Developing, testing and applying instruments for measuring rising dependencyacuity's impact on ward staffing and quality

Purpose This paper aims to explains how relatively simple nurse staffing formulas from best practice ward dependencyacuity data can be used for nursing workforce planning and development. Designmethodologyapproach The paper combines literature, detailed ward surveys, workshop and expert groupstakeholder information to generate and test care levelsnurse multipliers for setting ward establishments. Findings The paper finds that professionaljudgement based ward staffing can be abandoned, while complex acuityquality, timedtask and regressionbased nurse staffing algorithms for setting ward establishments may be unnecessary since the new multipliers, underpinned by robust validity and reliability testing, seem to be remarkably accurate nursestaffing determiners at a fraction of the cost. Research limitationsimplications As care levels and multipliers stand they are suitable only for UK National Health Service acute wards. Primary care, mental health, learning disability and other specialist group care levels and multipliers need developing. Practical implications Users, at a minimum, can adopt care level data and multiplier staffing recommendations for benchmarking purposes. Ultimately, the algorithms can be used to adjust ward establishments according to workload or set staffing for new, inpatient services. Originalityvalue The paper offers a simple system for assessing patients' nursing needs and setting ward staffing accordingly.