Registered Nurses' Association of Ontario

Background Context of the Guideline on Developing and Sustaining Effective Staffing and Workload Practices

  • The comprehensive nature of nursing roles has added further challenges that have made staffing allocation or decisions about the optimal number of nurses required to meet patients/clients needs, a highly complex matter.
  • In recruitment and retention surveys as well as research studies, nurses have indicated that they are unable to provide the required care elements consistent with standards defined by professional and regulatory bodies.
  • One report noted that the result for administration and nursing staff is “moral distress when they cannot find adequate numbers of qualified staff to deliver safe care”.
  • Collectively, this state of staffing and workload disequilibrium results in negative outcomes for patients/clients, (i.e. higher morbidity/mortality rates, failure to rescue, resulting in longer lengths of stay), nurses (i.e. job strain, increased levels of moral distress, illness and injury) and organizations (i.e. recruitment and retention challenges, overtime, absenteeism).
  • The evidence suggests that significant and immediate changes regarding staffing and workloads must be made to improve the quality of working lives for nurses and ensure that patients/clients receive safe, effective and ethical care, consistent with quality standards.
  • The recommendations presented in this document are based on the best available evidence and provide employers and nurses with solid strategies to maximize their collaborative efforts to effect positive outcomes through effective staffing and workload management.
Healthy Work Environment
Developing and Sustaining Effective Staffing and Workload Practices
Background Information