Patient acuity and nurse staffing challenges in Norwegian neonatal intensive care units.

Abstract

To describe fluctuations in patient numbers, patient acuity and the need for nurses in neonatal intensive care units based on population data. Neonatal intensive care units are difficult to staff appropriately due to fluctuations in patient volume and acuity. Staffing guidelines have been developed and applied in some countries to offer the neonatal population safe patient care. National data were used to describe patient load and acuity for two consecutive years. The need for nurses was calculated by combining these data with guidelines for nurse staffing. A total of 11.3% of all neonatal patients in Norway were categorised as intensive care patients. There were no differences in the need for nurses in weekends vs. weekdays or during summer holidays vs. days in the rest of the year. Small units have increased variability in staffing needs, and sufficient staffing is more challenging compared to that of larger units. Planning for reduced staffing for weekends and summer seasons is ineffective. Staffing planned for most of the days in a year instead of the median need for nurses will result in a greater increase in the need for nurses in small units compared to larger units.