Journal List > J Korean Acad Nurs Adm > v.23(2) > 1051908

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



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.


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.


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.


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

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)


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



Table 3

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

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)

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


*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.


This work was supported by Hospital Nurses Association Research Fund.


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