Staff recruitment and training

Nurses have a crucial role to play in keeping patients safe. Since nurses are the only people who are constantly with critically ill patients, they are in a unique position to observe and protect them. An ICU with insufficient nurses will not be safe.

In order to keep a unit staffed to its funded establishment of nurses, managers must continually take a positive and imaginative approach to nurse recruitment. Before appointing staff there should be careful reference checks and health screening. Suitability to deal with the stresses of intensive care work must be established as far as possible before appointment. Some recommendations as to how this might be done are found in the Allitt Inquiry ( Clothier and Mac.D.o.n.ald and are summarized in Table 1.

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Table 1 Select recommendations from the Allitt Inquiry concerning preappointment health screening

The competence of established staff at all levels will be improved by further training. A well-planned staff development program will help to achieve and maintain a balanced skill mix, which will contribute significantly to patient safety.

However, it is not sufficient to have a well-balanced establishment. It must also be the aim to achieve a balanced profile of skills throughout each shift. This can be done by good rota planning, careful patient allocation, and planning staff breaks with safety in mind.

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