Minimum staffing levels deemed essential for delivering safe care to children and young people have been set by the Royal College of Nursing.
There should be a minimum of one registered nurse per every three children aged under two years at all times on general wards and one nurse per every four children aged over two, the RCN said yesterday.
Smaller ratios are outlined for specialist wards such as high dependency and intensive care.
The core standards also include a minimum ratio of 70:30 registered to unregistered staff, supernumerary status for the shift supervisor in each clinical area and a minimum of two registered children’s nurses at all times in all inpatient and day care areas.
In addition, 70% of nurses should have additional specific training required for the speciality – for example children’s intensive care or neonatal intensive care, and there should be access to a senior children’s nurse for advice at all times.
The guidance applies to all types of services, including both community and acute care.
RCN chief executive and general secretary Peter Carter said: “Children’s services are increasingly complex and our members have consistently raised the importance of identifying the safe minimum staffing levels and skill mix across all settings, particularly at a time when many health and public services are facing financial challenges.”
The RCN is calling on individual children’s nurses to raise any concerns they have about safe staffing and skill mix.
It said workforce plans should be reviewed on an annual basis and more frequently in response to known service pressures.
A full risk assessment should be undertaken and escalation to senior management in all cases where staffing and skill-mix deficiencies continue and are deemed unacceptable against the standards.
The RCN also warned there is a lack of consistency and availability among community children’s services across the country, which was inhibiting care closer to or at home – particularly for children with minor acute illnesses and long term conditions, and those needing continuing care and end of life care support.
Mr Carter added: “Children requiring provision for end of life care should receive 24 hour community children’s nursing care wherever and whenever this is required.
“Unfortunately, in many parts of the country this is not available and children die in hospital settings, rather than at home.”
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