UCC School of Nursing and Midwifery Annual Report 2019

Healthcare Experience, Engagement and Reform

Safe Nurse Staffing and Skill-Mix

The team also developed an algorithm to identify nurse sensitive outcomes (NSOs) in HIPE data, the first team to do this in Ireland. Initial analysis of the HIPE data indicate fewer NSOs occurring in the data following implementation of the Framework and a reduction in the chance of NSOs occurring. Additionally, analysis of qualitative comments shows that there is a lot of positive support for the research project. Staff have looked favourably upon the research and the potential for improvements in their individual wards. Emergency Departments The research team were instrumental in developing an accurate staffing calculation method for Emergency Department settings. The ED branch of the research found variation in staffing in the pilot EDs and this resulted changes to staffing to match patient need. Follow-up data collection is ongoing to measure the impact of these changes. Data is also being collected and analysed to examine any changes on waiting times, patients leaving without being seen and time to antibiotics.

The most established project that the workforce planning research cluster manage is the Safe Nurse Staffing and Skill- Mix project. This project has been ongoing for almost four years and has three branches: General and Specialist Medical and Surgical Wards; Emergency Departments and Community Care Settings (beginning). General and Specialist Medical and Surgical Wards The Department of Health developed a Framework for Safe Nurse Staffing and Skill-Mix in medical and surgical wards and this branch of the project measures the impact of the implementation of this Framework. The research into medical and surgical settings has been ongoing for almost four years and has resulted in large improvements in wards taking part in the research with changes in staffing based on measured patient acuity and dependency. This reduced the variance between actual and required staffing. This resulted in a dramatic decrease of agency staff of up to 28%, decreases in one-to-one specialling as staff had more time for observation, improvements in quality of care and reductions in care being left undone. Staff also reported higher levels of job satisfaction and rated the ward environment more favourably.

Pictured left: Prof Jonathan Drennan (UCC), Professor Christine Duffield (University of Technology, Sydney, Centre for Health Services Management and Edith Cowan University, Nursing and Midwifery, Broadway, Australia) and Dr Nicola Cornally (UCC).

Far left: Health Workforce Research Team.

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