ASSESSMENT OF NURSE ? PATIENT RATIO IN THE DETERMINATION OF QUALITY NURSING CARE IN A GENERAL HOSPITAL IN OSUN STATE, NIGERIA

Adequate nurse - patient ratio is of paramount importance in the determination of quality of care in the health care setting. The study was conducted in the General Hospital, Iwo Osun State Nigeria. The study was carried out among the patients, nurses and midwives in 6 wards within the hospital. The wards are male and female medical and surgical wards as well as labour and post-natal wards. Each ward had a bed capacity of 28. Through simple random sampling, 80 respondents (A) and 35 respondents (B) were chosen as study sample. Respondents A were patients while respondents B rd th were 30 nurses and 5 midwives. After obtaining respondents’ consent, data collection was carried out on 3 and 4 November, 2014. A self developed questionnaire and checklist were used as the study instrument. The psychometric property of the questionnaire using Chronbatch’s coefficient of alpha showed 0.75. The questionnaire was administered to respondents A Checklist was used to observe the nurses’ and midwives’ compliance to items on the list during nursing procedures. Data analysis was by descriptive statistics making use of tables, percentages, means and standard deviation. Results of the study shows the age range of respondents A to be 17 ? 74 with a mean 34 ± 4.7 and that of respondents B as 25 -59 with a mean 31 ± 2.4. Also, the number of respondents B per shift within each ward ranged from 2 to 3 making nurse-patient ratio of 1:14 to 1:9. The percentage bed occupancy in each ward ranged from 75.0 - 92.8%. It was observed that morning and afternoon duty shifts were 8hours each while the night duty was 12hour duration. When respondents A were asked about the adequacy of nursing staff per shift, 75% believed that nurses were not adequate, 15% believed they were adequate while 10% were undecided on this. Also, only 27% or respondent A were satisfied with the nursing care received, the rest 73% believed they received poor nursing care because of the inadequacy of nurses to take care of their numerous needs. It was also observed that nurses at the study location were not making use of nursing care plan in rendering care. The results of the study further shows that 12% of respondents A developed complications which could have been avoided if nurse ? patient ratio had been adequate. The complications observed were: pressure sore in debilitated patients (9%), urinary tract infection in catheterised patients (11%) and foul smelling wound (17%). The study was concluded with a suggestion that the Nursing and Midwifery Council of Nigeria and the National Association of Nigerian Nurses and Midwives should work together to designed standard of nurse-patient ratio for various ailments based on the level of nursing attention required by each ailment, and that each and every health facility with deficient number of nursing staff should employ more so that quality nursing care could be guaranteed at all times.