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Reform Support

Supporting reforms to improve the quality and sustainability of our healthcare systems

Evidence based nurse staffing in Danish acute hospitals 

The Commission will support the Central Denmark Region (CDR) in developing methods and tools to establish safe nurse staffing levels to better match supply and demand for nursing care in acute hospitals. 

Context

The reform of the Danish hospital sector and increasing workforce shortages have highlighted the need to reflect on new work planning methods. These methods ensure patient safety as well as improve nurses’ performance and job satisfaction. 

In Denmark, each hospital is free to determine the nurse staffing levels because there are currently no national or regional guidelines. The required number of nurses in wards is typically based on the numbers of beds available, the expected bed occupancy and on chief-nurses judgement and subjective workload estimates. This rough estimation method does not guarantee a good match between the supply and demand for nurses as it does not account for patient characteristics. This results in a gap between the availability of nurses available and the needs of the patients at any given time.

The staffing method used in Denmark showed further limitations during the management of the COVID crisis as staff was allocated according to the number of COVID-19 beds. This approach did not fully take the needs of patients into consideration.  

Support to be delivered 

The technical support will be delivered through an analysis of the current situation in Denmark, building consensus on how to estimate safe nurse staffing levels in acute hospitals. Furthermore, it will determine the way in which processes and tools can be used to comply with the new staffing principles.  

Expected Results 

At the end of the project, the Central Denmark Region will have at their disposal: i) a report with an analysis of the current situation in acute hospitals, ii) a good practices report with lessons on methods, processes and tools used to define and implement safe nurse staffing levels, iii) a framework to establish safe nurse staffing levels in acute Danish hospitals, iv) scenarios and an action plan to implement safe nurse staffing levels, v) a design for an IT tool to manage optimal nursing levels and vi) a communication strategy and linked material. 

Ultimately, the technical support is expected to increase the capacity of managers and chief nurses to plan nurse resources in acute hospitals. Over the long run, this is expected to improve patient outcomes as well as the safety and working conditions for nurses.