Nurse-to-patient ratios and readiness for hospital discharge: A moderated mediation model.

This is a single-centre cross-sectional survey, so it cannot prove that higher nurse-to-patient ratios caused worse discharge readiness or that the assessment gap was the mechanism. All readiness data came from self-report questionnaires completed four hours before discharge, with no follow-up of actual post-discharge complications, readmissions, or patient outcomes. The sample was drawn from one cancer hospital in Shaanxi Province using convenience sampling, which limits how well the findings transfer to other settings or patient groups. The nurse-patient difference score was calculated by simple subtraction of two self-reported totals; the authors note that more specialized tools are still needed to properly evaluate these assessment differences. Important background variables such as the actual quality of discharge teaching were not measured, so they could be driving both the assessment gap and readiness scores.

Funded by the Department of Science and Technology of Shaanxi Province. The authors declare no conflicts of interest.

Do not read the finding that nurse-to-patient ratios were negatively associated with readiness as proof that adding staff will directly improve discharge outcomes. The study is cross-sectional and shows only that higher ratios coincided with wider nurse-patient assessment gaps, which in turn coincided with lower patient readiness scores. No patient was followed after discharge, so there is no evidence here that this pathway actually caused PICC complications or readmissions.