Consensus Development Project (CDP): An overview of staffing for safe and effective nursing care (18 July 2021)

Summary

This article presents an overview of the research evidence on nurse staffing levels in acute hospitals and how it has been applied to policy and practice, focusing primarily on the UK. Drawing on research reviews and examples of specific studies, the authors outline the current state of knowledge, much of which comes from cross-sectional studies. More recently, longitudinal studies allow a causal link between staffing and outcomes to be inferred. The authors argue that there is a lack of specificity on staffing levels, which has prevented research findings being effectively applied to nursing practice—research rarely specifies how many nurses are needed for safe and effective care. The most significant barrier to achieving safe staffing has been an underestimation of the number of registered nurses needed and overestimation of the potential for substitution, resulting in low baseline staffing and a national shortage of registered nurses. Repeatedly, new staffing solutions have been sought rather than tackling the problem of too few registered nurses head-on.