School of Health Sciences, The University of Southampton, UK.
Karolinska Institutet, Sweden.
Int J Nurs Stud. 2019 Sep;97:7-13. doi: 10.1016/j.ijnurstu.2019.04.015. Epub 2019 Apr 30.
Despite a long history of health services research that indicates that having sufficient nursing staff on hospital wards is critical for patient safety, and sustained interest in nurse staffing methods, there is a lack of agreement on how to determine safe staffing levels. For an alternative viewpoint, we look to a separate body of literature that makes use of operational research techniques for planning nurse staffing. Our goal is to provide examples of the use of operational research approaches applied to nurse staffing, and to discuss what they might add to traditional methods. The paper begins with a summary of traditional approaches to nurse staffing and their limitations. We explain some key operational research techniques and how they are relevant to different nurse staffing problems, based on examples from the operational research literature. We identify three key contributions of operational research techniques to these problems: "problem structuring", handling complexity and numerical experimentation. We conclude that decision-making about nurse staffing could be enhanced if operational research techniques were brought in to mainstream nurse staffing research. There are also opportunities for further research on a range of nurse staff planning aspects: skill mix, nursing work other than direct patient care, quantifying risks and benefits of staffing below or above a target level, and validating staffing methods in a range of hospitals.
尽管卫生服务研究领域有着悠久的历史，表明医院病房拥有足够的护士对患者安全至关重要，并且人们一直关注护士人力配置方法，但如何确定安全的人员配置水平仍存在争议。从另一个角度来看，我们可以参考另一部分文献，这些文献利用运筹学技术来规划护士人力配置。我们的目标是提供将运筹学方法应用于护士人力配置的示例，并讨论它们如何为传统方法增添价值。本文首先总结了传统的护士人力配置方法及其局限性。我们根据运筹学文献中的示例，解释了一些关键的运筹学技术及其与不同护士人力配置问题的相关性。我们确定了运筹学技术对这些问题的三个关键贡献：“问题结构”、处理复杂性和数值实验。我们得出结论，如果将运筹学技术引入主流护士人力配置研究，关于护士人力配置的决策制定将会得到改善。在一系列护士人员规划方面也有进一步研究的机会：技能组合、除直接患者护理以外的护理工作、量化人员配置低于或高于目标水平的风险和收益，以及在一系列医院中验证人员配置方法。
