Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology

Abstract

BackgroundCurrent human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care.Methods/DesignA multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences.This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of changing different aspects of the nursing work environment on quality of care and satisfaction of the nursing workforce.DiscussionRN4CAST is one of the largest nurse workforce studies ever conducted in Europe, will add to accuracy of forecasting models and generate new approaches to more effective management of nursing resources in Europe.

What impact does nursing care left undone have on patient outcomes? Review of the literature

“…Most studies measured missed care with nurse or patient surveys that have been widely used in the missed care literature, namely survey from the International Hospital Outcomes Consortium [IHOC]/RN4CAST (Sermeus et al., 2011); MISSCARE (Kalisch, 2006) and the Basel Extent of Rationing of Nursing Care: BERNCA (Schubert, Glass, Clarke, Schaffert‐Witvliet, & De Geest, 2007). Three studies were secondary analyses of the large RN4CAST study conducted across 15 European countries (Ausserhofer et al., 2013; Ball, Murrells, Rafferty, Morrow, & Griffiths, 2014; Bruyneel et al., 2015), where authors analysed and reported data from individual countries.…”

Relationships between nurses’ empathy, self-compassion and dimensions of professional quality of life: A cross-sectional study

“…Job stress and burnout are common in healthcare professionals (e.g., McCray, Cronholm, Bogner, Gallo, & Neill, 2008) and in nurses in particular (Sermeus et al, 2011;Dominguez-Gomez, & Rutledge, 2009). Several studies have reported that stress and burnout in healthcare professionals are associated with several physical and mental health problems, such as depression, anxiety and low self-esteem (e.g., Maslach, Schaufeli, & Leiter, 2001;Schulz et al, 2011).…”

The Impact of Heavy Perceived Nurse Workloads on Patient and Nurse Outcomes

“…Our study goal, therefore, was to focus on nurse-perceived workload factors that are assessable and actionable. In our study, we included workload factors from a variety of validated, publicly available assessment tools, particularly those used in the global RN4CAST studies [6]. We were also influenced by the human factors framework of Holden et al [7].…”