Consensus Development Project (CDP): An overview of staffing for safe and effective nursing care

Area of Science:

• Healthcare policy
• Nursing workforce research
• Patient safety

Background:

• Evidence on nurse staffing levels in acute care settings is crucial for policy and practice.
• The UK context is a primary focus for understanding the application of this research.
• Current knowledge synthesis draws from research reviews and specific study examples.

Purpose of the Study:

• To provide an overview of research evidence on nurse staffing in acute hospitals.
• To examine how this evidence has been translated into policy and practice, particularly in the UK.
• To identify impediments to achieving safe nurse staffing levels.

Main Methods:

• Review of existing research, including cross-sectional and longitudinal studies.
• Analysis of how research findings have been applied to policy and practice.
• Examination of specific study examples to illustrate key points.

Main Results:

• Much of the evidence originates from cross-sectional studies, with longitudinal studies offering more causal inference.
• A lack of specificity regarding required nurse staffing levels has impeded practical application.
• Underestimation of registered nurse (RN) needs and overestimation of substitution potentials are significant barriers.

Conclusions:

• The current state of knowledge highlights a gap between research evidence and its effective implementation in practice.
• Persistent understaffing and national RN shortages are linked to flawed assumptions about nurse requirements.
• Future efforts must address the core issue of insufficient RN numbers rather than seeking alternative solutions.