title: Standards for nurse staffing in critical care units determined by: The British Association of Critical Care Nurses, The Critical Care Networks National Nurse Leads, Royal College of Nursing Critical Care and In-flight Forum.
abstract: BACKGROUND
  Since 1967 the gold standard for nurse staffing levels in intensive care and subsequently critical care units has been one nurse for each patient. However, critical care has changed substantially since that time and in recent years this standard has been challenged. Previously individual nursing organisations such as the British Association of Critical Care Nurses (BACCN) and the Royal College of Nursing have produced guidance on staffing levels for critical care units. This paper represents the first time all three UK Professional Critical Care Associations have collaborated to produce standards for nurse staffing in critical care units. These standards have evolved from previous works and are endorsed by BACCN, Critical Care Networks National Nurse Leads Group (CC3N) and the Royal College of Nursing Critical Care and In-flight Forum.
  
  
  OBJECTIVE
  The aim of this paper is to provide an overview of the much more detailed document 'Standards for Nurse Staffing in Critical Care', which can be found on the BACCN web site at www.baccn.org.uk. The full paper has extensively reviewed the evidence, whereas this short paper provides essential detail and the 12 standard statements.
  
  
  METHODS
  Representation was sort from each of the critical care associations. The authors extensively reviewed the literature using the terms: (1) critical care nursing, (2) nursing, (3) nurse staffing, (4) skill mix, (5) adverse events, (6) health care assistants and critical care, (7) length of stay, (8) critical care, (9) intensive care, (10) technology, (11) infection control.
  
  
  RESULTS
  Comprehensive review of the evidence has culminated in 12 standard statements endorsed by BACCN, CC3N and the Royal College of Nursing Critical Care and In-flight Forum. The standards act as a reference for nursing staff, managers and commissioners associated with critical care to provide and support safe patient care.
  
  
  CONCLUSIONS
  The review of the evidence has shown that the contribution of nursing can be difficult to measure and consequently support nurse staffing ratios. However, there is a growing body of evidence which associates higher number of registered nursing staff to patient ratio relates to improved safety and better outcomes for patients. The challenge for nurses is to produce accurate and meaningful outcome measures for nursing and collect data that accurately reflect the input of nursing on patient outcomes and safety.
authors.affiliation: BACCN National Board, Benchmark Communications, Newcastle upon Tyne, NE1 4HZ, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Bray
authors.forename: Ian
authors.initials: I
authors.lastname: Wren
authors.forename: Andrea
authors.initials: A
authors.lastname: Baldwin
authors.forename: Una
authors.initials: U
authors.lastname: St Ledger
authors.forename: Vanessa
authors.initials: V
authors.lastname: Gibson
authors.forename: Sheila
authors.initials: S
authors.lastname: Goodman
authors.forename: Dominic
authors.initials: D
authors.lastname: Walsh
mesh_terms: D002983:Clinical Competence; D003422:Critical Care; D032022:Delegation, Professional / Q000592:standards; D017408:Guidelines as Topic / Q000592:standards*; D006301:Health Services Needs and Demand; D006801:Humans; D017053:Infection Control / Q000592:standards; D007362:Intensive Care Units; D007902:Length of Stay; D024802:Nurse's Role; D009728:Nursing Assistants / Q000600:supply & distribution; D009741:Nursing Staff, Hospital / Q000600:supply & distribution*; D009745:Nursing, Supervisory / Q000592:standards; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards; D000078329:Workforce; D016526:Workload / Q000592:standards