A debate on quality and safety in healthcare
It seems a day doesn’t go by when there isn’t a call to implement mandatory staffing levels. Indeed, there is evidence to suggest that low nurse staffing levels contributes to poorer outcomes for patients and staff, however, the effectiveness of staffing level tools to deliver better outcomes has not been proven. I am writing a proposal of research to examine the effectiveness of a community nurse workload assessment tool at delivering better patient safety outcomes and improved work-related stress for staff. A lay summary can be found below.
I am looking to build an expert and lay research advisory group to support the project, if you are interested in getting involved, please contact me: email@example.com.
The use of mandatory nursing levels is currently under debate. There is evidence to support a link between staff levels and poor patient outcomes in hospital wards.The evidence to support the relationship between staffing levels and patient outcomes in the community is less developed. Preliminary work in Scotland has produced a tool we can test in England. This project aims to examine whether the use of a community nurse workload assessment tool to determine caseloads, influences patient safety outcomes, staff work-related stress and the experiences of nurses.
In a cluster randomised control trial (RCT), staff teams will be randomly assigned to either an intervention group, which uses the assessment tool to determine caseload, or a control group, which continues with current operating procedures. This will be conducted over a 12 month period. Patient safety outcome data will be collected using the safety thermometer to track the four most common harms to patients every month including: falls, catheter related UTIs, pressure ulcers and venous thromboembolism. The Health and Safety Executive management standards indicator tool for work-related stress will be utilised quarterly to track work-related stress of both groups (4, 5). In addition, the nursing staff will be interviewed at the end of the trial in both the intervention and control groups.
Quantitative data will be analysed to determine if there is a statistically significant difference between the intervention group and control group. If a significant difference exists in favour of the tool, the researchers are able conclude that the differences obtained can be attributed to the use of the community nurse workload assessment tool. Qualitative data will be examined, and recurrent themes identified and described from both the intervention and control group. The themes can be compared between to two to determine commonalities and differences.