Rationale

Matching patient needs with adequately trained nurses and maintaining safe patient-to-nurse ratio is essential to ensure the provision of safe and high-quality patient care. As such, nurse staffing ratios in critical care units is an important aspect when planning care [16]. The literature on nursing ratios in ICU has confirmed the relationship between ICU nurse staffing and patient outcomes. The reviewed studies confirm that a higher number of registered nursing staff to patient ratio (1:1 or 1:2) is highly associated with improved patient safety and better outcomes [13]. In the U.S. and Canada, the nurse-to-patient ratio in ICU stays close to (1:1.5) at both time points. Western Europe and Latin America had lower nurse staffing, especially at night, with an overall ratio of (~1:1.8) [17]. Note that this is the preferable situation when applicable or during non-pandemic times.

Additionally, critically ill patients require the care of nurses who have specialized knowledge and skills and who are given enough time to provide that care safely. Appropriate staffing ensures effective pairing of patient/family needs with the assigned nurse's knowledge, skills, and abilities. In fact, evidence confirms that the likelihood of serious complications and mortality rates increase when fewer registered nurses (RNs) are assigned to care for patients [13,18,19]. Similarly, a considerable amount of research indicates healthy work environments and better patient outcomes when a higher percentage of patient care tasks are provided by RNs [20].
