Ward staffing guided by a patient classification system: A multi-criteria analysis of “fit” in three acute hospitals
Ward staffing guided by a patient classification system: A multi-criteria analysis of “fit” in three acute hospitals
Aims: To assess how well the Safer Nursing Care Tool (SNCT) predicts staffing requirements on hospital wards, and to use professional judgement to generate hypotheses about factors associated with a “poor fit”. Background: The SNCT is widely used in the UK, but there is scant evidence about factors that influence the quality of staffing decisions based upon such patient classification systems. Methods: Secondary analysis of data from 69 wards in three acute hospitals to assess the precision of the estimated staffing requirement, variation of estimates, correspondence with professional judgement and achieved staffing levels. Nursing workforce leads suggested factors associated with poor fit, based on the wards that rated worst. Results: 39% of wards were frequently understaffed, while frequent overstaffing was less common (12%). 24% of wards needed a sample of over 182 days to estimate the establishment precisely. Potential reasons identified for poor fit included high turnover, older patients, high levels of 1-to-1 specialing, cancer care, small ward size and high within-day variation in demand. Conclusions: Using a staffing tool without applying professional judgement or triangulating against other methods can lead to inaccurate estimates of staffing requirements and unsafe staffing levels. Implications for Nursing Management: Despite the availability of software to calculate staffing requirements, application of professional judgement remains essential.
Safer Nursing Care Tool, health services research, patient classification system, quantitative methods, staffing levels
2260-2269
Saville, Christina
2c726abd-1604-458c-bc0b-daeef1b084bd
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
October 2021
Saville, Christina
2c726abd-1604-458c-bc0b-daeef1b084bd
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Saville, Christina and Griffiths, Peter
(2021)
Ward staffing guided by a patient classification system: A multi-criteria analysis of “fit” in three acute hospitals.
Journal of Nursing Management, 29 (7), .
(doi:10.1111/jonm.13341).
Abstract
Aims: To assess how well the Safer Nursing Care Tool (SNCT) predicts staffing requirements on hospital wards, and to use professional judgement to generate hypotheses about factors associated with a “poor fit”. Background: The SNCT is widely used in the UK, but there is scant evidence about factors that influence the quality of staffing decisions based upon such patient classification systems. Methods: Secondary analysis of data from 69 wards in three acute hospitals to assess the precision of the estimated staffing requirement, variation of estimates, correspondence with professional judgement and achieved staffing levels. Nursing workforce leads suggested factors associated with poor fit, based on the wards that rated worst. Results: 39% of wards were frequently understaffed, while frequent overstaffing was less common (12%). 24% of wards needed a sample of over 182 days to estimate the establishment precisely. Potential reasons identified for poor fit included high turnover, older patients, high levels of 1-to-1 specialing, cancer care, small ward size and high within-day variation in demand. Conclusions: Using a staffing tool without applying professional judgement or triangulating against other methods can lead to inaccurate estimates of staffing requirements and unsafe staffing levels. Implications for Nursing Management: Despite the availability of software to calculate staffing requirements, application of professional judgement remains essential.
Text
Ward staffing guided by a patient classification system multi-criteria analysis of fit” in 3 acute hospitals
- Accepted Manuscript
More information
Accepted/In Press date: 6 April 2021
e-pub ahead of print date: 9 May 2021
Published date: October 2021
Additional Information:
Funding Information:
This report is independent research funded by the National Institute for Health Research ARC Wessex (grant number 519713103). The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
Publisher Copyright:
© 2021 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
Safer Nursing Care Tool, health services research, patient classification system, quantitative methods, staffing levels
Identifiers
Local EPrints ID: 448701
URI: http://eprints.soton.ac.uk/id/eprint/448701
ISSN: 0966-0429
PURE UUID: 3ca23574-9b1b-40aa-9b55-85648f3f3eb2
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Date deposited: 30 Apr 2021 16:32
Last modified: 17 Mar 2024 06:31
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