Purpose The aim was to develop guidelines for delegating nursing tasks among nurses in integrated nursing care wards. Methods This was a methodological approach. Literature reviews were conducted on delegation policies and practices for nurses in Korea and other countries to explore the area of nursing delegation. Focus group interviews were performed with nurses to identify the strength and weakness of the delegation of nursing tasks in clinical practice, and qualitative content analysis was conducted based on the interview. Ten areas and 115 items were derived through these steps, and their validity was confirmed using the Delphi technique. Results The delegation guidelines of nursing tasks consisted of nine domains, 21 sub-categories, and 101 items, including Nurses and nursing assistants' duties, the necessity of delegation, definition of terms, scope of delegation, considerations for delegation, procedure, characteristics, and principles of delegation, and educational content for delegation. Conclusion These guidelines can help nurses to make decisions about delegating nursing tasks according to the delegation procedure.
Education on the delegation of nursing tasks is necessary for both nurses and nursing assistants. The guidelines developed in this study can serve as a standard for delegating nursing tasks to ensure patient safety.
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Purpose This study examined patients’ call bell use and the relationship between call bell use and nursing care needs.
Methods: Nursing staff was asked to report patients’ call bell use during 15 shifts over five days in integrated nursing care wards. Nursing care needs were measured using summary scores of nursing activities and activities of daily living (ADLs). The relationship between call bell use and nursing care needs was analyzed using a zero-inflated negative binomial regression model.
Results: A total of 251 patients used call bells 235 times, with an average of 0.94 times per day. Only 72 patients (28.7%) used call bells once or more per day (range, 1~14 times), whereas the rest did not use call bells. Male gender, a high risk for falling, and a higher score on nursing activities were associated with a greater likelihood of using call bells. Pain and higher dependency on ADLs were associated with an increase in the frequency of call bell use.
Conclusion: Patients' call bell use needs to be minimized by meeting their nursing care needs to improve patient safety and nursing performance.
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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.
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