Understanding the impact of minimum staff level policies on the ward nursing team: Insights from a qualitative research study conducted in Germany

IF 3.6 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-02-26 DOI:10.1016/j.healthpol.2025.105286

Felix Miedaner , Werner Barbara , Bernhard Roth , Linda Metzner

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Abstract

Background

The implementation of legally mandated staffing levels for nurses has complex and wide-ranging effects on the organizational environment in which they operate.

Objective

The aim of this study was to investigate the perspectives of nursing staff on these consequences.

Methods

Nine guideline-based expert interviews were conducted with nursing staff at a hospital unit in Germany where minimum nurse-to-patient ratios have been mandated since 2017. The analysis was carried out according to the summarizing qualitative content analysis with the help of the inductive category formation according to Mayring (2015).

Results

The participants confirmed the intended effects, e.g. the gain in time for care, but also mentioned that strict nurse-to-patient ratio guidelines for different patient types may lack practical relevance. Furthermore, the staff policy had several unintended side-effects on the nursing team: Nurses reported the formation of subgroups within the team, and that new challenges had arisen due to the wider range of personal characteristics, qualifications and experience levels on the team.

Conclusions

Although the positive effects on patient care reflect the importance of minimum staff policies, the negative repercussions on the nursing team ward and its daily work processes need to be taken into account and actively managed.

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.