Cultura

The Impact of Nurse Staffing Levels on Patient Safety and Healthcare Outcomes: A Systematic Review

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Ibrahim Hamdan Abdullah Al Sofiany, Rawabi Turki Alotaibi, Nawaf Owaidh Saad Althagafi, Mohammed Saud Alharbi, Lama Ahmed Alnazawi, Mrouj Wasel Muktar, Majdah Abdulrahman Alamri, Sawsan Manea Alshehri, Abrar Abdulraheem Althmali

Abstract

This systematic review examines the relationship between nurse staffing levels and patient safety and healthcare outcomes. Nurse staffing is a critical indicator of healthcare quality, as inadequate staffing increases workload, delays care, and contributes to missed nursing care. The review aims to synthesize current evidence on how nurse-to-patient ratios, registered nurse hours per patient day, and skill mix influence outcomes such as mortality, hospital-acquired infections, medication errors, falls, pressure injuries, length of stay, readmission, and patient satisfaction. A systematic search should be conducted in databases such as PubMed, CINAHL, Scopus, Web of Science, and Google Scholar using keywords related to nurse staffing, patient safety, healthcare outcomes, and hospital care. Eligible studies may include systematic reviews, cohort studies, cross-sectional studies, and observational studies published in the last 10 years. The expected findings are that higher registered nurse staffing levels are associated with reduced adverse events, lower mortality, fewer complications, better patient experience, and improved care quality. The review highlights the need for evidence-based staffing policies, workforce planning, and leadership support to ensure safe and effective nursing care.

Keywords : nurse staffing, patient safety, healthcare outcomes, nurse-to-patient ratio, missed care, mortality, hospital-acquired infections.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty