Comparison of nurse staffing based on changes in unit-level workload associated with patient churn. J Nurs Manag 2015 Apr;23(3):390-400
Date
10/15/2013Pubmed ID
24118360DOI
10.1111/jonm.12147Scopus ID
2-s2.0-84926408752 (requires institutional sign-in at Scopus site) 28 CitationsAbstract
AIM: This analysis compares the staffing implications of three measures of nurse staffing requirements: midnight census, turnover adjustment based on length of stay, and volume of admissions, discharges and transfers.
BACKGROUND: Midnight census is commonly used to determine registered nurse staffing. Unit-level workload increases with patient churn, the movement of patients in and out of the nursing unit. Failure to account for patient churn in staffing allocation impacts nurse workload and may result in adverse patient outcomes.
METHOD(S): Secondary data analysis of unit-level data from 32 hospitals, where nursing units are grouped into three unit-type categories: intensive care, intermediate care, and medical surgical.
RESULT: Midnight census alone did not account adequately for registered nurse workload intensity associated with patient churn. On average, units were staffed with a mixture of registered nurses and other nursing staff not always to budgeted levels. Adjusting for patient churn increases nurse staffing across all units and shifts.
CONCLUSION: Use of the discharges and transfers adjustment to midnight census may be useful in adjusting RN staffing on a shift basis to account for patient churn.
IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should understand the implications to nurse workload of various methods of calculating registered nurse staff requirements.
Author List
Hughes RG, Bobay KL, Jolly NA, Suby CAuthor
Kathleen Bobay PhD Associate Professor in the Nursing department at Marquette UniversityMESH terms used to index this publication - Major topics in bold
Bed OccupancyHumans
Nurse Administrators
Nurses
Patients' Rooms
Personnel Staffing and Scheduling
Quality of Health Care
Time and Motion Studies
Workload
