Page 361 - Encyclopedia of Nursing Research

328 n NuRSe STAFFING

interdisciplinary collaboration in some nurs- plant, equipment, and supplies, is, of course,
ing and medical curricula. Shadowing pro- human resources. Institutions offering
N grams where residents shadow nurses have 24-hour services, such as hospitals and long-
recently been adopted in residency programs term care facilities, can face quite high costs
in an effort to enhance increased understand- for nursing personnel, and acute care hos-
ing, communication, and respect. In addition, pitals, where clients tend to require highly
health care organizations have adopted team- intensive and skilled care, are particularly
work initiatives promoting interdisciplinary dependent on the labor of registered nurses.
collaboration and have identified specific However, community-based and ambulatory
patient care outcomes to measure and evalu- clinics and services may also require consid-
ate collaboration. erable numbers of staff. Many nurse practice
Further research directed towards eval- settings are commonly characterized by high
uating the success of collaborative teamwork volumes of client care and a wide variety of
endeavors could be aimed at evaluating the client needs, especially across various clin-
degree of patient, nurse and physician satis- ics, care units, and departments. Attempts to
faction, and improved patient care outcomes. increase efficiencies within health care orga-
Finally, the development of positive collab- nizations by using only needed personnel
orative relationships can provide an oppor- without overstaffing or understaffing have
tunity for nurses and physicians to develop led to the development of nursing workload
innovative approaches and assist them to measurement systems to collect and analyze
reconnect with values that initially attracted patient-specific information about care needs
them to health care. in specific work groups over time.
For health care managers, staffing deci-
Tara C. Prescott sions are of interest because of the financial
implications of human resources costs for
their agencies. However, all stakeholders
in the health care system, including clini-
Nurse staffiNg cians and patients and their families, as well
as managers, find staffing to be of concern
because of the potential clinical consequences
Staffing is the process of allocating employ- of staffing decisions for patients (e.g., quality
ees to accomplish an organization’s pur- and safety outcomes).
pose. In the case of nursing, it refers to the Although statistical associations bet-
deployment of nursing staff to achieve the ween nursing ratios (such as RN-to-bed
operational goals of health care organiza- ratios) and acute care hospital patient out-
tions, high among these is meeting the care comes have long been identified in the
needs of the organization’s clients. Nurse broader health services research literature,
staffing levels, the measurable endpoint of these were often incidental findings embed-
the process, are typically thought of in terms ded in studies focused on hospital or physi-
of either (a) ratios of staff to patient or staff to cian characteristics (Aiken, Clarke, Sloane,
service volume that establish a level of cover- Sochalski, & Silber, 2002). After the publi-
age or attention patients receive in a setting cation of the Institute of Medicine’s (1996)
or (b) proportions of staff providing care in a landmark report declaring both a dearth
setting who hold specific qualifications, such of evidence and the need for a research
as specific levels of licensure or registration, agenda in this area, scholarly activity in the
degrees, or certifications. staffing–outcomes field peaked in the early
One of the major drivers of cost in health years of the millennium. Financially driven
care, beyond the exception of the physical organizational restructuring in acute care