EVALUATING THE IMPACT OF NURSE TO PATIENT RATIO ON PATIENT SAFETY AND QUALITY OF CARE IN DHQ HOSPITAL MUZAFFARGARH

Abstract

Introduction Nurse-to-patient ratios are a critical determinant of healthcare quality and nurse well-being. In settings with understaffed nursing units, increased workloads contribute to compromised patient care, missed interventions, and staff burnout. Developing countries like Pakistan face challenges in maintaining optimal staffing levels, particularly in public sector hospitals, where resource constraints are prevalent. Understanding the consequences of disproportionate nurse-to-patient ratios is essential for workforce planning and quality improvement. Study Purpose The purpose of this study was to evaluate the impact of nurse-to-patient ratios on quality of patient care and nurse well-being, including task completion, perceived care outcomes, and burnout levels, among nurses working at District Headquarters (DHQ) Hospital Muzaffargarh. Research Methodology A descriptive cross-sectional study was conducted among 82 female nurses working across general medical, surgical, and emergency wards at DHQ Hospital Muzaffargarh. Participants were recruited using a purposive sampling technique. Data were collected using a structured and pre-validated questionnaire covering demographics, workload, quality of care, and burnout indicators. Descriptive statistics were analyzed using SPSS Version 27. Results The majority (63.4%) of participants were aged 19–25 years. In terms of job title, 46.3% were registered nurses, 41.5% student nurses, and 12.2% faculty nurses. Over 58% of nurses reported that their patient load was not manageable, and 92.7% believed that high patient ratios compromised the quality of care. Around 62% were unable to complete essential tasks, while 69.5% admitted to missed care due to insufficient staffing. Additionally, 73% observed increased complications such as falls or pressure sores, and 66% noticed higher patient complaints during low-staffing periods. Burnout was evident, with 80.5% experiencing exhaustion and 28% reporting it very frequently. Despite these conditions, 65.9% of nurses, primarily from morning shifts, expressed job satisfaction. Conclusion The findings confirm that suboptimal nurse-to-patient ratios significantly hinder the delivery of quality care and contribute to nurse fatigue and dissatisfaction. The lack of consistent workload adjustments based on patient acuity further exacerbates stress and compromises patient safety. Urgent policy-level interventions are needed to enforce evidence-based staffing standards and implement supportive systems for nurse well-being in Pakistani healthcare settings.