Determining acute nurse staffing, a hermeneutic review of an evolving science.

Journal article


Leary, A and Punshon, G (2019). Determining acute nurse staffing, a hermeneutic review of an evolving science. BMJ Open. 9 (3). https://doi.org/10.1136/bmjopen-2018-025654
AuthorsLeary, A and Punshon, G
Abstract

Abstract
Background
Calculating nurse staffing in the acute hospital has become a key issue but solutions appear distant. Community, mental health and areas such as learning disability nursing have attracted less attention and remain intractable. This review aims to examine current approaches to the issue across many disciplines.
Design
The approach taken is iterative and in the form of a hermeneutic review. 769 pieces of evidence were reviewed from across disciplines such as nursing, medicine, engineering, statistics, population science, computer science and mathematics where hospital nurse staffing was the subject of the study.
Results
A number of themes emerged. The first iteration showed the predominance of unit base approaches (e.g. nurse numbers, ratios, activity and workload) the second was the development of methodologies. Subsequent iterations examined issues such as demand, safety, nurse education, turnover, patient outcomes, patient or staff satisfaction, workload and activity. The majority of studies examined (n=767) demonstrated some association between staffing (units or type/skill) and various factors such as staff or patient satisfaction, working conditions, safety parameters, outcomes complexity of work achieved, work left undone or other factors. Many potential areas such as operational safety research were not utilised.
Conclusion
Although the relationship between staffing in acute care and factors such as units, safety or workload is complex, the evidence suggests an interdependent relationship which should only be dismissed with caution. The nature of these relationships should be further examined in order to determine nurse staffing. The body of knowledge appears substantial and complex yet appears to have little impact on policy.

Year2019
JournalBMJ Open
Journal citation9 (3)
PublisherBMJ
ISSN2044-6055
Digital Object Identifier (DOI)https://doi.org/10.1136/bmjopen-2018-025654
Web address (URL)https://bmjopen.bmj.com/content/9/3/e025654
Publication dates
Print30 Mar 2019
Publication process dates
Deposited22 Mar 2019
Accepted01 Mar 2019
Accepted author manuscript
License
File Access Level
Open
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