Nursing intensity and costs of nurse staffing demonstrated by the RAFAELA system: liver vs. kidney transplant recipients

J Nurs Manag. 2016 Sep;24(6):798-805. doi: 10.1111/jonm.12384. Epub 2016 May 10.

Abstract

Aim: To compare nursing intensity and nurse staffing costs for liver transplant (LTx) vs. kidney transplant (KTx) patients through the use of the RAFAELA system (the OPCq instrument).

Background: High-quality patient care correlates with the correct allocation of nursing staff. Valid systems for obtaining data on nursing intensity, in relation to actual patient care needs, are needed to ensure correct staffing.

Methods: A prospective, comparative study of 85 liver and 85 kidney transplant patients. Nursing intensity was calculated using the Oulu Patient Classification (OPCq) instrument. The cost per nursing intensity point was calculated by dividing annual total nursing wage costs with annual total nursing intensity points.

Results: The results showed significantly higher nursing intensity per day for liver transplant patients compared to kidney transplant patients. The length of stay was the most important variable in relation to nursing intensity points per day.

Conclusions: The study demonstrated differences in nursing intensity and nurse staffing costs between the two patient groups.

Implications for nursing management: When defending nurse staffing decisions, it is essential that nurse managers have evidence-based knowledge of nursing intensity and nurse staffing costs.

Keywords: kidney transplant recipients; liver transplant recipients; nurse staffing costs; nursing intensity; the RAFAELA system.

MeSH terms

  • Adult
  • Female
  • Humans
  • Kidney Transplantation / economics
  • Kidney Transplantation / nursing*
  • Liver Transplantation / economics
  • Liver Transplantation / nursing*
  • Male
  • Middle Aged
  • Nurses / standards
  • Nurses / supply & distribution*
  • Patient Satisfaction
  • Personnel Staffing and Scheduling / economics*
  • Planning Techniques
  • Prospective Studies
  • Resource Allocation / methods
  • Workload / psychology
  • Workload / standards