Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care

Sung-Hyun Cho; Kyung Ja Song; Ihn Sook Park; Yeon Hee Kim; Mi Soon Kim; Da Hyun Gong; Sun Ju You; Young-Su Ju

doi:10.11111/jkana.2017.23.2.211

Articles

Page Path

Original Article

Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care

Sung-Hyun Cho¹, Kyung Ja Song², Ihn Sook Park³, Yeon Hee Kim⁴, Mi Soon Kim⁵, Da Hyun Gong⁶, Sun Ju You⁷, Young-Su Ju⁸

Journal of Korean Academy of Nursing Administration 2017;23(2):211-222.
Published online: March 31, 2017

DOI: https://doi.org/10.11111/jkana.2017.23.2.211

¹College of Nursing, Research Institute of Nursing Science, Seoul National University, Korea.

²Public Health Medical Service, Seoul National University Hospital, Korea.

³Department of Nursing, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Korea.

⁴Department of Nursing, Asan Medical Center, Korea.

⁵Department of Nursing, Samsung Medical Center, Korea.

⁶Department of Nursing, Dongguk University Ilsan Medical Center, Korea.

⁷Department of Nursing, Mokpo National University, Korea.

⁸College of Medicine, Hallym University, Korea.

Corresponding author: Cho, Sung-Hyun. College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-740-8821, Fax: +82-2-765-4103, sunghcho@snu.ac.kr

• Received: February 15, 2017 • Revised: March 20, 2017 • Accepted: March 20, 2017

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

23 Views
1 Download
33 Crossref

Full Article

Download PDF

Abstract
Article Information
REFERENCES

Abstract

Purpose
To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers.
Methods
A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care.
Results
Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units.
Conclusion
Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.
Key Words: Integrated inpatient nursing care; Nurse; Staffing; Nursing care delivery system

Article Information

This work was supported by Hospital Nurses Association Research Fund.

REFERENCES

1. Ministry of Health and Welfare (KR). Medical service act. Act No. 14438. 2016. 12 20.
2. National Health Insurance Service (KR). National Health Insurance integrated nursing care program manual. Wonju: National Health Insurance Service; 2016.
3. Cho SH, Kim YS, Yeon KN, You SJ, Lee ID. Effects of increasing nurse staffing on missed nursing care. Int Nurs Rev. 2015;62(2):267-274.
Article
4. Coffman JM, Seago JA, Spetz J. Minimum nurse-to-patient ratios in acute care hospitals in California. Health Aff (Millwood). 2002;21(5):53-64.
Article
5. State of California. California Code of Regulations [Internet]. 2017;cited 2017 January 12. Available from: http://www.dir.ca.gov/dlse/ccr.htm
6. Royal College of Nursing. Mandatory nurse staffing levels. . London: Royal College of Nursing; 2012.
7. National Institute for Health and Care Excellence (GB). Safe staffing for nursing in adult inpatient wards in acute hospitals [Internet]. updated July 2014. cited 2017 January 12. Available from: https://www.nice.org.uk/guidance/sg1
8. American Nurses Association. Principles for nurse staffing. 2nd ed. Silver Spring, Maryland: American Nurses Association; 2012.
9. Giovannetti P. Understanding patient classification systems. J Nurs Adm. 1979;9(2):4-9.
10. Song KJ, Kim EH, Yoo CS, Park HO, Park KO. Development of KPCS (Korean Patient Classification System for Nurses) based on nursing needs. J Korean Clin Nurs Res. 2009;15(1):5-17.
11. Song KJ, Kim EH, Yoo CS, Park HA, Song MS, Park KO. Verification of reliability and validity of KPCS-1 and estimation of nursing time conversion index. J Korean Clin Nurs Res. 2010;16(2):127-140.
12. Kim SS, Chae GS, Kim KN, Park KO, Seong SM. Survey on nursing care delivery systems of university affiliated hospitals in Korea. J Korean Clin Nurs Res. 2010;16(1):167-175.
13. Lankshear AJ, Sheldon TA, Maynard A. Nurse staffing and healthcare outcomes: A systematic review of the international research evidence. ANS Adv Nurs Sci. 2005;28(2):163-174.
14. Bae SH, Fabry D. Assessing the relationships between nurse work hours/overtime and nurse and patient outcomes: Systematic literature review. Nurs Outlook. 2014;62(2):138-156.
15. Olds DM, Clarke SP. The effect of work hours on adverse events and errors in health care. J Safety Res. 2010;41(2):153-162.
Article
16. Hendrich A, Chow MP, Skierczynski BA, Lu Z. A 36-hospital time and motion study: How do medical-surgical nurses spend their time? Perm J. 2008;12(3):25-34.
Article
17. Westbrook JI, Duffield C, Li L, Creswick NJ. How much time do nurses have for patients? A longitudinal study quantifying hospital nurses' patterns of task time distribution and interactions with health professionals. BMC Health Serv Res. 2011;11:319
Article
PDF
18. Institute for Healthcare Improvement (US). Percent of nurse time spent in direct patient care [Internet]. cited 2017 January 12. Available from: http://www.ihi.org/resources/Pages/Measures/PercentNurseTimeSpentinDirectPatientCare.asp
19. Royal College of Nursing. Accountability and delegation: What you need to know [Internet]. updated October 2011. cited 2017 January 12. Available from: https://www2.rcn.org.uk/__data/assets/pdf_file/0003/381720/003942.pdf

Table 1

Characteristics of Nursing Units, Number of Patients per Nursing Personnel by Shift, Work Hours, and Nursing Hours per Patient Day (N=80)

Nursing personnel include registered nurses and nursing assistants.

Table 2

Results from Time & Motion Study: Nursing Care Activities and Hours Provided by Team Nurses, Family Members, and Private Caregivers

IV=Intravenous.

Table 3

Patient Classification System (PCS) Scores and Groups by Hospital Type

Table 4

Direct Nursing Care Hours Provided by Nursing Personnel, Family, and Private Caregivers, and the Relationship between Direct Nursing Care Hours and Patient Classification System (N=109)

Table 5

Nurse-to-Patient Ratios for Tertiary and General Hospitals based on Patient Classification System Scores and Opinions of Nurse Unit Mangers on Provision of Integrated Inpatient Nursing Care

^*When based on patient classification system scores, registered nurse to patient ratio and nursing assistant to patient ratio are not fixed but variable under the same nursing personnel to patient ratio.

Figure & Data

References

Citations

Citations to this article as recorded by

Cancer Patients' and Caregivers' Experiences Admitted to Comprehensive Nursing Care Service Wards: An Exploratory Qualitative Research
Sarah Lim, Mee Young Cho, Hyun Joo Shin, Ki Yeon Song, Soo Kyoung Shim, Yoon Jung Lee, Hea Jin Kwon, Ji Eun Kim, Hui Ean Kim, Hyun Ja Park, Han Wool An, So Jeong Hyeon, Sue Kim
Asian Oncology Nursing.2024; 24(4): 173. 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
A phenomenological study of the experiences of nurses working in integrated nursing care wards in Korea
Young-mi Cho, Sun-hui Kim
BMC Nursing.2024;[Epub] 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
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
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
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
Factors Influencing on Performance for Infection Control of Nurses Working in Comprehensive Nursing Care Service Ward under COVID-19 Pandemic
Mi Jin Kwon, Yeojin Yi
Journal of Korean Academy of Nursing Administration.2022; 28(2): 121. CrossRef
Validity and Reliability of Korean Version of the Schwartz Center Compassionate Care Scale*
Seong Eun KIM, Jeong Suk KIM
Korean Journal of Medical Ethics.2022; 25(2): 137. CrossRef
What does family involvement in care provision look like across hospital settings in Bangladesh, Indonesia, and South Korea?
J. Y. Park, J. F. Pardosi, M. S. Islam, T. Respati, K. Chowdhury, H. Seale
BMC Health Services Research.2022;[Epub] CrossRef
Relationships among Non-Nursing Tasks, Nursing Care Left Undone, Nurse Outcomes and Medical Errors in Integrated Nursing Care Wards in Small and Medium-Sized General Hospitals
Ju-Young Park, Jee-In Hwang
Journal of Korean Academy of Nursing.2021; 51(1): 27. 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
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
Compare Value Congruence of Nurse-Patient Assignment with Work Performance in Neonatal Intensive Care Unit
Hye Min Kim, Dong Yeon Kim, Ji Young Kim, Ga Young Kim, Seol Hee Moon
Journal of Korean Academy of Nursing Administration.2021; 27(5): 355. CrossRef
Impact of nurse staffing on intent to leave, job satisfaction, and occupational injuries in Korean hospitals: A cross‐sectional study
Sujin Shin, Seung Jin Oh, Jeonghyun Kim, Inyoung Lee, Sung‐Heui Bae
Nursing & Health Sciences.2020; 22(3): 658. CrossRef
Determining Nurse Staffing By Classifying Patients Based on their Nursing Care Needs
Sung-Hyun Cho, Ji-Yun Lee, Kyung Jin Hong, Hyo-Jeong Yoon, Won-Hee Sim, Moon-Sook Kim, Iksoo Huh
Journal of Korean Academy of Nursing Administration.2020; 26(1): 42. CrossRef
Analysis of Nurses' Work Experience in Comprehensive Nursing Care Units of Small and Medium-sized Hospitals
Mi Ryeong Song, Su Hyang Ryu
Journal of Korean Academy of Nursing Administration.2020; 26(4): 419. CrossRef
Factors Affecting Use of Personal Protective Equipment related to Acute Respiratory Infections in General Hospital Nurses
Jungeun Kang, Jiyoung Kim
Journal of Korean Academy of Fundamentals of Nursing.2020; 27(3): 277. 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
The Relationship between Average Length of Stay and Nurse Staffing in General Hospitals from 1996 to 2016
Sung-Hyun Cho, Ji Yun Lee, Kyung Jin Hong, Iksoo Huh
Journal of Korean Academy of Nursing Administration.2020; 26(5): 521. CrossRef
Factors Associated with the Utilization of Comprehensive Nursing Services in Hospitals among Elderly Inpatients after Surgery
Dasom Son, Heejung Kim
Journal of Korean Gerontological Nursing.2020; 22(4): 358. CrossRef
Examining the inclusion of patients and their family members in infection prevention and control policies and guidelines across Bangladesh, Indonesia, and South Korea
Ji Yeon Park, Jerico Franciscus Pardosi, Holly Seale
American Journal of Infection Control.2020; 48(6): 599. CrossRef
Relation of Gratitude Disposition, Organizational Intimacy and Organizational Well-being on Comprehensive Nursing Service Units of Nurses
Soon Neum Lee, So Yeon Gu
Journal of Korean Academy of Nursing Administration.2019; 25(2): 97. CrossRef
The Analysis of Trends in Domestic Nursing Research on Integrated Nursing Care Service
Hyun Ju Choi
Journal of Korean Academy of Nursing Administration.2019; 25(5): 510. CrossRef
Work-related Characteristics and Sleep Quality of Nurses in Comprehensive Nursing Care Units of Small-medium Sized Hospitals
Sujin Shin, Inyoung Lee, Jeonghyun Kim, Sung-Heui Bae
Journal of Korean Academy of Fundamentals of Nursing.2019; 26(4): 260. CrossRef
Video Recording of Nursing Care Activities in Gerontological Nursing to Compare General Units and Comprehensive Nursing Care Units
Sung-Heui Bae, Jeonghyun Kim, Inyoung Lee, Seung Jin Oh, Sujin Shin
Journal of Korean Gerontological Nursing.2019; 21(3): 165. CrossRef
Adequacy of Nurse Staffing Level in Integrated Nursing Care
Jinhyun Kim, Sungjae Kim, Jinhee Park, Euntae Park, Suyong Jeong, Eunhee Lee
Journal of Korean Academy of Nursing Administration.2018; 24(4): 288. CrossRef
Nurses’ needs for care robots in integrated nursing care services
Jai‐Yon Lee, Young Ae Song, Ji Young Jung, Hyun Jeong Kim, Bo Ram Kim, Hyun‐Kyung Do, Jae‐Young Lim
Journal of Advanced Nursing.2018; 74(9): 2094. CrossRef
Associations of Nurse Staffing and Education With the Length of Stay of Surgical Patients
Eunhee Cho, Jeongyoung Park, Miyoung Choi, Hye Sun Lee, Eun‐Young Kim
Journal of Nursing Scholarship.2018; 50(2): 210. CrossRef
Nurses' Adherence and Difference Factors with Wearing Gloves in Peripheral Intravenous Catheter Insertion
Yeong Seo Ahn, Jae Sim Jeong, Hye Ran Choi, Jeong Hye Kim
Korean Journal of Healthcare-Associated Infection Control and Prevention.2018; 23(2): 63. CrossRef
Nursing, Robotics, Technological Revolution: Robotics to Support Nursing Work
Young Ae Song, Hyun Jeong Kim, Hyun Kyong Lee
Journal of Korean Gerontological Nursing.2018; 20(Suppl 1): 144. CrossRef
A Study on the Types of Hospitals Participating and the Factors Influencing Comprehensive Nursing Service
Ki-Sung Kim, Shin-Ho Lee, Mun-Hyung Ryu
The Korean Journal of Health Service Management.2017; 11(4): 239. CrossRef
Policy Issues and New Direction for Comprehensive Nursing Service in the National Health Insurance
Jinhyun Kim, Sungjae Kim, Euntae Park, Suyong Jeong, Eunhee Lee
Journal of Korean Academy of Nursing Administration.2017; 23(3): 312. CrossRef

Cite

CITE

export

Copy Download

Format
XML Download

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care

J Korean Acad Nurs Adm. 2017;23(2):211-222. Published online March 31, 2017

DOI: https://doi.org/10.11111/jkana.2017.23.2.211

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care

J Korean Acad Nurs Adm. 2017;23(2):211-222. Published online March 31, 2017

DOI: https://doi.org/10.11111/jkana.2017.23.2.211

Development of Guidelines for the Delegation of Nursing Tasks in Integrated Nursing Care Service

Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care

Table 1

Characteristics of Nursing Units, Number of Patients per Nursing Personnel by Shift, Work Hours, and Nursing Hours per Patient Day (N=80)

Nursing personnel include registered nurses and nursing assistants.

Table 2

Results from Time & Motion Study: Nursing Care Activities and Hours Provided by Team Nurses, Family Members, and Private Caregivers

IV=Intravenous.

Table 3

Patient Classification System (PCS) Scores and Groups by Hospital Type

Table 4

Direct Nursing Care Hours Provided by Nursing Personnel, Family, and Private Caregivers, and the Relationship between Direct Nursing Care Hours and Patient Classification System (N=109)

Table 5

Nurse-to-Patient Ratios for Tertiary and General Hospitals based on Patient Classification System Scores and Opinions of Nurse Unit Mangers on Provision of Integrated Inpatient Nursing Care

Table 1 Characteristics of Nursing Units, Number of Patients per Nursing Personnel by Shift, Work Hours, and Nursing Hours per Patient Day (N=80)

Nursing personnel include registered nurses and nursing assistants.

Table 2 Results from Time & Motion Study: Nursing Care Activities and Hours Provided by Team Nurses, Family Members, and Private Caregivers

IV=Intravenous.

Table 3 Patient Classification System (PCS) Scores and Groups by Hospital Type

Table 4 Direct Nursing Care Hours Provided by Nursing Personnel, Family, and Private Caregivers, and the Relationship between Direct Nursing Care Hours and Patient Classification System (N=109)

Table 5 Nurse-to-Patient Ratios for Tertiary and General Hospitals based on Patient Classification System Scores and Opinions of Nurse Unit Mangers on Provision of Integrated Inpatient Nursing Care

Articles

Page Path

Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care

Full Article

Abstract

Article Information

REFERENCES

Characteristics of Nursing Units, Number of Patients per Nursing Personnel by Shift, Work Hours, and Nursing Hours per Patient Day (N=80)

Results from Time & Motion Study: Nursing Care Activities and Hours Provided by Team Nurses, Family Members, and Private Caregivers

Patient Classification System (PCS) Scores and Groups by Hospital Type

Direct Nursing Care Hours Provided by Nursing Personnel, Family, and Private Caregivers, and the Relationship between Direct Nursing Care Hours and Patient Classification System (N=109)

Nurse-to-Patient Ratios for Tertiary and General Hospitals based on Patient Classification System Scores and Opinions of Nurse Unit Mangers on Provision of Integrated Inpatient Nursing Care

Figure & Data

References

Citations

CITE

Download Citation

Format:

Include:

Related articles

Characteristics of Nursing Units, Number of Patients per Nursing Personnel by Shift, Work Hours, and Nursing Hours per Patient Day (N=80)

Results from Time & Motion Study: Nursing Care Activities and Hours Provided by Team Nurses, Family Members, and Private Caregivers

Patient Classification System (PCS) Scores and Groups by Hospital Type

Direct Nursing Care Hours Provided by Nursing Personnel, Family, and Private Caregivers, and the Relationship between Direct Nursing Care Hours and Patient Classification System (N=109)

Nurse-to-Patient Ratios for Tertiary and General Hospitals based on Patient Classification System Scores and Opinions of Nurse Unit Mangers on Provision of Integrated Inpatient Nursing Care

Table 1

Table 2

Table 3

Table 4

Table 5

ABOUT

BROWSE ARTICLES

EDITORIAL POLICY

FOR CONTRIBUTORS