We are a research group, established to test the implementation of the “Framework for Safe Nurse Staffing and Skill-Mix in acute adult medical and surgical wards”. The Department of Health recently published this document and made a number of recommendations to ensure that the staffing of hospitals was safe and effective; that is to ensure the right number of nurses are in the right place at the right time and with the right skills to deliver care. This research intends to measure the extent to which the recommendations in this report impacts on patients and staff in hospitals and emergency departments (EDs). The research also examines how much the recommendations cost to implement. We measure a number of factors that we know are related to nurse staffing. These include missed care, which is looking at work that nurses may not have had time to complete, as well as how satisfied patients are with their care. We will look at whether changes in staffing will impact on the experience of patients in EDs, such as the length of time waiting for care. Based on our findings, we will make a number of recommendations to improve the staffing of wards and emergency departments in Ireland.
This is an interventional study using a pre-post-test design. There are four aims of the study:
- Measure the impact of implementing the pilot of the Framework (specifically Nursing Hours per Patient Day (NHPPD)) on nurse sensitive patient outcomes measures, staff outcome measures and organisational factors.
- Measure the economic impact of implementing the Framework using appropriate economic evaluation techniques.
- Using implementation science, provide an evidence-based assessment of the adoption and implementation of the Framework in practice to guide future national rollout decisions.
- Determine the extent to which the Framework delivered on its intended outcomes, including: stability of the nursing workforce and appropriate staffing and skill-mix to meet patient need.