Direct care nurses should be involved in all aspects of staffing, according to standards set forth in new guidance from the American Association of Critical-Care Nurses.
The AACN Standards for Appropriate Staffing in Critical Care, published April 23, provide a framework for how organizations should incorporate appropriate staffing into daily operations and patient care. The guidance outlines the following seven standards, each of which include actions for leaders and suggested tools:
- Direct care nurses participate in all aspects of staffing, including planning, implementation and evaluation.
- Hospitals establish, evaluate and refine unit-specific staffing guidelines based upon their effects on patient and nurse outcomes.
- Patient assignments for every shift are based on an accurate assessment of the current nursing workload generated by each patient's needs and align nurse competency with patient characteristics.
- Clinical leaders including charge nurses and nurse managers are not included in staffing assignments, except in crisis situations.
- Staffing plans and patient assignments support the unique needs of nurses new to the unit.
- Staffing plans are designed to prioritize the health of the work environment, which is closely tied to nurse recruitment and retention, as well as patient safety.
- Staffing plans recognize that critically ill or injured patients generally require a ratio of one nurse to two patients.
The AACN defines appropriate staffing as ensuring an "effective match between patient needs and nurse competencies."