Nurse staffing models in medical‐surgical units of acute care settings: A cross‐sectional study

Abstract

Background: Nurse staffing models have been developed across different countries to address nursing shortages and improve quality of nursing care. However, there is no published study that describes nurse staffing models in Ethiopian hospitals. Aims:To describe the existing staffing models for nursing practice in acute care units of two hospitals (one public and one private) in Ethiopia. Methods:A cross-sectional study was conducted from July to December 2018. A self-administered questionnaire was used to collect data such as shift patterns, hours worked, and number of patients cared for per shift. Unit-level data on nurse staffing were collected using a checklist developed specifically for this study.Results: Fifty-nine percent (59.9%) of participants reported that they worked six or seven days per week. On average, they worked 50 hours per week and 12% working over 60 hours per week. The number of patients they provided care for during their last shift ranged from four to 45 with an average of 13 patients. Conclusion:This study demonstrates that nurses working in acute care settings in Ethiopia are typically working more than 40 hours per week and caring for many patients per shift, which has the potential to impact patient safety. K E Y W O R D Sacute care, Ethiopia, medical-surgical, nurse staffing, nursing, staffing models SUMMARY STATEMENTWhat is already known about this topic?• Nurse staffing is a critical factor affecting patient safety and nurse workforce outcomes.• There are different staffing models in which staff are assigned to give care for patients in different healthcare settings but much of the research is from high-income countries.What this paper adds?• This paper describes nurse staffing in acute care settings in Ethiopia, a low-income country. The number of patients for whom nurses provide care per shift, and the number of hours nurses provide care per week, is very high compared with other settings.• Nurses work very long hours, often more than 50 hours per week.• Many nurses routinely work or seven days per week and on average nurses care for 13 patients per shift

Missed nursing care, nurse staffing levels and patient safety outcomes in low‐income country acute care settings: An observational study

“…There were no significant variations in relation to age, gender, educational status and years of work experience of the participants in TP1 and TP2. The sociodemographic characteristics of participant nurses during TP1 are presented elsewhere (Assaye et al, 2020).…”

“…Data on nurse‐to‐patient ratio in acute care settings in Ethiopia are scarce. Our previous research showed that the average nurse‐to‐patient ratio in medical‐surgical acute care units of the public hospital ranges from 1:7 to 1:27 across different units and shifts (Assaye et al, 2020). More than half of the nurses who worked in the units and participated in the study reported that they worked 6 or 7 days per week, with an overall average of 50 h worked per week (Assaye et al, 2020).…”

Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review

“…These were all labour-related reasons and included inadequate numbers of nurses and nurse assistive personnel and an unexpected rise in patient care numbers. Although the smaller numbers limit generalizability, they speak to the importance of poor staff to patient ratios in many LMIC; in the more resource constrained settings ratios have been reported to be as extreme as 1 nurse caring for around 25 patients [27,69]. Studies that investigate the role nurse staffing plays in missed nursing care within these environments would be helpful.…”

Identifying gaps in global evidence for nurse staffing and patient care outcomes research in low/middle-income countries: an umbrella review

“…The evolution and the evidence for nurse staffing in low/middle-income countries (LMICs) are less clear. In more resource-challenged LMIC settings, nurse staffing ratios might be as low as 1 nurse caring for over 25 patients on a shift 22 23. For such settings, the WHO has promoted the Workload Indicator Staffing Needs (WISN) planning tool which relies on data from health information systems 24.…”