PURPOSE This study was done to evaluate the adequacy of nurse staffing in integrated nursing care. METHODS Statistical data on integrated nursing care from the National Health Insurance Corporation was used in this study. We extracted hospital data and patient data related to patient needs for nursing care. We analyzed the differences in patient needs by staffing level of each type of medical institution. RESULTS Approximately 70% of medical institutions provided nursing care by the mid level of nurse staffing, which was 1:6, 1:10 and 1:12 in the tertiary hospital, general hospital and semi-hospital, respectively. The patients' characteristics were significantly different by hospital type. Especially, the distribution of the main diagnosis was completely different between the tertiary hospital and semi-hospital. In the tertiary hospital, the patient needs measured by severity and activities of daily living dependency were higher at higher staffing level than at lower staffing level. However, the nurse staffing was less relevant to the patient needs in the general hospital and semi-hospital. CONCLUSION To provide high-quality nursing care, accurate workload forecasting is required at the start, and then the standard nurse staffing level can established based on workload forecasting.
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PURPOSE This study was done to identify issues surrounding comprehensive nursing care within the national health insurance, analyze results and problems within national health insurance and to suggest new policy directions for stability. METHODS A literature search was performed using RISS, KISS, PUBMED databases. Eighteen studies were analyzed. RESULTS For implementation of comprehensive nursing care, there was improvement in nursing and in facilities. By improvement of structure, this new system showed positive outcomes in term of patient satisfaction and indicators related to patient safety. However, issues related to overload, job stress and evaluation of the system remain. In order to establish this system, staffing levels for nurses and nurse aids need to be adjusted to appropriate levels that reflect requirements for nursing. In addition, range of work needs to be determined clearly. Lastly, regular and systematic evaluation is needed to provide safe quality services to patients and to prevent waste of financial resources. CONCLUSION Comprehensive nursing care needs to be implemented in ways that patients can be provided with safe and high quality service. There is a need to resolve several issues to allow this new system to function.
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