Making the most of our precious nursing resources
Hospitals could save hundreds of thousands of dollars, improve patient care and allocate fairer nursing workloads if they rostered nurses according to patients' needs instead of by ratios, a Monash researcher has found.
Many hospitals worldwide use a range of ratio systems but Victoria is the only state in Australia that uses mandated ratios to allocate nurses in public hospitals.
Dr Virginia Plummer from the School of Nursing and Midwifery has completed a study of almost two million nursing hours in Australia and overseas. The study involved measuring the allocation of nursing resources in hospitals and found that, in many instances, TrendCare – an Australian computer system that allocates nurses across wards depending on patient needs – better met the needs of hospitals.
Mandated nurse-patient ratios were introduced to Victorian public hospitals five years ago as one of several strategies to recruit nurses back to the hospitals.
However, Dr Plummer's study has found that TrendCare predicts nursing care requirements with greater accuracy than ratios for all hospital settings and patient conditions in public and private hospitals and metropolitan and rural hospitals of all sizes in Australia and New Zealand. The study also found similar results in several Thai hospitals.
Mandated ratios could not take into account the needs of individual patients or the variable workload of nurses and could not be quickly changed if needed, Dr Plummer found. "If patients require higher levels of care, wards with nurses caring for these patients are not generally allocated more staff under the current Victorian system," she said.
"Under the TrendCare system there is a closer correlation between the needs of a patient and the care provided," said Dr Plummer. "If a patient's condition alters, or there is a sudden influx of patients after a major accident or incident, the TrendCare system can immediately identify the required staffing arrangements".
Dr Plummer said the introduction of nurse patient ratios to Victoria had allowed nurses to regain confidence and control over their working conditions and that this had resulted in a stabilisation of the Victorian public hospital system.
However, observers were now keen to see a closer analysis of nurse patient ratios and dependency systems in a stable health service, she said. This information could be used to contribute to better quality patient care, enhanced workplace satisfaction for nurses and reduction in the costs of care.
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