Aim: To compare the standards of nursing personnel involved in direct care in surgical and orthopedical wards, with those of the studies of Aiken et al.

Methods: A convenience snow ball sampling technique allowed to include 65 centres. Data were collected in an index day, in the middle of the week, in hospitals with a surgical and ortopedical ward on the following variables: number of nurses, number of nurses aids, average time of nursing care per patient over the 24 hours.

Results: Sixty-five surgical and 43 ortopedical wards for overall 2286 beds were included. A nurse, on average, cares for 8.9 patients (7.2 in the morning; 9.2 in the afternoon and 13.6 during the night). Over the 24 hours patients receive 70 minutes of care from nursing personnel and 96 from nurses aids.

Discussion: The number of patients cared for by Italian nurses is higher compared to that observed in Aikens' papers, although health care systems and organization are not strictly comparable. To reach the American standards 997 extra nurses would be necessary. The situation described stresses a critical problem and the need to define national standards on the number of nurses and health care personnel to guarantee to hospitalized patients.

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