1. All Wales Neonatal Nurse Staffing Audit 2014 - 2015
Wendy Davies, Lead Nurse
Wales Neonatal Network

2. Back ground Bliss baby report 2016: time for change Wales

3. Audit aim
To check if the required number of nurses on each shift meet the All Wales Neonatal Standards (2013) staffing requirements
11 neonatal units in Wales
Retrospective audit
Audit period was 2 years
(Jan – Dec 2014 & 2015)

4. A compliant nursing shift
enough nursing staff on a shift for the level of clinical dependency of each individual baby
Based on BAPM (2011)
All Wales Neonatal Standards 3rd edition (2013) staffing requirements
Nurse : Patient ratio
IT ratio 1:1
HD ratio 1:2
SC ratio 1:4
Standard – 100%
Categories of babies
requiring
Neonatal Care 2011

5. Methodology
All 11 units collected the number of nurses on each shift x 3 (am, pm, night)
Registered and non registered staff providing direct care
Neonatal Acuity Risk Assessment Tool - collection form
This information (shift compliance) is sent to the Neonatal Network on a monthly basis throughout

6. Shift Compliance
RESULTS
3 NICUs & 8LN/SCs

7. 3 NICUs % of Compliant Nursing Shifts 2014 – 2015
The average monthly % of compliant nursing shifts in the 3 NICUs
(Singleton, UHW, Royal Gwent) between 2014 and 2015.
2014 the average % of compliant shifts was 65.50%
2015 the average % of compliant shifts was 57.71%

8. Results – 3 NICUs UHW, Singleton, Royal Gwent

9. 8 units outside the NICUs % of Compliant Nursing Shifts 2014 - 2015
2014 the average % of compliant shifts was 96.50%
2015 the average % of complaint shifts was 90.05%

10. Average % of compliant nursing shifts
Results - 8 units outside the NICUs
Glangwilli
Average % of compliant nursing shifts
Mean
2014
84% - 100%
98%
2015
94% - 100%
99%
Princess of Wales
93% - 100%
90% - 100%
93%
Royal Glamorgan
75% - 100%
92%
65% - 100%
91%
Prince Charles
96%
73% - 100%
Nevill Hall
76% - 100%
88%
Ysbyty Gwynedd
99% - 100%
100% - 100%
100%
Ysbyty Glan Clwyd
87% - 100%
97%
95% - 100%
Wrexham Maelor
79% - 100%

11. Conclusions
The Neonatal Network has been monitoring shift compliance since 2013 as a key measurement of quality & safety – using Neonatal Acuity Tool (2009)
Ensuring units have the correct nursing workforce to meet patient dependency is vital for
Safe nursing practice
Infection control standards
Parent satisfaction
It is evident from the results that in the 3 NICUs, there is not always enough nurses on a shift to ensure safe patient clinical dependency requirements
8 LN/SC units we have also seen a fall in the number of nursing staff on a shift between

12. Recommendations The Safe Nurse Staffing Levels (Wales) Bill 2015
The Bill `seeks to ensure that nurse staffing levels
within the Wales NHS are sufficient to provide safe,
effective and quality nursing care to patients at all
times’.
Places a duty on health service bodies to `take all
reasonable steps` to maintain safe staffing ratios and
to monitor their compliance and to take action where
failings occur.
The Neonatal Network has recommended that all units
report nurse staffing levels on
Badgernet Nursing Numbers Report
1st August 2016

13. Wendy Davies, Lead Nurse Wales Neonatal Network
Thank you
Wendy Davies, Lead Nurse
Wales Neonatal Network