J Korean Clin Nurs Res.  2023 Dec;29(3):249-260. 10.22650/JKCNR.2023.29.3.249.

Path Analysis of the Effects of Nurse Staffing on Patient Outcomes in Long-Term Care Hospitals

• Seong J
• Cho SH

• KMID: 2551430
• DOI: http://doi.org/10.22650/JKCNR.2023.29.3.249

Abstract

Purpose
The study aimed to examine the effects of nurse staffing levels on patient outcomes in long-term care hospitals in South Korea using path analysis.
Methods
We conducted a secondary analysis of national data, which included the 2021 hospital assessment results of long-term care hospitals from the Health Insurance Review and Assessment Service. Data collection was performed between June 19 and June 27, 2023. The study sample consisted of 1,215 hospitals, and we analyzed the data using SAS 9.4 and Mplus 8 software.
Results
The average numbers of patients per registered nurse, certified nursing assistant, and nursing staff, including both registered nurses and certified nursing assistant, was 10.00, 7.43, and 4.00, respectively. Path analysis revealed that the number of patients per registered nurse had direct effects on improvements in activities of daily living and indirect effects on indwelling catheterization, pressure ulcer improvement, and weight loss. The number of patients per certified nursing assistant had direct effects on new pressure ulcer development and pressure ulcer improvement, with no indirect effects. The number of patients per nursing staff had direct effects on pressure ulcer improvement and no indirect effects on other patient outcomes.
Conclusion
The findings suggest that establishing policies to evaluate staffing levels of registered nurse and certified nursing assistants separately is necessary in order to improve registered nurse staffing levels and patient outcomes in long-term care hospitals.

Keyword

Nurses; Staffing; Patient Outcome; Hospital; Path Analysis