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Cho, Song, Park, Kim, Kim, Gong, You, and Ju: Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care
Original Article

Journal of Korean Academy of Nursing Administration 2017; 23(2): 211-222.

Published online: 31 March 2017

DOI: https://doi.org/10.11111/jkana.2017.23.2.211

Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care

Sung-Hyun Cho1, Kyung Ja Song2, Ihn Sook Park3, Yeon Hee Kim4, Mi Soon Kim5, Da Hyun Gong6, Sun Ju You7, Young-Su Ju8

1College of Nursing, Research Institute of Nursing Science, Seoul National University, Korea.

2Public Health Medical Service, Seoul National University Hospital, Korea.

3Department of Nursing, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Korea.

4Department of Nursing, Asan Medical Center, Korea.

5Department of Nursing, Samsung Medical Center, Korea.

6Department of Nursing, Dongguk University Ilsan Medical Center, Korea.

7Department of Nursing, Mokpo National University, Korea.

8College of Medicine, Hallym University, Korea.

Corresponding author: Cho, Sung-Hyun. College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-740-8821, Fax: +82-2-765-4103, sunghcho@snu.ac.kr

Received 15 February 2017       Revised 20 March 2017       Accepted 20 March 2017

Copyright © 2017 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 develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers.

Methods

A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care.

Results

Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units.

Conclusion

Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.

Keywords: Integrated inpatient nursing care, Nurse, Staffing, Nursing care delivery system

Figures and Tables

Table 1

Characteristics of Nursing Units, Number of Patients per Nursing Personnel by Shift, Work Hours, and Nursing Hours per Patient Day (N=80)

jkana-23-211-i001

Nursing personnel include registered nurses and nursing assistants.

Table 2

Results from Time & Motion Study: Nursing Care Activities and Hours Provided by Team Nurses, Family Members, and Private Caregivers

jkana-23-211-i002

IV=Intravenous.

Table 3

Patient Classification System (PCS) Scores and Groups by Hospital Type

jkana-23-211-i003
Table 4

Direct Nursing Care Hours Provided by Nursing Personnel, Family, and Private Caregivers, and the Relationship between Direct Nursing Care Hours and Patient Classification System (N=109)

jkana-23-211-i004
Table 5

Nurse-to-Patient Ratios for Tertiary and General Hospitals based on Patient Classification System Scores and Opinions of Nurse Unit Mangers on Provision of Integrated Inpatient Nursing Care

jkana-23-211-i005

*When based on patient classification system scores, registered nurse to patient ratio and nursing assistant to patient ratio are not fixed but variable under the same nursing personnel to patient ratio.

Notes

This work was supported by Hospital Nurses Association Research Fund.

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