Benchmark – Effective Approaches in Leadership and Management Paper

Benchmark – Effective Approaches in Leadership and Management Paper

Benchmark – Effective Approaches in Leadership and Management Paper

The nursing practice, its managers and leaders encounter diverse issues that impact their ability and competence to deliver quality and patient-centered care. These issues range from lateral violence to nurse turnover rates and even nurse staffing ratios that leaders and managers must address to ensure effective and quality care delivery. High rates of nurse turnover emanate from different factors like the nurse staffing ratios (Bryant et al., 2019). Recent legislations like in California focus on mandating healthcare organizations to ascertain that they have sufficient nurse staffing ratios to deliver quality patient care. The purpose of this paper is to discuss different approaches that nurse leaders and managers can employ in addressing nurse staffing ratio in healthcare settings.

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Nurse Staffing Ratios and Impacts on Quality of Care and Patient Safety

Nurse staffing ratio denote the ratio of nurses on a certain unit, floor or ward to the number of patients in such settings. For instance, units with increased acuity care like the intensive care unit (ICU) have lower ratio of nurses to patients meaning that nurses serve few patients as compared to those with lower acuity which experience fewer nurses to more patients (Antwi & Bowblis, 2018). The usual ratio for a medical-surgical unit would be one nurse to six patients while in higher acuity care areas like the ICU, the ratio is one nurse to two patients. However, the reality is that many units across the healthcare system are understaffed and experience high turnover rates making nurses to work based on unsafe ratios.

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The huge cuts in hospital and healthcare budgets as well as a shortage of qualified nurses have pushed many facilities and nurse practitioners to work with these unsafe ratios. High nurse staffing ratios presents significant challenges that impact patient safety and quality of care provided by the practitioners. Studies have consistently demonstrated that nurses caring for many patients beyond the recommended levels risk being stressed and experiencing burnout that impacts their ability to offer quality care (Vuong, 2020). These nurses may be prone to medication errors and mistakes because of the hectic schedules and having several patients to monitor and care for during their shifts (Bridges et al., 2019). For instance, nurses in such units may not have sufficient time to offer patient-centered care through provision of emotional support and comfort. Further, they cannot offer patient education and other primary care interventions to improve quality of care because of the large numbers that they must handle. According to the American Nurses Association (ANA, 2022), appropriate nurse staffing levels lead to improved patient outcomes and also better satisfaction for both providers and patients. Staffing impacts the ability of nurses to deliver safe and quality care in all setting. Imperatively, safe nurse staffing is important for both the profession and the overall health care system as it implies quality care and patient safety as well as improved outcomes.

Professional Standards of Practice to Address the Issue and Maintain Professional Conduct

Advanced practice registered nurses (APRNs) must adhere to the expected professional standards of practice as developed by their professional organizations like the American Nurses Association and regulatory entities like the National Council for State Boards of Nursing (NCSBN) and their respective state boards of nursing (BON) (Haegdorens et al., 2019). These professional standards are an integral part of how they handle diverse patients and situations like the nurse staffing ratios with the aim of maintaining their professional conduct. These standards reflect a desirable and attainable level of performance for each nurse to evaluate and compare theirs and ascertain if they meet the regulatory mandates (ANA, 2022). The primary purpose of professional standards of practice is to offer guidelines and directions as well as maintain a safe and clinically competent nursing workforce and practices. These standards address the right nurse to patient ratios to inform safe care delivery and ensure that nurses take responsibility for their actions on each patients.

Having a balanced or a requisite nurse-to-patient ratio can entail several professional standards and implore nurses to maintain such standards to deliver safe and quality care. Nurses, patients and the healthcare systems experience safer and quality outcomes when the staffing ratios are safe and within the best practices and professional standards (Haegdorens et al., 2019). Having safe staffing levels demonstrates the professional standards required and that should be maintained by nurse leaders and managers in different practice settings. Through these standard ratios, nurses will offer better and safe patient-centered care and develop best practices for long-term staff and patient satisfaction.

Roles and Approaches of Nurse Leaders and Managers

Nurse managers and nurse leaders may take diverse approaches and play different roles in addressing nurse staffing ratios in their facilities. Transformational nurse leaders are at the forefront of healthcare delivery systems and set practice standards aimed at delivering safe, quality and efficient patient care. They also bring their teams together and make sure that they attain unit goals and objects. They also delegate and acquire input from subordinates on the best way to handle the issue. A core aspect of these roles and approaches is innovation (Whitney, 2018). As innovative leaders, they creatively allow their teams to develop new ideas and ways of attaining requisite nurse-to-patient ratios in different units, from the ICU to medical-surgical wards based on the acuity levels (Rafferty, 2020). Nurse leaders can also take patient assignments despite their positions and responsibilities. Nurse leaders should always inspire their staff to voice their concerns and ideas on the issue at hand as such approaches institute and nurture trust and respect between the leader and the nursing staff.

Nurse managers have different approaches based on the responsibilities and positions that they hold. Nurse managers may be keen on maintaining the status quo and ensuring that they follow the management’s position on the issue (Reinhardt et al., 2020). For instance, nurse managers can make necessary changes like hiring appropriate number of nurses to attain adequate levels required. They also have a duty to develop schedules and planning in advance on issues that arise in the care setting. Nurse managers also mandate subordinates to report issues and concerns based on changes in their units for better staffing measures (Schwenker, 2022). Managers may be more transactional because they follow their functions like planning, hiring and directing. However, their approaches may be devoid of the best ways to handle the nurse-to-patient ratios.

Additional Aspects to Ensure Professionalism

Managers and leaders ensure professionalism in nursing practice when they are guided by best practice standards and increased use of evidence-based interventions to tackle the issue of nurse staffing ratios. Professionalism is a core aspect of nursing practice and both nurse leaders and managers should implore their subordinates to observe and maintain the expected standards (Reinhardt et al., 2020). These include cultural competent care, increased skills to deal with diverse patients, and integrative approach through inter-professional teams.

Effective communication and better planning are also core to ensuring professionalism. Effective nurse leaders and managers possess communication skills that allows them to have better rapports with patients and other providers (Bridges et al., 2019). Emotional intelligence is also an added aspect that improves professionalism for nurse managers and leaders to address the challenge of getting the right nurse-to-patient ratios in their settings. Emotionally intelligent leaders and managers have high levels of self-awareness and self-regulation as well as empathy to understand their nurses and how they deal with increased diversity in health care provision and delivery of care (Whitney, 2018). Nurse manager can enhance professionalism in diverse healthcare settings when they hire culturally-sensitive and trained nurses who appreciate diversity of the population that they serve in their facility or unit.

Leadership Style

The most effective leadership style to address the nurse staffing ratios issue is situational approach because it is flexible and allows leaders to adopt diverse styles based on the circumstances, culture and the nature of teams that they have in their units (Whitney, 2018). The nurse staffing ratios is an issue that keeps transforming and having a combination of leadership styles; from servant leadership to transformational and participative, the nurse leaders and managers can address the situation based on the dynamics at the moment (Schwenker, 2022). The issue of nurse staffing ration is contingent to the manager or leader’s approach to team collaboration, capabilities and cultural diversity as well as their motivation and vision to attain among the shift staff for effective patient care. The implication is that employing this approach to leadership is a critical aspect of care delivery as it demonstrates that leaders and managers are keen on addressing the staffing problems in their units and settings.


The increased need for nurses implores leaders and managers to develop professional and evidence-based approaches to address nurse staffing ratios. This means that they should have better retention levels and prevent possible turnovers. Nurse leaders and managers must use appropriate approaches and interventions to improve the workplace conditions of their nurses to attain quality care as poor ratios lead to low quality care and threatens patient safety.



American Nurses Association (ANA). (2022). Nurse Staffing.


Antwi, Y.A. & Bowblis, J.R. (2018). The impact of nurse turnover on quality of care and

mortality in nursing homes: Evidence from the great recession. American Journal of Health Economics, 4(2), 131–163.

Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M. (2019). Hospital nurse staffing and staff–

patient interactions: an observational study. BMJ quality & safety, 28(9), 706-713.

Bryant, K., Aebersold, M. L., Jeffries, P. R., & Kardong-Edgren, S. (2020). Innovations in

simulation: Nursing leaders’ exchange of best practices. Clinical Simulation in Nursing, 41, 33-40.

Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of

nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multi-center study. BMC health services research, 19(1), 1-9. DOI:

Rafferty, A. M. (2020). Nurse staffing impacts on patient and nurse outcomes. Nursing Standard,

            35(10):40-43. DOI: 10.7748/ns.35.10.40. s29

Reinhardt, A. C., Leon, T. G., & Summers, L. O. (2022). The Transformational Leader in

Nursing Practice–an approach to retain nursing staff. Administrative Issues Journal:

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Patient Ratios to Increase Patient Safety in Acute Care Settings. The Eleanor Mann School of Nursing Undergraduate Honors Theses.

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            DOI: 10.1097/01.NAJ.0000662724.83879.81

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Nursing Leadership & Management: Leading and Serving.

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Assessment Description
In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

Select an issue from the following list: bullying, unit closures and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
Discuss what additional aspects managers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.
Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

This benchmark assignment assesses the following programmatic competencies:


1.1: Exemplify professionalism in diverse health care settings.

1.3: Exercise professional nursing leadership and management roles in the promotion of patient safety and quality care.

3.4: Demonstrate professional standards of practice.

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