Development and evaluation of an RN/RPN utilization toolkit.
OBJECTIVE
To develop and evaluate a toolkit for Registered Nurse/Registered Practical Nurse (RN/RPN) staff mix decision-making based on the College of Nurses of Ontario's practice standard for utilization of RNs and RPNs.


METHODS
Descriptive exploratory. The toolkit was tested in a sample of 2,069 inpatients on 36 medical/surgical units in five academic and two community acute care hospitals in southern Ontario. Survey and focus group data were used to evaluate the toolkit's psychometric properties, feasibility of use and utility.


RESULTS
Results support the validity and reliability of the Patient Care Needs Assessment (PCNA) tool and the consensus-based process for conducting patient care reviews. Review participants valued the consensus approach. There was limited evidence for the validity and utility of the Unit Environmental Profile (UEP) tool. Nursing unit leaders reported confidence in planning unit staff mix ratios based on information generated through application of the toolkit, specifically the PCNA, although they were less clear about how to incorporate environmental data into staff mix decisions.


CONCLUSIONS
Results confirm that the toolkit consistently measured the constructs that it was intended to measure and was useful in informing RN/RPN staff mix decision-making. Further refinement and testing of the UEP is required. Future research is needed to evaluate the quality of decisions resulting from the application of the toolkit, illuminate processes for integrating data into decisions and adapt the toolkit for application in other sectors.
Blastorah
Margaret
M
Nursing Knowledge, Research and Innovation, Sunnybrook Health Sciences Centre, Toronto, ON. margaret.blastorah@sunnybrook.ca
Alvarado
Kim
K
Duhn
Lenora
L
Flint
Frances
F
McGrath
Petrina
P
Vandevelde-Coke
Susan
S
D002983:Clinical Competence / Q000592:standards*; D003625:Data Collection; D004521:Educational Measurement; D004522:Educational Status; D055318:Evidence-Based Nursing; D005240:Feasibility Studies; D017144:Focus Groups; D006801:Humans; D007297:Inpatients; D009718:Nurse Administrators; D009726:Nurses / Q000592:standards*; D015403:Nursing Evaluation Research; D009864:Ontario; D016730:Program Development; D011594:Psychometrics; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013637:Tape Recording