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Safe staffing levels for children's nursing benchmarked by RCN


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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Readers' comments (3)

  • tinkerbell

    let us continue to ensure that the children receive the highest, safest standards of care
    and staff to deliver that care. Safe in their hands.

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  • This is pie in the sky work....

    I believe we need more staff we may have 8 RNs for 44 children which can be a stretch on night shifts...but we do not seriously need 3 extra nurses.

    Still we can rest assured it won't happen in these austere times and the RCN will not have the guts to fight anyway.

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  • I work in the ROI ( there is no recommended nurse patient guidelines in Ireland) and we are being told by management that as per RCN guidelines, a nurse on night duty can have up to 7 patients!! I cannot see any evidence to support this. Can anybody confirm this? We have 3 nurses on nights atm for 14 patients and are due to go up to 19 pts but will only have 4 nurses on nights when this happens. Current numbers on days are 5 nurses including manager for 14pts. Those numbers will go up to 6 on days for 19 patients. Any feedback greatly appreciated.

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