Examining experiences of WA nurses workload under the NHPPD staffing model.
One of onus for practising nurses as highlighted by the ANMC code of ethics (2008) is that “Nurses value quality nursing care for all people”. This becomes significantly harder as several complexity or factors within the health system impedes on nurses ability to efficiently fulfil this role.
One of such issues is safe and effective workload or the optimal nurse to patient ratio for providing quality nursing care. As Twigg et al. (2011) noted the implementation of nursing hours per patient day (NHPPD) staffing model in 2002, a landmark event for western Australian public hospitals was a result of nurses taking a stand to combat the unreasonable workload that was being undertaken.
With evidence showing, mandated nursing staff levels having a significant impact on health outcomes, implementation of various staffing models to foster quality nursing care and improved patient outcomes in the health care setting has been widely utilised globally (Twigg et al. 2011). With prominent research done by Aiken and colleagues in the US, and with several other studies carried out internationally the gains achieved for patient outcomes through appropriate nursing staffing levels has been thoroughly highlighted.
Aiken et al (2002) demonstrates the significant impact low staffing levels has on patient’s mortality rate. The study noted that wards that had the worst staffing ratios saw a 31% increase in death rates. Increases of 23% and 15 % respectively were observed for emotional exhaustion and job dissatisfaction as nurse’s workload was increased per patient.
Aiken et al. (2008) alluded to the fact that “controlling for the effects of care environments” with each increase of a patient per nurse, chances of high emotional exhaustion and job dissatisfaction were likely to be reported by the nurse.
Needleman