Lynn Unruh, PhD, RN
Q: You recently examined published research on nurse-staff ratios and patient outcomes in acute-care settings. What can you tell us about the ratios in the long-term care arena?
A: The literature is much more homogeneous in long-term care than acute care. Almost unanimously, researchers find better staffing in nursing homes is related to better quality. Some of the researchers definitely are not union-oriented, either.

Q: What struck you most as you conducted your research?
A: There was an equally strong connection between  staffing levels  and how the levels related to patient outcomes, financial outcomes, and nurses themselves. They all affect one another.
Q: So can you recommend specific nurse-patient ratios?
A: No one has an answer as to the perfect amount. It’s not a pure numbers game but a workload issue. It’s self evident that if you give people too much to do, they won’t be able to do a good job.
Q: So what can providers do?
A: If it’s financially difficult to add staff, there are other ways to reduce workload reasonably. It can be affected by the structure, physical environment, the amount of paperwork they have to do, all of that kind of thing. It’s important not just for quality, but the cost will be as high if they don’t adequately staff in the first  place.