J Korean Acad Nurs Adm.  2020 Jan;26(1):42-54. 10.11111/jkana.2020.26.1.42.

Determining Nurse Staffing By Classifying Patients Based on their Nursing Care Needs

• Cho SH
• Lee JY
• Hong KJ
• Yoon HJ
• Sim WH
• Kim MS
• Huh I

• KMID: 2469367
• DOI: http://doi.org/10.11111/jkana.2020.26.1.42

Abstract

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.

Keyword

Hospitals; Nurses; Nursing care needs; Safer Nursing Care Tool; Staffing

MeSH Terms

Benchmarking
Humans
Inpatients
Nurses
Nursing Care*
Nursing*
Patients' Rooms
Tertiary Care Centers

Figure

• 

  Figure 1 (A) A decision tree result from recursive partitioning approach for classifying patients based on their nursing care needs; (B) corresponding visualization on two dimensional plane of the result.

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