives: To analyze and synthesize current evidence of the relationship between the patient-nurse staff ratio and patient mortality rates in the emergency department. Methods: Using relevant keywords, we extensively searched the Cochrane Database, PubMed, Google Scholar, JSTOR, and EBSCO electronic databases for studies published in English between (2010-2022), which focused on RN-to-patient ratio allocation and the subsequent impact on patients\u27 outcomes. A quality assessment of the reviewed studies was conducted. Results: In this review, a total of ten studies were included which consisted of five mixed-methods studies, four quantitative studies, and one qualitative study. Nurse-to-patient ratios positively influence various factors for both registered nurses and patients alike. A ratio of 1 RN to 3 patients showed a marked reduction in mortality rates among patients, as well as a reduction of the overall workload of registered nurses. Conclusions: Implementing appropriate nurse-to-patient ratios in Emergency Departments could decrease poor health outcomes and subsequent mortality rates