| Kyung Jin Hong | 8 Articles |
Purpose
This study aimed to not only examine the changes in working hours and labor intensity, but also investigate their effects on sleep difficulties of shift work nurses. Methods Data from the 3rd (2011) to the 6th (2020) Korean Working Condition Surveys were analyzed, and the final sample included data of 514 nurses. Working time was measured considering nurses’ weekly working hours, number of night shifts, and number of days in a month when they worked more than 10 hours a day. Labor intensity included labor density, emotional labor, and work interruption. Sleep difficulty was measured using three items in 5th and 6th surveys. Results Weekly working hours, and long working days tended to decrease with the flow of the year, while work density, emotional labor, and work interruption tended to increase. Number of long working days, work density, and work interruption were found to produce a sleep difficulty effect in nurses. Conclusion To avoid sleep difficulties in nurses, adequate nurse staffing is required to prevent long working hours, and work density and work interruption need to be considered when determining the nurses’ workload. Citations Citations to this article as recorded by
Purpose
To analyze the changes in nurse staffing grades and to estimate the revenue growth generated by applying government guidelines for improving nurses’ working conditions. Methods: Staffing grades, ranging from grade 1 (highest) to 7 (lowest), for 2018 and 2020 were analyzed for 326 general hospitals (GHs) and 1,419 non-general hospitals (NGHs). The annual revenue growth per nurse generated by changing inpatient nursing care fee schedules and newly introducing night shift nursing fees were estimated. Results: Grade 1 GHs increased from 6.9% in 2018 to 39.6% in 2020, whereas grades 6-7 decreased from 31.8% to 17.6%. NGHs with grades 6-7 decreased from 81.8% to 61.6%. GHs and NGHs with no reported staffing grades decreased from 10.6% to 0% and from 63.2% to 14.8%, respectively. The estimated annual revenue growth per nurse from inpatient nursing care fees resulting from 1-grade improvements in staffing was 1.44~7.26 million Korean won (KRW) and 1.25~9.75 million KRW for GHs and NGHs, respectively, while the results from night shift nursing fees were 2.37~5.54 million KRW and 2.20~5.14 million KRW for GHs and NGHs, respectively. Conclusion: The increased revenues should be utilized to augment nurses’ wages and staffing levels as the guidelines recommend. Citations Citations to this article as recorded by
Purpose
To analyze the effects of average length of stay (ALOS) on RN staffing. Methods: Public data of patient surveys collected 8 times between 1996 and 2016 were analyzed. The sample included 2,408,669 discharged patients from 2,266 general hospitals. The ALOS for each hospital was computed by dividing the sum of inpatient days by the number of discharges. RN staffing was defined as the number of RNs per 100 inpatients. ALOS was transformed into base-2 logarithmic values for regression analysis. Results: ALOS decreased from 13.3 to 9.6 days. Large hospitals in the capital region had the greatest reduction, from 15.7 to 7.4 days. RN staffing increased from 32.7 to 54.8 RNs per 100 patients. ALOS had an inverse relationship with RN staffing. Controlling for other factors, a 50% reduction in ALOS was associated with increases in RN staffing by 12.18 and 13.72 RNs per 100 inpatients in large hospitals in the capital region and elsewhere, respectively. Conclusion: Hospitals may have to increase staffing to respond to the increased workload resulting from the shortened ALOS. It remains uncertain whether such increases in staffing were sufficient for the increased workload. Changes in ALOS should be taken into account when determining appropriate staffing. Citations Citations to this article as recorded by
Purpose
To compare actual versus expected nursing hours based on patients’ nursing care needs. Methods The nursing care needs of 898 inpatients in 20 wards at 11 hospitals were measured using the 14 items developed by the National Health Insurance Service (NHIS). Nursing activities from 474 nursing personnel were observed every 10 minutes for 24 hours. Actual hours indicated direct care hours per patient day provided by registered nurses according to 3 types: (1) standard hours based on staffing standards approved by the NHIS, (2) scheduled hours excluding overtime hours, and (3) observed hours including overtime. Expected hours were estimated from the linear mixed effect model including hospital type, nursing care need items and their interaction terms. Results Standard hours ranged from 0.92 to 2.15; scheduled hours from 0.88 to 1.95; observed hours from 1.00 to 2.40; expected hours from 0.88 to 2.33. Eight hospitals had standard hours not meeting the expected hours and 2 hospitals did observed hours not meeting the expected hours due to nurses’ overtime. In 3 hospitals, all types of actual hours exceeded the expected hours. Conclusion Staffing needs to be determined based on patients’ care needs and to be improved to minimize nurses’ overtime work. Citations Citations to this article as recorded by
Purpose
The aim of this study was to examine the differences in nurse staffing levels and patient outcomes in long-term care hospitals by region and to identity the effects of nurse staffing level and registered nurse proportion on patient outcomes. Methods A secondary analysis of national data that included general characteristics of hospitals and long-term care hospitals’ evaluation results from the Health Insurance Review and Assessment Services was conducted, and 1,205 hospitals were selected. Results Results showed that the mean number of patients per nursing staff and registered nurse proportion were 4.27 and 0.43, respectively. The differences in long-term care hospitals’ evaluation results and nurse staffing levels according to region were significant. A logistic regression analysis showed that the number of patients per nursing staff affected the probability of the patient experiencing a decline in daily life activities, as well as a decline in the outcomes of patients who were non-dementia; registered nurse proportion affected the outcomes of patients with dementia. Conclusion The findings suggest that implementing policies to improve long-term care hospitals’ nurse staffing level and registered nurse proportion is important. Ensuring mandatory registered nurse staffing levels based on the severity of patients’ diagnoses is also necessary. Citations Citations to this article as recorded by
PURPOSE
To determine nurse staffing by classifying patients based on their nursing care needs and to benchmark current staffing against the Safer Nursing Care Tool (SNCT) staffing requirements. METHODS Cross-sectional data were collected from four general wards at a tertiary hospital. Nursing activities conducted by 86 registered nurses were observed at 10-minute intervals. The nursing care needs of 780 inpatients were measured with two dimensions: acuity (10 nursing activities) and dependency (four activities of daily living). RESULTS Nurses worked for 9.3 hours per shift on average, reflecting overtime work of 1.3 hours per nurse. Nurses spent 37% of their time on direct care, 54% on indirect care, and 9% on associated work. Nursing hours per patient day increased as nursing care needs became higher. Patients were classified into four groups based on their level of nursing care needs. The staffing ratio of groups 1-4 was 1:9.8, 1:8.0, 1:7.0, and 1:4.6, respectively. The current staffing (i.e., nursing hours) was as low as 53% of the SNCT benchmark, resulting in informal caregiving by patients' family or their privately hired attendants. CONCLUSION Appropriate and safe staffing is required to meet patients' nursing care needs and to improve the quality of nursing care. Citations Citations to this article as recorded by
PURPOSE
This study aims to examine the working time quality and work-life imbalance and verify the effect of working time quality on nurses' work-life imbalance. METHODS Data from the Korean Working Condition Survey were analyzed, and a total of 296 nurses were included. Working time quality was measured using the following: number of work hours per week, amount of weekend work, whether work was done during free time to meet work demands, and whether there were any changes in work hours. Five items were used to determine levels of work-life imbalance. RESULTS The number of weekend work days was positively related to work-life imbalance (p=.036). Nurses who spent their free time working to meet work demands (p<.001), as well as nurses whose work time changed through an increase in hours (p=.001), showed higher levels of work-life imbalance. In addition, nurses who had worked for less than 1 year had a poor work-life balance compared with those who worked 10 years or more. CONCLUSION To improve nurses' work-life balance, it is essential to improve quality of work time by providing fair schedules, avoiding unpredictable changes in work schedule, and supporting new nurses. Citations Citations to this article as recorded by
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. Citations Citations to this article as recorded by
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