6 Glossary

Adult inpatient wards in acute hospitals

Wards that provide overnight care for adult patients in acute hospitals, excluding intensive care, high dependency, maternity, mental health, day care, acute admission or assessment units or wards. Other than these exceptions, the guideline covers all general and specialist inpatient wards for adults in acute hospitals.

Bed utilisation

The number of patients that the ward nursing team is responsible for during each 24‑hour period. This includes patients who are discharged or transferred to another ward during the 24‑hour period.

Decision support toolkit

A practical resource to facilitate the process of calculating the nursing staff requirements for wards or organisations. It may be electronic or paper-based.

Healthcare assistant

Healthcare assistants are all unregistered clinical staff working in hospital or community settings under the guidance and supervision of a registered healthcare professional. They may have a variety of titles such as healthcare support worker, nursing auxiliary and nursing assistant. In this guideline, the term healthcare assistants also includes assistant practitioners. The responsibilities of healthcare assistants vary, depending upon the healthcare setting and their level of training and competence.

Missed care

When a patient does not receive an aspect of planned care that has been assessed by healthcare professionals as being required. Care may be delayed, performed to a suboptimal level, omitted or inappropriately delegated.

Nursing hours per patient

This is how the measure of nursing staff requirements could be expressed. It represents the number of hours of nursing time (for both direct patient care and other nursing activities) provided by registered nurses and healthcare assistants per patient over a defined period. This is an alternative to expressing nursing time as a ratio of how many patients each nurse cares for. The 2 measurements are interchangeable. For example, a registered nurse or healthcare assistant working an 8-hour shift (after accounting for breaks) can contribute 8 hours of nursing time that day, which includes direct patient care as well as other necessary nursing activities.

Nursing red flag events

Events that prompt an immediate response by the registered nurse in charge of the ward. The response may include allocating additional nursing staff to the ward or other appropriate responses.

Nursing skill mix

The composition of the nursing team in terms of qualification and experience. This is typically expressed as a percentage of registered nurses to healthcare assistants. Nursing skill mix should also encompass individual clinical competencies and different areas of expertise and grades of registered nurses healthcare assistants.

Nursing staff

This refers to registered nurses and healthcare assistants, unless otherwise specified.

Nursing staff requirement

The nursing staff required by each ward. This should take into account all nursing care needs of patients, ward factors and staff factors including nursing activities other than direct patient care. This can be expressed as number of nursing hours.

Nursing staff roster

The daily staffing schedule for registered nurses and healthcare assistants to work on an individual ward.

Patient acuity

This refers to how ill the patient is, their increased risk of clinical deterioration and how complex their care needs are. This term is sometimes used interchangeably with the terms 'patient complexity' and 'nursing intensity'.

Patient dependency

The level to which the patient is dependent on nursing care to support their physical and psychological needs and activities of daily living, such as eating and drinking, personal care and hygiene, mobilisation.

Patients' nursing needs

The total nursing care needed by each patient on an individual ward that has been assigned to the nursing profession. This term is used throughout the guideline to include both patient acuity and patient dependency.

Patient turnover

Rate of movement of patients into and out of a ward. This can be calculated by the number of patient admissions, discharges and internal transfers during a defined period of time.

Registered nurse

A registered nurse holds active registration with the Nursing and Midwifery Council with a licence to practise.

Nursing is a regulated profession for registered nurses, but they may appropriately delegate and supervise the delivery of nursing activities to healthcare assistants.

Safe nursing care

When reliable systems, processes and practices are in place to meet required care needs and protect people from missed care and avoidable harm.

Ward nursing staff establishment

The number of registered nurses and healthcare assistants funded to work in a particular ward, department or hospital. This includes all nursing staff in post, as well as unfilled vacancies or vacancies being covered by temporary staff. Ward nursing staff establishments are usually expressed in number of whole time equivalents.