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首页> 外文期刊>Journal of Health Services Research & Policy >A certain ratio? The policy implications of minimum staffing ratios in nursing
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A certain ratio? The policy implications of minimum staffing ratios in nursing

机译：有一定比例？护理最低人员比例的政策含义

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The debate about how best to determine nurse staffing levels continues. The conventional wisdom is that determining staffing levels is something best left to local management, taking account of local workload and resources. nnThis 'bottom up' philosophy has now been challenged by the use of a different approach – the use of 'top down'standardized, and mandatory, nurse:patient or nurse:bed ratios. This paper examines the characteristics and early results of the use of staffing ratios in the two health systems where nurse staffing ratios are now mandatory – the states of Victoria (Australia) and California (USA). It then discusses the policy implications of using ratios. nnThe paper identifies the main weaknesses of the use of nurse:patient ratios as being their relative inflexibility and their potential inefficiency, if they are wrongly calibrated. Their strength is their simplicity and their transparency. Their impact will be most pronounced when ratios are mandatory and where they offer a mechanism to improve and then to maintain staffing levels at some pre-determined level. The biggest challenges in their use are calibration (what is 'safe'? or 'minimum'?) and achieving the support of all stake-holders. nnThe paper concludes that nurse:patient ratios are a blunt instrument for achieving employer compliance, where reliance on alternative, voluntary (and often more sophisticated) methods of determining nurse staffing have not been effective.
机译：关于如何最佳确定护士人员配置水平的争论仍在继续。传统观点认为，考虑到本地工作量和资源，确定人员配备水平最好留给本地管理。 nn现在，这种“自下而上”的理念受到了另一种方法的挑战-使用“自上而下”的标准化，强制性护士，患者或护士：床位比例。本文研究了维多利亚州（澳大利亚）和加利福尼亚州（美国）这两个强制执行护士人员配备比率的卫生系统中使用人员配备比率的特点和早期结果。然后讨论使用比率的政策含义。 nn本文将护士与患者比例的使用的主要弱点确定为，如果校准不当，它们的相对灵活性和潜在的效率低下。它们的优势在于其简单性和透明性。如果比率是强制性的，并且它们提供了一种改善机制，然后将人员编制水平保持在预定水平的机制，那么它们的影响将最为明显。使用它们的最大挑战是校准（什么是“安全”或“最小”）以及如何获得所有利益相关者的支持。 nn本文得出的结论是，护士与患者的比例是实现雇主合规的一种钝器，在这种情况下，依靠替代性，自愿（且通常更为复杂）的方法来确定护士的人手并不有效。

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