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Development, Validation, and Implementation of a Clinic Nurse Staffing Guideline

Deeken, Debra Jean MSN, RN; Wakefield, Douglas PhD; Kite, Cora ADN, RN; Linebaugh, Jeanette MSN, RN; Mitchell, Blair MHA; Parkinson, Deidre CPC; Misra, Madhukar MD

JONA: The Journal of Nursing Administration: October 2017 - Volume 47 - Issue 10 - p 515–521
doi: 10.1097/NNA.0000000000000524

Ensuring that the level of nurse staffing used to care for patients is appropriate to the setting and service intensity is essential for high-quality and cost-effective care. This article describes the development, validation, and implementation of the clinic technical skills permission list developed specifically to guide nurse staffing decisions in physician clinics of an academic medical center. Results and lessons learned in using this staffing guideline are presented.

Supplemental digital content is available in the text.

Author Affiliations: Director (Ms Deeken), Ambulatory Patient Care Services; Director (Dr Wakefield), Center for Health Care Quality; Clinical Nursing Supervisor, Surgery Clinic, (Ms Kite); Manager (Ms Linebaugh), Outpatient Clinics and Infusion Unit, Ellis Fischel Cancer Center; Manager (Ms Mitchell), Dermatology Department and Clinics; Business Manager (Ms Parkinson), Ambulatory Care Administration; and Professor (Dr Misra), Nephrology, University of Missouri Health Care, Columbia.

The authors declare no conflicts of interest.

Correspondence: Ms Deeken, University of Missouri Health Care, Room 1 N04, 1 Hospital Dr, Columbia, MO 65212 (

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