Document Type
Article
Language
eng
Format of Original
11 p.
Publication Date
4-2015
Publisher
Wiley
Source Publication
Journal of Nursing Management
Source ISSN
1365-2834
Original Item ID
doi: 10.1111/jonm.12147
Abstract
Aim
This analysis compares the staffing implications of three measures of nurse staffing requirements: midnight census, turnover adjustment based on length of stay, and volume of admissions, discharges and transfers.
Background
Midnight census is commonly used to determine registered nurse staffing. Unit-level workload increases with patient churn, the movement of patients in and out of the nursing unit. Failure to account for patient churn in staffing allocation impacts nurse workload and may result in adverse patient outcomes.
Method(s)
Secondary data analysis of unit-level data from 32 hospitals, where nursing units are grouped into three unit-type categories: intensive care, intermediate care, and medical surgical.
Result
Midnight census alone did not account adequately for registered nurse workload intensity associated with patient churn. On average, units were staffed with a mixture of registered nurses and other nursing staff not always to budgeted levels. Adjusting for patient churn increases nurse staffing across all units and shifts.
Conclusion
Use of the discharges and transfers adjustment to midnight census may be useful in adjusting RN staffing on a shift basis to account for patient churn.
Implications for nursing management
Nurse managers should understand the implications to nurse workload of various methods of calculating registered nurse staff requirements.
Recommended Citation
Hughes, Ronda G.; Bobay, Kathleen; Jolly, Nicholas A.; and Suby, Chrysmarie, "Comparison of Nurse Staffing Based on Changes in Unit-level Workload Associated with Patient Churn" (2015). College of Nursing Faculty Research and Publications. 372.
https://epublications.marquette.edu/nursing_fac/372
Comments
Accepted version. Journal of Nursing Management, Vol. 23, No. 3 (April 2015): 390-400. DOI.© 2015 John Wiley & Sons Ltd. Used with permission.
This is the peer reviewed version of the following article: "Comparison of Nurse Staffing Based on Changes in Unit-level Workload Associated with Patient Churn." Journal of Nursing Management, Vol. 23, No. 3 (April 2015): 390-400. which has been published in final form at DOI. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.