Guidance
This guideline covers organisational and managerial approaches to safe nurse staffing of inpatient wards for people aged 18 and over in acute hospitals. It aims to ensure that patients receive the nursing care they need, regardless of the ward to which they are allocated, the time of the day, or the day of the week.
The guideline focuses on wards that provide overnight care for adult patients in acute hospitals. It does not cover intensive care, high dependency, maternity, mental health, acute admission or assessment units or wards, or inpatient wards in community hospitals.
Recommendations
This guideline includes recommendations on:
- organisational strategy
- principles for determining nursing staff requirements
- setting the number of registered nurses and healthcare assistants for particular wards
- assessing if nursing staff available on the day meet patients' nursing needs
- monitoring and evaluating ward staff numbers
Who is it for?
- Hospital boards and senior management
- Commissioners
- Ward managers
- Registered nurses
- Nursing managers and matrons
- Healthcare assistants
- Adults in inpatient wards at acute hospitals and their families and carers
Guideline development process
How we develop NICE guidelines
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.