Practice priorities for acute care nursing: A Delphi study

Area of Science:

• Nursing
• Healthcare Management
• Patient Safety

Background:

• Increasing healthcare demands negatively affect nursing care quality and safety.
• Acute care settings face escalating pressures impacting patient outcomes.

Purpose of the Study:

• To identify and describe the risks and frequency of challenges in acute care nursing.
• To determine practice priorities for Australian hospital wards based on expert consensus.

Main Methods:

• A three-round electronic Delphi method was employed.
• Expert consensus was synthesized from 30 participants (Rounds 1 & 2) and 12 (Round 3).

Main Results:

• High patient acuity, inadequate bed space, and patient boarding are frequent, very high risks.
• Inadequate staffing, poor communication, and premature discharge pose very high risks, occurring sometimes.
• Pressure to admit and delayed medical reviews are high risks occurring often.

Conclusions:

• Nurse managers must prioritize system-wide frameworks addressing patient boarding, communication, and discharge.
• Improving nurse job satisfaction, staffing levels, and expertise are crucial practice priorities.
• This study details challenges in delivering safe, high-quality acute care nursing.