van der Mark Carmen J E M, Vermeulen Hester, Hendriks Paul H J, Oostveen Catharina J van
Department of Capacity Management, Rijnstate Hospital, Arnhem, The Netherlands
Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboudumc, Nijmegen, The Netherlands.
BMJ Open. 2021 Apr 20;11(4):e045245. doi: 10.1136/bmjopen-2020-045245.
Matching demand and supply in nursing work continues to generate debate. Current approaches focus on objective measures, such as nurses per occupied bed or patient classification. However, staff numbers do not tell the whole staffing story. The subjective measure of nurses' perceived adequacy of staffing (PAS) has the potential to enhance nurse staffing methods in a way that goes beyond traditional workload measurement or workforce planning methods.
To detect outcomes associated with nurses' PAS and the factors that influence PAS and to review the psychometric properties of instruments used to measure PAS in a hospital setting.
A scoping review was performed to identify outcomes associated with PAS, factors influencing PAS and instruments measuring PAS. A search of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Business Source Complete and Embase databases identified 2609 potentially relevant articles. Data were independently extracted, analysed and synthesised. The quality of studies describing influencing factors or outcomes of PAS and psychometric properties of instruments measuring PAS were assessed following the National Institute for Health and Care Excellence quality appraisal checklist and the COnsensus-based Standards for the selection of health Measurement INstruments guidelines.
Sixty-three studies were included, describing 60 outcomes of PAS, 79 factors influencing PAS and 21 instruments measuring PAS. In general, positive PAS was related to positive outcomes for the patient, nurse and organisation, supporting the relevance of PAS as a staffing measure. We identified a variety of factors that influence PAS, including demand for care, nurse supply and organisation of care delivery. Associations between these factors and PAS were inconsistent. The quality of studies investigating the development and evaluation of instruments measuring PAS was moderate.
Measuring the PAS may enhance nurse staffing methods in a hospital setting. Further work is needed to refine and psychometrically evaluate instruments for measuring PAS.
护理工作中的供需匹配问题一直存在争议。目前的方法侧重于客观指标，如每占用床位的护士人数或患者分类。然而，员工数量并不能完全说明人员配备情况。护士对人员配备充足性的主观感受（PAS）这一指标，有可能以一种超越传统工作量测量或劳动力规划方法的方式，改进护士人员配备方法。
检测与护士PAS相关的结果以及影响PAS的因素，并评估在医院环境中用于测量PAS的工具的心理测量特性。
进行了一项范围综述，以确定与PAS相关的结果、影响PAS的因素以及测量PAS的工具。检索了PubMed、护理及相关健康文献累积索引（CINAHL）、商业资源完整版和Embase数据库，共识别出2609篇潜在相关文章。数据由独立人员提取、分析和综合。按照英国国家卫生与临床优化研究所的质量评估清单以及基于共识的健康测量工具选择标准指南，对描述PAS影响因素或结果以及测量PAS工具的心理测量特性的研究质量进行了评估。
纳入了63项研究，描述了PAS的60个结果、影响PAS的79个因素以及测量PAS 的21种工具。总体而言，积极的PAS与患者、护士和组织的积极结果相关，这支持了PAS作为一种人员配备指标的相关性。我们确定了多种影响PAS的因素，包括护理需求、护士供应和护理服务组织。这些因素与PAS之间的关联并不一致。研究测量PAS工具的开发和评估的研究质量中等。
测量PAS可能会改进医院环境中的护士人员配备方法。需要进一步开展工作，以完善并从心理测量学角度评估测量PAS的工具。
