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Cho, Lee, June, Hong, and Kim: Nurse Staffing Levels and Proportion of Hospitals and Clinics Meeting the Legal Standard for Nurse Staffing for 1996~2013
Original Article

Journal of Korean Academy of Nursing Administration 2016; 22(3): 209-219.

Published online: 30 June 2016

DOI: https://doi.org/10.11111/jkana.2016.22.3.209

Nurse Staffing Levels and Proportion of Hospitals and Clinics Meeting the Legal Standard for Nurse Staffing for 1996~2013

Sung-Hyun Cho1, Ji-Yun Lee2, Kyung-Ja June3, Kyung Jin Hong4, Yunmi Kim5

1College of Nursing · Research Institute of Nursing Science, Korea.

2Seoul National University Department of Nursing, Korea.

3Kangwon National University Department of Nursing

4Soonchunhyang University College of Nursing, Korea.

5Seoul National University College of Nursing, Eulji University, Korea.

Corresponding author: Cho, Sung-Hyun. College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Tel: +82-2-740-8821, Fax: +82-2-765-4103, sunghcho@snu.ac.kr

Received 8 December 2015       Revised 20 February 2016       Accepted 2 May 2016

Copyright © 2016 Korean Academy of Nursing Administration

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the proportion of medical institutions meeting the legal standard for nurse staffing.

Methods

Data collected from 29,282 institutions between 1996 and 2013 were analyzed. Nurse staffing was measured as daily patient census per registered nurse (RN). The standard for general hospitals, hospitals, and clinics is 2.5 or less, and that for long-term care hospitals is 6.0 or less of the daily patient census per RN. Clinics may substitute nursing assistants for RNs by 50% or 100% depending on their daily inpatient census; long-term care hospitals may substitute nursing assistants for RNs by two thirds of the required number of RNs.

Results

The proportion of general hospitals, hospitals, clinics, and long-term care hospitals meeting the standards was 63%, 19%, 63%, and 94%, respectively, in 2013. While general hospitals had an increase in the proportion during the 1996-2013 period, small changes were found in hospitals and clinics. In 2013, nurses were estimated to care for 16 (interquartile range: 12~24) patients per shift in general hospitals. Three quarters of clinics had no RNs in 2013.

Conclusion

Many medical institutions did not meet the legally mandated minimum staffing level. The government must implement policy actions for all medical institutions to meet the legal standards.

Keywords: Nurse, Staffing, Medical institution, Legal standard, Minimum staffing

Figures and Tables

Table 1

Proportion of General Hospitals, Hospitals and Clinics Meeting the Legal Standard for Nurse Staffing

jkana-22-209-i001

NA=Nursing assistant.

Table 2

Nurse Staffing Levels in General Hospitals

jkana-22-209-i002

RN=Registered nurse; IQR=Interquartile range (1st quartile to 3rd quartile).

Table 3

Nurse Staffing Levels in Hospitals

jkana-22-209-i003

*Hospitals with no RN were excluded; RN=Registered nurse; IQR=Interquartile range (1st quartile to 3rd quartile).

Table 4

Staffing Levels of Registered Nurses and Nursing Assistants in Clinics

jkana-22-209-i004

*Because the majority of the clinics had no RN, the median and IQR were not presented; RN=Registered nurse; nursing staff=registered nurses + nursing assistants; NSM=Nursing staff member; IQR=Interquartile range (1st quartile to 3rd quartile).

Table 5

Staffing Levels of Registered Nurses and Nursing Assistants in Long-term Care Hospitals

jkana-22-209-i005

RN=Registered nurse; nursing staff=registered nurses + nursing assistants; NSM=Nursing staff member; IQR=Interquartile range (1st quartile to 3rd quartile).

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