A descriptive survey of the nursing workforce in critical care unit in hospitals of the Western Cape Province
A global shortage of Registered Nurses (RNs) has been reported internationally, and confirmed in South Africa by the National Audit of Critical Care services. Critical Care Nurses (CCNs) especially are in great demand and short supply. This has affected the quality of patient care. The purpose of this study was to perform a workforce analysis and needs assessment of critical care nursing services in the Western Cape Province as at 1 January 2005. The study design is a descriptive survey conducted on site in the critical care units of the private and public sector hospitals of the Western Cape, using a structured questionnaire, with a 96.5% return rate. Findings showed that the 35 hospitals surveyed in the public and private healthcare sectors had 80 functional critical care units including Intensive Care Units and High Care Units for adults, children and neonates, and High Dependency Units for adults. Factors that contribute to the demand for critical care nurses include the number of critical care beds, patient admissions, severity of illness, available facilities, medical, nursing and support staff. Compared to internationally accepted norms, the Western Cape units have a deficit of 74% of Registered Nurses (RNs) in the public sector hospitals, and a deficit of 82% in the private sector. This equates to an actual shortage of 3010 RNs for both sectors. If all categories of nursing staff are included in the calculation, the public sector meets 49% of its requirements and the private sector 24%. Half of the private sector and 28.9% of the public sector Registered Nurses are Critical Care Nurses. Few measures appear to be taken to recruit and retain nursing staff. The number of students being trained at both the undergraduate (300 during 2004) and the postgraduate (80 CCNs during 2004) level at the educational institutions, in conjunction with the hospitals, is inadequate. Clinical training institutions are available, but the numbers of educators and clinical mentors are inadequate to train the number of nurses required to meet the demand.
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