Changes in Nurse Staffing Grades in General Wards and Adult and Neonatal Intensive Care Units / 임상간호연구

PURPOSE: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. METHODS: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. RESULTS: The staffing grade for the general wards improved during 2008-2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. CONCLUSION: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing.

Comparison of Nurses' Job Satisfaction, Patients' Satisfaction and Direct Nursing Time according to the Change in Grade of the Nursing Management Fee / 중환자간호학회지

PURPOSE: This study aimed to identify nurses' job satisfaction, patients' satisfaction, and direct nursing time according to the change in grade of nursing management fee.METHODS: Descriptive design was used in this study. Nurses (n = 200) and patients (n = 200) were recruited from one university hospital in Busan. Four aspects were measured: direct nursing time, overtime, nurses' job satisfaction, and patients' satisfaction. Data were analyzed using descriptive statistics, χ2-tests, and t-tests.RESULTS: There was a significant difference in patient satisfaction (t = -2.09, p = .038) and direct nursing time (t = -4.77, p < .001) when the nurse staffing grade was changed from the level two to the level one.CONCLUSION: The findings from this study showed that a higher nurse-to-patient ratio can provide a greater amount of direct nursing time for individual patients and increase patient satisfaction.

Effects on Long-Term Care Hospital Staff Mixing Level after Implementing Differentiated Inpatient Nursing Fees by Staffing Grades / 간호행정학회지

PURPOSE: The purpose of this study was to examine trends in number of nursing staff and skill mix. METHODS: Nursing staff and skill mix were measured using the number of nursing staff including nurse aids and registered nurses per bed. Descriptive and panel data regression analyses were conducted using data on long-term care hospitals which included yearly series data from 2006 to 2010 for 119 hospitals. RESULTS: The number of nursing staff per bed increased significantly but percentage of registered nurses decreased significantly from 2007 to 2010. The regression model explained this variation as much as 35% and 44%. CONCLUSION: The results showed that in long-term care hospitals there were more nurse aids employed instead of registered nurses after the implemention of differentiated inpatient nursing fees. Thus clarifying the job descriptions for nurses and nurse aids is needed and appropriate hospital incentive policies should be implemented.