The Scottish Safe Staffing Act at Baseline: Quantitative Findings

Area of Science:

• Healthcare policy and management
• Nursing workforce studies
• Health services research

Background:

• Global nurse staffing crisis necessitates legislative action.
• Scotland's Health and Care (Staffing) (Scotland) Act 2019 mandates guiding principles, duties, and a common staffing method, diverging from patient-to-nurse ratios.
• Baseline assessment of adherence to the Act is crucial for policy evaluation and identifying areas needing employer support.

Purpose of the Study:

• To establish the baseline of nurse staffing standards in Scotland following the Act's implementation in April 2024.
• To assess nurses' perceptions of quality, safety, and their intent to leave their jobs.
• To inform policymakers on the Act's initial fulfillment and identify areas for improvement.

Main Methods:

• Cross-sectional study design.
• Online survey distributed to a convenience sample of 1870 registered nurses and nursing support workers from May 1 to July 31, 2024.
• Data collected on demographics, professional characteristics, international nursing metrics, Act provisions, and job intentions; analyzed using descriptive statistics.

Main Results:

• Only 9% of nurses reported appropriate staffing for safe, high-quality care.
• Low percentages reported excellent quality (17%) or an 'A' grade for safety (10%).
• Most nurses found staffing levels insufficient according to the Act's principles, with common methods and duties followed only occasionally; 45% intend to leave their jobs within a year, with half of those exiting the profession.

Conclusions:

• The Act's goal of safe staffing is not being met at implementation, with significant nurse dissatisfaction and intent to leave.
• Workforce disruption is anticipated due to turnover, necessitating retention policies.
• The Act's complexity may hinder achieving safe staffing goals and could be a challenge for widespread adoption.