title: Developing, testing and applying instruments for measuring rising dependency-acuity's impact on ward staffing and quality.
abstract: OBJECTIVE
  This paper aims to explains how relatively simple nurse staffing formulas from "best practice" ward dependency-acuity data can be used for nursing workforce planning and development.
  
  
  METHODS
  The paper combines literature, detailed ward surveys, workshop and expert group/stakeholder information to generate and test care levels/nurse multipliers for setting ward establishments.
  
  
  RESULTS
  The paper finds that professional-judgement based ward staffing can be abandoned, while complex acuity-quality, timed-task and regression-based nurse staffing algorithms for setting ward establishments may be unnecessary since the new multipliers, underpinned by robust validity and reliability testing, seem to be remarkably accurate nurse-staffing determiners at a fraction of the cost.
  
  
  CONCLUSIONS
  As care levels and multipliers stand they are suitable only for UK National Health Service acute wards. Primary care, mental health, learning disability and other specialist group care levels and multipliers need developing.
  
  
  CONCLUSIONS
  Users, at a minimum, can adopt care level data and multiplier staffing recommendations for benchmarking purposes. Ultimately, the algorithms can be used to: adjust ward establishments according to workload; or set staffing for new, inpatient services.
  
  
  CONCLUSIONS
  The paper offers a simple system for assessing patients' nursing needs and setting ward staffing accordingly.
authors.affiliation: Infection Control and Patient Safety, Nottingham University Hospitals Trust, Nottingham, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Smith
authors.forename: Ann
authors.initials: A
authors.lastname: Casey
authors.forename: Keith
authors.initials: K
authors.lastname: Hurst
authors.forename: Katherine
authors.initials: K
authors.lastname: Fenton
authors.forename: Hilary
authors.initials: H
authors.lastname: Scholefield
mesh_terms: D000465:Algorithms; D006301:Health Services Needs and Demand / Q000458:organization & administration; D006304:Health Status; D006801:Humans; D015401:Nursing Administration Research / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000458:organization & administration; D011787:Quality of Health Care / Q000458:organization & administration*; D012107:Research Design; D006113:United Kingdom