NIHR ARC Wessex, Southampton, UK.
School of Health Sciences, University of Southampton, Southampton, UK.
J Nurs Manag. 2021 Oct;29(7):2260-2269. doi: 10.1111/jonm.13341. Epub 2021 May 9.
To assess how well the Safer Nursing Care Tool (SNCT) predicts staffing requirements on hospital wards, and to use professional judgement to generate hypotheses about factors associated with a "poor fit".
The SNCT is widely used in the UK, but there is scant evidence about factors that influence the quality of staffing decisions based upon such patient classification systems.
Secondary analysis of data from 69 wards in three acute hospitals to assess the precision of the estimated staffing requirement, variation of estimates, correspondence with professional judgement and achieved staffing levels. Nursing workforce leads suggested factors associated with poor fit, based on the wards that rated worst.
39% of wards were frequently understaffed, while frequent overstaffing was less common (12%). 24% of wards needed a sample of over 182 days to estimate the establishment precisely. Potential reasons identified for poor fit included high turnover, older patients, high levels of 1-to-1 specialing, cancer care, small ward size and high within-day variation in demand.
Using a staffing tool without applying professional judgement or triangulating against other methods can lead to inaccurate estimates of staffing requirements and unsafe staffing levels.
Despite the availability of software to calculate staffing requirements, application of professional judgement remains essential.
评估安全护理人员配备工具 (SNCT) 预测医院病房人员配备需求的能力，并运用专业判断生成与“不匹配”相关因素的假设。
SNCT 在英国被广泛使用，但关于影响基于此类患者分类系统的人员配备决策质量的因素的证据很少。
对来自三家急性医院的 69 个病房的数据进行二次分析，以评估估计人员配备需求的精度、估计值的变化、与专业判断的一致性以及实际人员配备水平。根据评价最差的病房，护理人员负责人根据提出了与不匹配相关的因素。
39%的病房经常人手不足，而人手过多的情况较少（12%）。24%的病房需要超过 182 天的样本才能准确估计编制。发现不匹配的潜在原因包括高周转率、老年患者、1 对 1 专业护理水平高、癌症护理、病房规模小以及需求在一天内的变化大。
不应用专业判断或与其他方法进行三角测量而使用人员配备工具会导致人员配备需求的不准确估计和不安全的人员配备水平。
尽管有计算人员配备需求的软件，但应用专业判断仍然至关重要。
