Influence of Nurse-Patient Ratios on Care Quality Indicators in Paediatric Wards of Government Hospitals in Ogun State

Background: Paediatric nursing requires close surveillance and care coordination that is highly sensitive to nurse-to-patient ratios. Despite clear international evidence, nurse-to-patient ratios in Nigerian paediatric settings are rarely studied or regulated. Aim: This study examined the influence of nurse-patient ratios on care quality indicators in paediatric wards of government hospitals in Ogun State, South West Nigeria. Methods: A retrospective correlational design reviewed staffing records and patient outcome data across 12 months from six government hospitals. Pearson's correlation and multiple linear regression were used. Quality indicators included medication error rates, unplanned extubations, falls, and patient satisfaction scores. Results: Mean nurse-to-patient ratios ranged from 1:7 to 1:13 across study sites. Significant correlations were found between higher ratios and increased medication errors, falls, and lower satisfaction scores. The threshold effect showed marked outcome deterioration above 1:8 ratios. Conclusion: Nurse-to-patient ratios are independently associated with paediatric care quality. Evidence-based minimum staffing standards for paediatric wards and recruitment of additional paediatric nurses are critical policy requirements in Nigerian government hospitals. Keywords: nurse-patient ratios, paediatric nursing, care quality, Ogun State, staffing.