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'How do those charged with delivering safe care ensure safe staffing?'

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Julie Haliday and Katherine Fenton believe their tool can inform decisions on nurse staffing and ensure the delivery of high quality care now and in the future

Attention is focused more than ever on the issue of safe nurse staffing. Recently, nurse staffing failures have been a major factor in undermining patient safety in a number of well publicised cases. In addition, accountability for safe staffing is now a clear requirement for boards and is reinforced by standards set by both the Nursing and Midwifery Council and Care Quality Commission.

The NHS is striving to meet the challenge of the unprecedented £15m saving required. It is easy to see why eyes might be drawn to the largest NHS workforce - nurses - to make savings. So how do those charged with the responsibility for delivering safe, high quality care while also contributing to cost savings get the information and evidence needed to do ensure safe staffing levels are in place?

The launch of the new on-line Safer Nursing Care Tool (SNCT) can inform decisions on nurse staffing, a critical factor in delivery of high quality care. It can help plan for future nursing workforce requirements and benchmark the quality of patient care.

Information gathered by the SNCT can be used at ward and board level to influence key decisions on staffing and generate nurse sensitive outcome indicators, a key part of an organisations quality and productivity plans (QIPP). A natural extension to the ‘acuity/dependency’ tool developed by the Association of UK University Hospitals (AUKUH) it is an example of the acuity – quality approach to nurse staffing.

As a key part of the ‘Energise for Excellence in Care’ (E4E) movement the SNCT allows safe staff management. Overall E4E aims to help improve fundamental nursing care and nurses will be able to use the SNCT to compare and benchmark data on nurse-specific quality indicators, such as those for falls, pressure ulcers and nutrition in addition to producing staffing information

Developed by SHA Chief Nurses in conjunction with NHS Institute for Innovation & Improvment, it will help categorise patients across five classifications depending on their conditions and used to help inform staffing levels, skill mix and workforce development needs on acute wards.

The SNCT is a great addition to the tools available for nurse leaders in the area of safe staffing and quality of care. Triangulation in this area is important and we should consider the use of other methods, e.g. staffing ratios while not forgetting the key role of professional judgement when taking such key decisions. After all, we know the strong links to the quality of care and both patient and staff experience.

Julie Halliday is the Director of Implementation Energise for Excellence in Care and HIAs and Katherine Fenton is the Chief Nurse at University College London Hospitals NHS Foundation Trust.

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Readers' comments (1)

  • It is true to say in my experience that it is essential to have a tool in place to give some guidance about safe staffing levels. However when the ward is full it is full and the workload may be very busy but at least there is a ceiling on how many patients generate the workload. This is not true within the primary care setting.It seem that you have enough staff one minute then friday 4pm comes and the secondary care system decide to discharge various cases requiring care. It isn't cost effective or possible to staff primary care with this hit and miss sytem of secondary care discharge, and potential workload. I don't have any answers even with the best tool in the world predicting discharge events is a lottery. Bank staff are a myth. Perhaps friday should be red alert day.

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