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
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
Differences in Medical Use and Patient Outcomes between Patients Admitted to the Integrated Nursing Care Ward and the General Ward Jeong Eun Mun, Bohyun Park Journal of Korean Academy of Nursing Administration.2024; 30(5): 439. CrossRef
Relationship between Nurse Staffing and Critical Nursing Activities in Intensive Care Units : Analysis of National Health Insurance Claims Data from 2009 to 2020 U Ri Go, Sung-Hyun Cho Journal of Korean Critical Care Nursing.2024; 17(2): 25. CrossRef
Experiences of Nurses Working as Helpers in a Dedicated COVID-19 Ward of a Certified Tertiary Hospital Eun Hyang Park, Hee Kyung Chang Journal of Korean Association for Qualitative Research.2024; 9(2): 93. CrossRef
Exploring the Roles and Outcomes of Nurse Educators in Hospitals: A Scoping Review Soyoung Kim, Sujin Shin, Inyoung Lee Korean Medical Education Review.2023; 25(1): 55. CrossRef
Changes in Working Hours and Labor Intensity and Their Effect on Sleep Difficulties of Shift Work Nurses in Hospitals Ji Yun Lee, Kyung Jin Hong Journal of Korean Academy of Nursing Administration.2023; 29(4): 446. CrossRef
The Effect of Work Interruption on Workload and Perception of Patient Safety Culture in Ward Nurses Doo-Nam Oh, Ye-Won Lee Quality Improvement in Health Care.2022; 28(2): 2. CrossRef
Factors Associated with Hospital Length of Stay among Women’s Cancer Patients: Based on the In-depth Injury Patient Surveillance System Data Yoonjung Kang, Hyewon Lee Journal of Health Informatics and Statistics.2022; 47(2): 148. CrossRef
Estimation of Revenue Growth Generated by Changing Nurse Staffing Grades and Fees and Introducing Night Shift Nursing Fees Sung-Hyun Cho, Kyung Jin Hong, Ji-Yun Lee Journal of Korean Academy of Nursing Administration.2021; 27(3): 191. 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
Citations to this article as recorded by
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
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
Relationship between Patient Classification System and APACHE II Scores, and Mortality Prediction in a Surgical Intensive Care Unit U Ri Go, Sung-Hyun Cho Journal of Korean Academy of Nursing Administration.2024; 30(1): 67. CrossRef
Experiences of South Korean mothers of children with medical complexity under long‐term hospitalization Ji Young An, So‐Hi Kwon, Hye Ri Choi Nursing Open.2023; 10(3): 1840. CrossRef
Association of nursing hours with cognitive function, balance, and dependency level of stroke patients Haneul Lee, Kyounga Lee, Seon‐Heui Lee Nursing Open.2023; 10(3): 1735. CrossRef
Nursing students' experiences and perceptions of barriers to the implementation of person‐centred care in clinical settings: A qualitative study Seonho Kim, Myoungsuk Kim Nursing Open.2023; 10(3): 1889. CrossRef
Exploring nurses' multitasking in clinical settings using a multimethod study Yoojin Kim, Mi Ja Lee, Mona Choi, Eunhee Cho, Gi Wook Ryu Scientific Reports.2023;[Epub] CrossRef
Relationships between Alternative Nurse Staffing Level Measurements and Nurses’ Perceptions of Nurse Staffing Level Adequacy, Fatigue, and Care Quality Kyung Jin Hong, Hyesook Chung, Young Mi Jo, Paolo C. Colet Journal of Nursing Management.2023; 2023: 1. CrossRef
An Analysis of Tasks of Nurses Caring for Patients with COVID-19 in a Nationally-Designated Inpatient Treatment Unit Minho Jung, Moon-Sook Kim, Joo-Yeon Lee, Kyung Yi Lee, Yeon-Hwan Park Journal of Korean Academy of Nursing.2022; 52(4): 391. CrossRef
Measuring patient acuity and nursing care needs in South Korea: application of a new patient classification system Jeounghee Kim, TaeRim Kang, Hyun-Ju Seo, So-Young Seo, Myoungsook Kim, Youngsun Jung, Jinhyun Kim, Jung- Bok Lee BMC Nursing.2022;[Epub] 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 Nurse Staffing in Intensive Care Units based on Nursing Care Needs: A Multicenter Study Miok Park, Eunjin Yang, Mimi Lee, Sung-Hyun Cho, Miyoung Shim, Soon Haeng Lee Journal of Korean Critical Care Nursing.2021; 14(2): 1. 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
Estimation of Expected Nursing Hours Based on Patients' Nursing Care Needs and a Comparison with Actual Nursing Hours in Comprehensive Nursing Care Wards Sung-Hyun Cho, Kyung Jin Hong, Hyo-Jeong Yoon, Sun Ju Chang, Kyunghi Choi, Hyang-Jeong Park, Iksoo Huh Journal of Korean Academy of Nursing Administration.2020; 26(4): 365. CrossRef
First
Prev
