Many researchers and health care leaders want to measure nurse staffing according to the workload of each nurse, although “workload” does not have an agreed-upon definition. Most hospitals can easily report the average number of productive nursing hours per patient day (“hours per patient day” or HPPD), because they keep data on nursing hours and patient days. However, many health care leaders prefer to conceptualize workload as a nurse-to-patient ratio, such as “one nurse for every five patients.” Although the way this measure is stated implies that a single nurse has responsibility for a set group of patients, this might not be the case. The nurse might work on a team of three nurses for 15 patients. More importantly, the nurse's patients change as they are admitted and discharged during a shift; thus, a nurse might care for 10 patients during a shift, with the five patients present at the start of the shift being replaced by five other patients later in the shift.
In theory, the nurse-to-patient ratio can be computed from productive direct patient care nursing hours. If each patient day comprises 24 hours, then: