ORAHS2025
Abstract Submission

93. Nurse to patient ratios in South Africa and its impact on nurse and patient outcomes

Invited abstract in session MC-3: Staff scheduling, stream Sessions.

Monday, 11:00-12:30
Room: NTNU, Realfagbygget R9

Authors (first author is the speaker)

1. Siedine Coetzee
North-West University
2. Jacoba Bührmann
School of Industrial Engineering, North-West University

Abstract

Introduction: Systematic reviews confirm that higher nurse-to-patient ratios are associated with poorer nurse and patient outcomes. Countries worldwide have adopted varied approaches to managing nurse staffing but developing countries such as South Africa (SA) provide little guidance.
Aim: To determine the current nurse-to-patient ratio and its impact on nurse and patient outcomes.
Method: The dataset was a national survey conducted in 2021/2022 among nurses in SA (n=4554). Principal component analysis was used to identify key explanatory variables of nurse-to-patient ratios, which were then compared to key outcomes. Trend analysis highlighted negative declines in outcomes as nurse staffing ratios increased. Robust logistic models estimated the association between nurse staffing and adverse outcomes.
Results: The overall nurse-to-patient ratio was 4.70, while for Registered Nurses it was 14.23. Each additional patient per nurse led to a 16.2% increase in job dissatisfaction, a 17.0% increase in emotional exhaustion, and a 9.9% increase in turnover intention. Patient outcomes showed a 21.2% decrease in nurse-perceived patient safety and a 25.7% decrease in nurse-perceived quality of care.
Conclusion: SA’s current RN-to-patient ratio is considerably higher than what is recommended in developed countries and negatively impacts both nurse and patient outcomes. The researchers recommend a nurse-to-patient ratio of at least 1:8 based on national data.

Keywords

Status: accepted


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