• Manar Aslan and Ergin Toros.
• Department of Nursing, Trakya University Faculty of Health Sciences, Edirne, Turkey.
• J Eval Clin Pract. 2025 Feb 1; 31 (1): e70001e70001.

ObjectiveThis study aims to assess the performance of machine learning (ML) techniques in optimising nurse staffing and evaluating the appropriateness of nursing care delivery models in hospital wards. The primary outcome measures include the adequacy of nurse staffing and the appropriateness of the nursing care delivery system.BackgroundHistorical and current healthcare challenges, such as nurse shortages and increasing patient acuity, necessitate innovative approaches to nursing care delivery. For instance, the COVID-19 pandemic highlighted the need for flexible and scalable staffing models to manage surges in patient volume and acuity.Materials And MethodsA descriptive study was conducted in 39 inpatient wards across a university hospital and three state hospitals, involving 117 ward-level observations. Data were collected using the Rush Medicus Patient Classification Scale and analysed using k-Nearest Neighbour, Support Vector Machine, Random Forest, and Logistic Regression algorithms. Effectiveness was measured by the accuracy of machine learning predictions regarding nurse staffing adequacy, while suitability was determined by the congruence between observed nursing care models and patient needs.Reporting MethodSTROBE checklist.ResultsThe Random Forest algorithm demonstrated the highest accuracy in predicting both nurse staffing adequacy and the appropriateness of nursing care delivery systems. The study found that 68.4% of wards had sufficient nurse staffing and 26.5% of wards used appropriate care delivery models, with functional nursing and total patient care models being the most commonly used.DiscussionThe study highlights functional nursing and total patient care models, emphasising the need to consider nurse qualifications and patient needs in selecting care systems. Machine learning, particularly the Random Forest algorithm, proved effective in aligning staffing with patient requirements.ConclusionMachine learning, particularly the Random Forest algorithm, proves effective in optimising nursing care delivery models, suggesting significant potential for enhancing patient care and nurse satisfaction.ImplicationsThe research underscores machine learning's role in improving nursing care delivery, aligning nurse staffing with patient needs, and advancing healthcare outcomes.ImpactThe findings advocate for integrating machine learning in the planning of nursing care delivery models. This study sets a precedent for using data-driven approaches to improve nurse staffing and care delivery, potentially enhancing global clinical outcomes and operational efficiencies. The global clinical community can learn from this study the value of employing machine learning techniques to make informed, evidence-based decisions in healthcare management.Patient Or Public ContributionWhile the study lacked direct patient involvement, its goal was to enhance patient care and healthcare efficiency. Future research will aim to incorporate patient and public insights more directly.© 2025 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

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