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Arising from efforts to introduce a systematic approach to the determination of safe and appropriate nurse staffing levels in the Irish healthcare system, where historical need and legacy issues were often key determinants in staffing decisions, the Department of Health published a policy document titled: A Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Ireland (Department of Health 2018) (henceforth referred to as the Framework). Based on the research undertaken by a research team from University College Cork, the University of Southampton, University of Technology Sydney, and National University of Ireland Galway (Drennan at al. 2018), this report outlined a number of recommendations to ensure staffing levels in medical and surgical wards in acute hospitals were safe and effective in the delivery of care. In a continuation of this evidence-based approach, the Department of Health made the decision to extend the model to develop a framework for emergency care settings; this resulted in the publication of a draft document titled: A Pilot to Implement the Framework for Safe Nurse Staffing and Skill Mix in Emergency Care Settings (Department of Health, 2018). This document outlined a number of recommendations to ensure the safe staffing of emergency care settings. Central among these recommendations was the introduction of a systematic approach to the determination of staffing levels, the adjustment of skill mix to ensure that care was delivered by 85% RN and 15% HCA, and to ensure that the CNM 2 role was 100% supervisory. The research in this report provides data on the implementation of the recommendations of the Draft Framework in three emergency departments (EDs) and one injury unit (IU). Exploring the extent to which changes in staffing within the selected departments have had an impact on patientsâ experience within the emergency care setting, as well as on the experience of the nursing and healthcare assistant workforce and on organisational factors, this report outlines the methods and results of the programme of research examining the impact of introducing a pilot safe staffing framework to emergency care settings.