Purpose
To develop a web-based solution for patient need-driven staffing (PNDS) that automatically determines nurses’ staffing requirements. Methods: Activities provided by nurses in four integrated nursing care wards (INCWs) and non-INCWs each in a tertiary hospital were observed over three days. Nursing hours per patient hour (NHPPH) were calculated by dividing nursing hours by patient stay hours per day. Patient needs were evaluated using 19 items. Results: The nurse-patient ratios in INCWs and non-INCWs were 1:4.5 and 1:8.1 (including overtime), respectively. Admitted and transferred-in patients had higher NHPPHs than those with continuing stays. The patients were classified into five groups: Group A for admissions and transfers-in, and Groups 1~4 for the remainder. In INCWs, the nurse-patient ratios ranged from 1:5.3 (Group 1) to 1:2.4 (Group 4), and Group A required 1:3.0, the secondhighest level. In non-INCWs, ratios ranged from 1:9.4 (Group 1) to 1:5.2 (Group 4 and Group A). The PNDS solution was developed to determine staffing requirements by classifying patients into five groups using the entered data on patient needs, assigning the group’s NHPPH to each patient, and calculating the staffing ratio required in the unit. Conclusion: The PNDS is expected to support staffing decisions to meet patient needs.

Citations

• Comparisons of nursing hours and nurse-to-patient ratios required for patients with mechanical ventilation, CRRT, and ECMO in intensive care units: A cross-sectional study
  Sung-Hyun Cho, Shin-Ae Kim, Eunhye Kim
  Intensive and Critical Care Nursing.2025; 89: 103982.     CrossRef
• Comparison of Nurse Work Hours and Nursing Activities Between High‐ and Low‐Staffed General Wards: A Cross‐Sectional Study
  Jiyeong Seong, Sung‐Hyun Cho, Hyo‐Jeong Yoon, Won‐Hee Sim, Moon‐Sook Kim
  Nursing Open.2024;[Epub]     CrossRef
• Trajectories of nursing hours over the course of hospitalization and estimated additional nurse staffing requirements to reduce the length of stay
  Shin‐Ae Kim, Sung‐Hyun Cho
  Journal of Nursing Scholarship.2024; 56(5): 694.     CrossRef
• Recommending Revised Inpatient Nursing Fee Schedules Based on Actual Nurse Staffing Levels in General Wards
  Sung-Hyun Cho, Jinhyun Kim, Jiyeong Seong, Ji-Yun Lee
  Journal of Korean Academy of Nursing Administration.2023; 29(5): 540.     CrossRef

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

• Factors Affecting the Direct and Indirect Performance of Infection Control for Centrally Inserted Central Catheters Among ICU Nurses
  Yoonjeong Park, Seunghye Choi
  Healthcare.2025; 13(9): 988.     CrossRef
• A comparative analysis of nurses' reported number of patients and perceived appropriate number of patients in integrated nursing care services
  Hyunjeong Kwon, Jinhyun Kim
  Nursing & Health Sciences.2024;[Epub]     CrossRef
• Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design
  Hyun-Joo Kim, Sun-Hee Lee, Jai-Jung Lee, Sun-Suk Seong, Hee Yang, Hyang-Yuol Lee
  Journal of Korean Academy of Nursing.2024; 54(2): 237.     CrossRef
• Comparison of Factors Affecting Delirium Nursing Stress between Nurses in Comprehensive Nursing Care Service Wards and General Wards
  Sumin Gwon, Gaeun Kim
  Journal of Korean Academy of Nursing Administration.2024; 30(5): 517.     CrossRef
• Factors associated with nursing needs and nursing hours in acute care hospital settings: A cross‐sectional study
  Seon Heui Lee, Hanju Lee, Soyoung Yu
  Journal of Nursing Management.2022; 30(6): 2005.     CrossRef
• Patient‐level and organizational‐level factors influencing in‐hospital falls
  Jinhyun Kim, Eunhee Lee, Yoomi Jung, Hyunjeong Kwon, Sunmi Lee
  Journal of Advanced Nursing.2022; 78(11): 3641.     CrossRef
• Development of a Web-Based Solution for Patient Need-Driven Staffing to Determine Nurse Staffing Requirements
  Sung-Hyun Cho, Hyo-Jeong Yoon, Sun Ju Chang, Ji-Yun Lee, Won-Hee Sim, Moon-Sook Kim, Sung-Cheol Yun
  Journal of Korean Academy of Nursing Administration.2022; 28(3): 238.     CrossRef
• The Relationship between Nursing Care Needs and Nurse Staffing in Pulmonology Nursing Units
  Hye-Kyung Jo, Sung-Heui Bae
  Korean Journal of Adult Nursing.2021; 33(3): 236.     CrossRef
• Characteristics of Medication Administration Error Alerts in Application of Mobile Medication System
  Suk-Hee Song, Ju-Won Back, In-Seon Han, Eun-Hye Kim, Nyeon-Im Byun, Eun-Mi Cho, Ta-Sea An, Hui-Joeng Hong
  Journal of Korean Academy of Fundamentals of Nursing.2021; 28(2): 149.     CrossRef