14 July 2023

Perth Children's Hospital Emergency Department introduces nurse to patient ratios

Perth Children’s Hospital emergency department (PCH ED) is the first site in our public health system to introduce nurse to patient ratios.

In consultation with a dedicated PCH working group that included ED nurses, the ratios – 1 nurse to 3 patients in the PCH ED and 1 nurse to 4 patients in the Emergency Short Stay Unit – are being implemented first.

Patient safety and clinical decision-making remains at the forefront of staffing allocations, ensuring flexibility on a shift-by-shift basis.

For example, some nurses or midwives may have fewer patients if they’re of a higher acuity, and other nurses or midwives may have more patients of lower acuity.

The introduction of nurse to patient ratios also meets one of Deputy State Coroner Linton’s recommendations from the Inquest into the tragic death of Aishwarya Aswath.

The next few months will be a period of transition for PCH ED which will continue to refine the model.

Lessons learned will be important to our progressive roll-out of nurse and midwife to patient ratios (NMTPR) across the broader system.

Workload feedback

If any nurse or midwife has feedback on their workload, we encourage them to talk to their shift coordinator or manager.

A specific reporting and escalation process for ratios is being developed to help support staff.

The WA Health System – Australian Nursing Federation – Registered Nurses, Midwives, Enrolled (Mental Health) and Enrolled (Mothercraft) Nurses – Industrial Agreement 2020 also provides pathways for employees to formally raise workload concerns, if required.

Building workforce capability and capacity

We recognise that all health jurisdictions across the world, including Western Australia, are facing ongoing workforce challenges, which is why we are continuing our efforts to attract, train and upskill and support all staff.

Belong (external site), a major international and domestic campaign to attract experienced and skilled clinical health professionals, will continue.

Support is also offered for existing nurses to upskill to take up new opportunities.

The Child and Adolescent Health Service has launched a six-week ‘transition to paediatrics program’ to train nurses who care for adult patients.

It is also introducing more frequent training, employing a nurse educator to do one-on-one training with individual staff, and offering family friendly shifts.

Applications are now open for GradConnect to recruit graduate nurses and midwives and give them practical support through their transition to clinical practice in the hospital.