Safe float nurses, safe patients: Problems and feasible solutions. A qualitative analysis and scoping review.

Abstract

Background and objective: Float nurses are frequently assigned to unfamiliar settings where they must perform a wide range of tasks, often without prior orientation, specific training, or knowledge of local protocols and equipment. Given the widespread use of floating as a staffing strategy, it is essential to allocate resources that support their integration while prioritising patient safety. This study aimed to develop a self-administered Integration Checklist for float nurses, highlighting key aspects to address before delivering direct patient care.

Materials and methods: A three-phase approach was employed, integrating brainstorming sessions with nurses and patient safety experts alongside a literature review: (A) identification of key barriers encountered by float nurses; (B) critical analysis of literature-based solutions; and (C) development of the Integration Checklist.

Results: After identifying core challenges and reviewing solutions at the institutional-level, a practical Integration Checklist was created using a reverse approach to conventional orientation programmes. The tool comprised three sections: administrative, unit-specific, and patient care. Each section included targeted questions to ensure that float nurses were aware of the critical information relevant to each area before delivering care.

Conclusions: The implementation of a Safety Integration Checklist for float nurses has the potential to enhance the onboarding process into new units by optimising transition time, increasing professional confidence, and reducing staff-related stress. However, further research is needed to assess its practical value and effectiveness in improving both patient and staff outcomes across diverse clinical settings.