NICE has issued final advice to the NHS on how to make the right decisions about nursing staff requirements to provide safe care for patients on adult inpatient wards in acute hospitals.
Following on from the Francis and Berwick reports, the Department of Health and NHS England asked NICE to develop evidence-based guidelines to advise the NHS about safe staffing.
Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: “Safe staffing is more complex than setting a single ratio. The emphasis should not just be on the available number of staff, it should be on delivering safe patient care and making sure that hospital management and nursing staff are absolutely clear on best practice to do this.”
The guideline states that patient needs must come first when making decisions about safe staffing for nursing on acute wards. It sets out ‘red flag events’ which warn when nurses in charge of shifts must act immediately to ensure they have enough staff to meet the needs of patients on that ward. ‘Red flag events’ include patients not being provided with basic care such as pain relief or help to visit the bathroom. An appropriate response could be to provide more skilled nurses or increase numbers of staff.
The guideline also identifies measures that can be used by management to help determine whether staffing on each ward is meeting expected standards. These ‘safe nursing indicators’ include incidents affecting patient safety such as falls and pressure ulcers or staff reported outcomes such as missed breaks and overtime.
Jane Cummings, Chief Nursing Officer for England, said: “Each ward needs the right team of staff to provide high quality care for their patients and their individual needs. This doesn’t happen by accident – it requires an evidence based approach, clinical judgment and regular monitoring, with the flexibility to quickly adapt to changing circumstances. NICE have brought together expert evidence to produce a set of guidelines that hospitals can use to ensure that patients are always at the centre of every staffing decision.”
The Clinical Services Journal will feature a detailed insight into the NICE guidance on safe staffing in the September printed edition.
