Appropriate staffing in critical units : a review of the literature

Objectives: To review the literature surrounding the allocation, skill mix and experience recommended for nurses working in critical care environments. Settings: Critical care units. Primary Argument: There are many factors that need to be considered in the rostering of critical care units. These include the manager’s qualities, the skill mix, staff experience, workload, patient condition, patient flow, staffing costs, support structures, education, team cohesion and the model of care utilised. There are various staffing models utilised in critical care units. A multifactorial model approach which considers the interplay of these factors including the appropriateness of skill mixing may influence the work environment, staff retention, recruitment and ultimately nursing job satisfaction. Conclusion: Synergy between the multiple factors that can influence the quality of care and team cohesiveness of a critical care unit may be the optimal method to ensure positive patient outcomes and staff retention and satisfaction. The method through which to achieve this balance may be different between units which may present a challenge for Nursing Unit Managers.