Senior nurses have developed a simple way of assessing the safe number of nurses needed for a ward, which health workforce experts say can be used to argue against post cutting.
Nursing teams can use the Safer Nursing Care Tool to work out safe staffing on hospital wards by putting in information about patients’ conditions.
They can also match staffing levels with nursing performance in areas such as pressure sores, nutrition and falls, and compare results with similar wards and departments at their hospital or other hospitals.
The tool – launched online this month after extensive trials – builds on the Association of UK University Hospitals’ acuity/dependency tool and was developed by strategic health authority chief nurses with the NHS Institute for Improvement and Innovation.
Project lead Katherine Fenton, chief nurse at University College London Hospitals Foundation Trust, told Nursing Times it tied in with recommendations from last year’s Mid Staffordshire inquiry report, which concluded chronic staffing shortages were largely to blame for substandard care.
She said: “It shows what numbers you should have for the acuity and dependency of the patients you’ve got, and gives nurses the ability to evidence what staff they need to care for patients safely and effectively.”
She added: “We are starting to link that to nurse sensitive outcome indicators, like pressure sores, and identifying a possible link between the two, although that work is in its early stages.”
It was initially tested at three trusts – North Tees and Hartlepool Foundation Trust, Nottingham University Hospitals NHS Trust and Royal Wolverhampton Hospitals NHS Trust – and in July 2010 was rolled out to a further 20 across seven SHAs.
Rachel Finn, senior improvement lead at Nottingham University Hospitals, said the trust had used the tool on 70 adult wards and it had helped ensure nurses were deployed “in the right place”.
“It has helped us identify where we’re performing well and where improvements need to be made and, of course, that is going to drive standards up,” she said. “Where staffing has been increased because the tool showed we needed more staff, then we have seen metrics improve.”
She admitted some nurses had been sceptical at first and worried it would take too much time, but they found it took just 10 to 15 minutes a day and was “robust, reliable and easy to use”.
Ms Finn added: “Some people have had their budgets reduced and some have had theirs increased, so there have been no net job losses. We have also been able to identify specific performance issues and take action.”
For example, she said the tool had helped identify a need for more nurse training on hospital-acquired pressure sores in critical care.
She said the tool was not used in isolation but alongside professional judgement, dependency scores and benchmarking.
James Buchan, professor of health sciences at Edinburgh’s Queen Margaret University, told Nursing Times the tool could be used to argue against job cuts.
He said: “It could demonstrate the risks associated with running at low staffing levels and provide an additional tool in the armoury of ward sisters and matrons.”
Chief nursing officer for England Christine Beasley described the resource as “valuable and timely”.
She told Nursing Times: “It is one of a number of tools that can help directors of nursing get nurse staffing in acute hospitals right. It has a strong evidence base, has been widely tested and links staffing to quality outcomes for patients.”
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- For more information go to http://www.institute.nhs.uk/quality_and_value/introduction/safer_nursing_care_tool