Nurse/midwife-to-patient ratios: A scoping review

Abstract

Background: A significant body of work has linked high nurse or midwife workload to negative patient outcomes. Anecdotal reports suggest that mandated ratio models enhance patient care and improve nurse job satisfaction. However, there is limited focused research.

Objective: To identify key outcomes, implementation processes, and research needs regarding nurse/midwife-to-patient ratios in the Australian healthcare context.

Design: Scoping review.

Methods: Data sources were CINAHL, Open Dissertations, Medline, and Scopus. 289 articles screened, and 53 full text documents independently assessed against criteria by two reviewers and conflicts resolved by a third reviewer, using Covidence™. Three studies were included in this review.

Results: Studies focused on nurse (job satisfaction, burnout), patient (mortality, readmission, length of stay) and system (costs) outcomes with limited information on implementation processes and no midwifery research.

Conclusions: Ratios provide benefits for patients, nurses, and hospitals although there is limited research in Australia. Implementation was poorly reported..

Keywords: implementation; midwifery; nursing; ratios; workload.