Developing a Nursing Workload Intensity Staffing Model

OBJECTIVE: To explore a workload intensity staffing (WIS) model's effect on nurse and patient outcomes. BACKGROUND: Little is known about the relationship between WIS and nurse and patient outcomes. METHODS: A point-based workload intensity tool was developed and implemented to determine the level of care for adult inpatients. Before and after implementation, nurses provided feedback on staffing practices. Rates for catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSI), and patient fall rates were collected. RESULTS: Nurses indicated that patients were equally distributed among nurses (pre-score mean [M] = 3.7 vs post M = 3.6, P = 0.609) and that patient work intensity was incorporated into patient assignments (pre M = 3.4 vs post M = 3.5, P = 0.717). A significant negative trend was revealed for patient falls per 1000 patient-days (b = -0.063, P = 0.010) with fewer falls post-WIS implementation and a significant decrease in falls with injury (b = -0.085, P = 0.002). There was no significant difference in CAUTI and CLABSI rates for pre- versus post-WIS and WIS implementation. CONCLUSIONS: Although these initial results are promising, more research is needed on WIS and nurse and patient outcomes.