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Nurse staffing levels within acute care : results of a national day of care survey

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Hegarty, Hannah, Knight, Thomas, Atkin, Catherine, Kelly, Tash, Subbe, Chris, Lasserson, Daniel and Holland, Mark (2022) Nurse staffing levels within acute care : results of a national day of care survey. BMC Health Services Research, 22 (1). 493. doi:10.1186/s12913-022-07562-w

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Official URL: https://doi.org/10.1186/s12913-022-07562-w

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Abstract

The relationship between nurse staffing levels and patient safety is well recognised. Inadequate provision of nursing staff is associated with increased medical error, as well as higher morbidity and mortality. Defining what constitutes safe nurse staffing levels is complex. A range of guidance and planning tools are available to inform staffing decisions. The Society for Acute Medicine (SAM) recommend a 'nurse-to-bed'ratio of greater than 1:6. Whether this standard accurately reflects the pattern and intensity of work on the Acute Medical Unit (AMU) is unclear. Nurse staffing levels in AMUs were explored using the Society for Acute Medicine Benchmarking Audit 2019 (SAMBA19). Data from 122 acute hospitals were analysed. Nurse-to-bed ratios were calculated and compared. Estimates of the total nursing time available within the acute care system were compared to estimates of the time required to perform nursing activities. The total number of AMU beds across all 122 units was 4997. The mean daytime nurse-to-bed ratio was 1:4.3 and the mean night time nurse-to-bed ratio was 1:5.2. The SAM standard of a nurse to bed ratio of greater than 1:6 was achieved in 99 units (81.9%) during daytime hours and achieved by 74 units (60.6%) at night. The estimated time required to deliver direct clinical care was 35,698 h. A deficit of 4128 h (11.5% of time required) was estimated, representing the time difference between the total number of nursing hours available with current staffing and the estimated time needed for direct clinical care across all participating units. This UK-wide study suggests a significant proportion of AMUs do not meet the recommenced SAM staffing levels, particularly at night. A difference was observed between the total number of nursing hours within the acute care system and the estimated time required to perform direct nursing activities. This suggests a workforce shortage of nurses within acute care at the system level.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
R Medicine > RT Nursing
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Nurses, Critical care medicine, Intensive care units -- Nurses, Nursing -- Standards, Medical emergencies, Nurses -- Supply and demand, Nursing, Hospital care
Journal or Publication Title: BMC Health Services Research
Publisher: Biomed central
ISSN: 1472-6963
Official Date: 13 April 2022
Dates:
DateEvent
13 April 2022Published
24 January 2022Accepted
Volume: 22
Number: 1
Article Number: 493
DOI: 10.1186/s12913-022-07562-w
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDNational Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands UNSPECIFIED

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