Identification of nursing workload determinants for management of staffing resources: a cross-sectional pilot study.

Background: Top managers and policy makers measure nursing workload (NW) based on nurse-to-patient ratios or on nursing hours per patient a day, as a standard. To offer patients care of quality and to prevent negative outcomes on staff, leaders should consider specific workflow aspects when determining staffing assets.

Objective: The aim of this study was to identify some of NW deter-minants, particularly those linked to adequacy of staffing resources.

Methods: This was a cross-sectional prospective pilot study. Data were gathered in five medical-surgical wards of a University Hospital, through an online survey, asking nurses at the end of every shift, for three consecutive weeks, to describe the workload perceived.

Results: We collected 205 surveys. A multivariate regression model was tested. Adequacy of staffing resources was signifi-cantly related to NW ( =0.372), whether nurse-to-patient ratio was not.

Conclusions: Our findings, although arising from a pilot study, are very important for organizations. These results put in discussion what was up to now used to take decisions on staffing resources, i.e., Nurse-to-Patient Ratios or Nursing Hours Per Patient a Day indicators. Further research is needed to confirm our results. Conclusions: Our findings can be useful to hospitals middle and top management for definition of staffing assets. Adequacy of staffing includes not only the number of nurses and nurse assistants present in the shift, but also their expertise and ability to organize the work of these resources. Therefore, staffing adequacy rather than nurse-to-patient ratio should be considered when planning staffing assets. Interventions to improve nurses and nurse assistants' expertise are essential.