American Psychiatric Nurses Association Position: Staffing Inpatient Psychiatric Units

Author:

Johnson Celeste1,Delaney Kathleen R.2ORCID,Cirpili Avni3,Marriott Suzie4,O’Connor Janette5

Affiliation:

1. Celeste Johnson, DNP, APRN, PMH CNS, CMJ Behavioral Health Consulting, LLC, Garland, TX, USA

2. Kathleen R. Delaney, PhD, PMH-NP, FAAN, Rush University College of Nursing, Chicago, IL, USA

3. Avni Cirpili, DNP, RN, Vanderbilt Psychiatric Hospital, Nashville, TN, USA

4. Suzie Marriott, MS, RN, PMH-BC, Stony Brook Eastern Long Island Hospital, Port Jefferson Station, NY, USA

5. Janette O’Connor, MS, BS, BSN, RN, PMH-BC, New York Presbyterian Hospital, White Plains, NY, USA

Abstract

OBJECTIVE: An American Psychiatric Nurses Association (APNA) task force reviewed current staffing research to revise and update the 2011 APNA “Staffing inpatient psychiatric units” position paper and provide recommendations to the APNA Board of Directors on how psychiatric mental health (PMH) nurses might champion the staffing needs of inpatient psychiatric units. METHODS: Current research on staffing and nursing practice in inpatient psychiatric units was reviewed as well as variables believed to influence staffing and nursing practice, such as consumer needs and workplace culture. Since current nurse staffing principles emphasize nursing value and how that value is connected to outcomes, the literature search included a focus on staffing and related patient outcomes. RESULTS: PMH nurses are critical to the safety and quality of care in inpatient psychiatric units. However, there are little existing data on the relationship between staffing levels and even common adverse events such as staff injury and restraint of patients. Furthermore, there is scant research conducted on inpatient psychiatric units that informs optimal staffing models or establishes links between staffing and patient outcomes. CONCLUSIONS: Consistent with current evidence, the universal use of a single method or model of determining staffing needs (e.g., nursing hours per, case mix index, or mandatory ratios) is not recommended. PMH nurses should champion systematic evaluation of staffing on their inpatient units against select patient, nurse, and system outcomes. A data repository of PMH nurse-sensitive outcomes is necessary to benchmark unit performance and staffing.

Publisher

SAGE Publications

Subject

Pshychiatric Mental Health

Reference104 articles.

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3. Decreasing Duration of Mechanical Restraint Episodes by Increasing Registered Nurse Assessment and Surveillance in an Acute Psychiatric Hospital

4. American Nurses Association. (2020). Principles for nurse staffing. (3rd ed.). https://cdn2.hubspot.net/hubfs/4850206/PNS3E_ePDF.pdf

5. APNA Position Statement

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