HealthcareNursingPatient Safety

Saudi Arabia Safe Nurse Staffing: From Table To Implementation

Dr. Faisal Alotaibi, MSc, CPHQ, C-KPI

Unified Nursing Research, Midwifery & Women’s Health Journal
Author Name: Dr. Faisal Alotaibi
Category: Abstract
Keywords: Workforce Safety, Nurse, Staffing, Patient Safety
Research Interest: Quality Management, Improvement and Patient Safety Culture

Unified Citation Journals, 2(1) 6-8;
ISSN 2754-0944

Introduction: Adequate nurse staffing significantly impacts the reduction of mortality rate and improved nurse-sensitive patient outcomes. Several studies have demonstrated that inadequate nurse staffing levels and other factors can contribute to an unsafe work climate. Analysis of the sentinel events reported contributing factors in 2020 showed that staff shortage and low staff-to-patient ratio represented 13% and 10%, respectively. Among the top reported events, the reported staff shortages were the surgical ward, delivery room, midwife, emergency, antenatal care, and nursery nurses.
Since 2017, the SPSC has been conducting Hospital Surveys on Patient Safety Culture in Saudi Arabia. In 2019, the results indicated that Staffing is perceived as a significant issue and negatively impacts the culture. Where only 31.73% of respondents reported that there is enough staff to handle the workload. Thus, the Saudi Patient Safety Center emphasizes the urgency for healthcare facilities to prioritize nurse staffing levels and promote workforce safety.

The nurse/midwife-to-patient ratio was based on the following sources: the SPSC initiated collaborative efforts with the International Council of Nurses (ICN) to establish safe and appropriate nurse-patient ratios [2]. This collaborative endeavor aimed to provide a framework for effective nurse staffing practices. Several national and international experts from different sectors participated in writing and reviewing the recommendations.

Results: The SPSC endorsed and approved the evidence-based recommendation for the ICN considering many points. The top ratio showed in Table 1. Mainly, systematic assessment for the factors that affect the allocation of nurses to patients must be followed at different levels, e.g., units, daily basis or frequently as needed. Table 1: The top Nurse\Midwife-to-Patient Ratios recommendations.


Furthermore, the overall availability of ancillary staff/allied health professionals. The recommended ratios were put forward based on the premise that a full complement of ancillary and support staff is always present during each shift within a unit.

What is next: The SPSC is preparing to conduct a correlation study investigating the relationship between nurses’ staffing levels and patient safety. This study aims to investigate how varying levels of nurse staffing impact patient safety outcomes and determine any potential causal relationships. The study is expected to contribute to the growing body of research on nursing staffing levels and their impact on patient safety, which is a critical area of concern for healthcare organizations worldwide.


[1] JCAHO approves National Patient Safety Goals for 2003. Jt Comm Perspect. 2002 Sep;22(9):1-3.
[2] Al Hawsawi. A et al. (2021) Safe Staff Saves Lives: Nurse Staffing Levels for Patient Safety and Workforce Safety, SPSC.
[3] SPSC, ICN (2019), Nurse Staffing Levels for Patient Safety and Workforce Safety.

Biography: Faisal is a patient safety specialist at the Saudi Patient safety center. His background is in Biomedical Engineering, and he obtained a master’s degree in quality and Patient Safety Improvement from the University of Nottingham, UK. He is Certified as (CPHQ) from NAHQ and KPI Professional (C-KPI) from The KPI institute. He values participatory action research in alignment with the priority of patient safety.

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