Here is how the ENA Staffing Best Practices Tool and Guidelines was validated, according to Joanne Ingalls McKay, RN, MSN, CEN, a member of the Des Plaines, IL-based Emergency Nurses Association’s Staffing Best Practice Workgroup:
The tool was tested using data from more than 30 volunteer EDs from across the United States with a range of patient volumes and facility types (academic, community, urban, rural, pediatric, and government). Each facility submitted a completed staffing worksheet with the necessary data. The submitted data in the worksheet were entered into the tool to test reliability and validity.
The results showed that if an ED had longer lengths of stay, the total number of nursing staff needed to provide care for the patients consistently was increased. Where there was higher length of stay, there was a consistent need for more staff of nurses and non-nurses. EDs of the same volumes were found to have varying length of stay times for patients and they, based on their length of stay times, required varying numbers of nurses and non-nurses based on that one variable. Length of stay times and processes used to deliver care in EDs were critical variables in the number of staff required.
The tool consistently validated the staffing needs required for the various EDs, as long as the data was accurate and not estimates or guesses. Staffing FTEs, as predicted by the tool, frequently were found to be in agreement with the self-reported ED managers’ perceptions of staffing needs. The results also reflected FTE changes that were required to adjust for patient volume, patient acuity, and ED length of stay.
According to the tool, some EDs were found to be understaffed, while others were identified as being overstaffed, often due to significant physical or process barriers that required extra staff. Some EDs were found to have inadequate number of nurses in relation to the skill mix delivering direct patient care.
The ENA Staffing Best Practices Tool and Guidelines was tested using data from more than 30 volunteer EDs from across the United States with a range of patient volumes and facility types.
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