The Zebra index: one method for comparing units in terms of nursing care

To describe an approach for developing a nursing index that is based on the patients' needs of nursing care and enables nursing costs to be calculated.

Usually staffing resources are calculated as the ratio between the number of staff and the number of occupied beds per unit.

The index was developed from two parts of the Zebra method. The index factor per patient category of care was calculated first. The patient days per category of care was multiplied next with the index factor for the category, which gives the same value in terms of nursing care given for all the patient days. The third step was the calculation of the Zebra index (ZI).

The ZI shows 'the intensity of nursing care' given. The index makes it possible to follow changes in the nursing care given over a period of time and it can also explain why two similar units with the same number of staff per patient can have a totally different workload situation.

The ZI obtains reliable information about the changing nursing situations over a period of time.

The approach described can be used in different settings and is not bound to Sweden but can be looked upon as a general method. The index is useful for comparing different units and clinics in terms of nursing care and staffing.