Staffing norms in psychiatric nursing

Introduction. The assessment of nursing care needs and appropriate staffing is an essential part of providing the hospitalized
patients with safety.
Planning and delivering care according to actual care needs are facilitated by the methods of staffing planning embraced
under the name Patient Classification System.

Aim. The aim of the work was to determine the care needs of psychiatric patients for the needs of indicating the norms
of staffing.

Material and methods. The study was conducted in the years 2008–2011 in general psychiatric wards in three hospitals in
the south-east of Poland. The study covered 1828 patients and 44 line nurses.
The applied methods were: the method of measuring worktime, the method of patient classification and the analysis of
documentation whereas the applied techniques were the continuous observation (individual photograph of a workday),
snapshot observation (Tippet`s method) as well as timing of nursing activities.
During the study the standardized tools necessary for the continuous observation, snapshot observation, timing and the
classification form with care criteria were used but the above had been validated.
Results and conclusions. On the basis of the assumed criteria, the patients were appointed the following care categories:
minimal, moderate, intensified.
By using the timing the length of the time of the particular nursing activities (included in direct care in the particular care
categories) was calculated.
The delivered (actual) time of direct care in psychiatric wards in the particular care was as follows: category 1 — 29 min/
/24 h/per patient; category 2 — 69 min/24 h/per patient; category 3 — 111 min/24 h/per patient.
The standard (optimal) time of direct care for psychiatric patients is as follows: category 1 — 41 min/24 h/per patient;
category 2 — 96 min/24 h/ per patient; category 3 — 233 min/24 h/per patient.
To determine the auxiliary time it has been assumed that the average time of performing these activities may account for
25% to 50% of direct care time.
The comparison of actual staffing in psychiatric wards with the standards has indicated that it is not sufficient.