ArticleJournal of the American Geriatrics Society2025
An Objective Method to Determine Nurse Staffing for an Acute Care for Elders (ACE) Hospital Unit: Discrete Event Simulation.
Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Inverting the 'dementia triangle' as a salutogenic approach to avoiding the "treadmill of disasters" in changed behaviors: a qualitative study.Frontiers in dementia · 2026Article
- An Observational Study of Nursing Delivery of Mobility Assistance in Acute Care.Journal of the American Medical Directors Association · 2025Observational
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Authors and funding
8 authors.
Funding
Abstract
backgroundMany hospitals have acute care for elders (ACE) units or engage in programs to enhance care for older inpatients. However, few studies have objectively evaluated nurse staffing models to support care for older inpatients.
methodsThis study applied discrete event simulation (DES) to an ACE unit to objectively evaluate registered nurse (RN) and nursing assistant (NA) staffing allocations. Research staff collected standardized, objective data related to nursing tasks and time requirements to model the ACE unit clinical care environment and evaluate varying RN and NA staffing allocations on measures of nursing workload, care quality, and care efficiency.
resultsOn a 22-bed ACE unit, 85% of patients were aged 65 or older, 37% had cognitive impairment, and 89% required toileting and/or mobility assistance. Nurse care routines were interrupted frequently by unscheduled patient care requests, with an average frequency of 6.1 (±1.6) requests per hour. DES was used to simulate four different RN and NA staffing allocations. Results showed the most common staffing (four RNs and one NA) resulted in the highest nursing workload rates (89% and 88% for RNs and NAs, respectively) and the highest rate of predicted care omissions (6.2%). Additionally, RNs were predicted to help with 83% of NA care tasks related to toileting and mobility assistance. Alternative allocations of four RNs and three NAs or five RNs and two NAs resulted in more feasible workload rates, lower rates of care omissions, and less reliance on RNs for NA care tasks.
conclusionsDES provides an objective method to identify nurse staffing needs for an ACE hospital unit. This approach can be used to safely evaluate the potential impact of varying nurse staffing allocations. The DES model for the ACE unit is adaptable to other types of hospital units that care for older patients.
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