Implementing Staffing Standards in Adult Critical Care

Staffing challenges, such as shortages, are among the leading problems in nursing today. Appropriate staffing is crucial for quality patient care and for maintaining healthy work environments for nurses.There are various tools available for measuring nursing workload. In the webinar, we highlighted 2 tools that are integrated into the electronic health record (EHR). The first tool was described in a staffing story shared by Maurice Kibisu, an intensive care unit (ICU) charge nurse. This tool was purchased from a technology company and was adapted and tested by ICU staff. The second tool was developed by Kelsey Jones, a nurse. Jones and her colleagues collaborated with the hospital system’s leaders and information technology (IT) team to create a tool that calculates a nursing workload score from EHR documentation. Tools not integrated into the EHR include the CAMEO, a tool designed to measure the acuity and nursing workload of pediatric cardiology patients.Innovative uses of virtual care are exciting! A virtual nurse is not a replacement for hands-on care but can augment and support care delivery. Nursing tasks such as admission processes and discharge teaching do not require in-person interaction and can be conducted virtually, allowing direct care nurses to dedicate more time to other aspects of care. Any use of technology should be evaluated and refined based on its impact on patient outcomes and nurse workload.Consistent with staffing standard 1, direct care nurses should be included in the development, testing, and evaluation of any tools that measure acuity or nursing workload. The 2 staffing stories shared in the webinar illustrate how nurses were involved in these processes. In Maurice Kibisu’s story, a tool developed by the EHR vendor was tested and validated by direct care nurses. In Kelsey Jones’s story, the tool was created by nurses working with IT, then tested by nurses across different settings within the health system. Feedback from the testing process was used to make changes to the tool and improve its accuracy.