Solutions to Nurse Staffing Challenges Require Creativity, Commitment

Healthcare leaders discuss strategies for appropriate nurse staffing at American Association of Critical-Care Nurses summit


Newswise — Responses from more than 400 nurses at a recent national summit highlight the frequency and scope of challenges related to nurse staffing, but creativity and a commitment to the overall health of the work environment help hospitals find innovative solutions.

The American Association of Critical-Care Nurses (AACN) held the half-day summit May 18 as part of its National Teaching Institute & Critical Care Exposition (NTI) in New Orleans.

During the event, healthcare leaders discussed variables that create staffing mismatches, identified potential barriers to solving the problem and explored potential solutions.

Research shows that staffing influences patient safety, clinical outcomes and the work environment, while changes in the healthcare environment have increased pressure on organizations to seek solutions for lowering costs and increasing productivity.

The daily decisions related to staffing frequently lead to a mismatch between supply and demand.

Of the more than 400 nurses at the summit, 64 percent responded that staffing in their unit was appropriate less than half the time during the past month. Only 8 percent thought their unit had appropriate staffing at least three-quarters of the time.

AACN Chief Clinical Officer Connie Barden recommended having a formal process in place to evaluate staffing, because situations may be different from unit to unit.

“Staffing is a complex process with the goal of matching the needs of patients and their families with the competencies of nurses. Get together and look at your unit and what outcomes in your unit will reflect whether or not your staffing is appropriate,” she said. “Create the process, make it measurable and then hold yourselves accountable to whatever measures you put in place.”

The summit included several TED-style presentations that shared potential solutions to manage the challenges of staffing and barriers to practice. Among the strategies discussed were: • Acuity-based staffing systems, which allocate the number and skill level of nurses on a shift according to patient needs, not solely according to number of patients• Nurse-driven staffing committees that focus on collaborative scheduling, nursing teams working together and staff-developed incentive programs • Access to off-site expertise via telehealth to reduce variation, increase reliability and improve outcomes• In-house pool of experienced nurses to minimize others having to float during shifts

Participants indicated that the summit offered creative solutions and increased their confidence in addressing the issue with management. In a two-part question at the conclusion of the event, more than 80 percent answered that they were confident or very confident that they had at least one potential strategy to share with their institution and felt very or extremely comfortable having a meaningful discussion with their leadership team about staffing issues.

The summit follows the recent publication of the second edition of “AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence,” which provides a blueprint for healthcare organizations seeking to improve performance, patient safety, staff recruitment and retention, and their workplace environment. Appropriate staffing is one of the six essential standards that must be in place to create and help ensure a healthy work environment.

Over the past several years, AACN has been at the forefront of addressing issues related to healthy work environments through its scientific and clinical journals and professional development programs. About the National Teaching Institute & Critical Care Exposition: Established in 1974, AACN’s National Teaching Institute & Critical Care Exposition (NTI) represents the world’s largest educational conference and trade show for nurses who care for acutely and critically ill patients and their families. Bedside nurses, nurse educators, nurse managers, clinical nurse specialists and nurse practitioners attend NTI.

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than 500,000 acute and critical care nurses and includes more than 225 chapters worldwide. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. www.aacn.org; www.facebook.com/aacnface; www.twitter.com/aacnme

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