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.
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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.
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PURPOSE In this paper issues and challenges of the workforce policy for nursing were explored and appropriate policy responses identified. RESULTS Many countries, including South Korea, are facing a shortage of nurses. In South Korea, the number of practicing registered nurses is about half the average for Organization for Economic Cooperation and Development (OECD) member countries. The shortage of nurses is not necessarily a shortage of individuals with nursing qualifications but also includes complex issues, such as lack of well-educated nurses, shortage of nurses willing to work, and geographical imbalances of nurses. The present nurse workforce policies are to increase number of nursing schools, to reduce the length of training, and to replace nurses with nursing assistants. However, the findings of many studies have shown that these attempts resulted in a worsening of patient outcomes and increasingly low quality of care. CONCLUSION The findings in this study indicate that nurse workforce policy should have a multi-faceted approach in order to address the many factors affecting nurse shortages.
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PURPOSE To analyze trends in salaries for registered nurses when compared with salaries for elementary school teachers from 2002 to 2009 and identify salary gaps of nurses according to workplace size and geographic location. METHODS Data were obtained from the Occupational Employment Statistics collected by the Korea Employment Information Services each year from 2002 to 2009. The study sample consisted of 2,281 registered nurses and 2,578 elementary school teachers. Linear multiple regression analyses were conducted to analyze salary trends and differences. RESULTS Elementary school teachers had higher monthly salaries than nurses with a baccalaureate degree after adjusting for years of work. Salary differences increased significantly by 40,000 won every year (p<.001). Nurses working in large facilities in Seoul had the highest salaries, whereas those in small/medium, non-Seoul facilities had the lowest salaries consistently over time. Salary differences between the two groups increased by 47,000 won every year (p=.001); salary differences between nurses in large, non-Seoul facilities and those in small/medium, non-Seoul facilities also increased by 40,000 won annually (p=.001). CONCLUSION Geographical imbalances in the nurse workforce and nurse shortages in small/medium, non-capital facilities could be reduced by increasing the salary of nurses working in those facilities.
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