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  • Measuring perceived adequacy of staffing to incorporate nurses’ judgement into hospital capacity management: a scoping review

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Nursing
Original research
Measuring perceived adequacy of staffing to incorporate nurses’ judgement into hospital capacity management: a scoping review
  1. Carmen J E M van der Mark1,2,
  2. Hester Vermeulen2,3,
  3. Paul H J Hendriks4,
  4. Catharina J van Oostveen5,6
  1. 1Department of Capacity Management, Rijnstate Hospital, Arnhem, The Netherlands
  2. 2Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboudumc, Nijmegen, The Netherlands
  3. 3Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
  4. 4Institute for Management Research, Radboud University, Nijmegen, The Netherlands
  5. 5Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
  6. 6Spaarne Gasthuis Academy, Spaarne Gasthuis Hospital, Hoofddorp and Haarlem, The Netherlands
  1. Correspondence to Ms Carmen J E M van der Mark; cvandermark{at}rijnstate.nl

Abstract

Background Matching demand and supply in nursing work continues to generate debate. Current approaches focus on objective measures, such as nurses per occupied bed or patient classification. However, staff numbers do not tell the whole staffing story. The subjective measure of nurses’ perceived adequacy of staffing (PAS) has the potential to enhance nurse staffing methods in a way that goes beyond traditional workload measurement or workforce planning methods.

Objectives To detect outcomes associated with nurses’ PAS and the factors that influence PAS and to review the psychometric properties of instruments used to measure PAS in a hospital setting.

Design and methods A scoping review was performed to identify outcomes associated with PAS, factors influencing PAS and instruments measuring PAS. A search of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Business Source Complete and Embase databases identified 2609 potentially relevant articles. Data were independently extracted, analysed and synthesised. The quality of studies describing influencing factors or outcomes of PAS and psychometric properties of instruments measuring PAS were assessed following the National Institute for Health and Care Excellence quality appraisal checklist and the COnsensus-based Standards for the selection of health Measurement INstruments guidelines.

Results Sixty-three studies were included, describing 60 outcomes of PAS, 79 factors influencing PAS and 21 instruments measuring PAS. In general, positive PAS was related to positive outcomes for the patient, nurse and organisation, supporting the relevance of PAS as a staffing measure. We identified a variety of factors that influence PAS, including demand for care, nurse supply and organisation of care delivery. Associations between these factors and PAS were inconsistent. The quality of studies investigating the development and evaluation of instruments measuring PAS was moderate.

Conclusions Measuring the PAS may enhance nurse staffing methods in a hospital setting. Further work is needed to refine and psychometrically evaluate instruments for measuring PAS.

  • organisation of health services
  • quality in health care
  • human resource management
  • organisational development
  • health economics

Data availability statement

Data are available in a public, open access repository.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2020-045245

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    Data availability statement

    Data are available in a public, open access repository.

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    Footnotes

    • Contributors All authors (CM, HV, PH and CO) were involved in planning the scoping review. CM and CO were involved in the search strategy, extraction, quality appraisal and synthesis of data, and wrote the first draft of the manuscript. All authors revised the manuscript drafts and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.