Assignment Prompt & Instructions
– ## DecisionMakingProcessPaperDue.docx
– ## TOPICandOUTLINEWritingAssignment3.docx
**## DecisionMakingProcessPaperDue.docx**
Decision Making Process Paper Due
**Decision-Making Process Paper**
Instructions
In this assignment, you will be writing a 6–8-page paper identifying, comparing and contrasting at least 3 different decision-making approaches of care from a multidisciplinary perspective using a pertinent and significant topic in nursing (examples might include nursing shortage and nurse turn-over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation or another current and relevant nursing issue) the topic
**MUST BE APPROVED** **by your nursing instructor before writing the paper. .** You are required to use APA 7th edition format and the page count does not include title page or reference page. Reflect on your own decision-making practices and the implications this will have regarding differing approaches taken of nursing leaders and staff nurses/clinical practitioners in decision making within to issues in practice. To complete this assignment, do the following:
1. Select and describe an issue in nursing that impacts nurses at all levels from bedside to advanced practice. Make sure to provide an adequate background and its significance to all levels of nursing using a strong review of the literature. Additionally, this should include a thorough literature review that provides a good understanding of what the cause of this problem is; what is suggested to address this problem. Essentially, this review must support your choices of the decision-making models and this needs to include how all levels of nursing practice (the bedside nurse to the APN are impacted by the problem).
2. Identify how you would expect a nurse leader/manager, a bedside/staff nurse and an Advanced practice nurse (CNO or NP) to address your selected issue using at least 3different decision-making approaches which are clearly supported by the literature review. This must first include aa detailed analysis/overview of the selected decision making models and how they are used in practice. Then a detailed analysis of how these decision-making approaches/models would address the problem/along with a detailed analysis of how each of the three selected models would be applied to address the selected issue/problem making sure to incorporate this at all levels of practice. One of the decision-making models may be more applicable to the bedside nurse; whereas the other more applicable to the APN; however, all levels of nursing practice need to be addressed with at least one of the chosen 3 decision-making models. However, this does not mean that each decision-making model will apply to all levels of practice only that in this discussion needs to include how each level of nursing practice would utilize the decision-making model to address the problem. For instance,one decision making model may apply to the bedside nurse; the second decision making model may be more applicable at the level of APN (CNO, NP, etc) and the other decision-making model may be best applied to the nurse manager. This section should be detailed; meaning specific, well thought out, realistic solutions of how the nurse (at the level identified; this may include more than one level for the same decision-making model or not) would address the problem using the decision-making model is provided and well supported by the literature. of the benefits and limitations of various decision-making approaches that are applied appropriately to the level of nursing practice to address the selected issue/problem. This is informed from course readings,literature, clinical scenarios and other evidence-based and scholarly sources.
3. Prioritize the best decision-making approach/model to address the selected problem that is grounded in best practice. This should provide a well-supported rationale for this choice that includes a good comparison and contrasting of the 3 chosen decision-making models that clearly illustrates why the choice was made, that is consistent with the decision making model and how it would address the chosen topic or problem.
4. Identify a possible funding source that would addresses your approach to solving the problem. For instance, if the best approach to solving the nurse-to-patient ratio problem is through the use of SDM and shared governance, perhaps you may seek a local funding source to provide you with funding to implement a small EBP or research project that would be funded by a local nursing organization such as Sigma Theta Tau or perhaps if it was geared more towards assessing the value of this model towards NP in practice than seeking a local organization that supports funding for projects being implemented by practicing NP? If seeking money for research this would need to be overseen by a nurse with a DNP or a PhD or someone with the credentials to do so that are part of their scope of practice. Consider looking at federal, state,or local organizations. For example: There are many grants available through the CDC,HRSA, etc. Again, this need to be specifically applied with sufficient details
Use at least 10 references other than your main text.Uses APA 7th edition formatting.
Please submit the Decision Making Process Paper in Word Format APA 7th ed. formatted (see instructions in the Assignments Tab of Blackboard along with the grading rubric).
**## TOPICandOUTLINEWritingAssignment3.docx**
2
**Nurse Staffing Ratios and Their Impact on Patient Outcomes: A Multilevel Decision-Making Approach**
David Alexander Revilla Cano
Florida National University
## Decision Making-DBX-DL01
## Dr. Nora Hernandez-Pupo
## July 14, 2025
**Nurse Staffing Ratios and Their Impact on Patient Outcomes: A Multilevel Decision-Making Approach**
**I. Introduction** **A**.
**Background Information**
Inadequate nurse staffing ratios are a pressing concern in healthcare systems globally. They directly impact patient outcomes, nurse well-being, and institutional performance. Mounting evidence links high patient-to-nurse ratios to increased mortality, medical errors, and nurse burnout (Twigg et al., 2021).
**B**.
**Statement of the Problem**
Despite the proven connection between safe staffing levels and positive outcomes, many healthcare institutions continue to struggle with chronic understaffing due to budgetary and regulatory constraints. The COVID-19 pandemic further exposed these vulnerabilities.
**C**.
**Thesis Statement**
This paper will examine how nurse staffing ratios affect all levels of nursing practice and how staff nurses, nurse managers, and advanced practice nurses can use Shared Decision-Making (SDM), Evidence-Based Practice (EBP), and Transformational Leadership to address the issue. The article will assess various methods and recommend the best strategy for sustainable clinical staffing improvements.
**II. Literature Review/Background** **A**.
**Overview of Existing Research**
Numerous studies have confirmed that safer staffing ratios correlate with improved patient safety and nurse retention (McHugh et al., 2021). Understaffing is also linked to documentation errors and missed care (Poudel, 2025).
**B**.
**Key Theories and Models**
1.
**Shared Decision-Making (SDM):** A participatory model that empowers bedside nurses in staffing-related decisions (Galletta et al., 2022).
2.
**Evidence-Based Practice (EBP):** Utilizes data to support staffing strategies that align with patient acuity and safety .
3.
**Transformational Leadership:** Encourages executive advocacy and systemic change by aligning workforce policies with nursing values .
**III. Main Body/Discussion**
A.
**Topic Analysis or Context**
1. Overview of staffing challenges in current hospital environments.
2. Regulatory disparities across states and implications for equity and care quality .
3. The financial and ethical burden of chronic understaffing .
B.
**Comparative Analysis of Decision-Making Approaches**
1.
**Shared Decision-Making:** Promotes inclusivity and improves bedside nurse morale but may be limited in hierarchical settings.
2.
**Evidence-Based Practice:** Equips nurse managers with data to justify staffing needs.
3.
**Transformational Leadership:** Enables executives to drive systemic changes, enhance job satisfaction, and reduce turnover (Hilton et al., 2021).
**C**.
**Application and Implications**
1. Case examples of model implementation at various nursing levels.
2. Integration of SDM, EBP, and Transformational Leadership into a unified, collaborative staffing strategy.
3. Institutional readiness, challenges, and recommendations for sustaining staffing reforms.
**IV. Conclusion** **A.** **Summary of Key Points**
Each model SDM, EBP, and Transformational Leadership contributes uniquely to solving the nurse staffing crisis. Their combined application enables data-informed, inclusive, and transformative solutions.
**B.** **Implications and Next Steps**
The final paper will synthesize these models to offer actionable recommendations for nursing leadership and healthcare institutions. A focus on infrastructure, leadership development, and interdisciplinary collaboration will be emphasized.
**References**
Galletta, M., Piazza, M. F., Meloni, S. L., Chessa, E., Piras, I., Arnetz, J. E., & D’Aloja, E. (2022). Patient involvement in shared decision-making: Do patients rate physicians and nurses differently?
_International Journal of Environmental Research and Public Health_,
_19_(21), 14229.
[https://doi.org/10.3390/ijerph192114229](https://doi.org/10.3390/ijerph192114229)
Hilton, S. K., Madilo, W., Awaah, F., & Arkorful, H. (2021). Dimensions of transformational leadership and organizational performance: The mediating effect of job satisfaction.
_Management Research Review_,
_46_(1).
[https://doi.org/10.1108/mrr-02-2021-0152](https://doi.org/10.1108/mrr-02-2021-0152)
McHugh, M., Aiken, L., Sloane, D., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals.
_The Lancet_,
_397_(10288), 1905–1913.
[https://doi.org/10.1016/S0140-6736(21)00768-6](https://doi.org/10.1016/S0140-6736(21)00768-6)
Poudel, B. (2025). The impact of Nurse Workload on Medication Administration Errors.
_Theseus.fi_. http://www.theseus.fi/handle/10024/894195
Twigg, D. E., Whitehead, L., Doleman, G., & El‐Zaemey, S. (2021). The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review.
_Journal of Advanced Nursing_,
_77_(12), 4599–4611. https://doi.org/10.1111/jan.14909
**## TOPICandOUTLINEWritingAssignment3.docx**
2
**Nurse Staffing Ratios and Their Impact on Patient Outcomes: A Multilevel Decision-Making Approach**
David Alexander Revilla Cano
Florida National University
## Decision Making-DBX-DL01
## Dr. Nora Hernandez-Pupo
## July 14, 2025
**Nurse Staffing Ratios and Their Impact on Patient Outcomes: A Multilevel Decision-Making Approach**
**I. Introduction** **A**.
**Background Information**
Inadequate nurse staffing ratios are a pressing concern in healthcare systems globally. They directly impact patient outcomes, nurse well-being, and institutional performance. Mounting evidence links high patient-to-nurse ratios to increased mortality, medical errors, and nurse burnout (Twigg et al., 2021).
**B**.
**Statement of the Problem**
Despite the proven connection between safe staffing levels and positive outcomes, many healthcare institutions continue to struggle with chronic understaffing due to budgetary and regulatory constraints. The COVID-19 pandemic further exposed these vulnerabilities.
**C**.
**Thesis Statement**
This paper will examine how nurse staffing ratios affect all levels of nursing practice and how staff nurses, nurse managers, and advanced practice nurses can use Shared Decision-Making (SDM), Evidence-Based Practice (EBP), and Transformational Leadership to address the issue. The article will assess various methods and recommend the best strategy for sustainable clinical staffing improvements.
**II. Literature Review/Background** **A**.
**Overview of Existing Research**
Numerous studies have confirmed that safer staffing ratios correlate with improved patient safety and nurse retention (McHugh et al., 2021). Understaffing is also linked to documentation errors and missed care (Poudel, 2025).
**B**.
**Key Theories and Models**
1.
**Shared Decision-Making (SDM):** A participatory model that empowers bedside nurses in staffing-related decisions (Galletta et al., 2022).
2.
**Evidence-Based Practice (EBP):** Utilizes data to support staffing strategies that align with patient acuity and safety .
3.
**Transformational Leadership:** Encourages executive advocacy and systemic change by aligning workforce policies with nursing values .
**III. Main Body/Discussion**
A.
**Topic Analysis or Context**
1. Overview of staffing challenges in current hospital environments.
2. Regulatory disparities across states and implications for equity and care quality .
3. The financial and ethical burden of chronic understaffing .
B.
**Comparative Analysis of Decision-Making Approaches**
1.
**Shared Decision-Making:** Promotes inclusivity and improves bedside nurse morale but may be limited in hierarchical settings.
2.
**Evidence-Based Practice:** Equips nurse managers with data to justify staffing needs.
3.
**Transformational Leadership:** Enables executives to drive systemic changes, enhance job satisfaction, and reduce turnover (Hilton et al., 2021).
**C**.
**Application and Implications**
1. Case examples of model implementation at various nursing levels.
2. Integration of SDM, EBP, and Transformational Leadership into a unified, collaborative staffing strategy.
3. Institutional readiness, challenges, and recommendations for sustaining staffing reforms.
**IV. Conclusion** **A.** **Summary of Key Points**
Each model SDM, EBP, and Transformational Leadership contributes uniquely to solving the nurse staffing crisis. Their combined application enables data-informed, inclusive, and transformative solutions.
**B.** **Implications and Next Steps**
The final paper will synthesize these models to offer actionable recommendations for nursing leadership and healthcare institutions. A focus on infrastructure, leadership development, and interdisciplinary collaboration will be emphasized.
**References**
Galletta, M., Piazza, M. F., Meloni, S. L., Chessa, E., Piras, I., Arnetz, J. E., & D’Aloja, E. (2022). Patient involvement in shared decision-making: Do patients rate physicians and nurses differently?
_International Journal of Environmental Research and Public Health_,
_19_(21), 14229.
[https://doi.org/10.3390/ijerph192114229](https://doi.org/10.3390/ijerph192114229)
Hilton, S. K., Madilo, W., Awaah, F., & Arkorful, H. (2021). Dimensions of transformational leadership and organizational performance: The mediating effect of job satisfaction.
_Management Research Review_,
_46_(1).
[https://doi.org/10.1108/mrr-02-2021-0152](https://doi.org/10.1108/mrr-02-2021-0152)
McHugh, M., Aiken, L., Sloane, D., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals.
_The Lancet_,
_397_(10288), 1905–1913.
[https://doi.org/10.1016/S0140-6736(21)00768-6](https://doi.org/10.1016/S0140-6736(21)00768-6)
Poudel, B. (2025). The impact of Nurse Workload on Medication Administration Errors.
_Theseus.fi_. http://www.theseus.fi/handle/10024/894195
Twigg, D. E., Whitehead, L., Doleman, G., & El‐Zaemey, S. (2021). The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review.
_Journal of Advanced Nursing_,
_77_(12), 4599–4611. https://doi.org/10.1111/jan.14909
**## DecisionMakingProcessPaperDue.docx**
Decision Making Process Paper Due
**Decision-Making Process Paper**
Instructions
In this assignment, you will be writing a 6–8-page paper identifying, comparing and contrasting at least 3 different decision-making approaches of care from a multidisciplinary perspective using a pertinent and significant topic in nursing (examples might include nursing shortage and nurse turn-over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation or another current and relevant nursing issue) the topic
**MUST BE APPROVED** **by your nursing instructor before writing the paper. .** You are required to use APA 7th edition format and the page count does not include title page or reference page. Reflect on your own decision-making practices and the implications this will have regarding differing approaches taken of nursing leaders and staff nurses/clinical practitioners in decision making within to issues in practice. To complete this assignment, do the following:
1. Select and describe an issue in nursing that impacts nurses at all levels from bedside to advanced practice. Make sure to provide an adequate background and its significance to all levels of nursing using a strong review of the literature. Additionally, this should include a thorough literature review that provides a good understanding of what the cause of this problem is; what is suggested to address this problem. Essentially, this review must support your choices of the decision-making models and this needs to include how all levels of nursing practice (the bedside nurse to the APN are impacted by the problem).
2. Identify how you would expect a nurse leader/manager, a bedside/staff nurse and an Advanced practice nurse (CNO or NP) to address your selected issue using at least 3different decision-making approaches which are clearly supported by the literature review. This must first include aa detailed analysis/overview of the selected decision making models and how they are used in practice. Then a detailed analysis of how these decision-making approaches/models would address the problem/along with a detailed analysis of how each of the three selected models would be applied to address the selected issue/problem making sure to incorporate this at all levels of practice. One of the decision-making models may be more applicable to the bedside nurse; whereas the other more applicable to the APN; however, all levels of nursing practice need to be addressed with at least one of the chosen 3 decision-making models. However, this does not mean that each decision-making model will apply to all levels of practice only that in this discussion needs to include how each level of nursing practice would utilize the decision-making model to address the problem. For instance,one decision making model may apply to the bedside nurse; the second decision making model may be more applicable at the level of APN (CNO, NP, etc) and the other decision-making model may be best applied to the nurse manager. This section should be detailed; meaning specific, well thought out, realistic solutions of how the nurse (at the level identified; this may include more than one level for the same decision-making model or not) would address the problem using the decision-making model is provided and well supported by the literature. of the benefits and limitations of various decision-making approaches that are applied appropriately to the level of nursing practice to address the selected issue/problem. This is informed from course readings,literature, clinical scenarios and other evidence-based and scholarly sources.
3. Prioritize the best decision-making approach/model to address the selected problem that is grounded in best practice. This should provide a well-supported rationale for this choice that includes a good comparison and contrasting of the 3 chosen decision-making models that clearly illustrates why the choice was made, that is consistent with the decision making model and how it would address the chosen topic or problem.
4. Identify a possible funding source that would addresses your approach to solving the problem. For instance, if the best approach to solving the nurse-to-patient ratio problem is through the use of SDM and shared governance, perhaps you may seek a local funding source to provide you with funding to implement a small EBP or research project that would be funded by a local nursing organization such as Sigma Theta Tau or perhaps if it was geared more towards assessing the value of this model towards NP in practice than seeking a local organization that supports funding for projects being implemented by practicing NP? If seeking money for research this would need to be overseen by a nurse with a DNP or a PhD or someone with the credentials to do so that are part of their scope of practice. Consider looking at federal, state,or local organizations. For example: There are many grants available through the CDC,HRSA, etc. Again, this need to be specifically applied with sufficient details
Use at least 10 references other than your main text.Uses APA 7th edition formatting.
Please submit the Decision Making Process Paper in Word Format APA 7th ed. formatted (see instructions in the Assignments Tab of Blackboard along with the grading rubric).
**## TOPICandOUTLINEWritingAssignment3.docx**
2
**Nurse Staffing Ratios and Their Impact on Patient Outcomes: A Multilevel Decision-Making Approach**
David Alexander Revilla Cano
Florida National University
## Decision Making-DBX-DL01
## Dr. Nora Hernandez-Pupo
## July 14, 2025
**Nurse Staffing Ratios and Their Impact on Patient Outcomes: A Multilevel Decision-Making Approach**
**I. Introduction** **A**.
**Background Information**
Inadequate nurse staffing ratios are a pressing concern in healthcare systems globally. They directly impact patient outcomes, nurse well-being, and institutional performance. Mounting evidence links high patient-to-nurse ratios to increased mortality, medical errors, and nurse burnout (Twigg et al., 2021).
**B**.
**Statement of the Problem**
Despite the proven connection between safe staffing levels and positive outcomes, many healthcare institutions continue to struggle with chronic understaffing due to budgetary and regulatory constraints. The COVID-19 pandemic further exposed these vulnerabilities.
**C**.
**Thesis Statement**
This paper will examine how nurse staffing ratios affect all levels of nursing practice and how staff nurses, nurse managers, and advanced practice nurses can use Shared Decision-Making (SDM), Evidence-Based Practice (EBP), and Transformational Leadership to address the issue. The article will assess various methods and recommend the best strategy for sustainable clinical staffing improvements.
**II. Literature Review/Background** **A**.
**Overview of Existing Research**
Numerous studies have confirmed that safer staffing ratios correlate with improved patient safety and nurse retention (McHugh et al., 2021). Understaffing is also linked to documentation errors and missed care (Poudel, 2025).
**B**.
**Key Theories and Models**
1.
**Shared Decision-Making (SDM):** A participatory model that empowers bedside nurses in staffing-related decisions (Galletta et al., 2022).
2.
**Evidence-Based Practice (EBP):** Utilizes data to support staffing strategies that align with patient acuity and safety .
3.
**Transformational Leadership:** Encourages executive advocacy and systemic change by aligning workforce policies with nursing values .
**III. Main Body/Discussion**
A.
**Topic Analysis or Context**
1. Overview of staffing challenges in current hospital environments.
2. Regulatory disparities across states and implications for equity and care quality .
3. The financial and ethical burden of chronic understaffing .
B.
**Comparative Analysis of Decision-Making Approaches**
1.
**Shared Decision-Making:** Promotes inclusivity and improves bedside nurse morale but may be limited in hierarchical settings.
2.
**Evidence-Based Practice:** Equips nurse managers with data to justify staffing needs.
3.
**Transformational Leadership:** Enables executives to drive systemic changes, enhance job satisfaction, and reduce turnover (Hilton et al., 2021).
**C**.
**Application and Implications**
1. Case examples of model implementation at various nursing levels.
2. Integration of SDM, EBP, and Transformational Leadership into a unified, collaborative staffing strategy.
3. Institutional readiness, challenges, and recommendations for sustaining staffing reforms.
**IV. Conclusion** **A.** **Summary of Key Points**
Each model SDM, EBP, and Transformational Leadership contributes uniquely to solving the nurse staffing crisis. Their combined application enables data-informed, inclusive, and transformative solutions.
**B.** **Implications and Next Steps**
The final paper will synthesize these models to offer actionable recommendations for nursing leadership and healthcare institutions. A focus on infrastructure, leadership development, and interdisciplinary collaboration will be emphasized.
**References**
Galletta, M., Piazza, M. F., Meloni, S. L., Chessa, E., Piras, I., Arnetz, J. E., & D’Aloja, E. (2022). Patient involvement in shared decision-making: Do patients rate physicians and nurses differently?
_International Journal of Environmental Research and Public Health_,
_19_(21), 14229.
[https://doi.org/10.3390/ijerph192114229](https://doi.org/10.3390/ijerph192114229)
Hilton, S. K., Madilo, W., Awaah, F., & Arkorful, H. (2021). Dimensions of transformational leadership and organizational performance: The mediating effect of job satisfaction.
_Management Research Review_,
_46_(1).
[https://doi.org/10.1108/mrr-02-2021-0152](https://doi.org/10.1108/mrr-02-2021-0152)
McHugh, M., Aiken, L., Sloane, D., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals.
_The Lancet_,
_397_(10288), 1905–1913.
[https://doi.org/10.1016/S0140-6736(21)00768-6](https://doi.org/10.1016/S0140-6736(21)00768-6)
Poudel, B. (2025). The impact of Nurse Workload on Medication Administration Errors.
_Theseus.fi_. http://www.theseus.fi/handle/10024/894195
Twigg, D. E., Whitehead, L., Doleman, G., & El‐Zaemey, S. (2021). The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review.
_Journal of Advanced Nursing_,
_77_(12), 4599–4611. https://doi.org/10.1111/jan.14909
**## DecisionMakingProcessPaperDue.docx**
Decision Making Process Paper Due
**Decision-Making Process Paper**
Instructions
In this assignment, you will be writing a 6–8-page paper identifying, comparing and contrasting at least 3 different decision-making approaches of care from a multidisciplinary perspective using a pertinent and significant topic in nursing (examples might include nursing shortage and nurse turn-over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation or another current and relevant nursing issue) the topic
**MUST BE APPROVED** **by your nursing instructor before writing the paper. .** You are required to use APA 7th edition format and the page count does not include title page or reference page. Reflect on your own decision-making practices and the implications this will have regarding differing approaches taken of nursing leaders and staff nurses/clinical practitioners in decision making within to issues in practice. To complete this assignment, do the following:
1. Select and describe an issue in nursing that impacts nurses at all levels from bedside to advanced practice. Make sure to provide an adequate background and its significance to all levels of nursing using a strong review of the literature. Additionally, this should include a thorough literature review that provides a good understanding of what the cause of this problem is; what is suggested to address this problem. Essentially, this review must support your choices of the decision-making models and this needs to include how all levels of nursing practice (the bedside nurse to the APN are impacted by the problem).
2. Identify how you would expect a nurse leader/manager, a bedside/staff nurse and an Advanced practice nurse (CNO or NP) to address your selected issue using at least 3different decision-making approaches which are clearly supported by the literature review. This must first include aa detailed analysis/overview of the selected decision making models and how they are used in practice. Then a detailed analysis of how these decision-making approaches/models would address the problem/along with a detailed analysis of how each of the three selected models would be applied to address the selected issue/problem making sure to incorporate this at all levels of practice. One of the decision-making models may be more applicable to the bedside nurse; whereas the other more applicable to the APN; however, all levels of nursing practice need to be addressed with at least one of the chosen 3 decision-making models. However, this does not mean that each decision-making model will apply to all levels of practice only that in this discussion needs to include how each level of nursing practice would utilize the decision-making model to address the problem. For instance,one decision making model may apply to the bedside nurse; the second decision making model may be more applicable at the level of APN (CNO, NP, etc) and the other decision-making model may be best applied to the nurse manager. This section should be detailed; meaning specific, well thought out, realistic solutions of how the nurse (at the level identified; this may include more than one level for the same decision-making model or not) would address the problem using the decision-making model is provided and well supported by the literature. of the benefits and limitations of various decision-making approaches that are applied appropriately to the level of nursing practice to address the selected issue/problem. This is informed from course readings,literature, clinical scenarios and other evidence-based and scholarly sources.
3. Prioritize the best decision-making approach/model to address the selected problem that is grounded in best practice. This should provide a well-supported rationale for this choice that includes a good comparison and contrasting of the 3 chosen decision-making models that clearly illustrates why the choice was made, that is consistent with the decision making model and how it would address the chosen topic or problem.
4. Identify a possible funding source that would addresses your approach to solving the problem. For instance, if the best approach to solving the nurse-to-patient ratio problem is through the use of SDM and shared governance, perhaps you may seek a local funding source to provide you with funding to implement a small EBP or research project that would be funded by a local nursing organization such as Sigma Theta Tau or perhaps if it was geared more towards assessing the value of this model towards NP in practice than seeking a local organization that supports funding for projects being implemented by practicing NP? If seeking money for research this would need to be overseen by a nurse with a DNP or a PhD or someone with the credentials to do so that are part of their scope of practice. Consider looking at federal, state,or local organizations. For example: There are many grants available through the CDC,HRSA, etc. Again, this need to be specifically applied with sufficient details
Use at least 10 references other than your main text.Uses APA 7th edition formatting.
Please submit the Decision Making Process Paper in Word Format APA 7th ed. formatted (see instructions in the Assignments Tab of Blackboard along with the grading rubric).
**## TOPICandOUTLINEWritingAssignment3.docx**
2
**Nurse Staffing Ratios and Their Impact on Patient Outcomes: A Multilevel Decision-Making Approach**
David Alexander Revilla Cano
Florida National University
## Decision Making-DBX-DL01
## Dr. Nora Hernandez-Pupo
## July 14, 2025
**Nurse Staffing Ratios and Their Impact on Patient Outcomes: A Multilevel Decision-Making Approach**
**I. Introduction** **A**.
**Background Information**
Inadequate nurse staffing ratios are a pressing concern in healthcare systems globally. They directly impact patient outcomes, nurse well-being, and institutional performance. Mounting evidence links high patient-to-nurse ratios to increased mortality, medical errors, and nurse burnout (Twigg et al., 2021).
**B**.
**Statement of the Problem**
Despite the proven connection between safe staffing levels and positive outcomes, many healthcare institutions continue to struggle with chronic understaffing due to budgetary and regulatory constraints. The COVID-19 pandemic further exposed these vulnerabilities.
**C**.
**Thesis Statement**
This paper will examine how nurse staffing ratios affect all levels of nursing practice and how staff nurses, nurse managers, and advanced practice nurses can use Shared Decision-Making (SDM), Evidence-Based Practice (EBP), and Transformational Leadership to address the issue. The article will assess various methods and recommend the best strategy for sustainable clinical staffing improvements.
**II. Literature Review/Background** **A**.
**Overview of Existing Research**
Numerous studies have confirmed that safer staffing ratios correlate with improved patient safety and nurse retention (McHugh et al., 2021). Understaffing is also linked to documentation errors and missed care (Poudel, 2025).
**B**.
**Key Theories and Models**
1.
**Shared Decision-Making (SDM):** A participatory model that empowers bedside nurses in staffing-related decisions (Galletta et al., 2022).
2.
**Evidence-Based Practice (EBP):** Utilizes data to support staffing strategies that align with patient acuity and safety .
3.
**Transformational Leadership:** Encourages executive advocacy and systemic change by aligning workforce policies with nursing values .
**III. Main Body/Discussion**
A.
**Topic Analysis or Context**
1. Overview of staffing challenges in current hospital environments.
2. Regulatory disparities across states and implications for equity and care quality .
3. The financial and ethical burden of chronic understaffing .
B.
**Comparative Analysis of Decision-Making Approaches**
1.
**Shared Decision-Making:** Promotes inclusivity and improves bedside nurse morale but may be limited in hierarchical settings.
2.
**Evidence-Based Practice:** Equips nurse managers with data to justify staffing needs.
3.
**Transformational Leadership:** Enables executives to drive systemic changes, enhance job satisfaction, and reduce turnover (Hilton et al., 2021).
**C**.
**Application and Implications**
1. Case examples of model implementation at various nursing levels.
2. Integration of SDM, EBP, and Transformational Leadership into a unified, collaborative staffing strategy.
3. Institutional readiness, challenges, and recommendations for sustaining staffing reforms.
**IV. Conclusion** **A.** **Summary of Key Points**
Each model SDM, EBP, and Transformational Leadership contributes uniquely to solving the nurse staffing crisis. Their combined application enables data-informed, inclusive, and transformative solutions.
**B.** **Implications and Next Steps**
The final paper will synthesize these models to offer actionable recommendations for nursing leadership and healthcare institutions. A focus on infrastructure, leadership development, and interdisciplinary collaboration will be emphasized.
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