Utfordringer knyttet til bemanning av norske nyfødtavdelinger - en kartleggingsstudie av pasientaktivitet og sykepleiebehov

Abstract

Aims: The aim of this study was to estimate the number of nurses needed in Norwegian Neonatal Intensive Care Units based on a national patient classification system. We surveyed (1) the need for nurses in weekends compared to weekdays, (2) the need for nurses in summer holidays compared to the rest of the year, and (3) the occupancy fluctuation effect on staffing needs in a small units compared to larger units. Results are presented in a paper for publication in JAN. The aim of the essay was to thoroughly describe the study design and methodological challenges.

Background: Neonatal intensive care units are difficult to staff appropriately due to fluctuations in patient volume and acuity. Staffing guidelines have been developed and applied in some countries for the purpose of offering safe patient care in neonatal units.

Design: A national population based cross-sectional study.

Method: We used data from The Norwegian Neonatal Network Central Database to describe patient load and acuity every day in the year 2013 and 2014. We calculated the need for nurses in each unit by combining these data with a proposed staffing guideline.

Results: A cross-sectional study design was found suitable. Of all neonatal patients in Norway 11.3% can be categorised as intensive care patients. There are no differences in need for nurses in weekends versus weekdays and during summer holidays versus days in the rest of the year. Small units have increased variability in staffing needs and sufficient staffing is more challenging compared to larger units.

Conclusions: Planning for reduced nurse staffing in weekends and summer seasons will probably results in need of additional nurses in order to meet the demand. Staffing scheduled for most of the days in a year, instead of the median need for nurses, will results in a greater increase in need for nurses in small units compared to larger units.