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

摘要

IntroductionIdentifying safe approaches to nurse staffing in hospital wards is a key challenge for healthservice providers. The National Institute for Health and Care Excellence (NICE) has beenasked by the Department of Health and NHS England to develop an evidence-basedguideline 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 exploreevidence to inform guidance related to the following three sets of questions, set out in thescope.1. What patient safety outcomes are associated with nurse and healthcareassistant staffing levels and skill mix?a. What outcomes are associated with tasks undertaken by registerednurses, 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 staffingrequirements at different times during the day? These include:a. Patient dependency and acuity assessment and gradingb. Patient turnover.3. How does the ward environment, including physical layout and diversity ofclinical disciplines, affect safe staffing requirements?