The association between patient safety outcomes and nurse/healthcare assistant skill mix and staffing levels and factors that may influence staffing requirements

Abstract

Introduction
Identifying safe approaches to nurse staffing in hospital wards is a key challenge for health
service providers. The National Institute for Health and Care Excellence (NICE) has been
asked by the Department of Health and NHS England to develop an evidence-based
guideline on safe and efficient staffing in acute adult inpatient wards.
This review is the first of two reviews to inform the safe staffing guideline. It aims to explore
evidence to inform guidance related to the following three sets of questions, set out in the
scope.
1. What patient safety outcomes are associated with nurse and healthcare
assistant staffing levels and skill mix?
a. What outcomes are associated with tasks undertaken by registered
nurses, healthcare assistants (HCA), and other staff?
b. Which outcomes should be used as indicators of safe staffing?
2. What patient factors affect nurse and healthcare assistant staffing
requirements at different times during the day? These include:
a. Patient dependency and acuity assessment and grading
b. Patient turnover.
3. How does the ward environment, including physical layout and diversity of
clinical disciplines, affect safe staffing requirements?

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Identifiers

ORCID for Peter Griffiths: orcid.org/0000-0003-2439-2857

ORCID for Jonathan Drennan: orcid.org/0000-0001-7365-4345

ORCID for Liz James: orcid.org/0000-0001-9355-0295

ORCID for Alejandra Recio: orcid.org/0000-0003-2823-4573

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