Abstract
What is the ideal ratio of categories of nurses for the South African public health system?
Highlights
A higher number of RNs was associated with fewer occurrences in medical patients of urinary tract infections, upper gastrointestinal bleeding, hospital-acquired pneumonia and shock and cardiac arrest, and in surgical patients of urinary tract infections and failures to rescue additional RN hour/day reduced the incidence of falls in ICU
Fewer studies are available with regard to RN/M and SRN/M ratios
According to the Australian College of Critical Care Nurses, ICUs must have a minimum of 50% qualified critical care nurses, as well as a nursing manager for each unit and a clinical nurse educator for every 50 nurses in ICU.[9]
Summary
In South Africa we have four categories of nurses according to the qualifications framework currently in use: (1) enrolled nursing auxiliaries (ENA) who train for 1 year, (2) enrolled nurses (EN) who train for 2 years, (3) registered nurses/midwives (RN/M) who train for 4 years and (4) specialist registered nurses/midwives (SRN/M) who have 1 or 2 years post-RN/M training. In March 2011, a draft document was produced by the Department of Health entitled ‘Planning for Key Health Professional Categories’ in which the same issue was highlighted as a problem that needs to be addressed before the workforce can be reliably planned. We have based this commentary on the current nursing qualification framework, and not on the new proposed framework, which will take at least 5 years to produce its first group of nurses. We assume that the ratio of categories will have to be reviewed in 5 years and treat registered nurses and midwives as a single group of registered professionals (RN/Ms)
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