A higher nurse-to-patient ratio was significant in patient outcomes, although none of the studies could provide a specific RN-to-patient ratio that achieved the best patient outcomes (Patrician et al , 2011; A familiar theme across studies was to consider patient care needs and match these needs to the number of nurses needed to meet patient care needs. Recommendation is needed to manage staffing issues to have a nursing staff council and position control group (Dent, 2015; McKenna,