Abstract
Background: Adequate staffing is key to the delivery of nursing care and thus to improved inpatient and health service outcomes. Several systematic reviews have addressed the relationship between nurse staffing and these outcomes. Most primary studies within each systematic review are likely to be from high-income countries which have different practice contexts to low and middle-income countries (LMICs), although this has not been formally examined. We propose conducting an umbrella review to characterise the existing evidence linking nurse staffing to key outcomes and explicitly aim to identify evidence gaps in nurse staffing research in LMICs. Methods and analysis: This protocol was developed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P). Literature searching will be conducted across Ovid Medline, Embase and EBSCO Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Two independent reviewers will conduct searching and data abstraction and discordance will be handled by discussion between both parties. The risk of bias of the individual studies will be performed using the AMSTAR-2 . Ethics and dissemination: Ethical permission is not required for this review as we will make use of already published data. We aim to publish the findings of our review in peer-reviewed journals. PROSPERO registration number: CRD42021286908.
Highlights
Adequate staffing is key to the delivery of nursing care and to improved inpatient and health service outcomes
3% of the global nurses reside in Africa, which houses 17.2% of the world’s population; this is in contrast to Europe and the Americas where 26% and 30% of global nurses reside and which have 9.6% and 17.2% share of the global population respectively[1,3]
Setting We aim to identify the broad range of quality-of-care outcomes studied across systematic reviews and identify how these reported outcomes differ between high-income countries (HICs) and low and middle-income countries (LMICs)
Summary
Adequate staffing is key to the delivery of nursing care and to improved inpatient and health service outcomes. Nurses represent almost three-fifths of all health professionals and are key to the attainment of universal health coverage[1] They are integral to ensuring the quality of patient care and are crucial in all health systems, playing significant roles at all levels of healthcare, including primary care where they promote mental health and well-being and anchor maternal health, growth monitoring and immunization services. The demand is fuelled by rapid population expansion and health policies promoting universal free medical care without commensurate expansion in health services to cater for these demands[1] It is driven by a rapid expansion in the scope of healthcare, changing population expectations and the increasing use of medical technologies that require more intensive nursing, for example, the use of mechanical ventilators or continuous positive airway pressure machines. A changing population structure resulting in an ageing population with greater healthcare needs and a steadily ageing nurse workforce, has resulting in an imbalance between nursing service demand and supply[8]
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