Nurse staffing norms in a hospital: Determining a golden standard using a new estimation method

Abstract

ABSTRACT One of the main challenges of hospitals is estimating the nurses required. This study aims to develop a norm for estimating the required number and types of hospital nurses using standard ratios of nursing needs. This cross-sectional study was conducted in 53 inpatient departments of 14 referral hospitals in Iran. Specialized nominal group technique was used to determine the nurse to patient ratio for different inpatient departments. By using nurse to patient ratio and nurses’ available working time, a norm for estimating the required number and types of nurses of referral hospitals in five different scenarios was developed. The hospitals’ inpatient departments were ranked in nine classes according to the nurse to patient ratio, and in 12 classes by considering nurses’ available working time. In all scenarios, the highest norm was for ICU department of burns, and the lowest norm was for psychiatric departments. The nurse to patient ratio and the available working time of nurses are two important components of developing a norm for estimating the required nurses in different hospital departments. Using a norm would help health system managers to have a fair distribution of nurses in hospitals and will prevent arbitrary decisions on nurse staffing.