Adequate nursing staff is essential for high-quality patient care. As the Institute of Medicine’s Committee on the Adequacy of Nurse Staffing in Hospitals and Nursing Homes stated: “Nursing is a critical factor in determining the quality of care in hospitals and the nature of patient outcomes.” Most agree that nurse staffing affects patient safety, but the controversy lies in what research and evidence dictates policies and in how staffing is determined.

Many hospitals have introduced new models for staffing hospital units in response to shortages of qualified nurses and changes in patient care needs. Staffing is especially important in intensive care units (ICUs), where rapid changes in patients’ condition are often life-threatening.

Nurse managers use numerous tools to help staff units adequately. Acuity tools are used to decide staffing patterns for oncoming shifts, document patient acuity and historical staffing trends, and determine staff mixing models. Staffing levels...

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