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Nurse managers are responsible for addressing staff and patient needs. Optimal patient care can be achieved by implementing a nursing staff model that incorporates nurses’ aides with highly skilled nurses. Introducing an acuity tool can improve nursing assignment load and further reduce the likelihood of nurse burnout. Adhering to a nursing model can be difficult, particularly when there is a fiscal crisis in an institution. An acuity tool can further enforce a nursing model and ratio complies when a nurse manager is unavailable

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Hockenberry, J. M., & Becker, E. R. (2016). How do hospital nurse staffing strategies affect patient satisfaction?. ILR Review, 69(4), 890-910. doi:10.1177/0019793916642760

Vortherms, J., Spoden, B., & Wilcken, J. (2015). From evidence to practice: developing an outpatient acuity-based staffing model. Clinical Journal Of Oncology Nursing, 19(3), 332-337. doi:10.1188/15.CJON.332-337

Yang, P., Hung, C., & Chen, Y. (2015). The impact of three nursing staffing models on nursing outcomes. Journal Of Advanced Nursing, 71(8), 1847-1856. doi:10.1111/jan.12643

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Acuity based staffing models allow administration to adapt to patients needs and achieve staffing level benchmarks based on the skill level of the nurse and the needs of the patient (Vortherms et al., 2015). An acuity tool can prove to be beneficial in a department that has a stable patient population. However, predicting staffing needs in an emergency department or an ICU may not be possible with an acuity tool since it is a constantly changing environment

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During nursing shortages, Nursing administrators may choose to use contract nurses. Independent studies find that the impact of using contract nurses negatively affects patient satisfaction and staff communication (Hockenberry & Becker, 2016).

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In one study, three mixed models of nursing staff were evaluated where 100% of the staff were RNs, 92% of the staff were RNs, and 76% of the staff were RNs and the remaining percentage of each was nurses’ aides Having a staffing model of 100% registered nurses, leads to a decline in patient satisfaction, employee satisfaction, and staffing retention. Furthermore, the study found that the group with more nursing aides made fewer medication errors  (Yang et al., 2015).

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The purpose of nursing staffing models is to promote patient safety and quality of care while keeping nursing costs at a minimum. To decrease nursing costs during staff shortages, administration may create a new proportion of registered nurses to nurses’ aides (i.e. Certified Nurses’ Assistant). Currently, there is currently no ideal ratio for patients and Registered Nurses (RNs) and nurses’ aides (Yang et al., 2015).