J Korean Clin Nurs Res.
2023 Dec;29(3):312-326. 10.22650/JKCNR.2023.29.3.312.
A Study on Appropriate Nurse Staffing Levels in Intensive Care Units and Improvement of the Critical Care Nursing Fee Schedules
- Affiliations
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- 1Unit Manager, Department of Nursing, Asan Medical Center, Seoul, Korea
- 2Professor, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Korea
- 3Team Leader, Department of Referral Center, Seoul National University Hospital, Seoul, Korea
- 4Team Leader, Department of Nursing, Severance Hospital, Seoul, Korea
- 5RN, Department of Nursing, Seoul National University Hospital, Seoul, Korea
- 6Professor, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- KMID: 2551435
- DOI: http://doi.org/10.22650/JKCNR.2023.29.3.312
Abstract
- Purpose
This study attempted to analyze the staffing level and critical care nursing fees of intensive care units at tertiary and general hospitals and to provide a professional judgment-based recommendation on staffing level and critical care nursing fee schedules. Methods: Staffing grades and critical care nursing fee schedules for the first quarter of 2017~2020 and the fourth quarter of 2020~2022 were analyzed. A survey was conducted on nursing managers and nurses about the current and appropriate staffing levels. A total of 77 nurse managers and 708 nurses working in Intensive Care Unit(ICU)s at tertiary and general hospitals participated in the study.
Results
Grade 1 staffing increased from 25.6% in 2017 to 92.1% in 2022 at tertiary hospitals and from 0.8% in 2017 to 28.4% in 2022 at general hospitals. The current staffing ratios of tertiary and general hospitals were 1:2.21 and 1:2.77, respectively. The appropriate staffing ratio according to nurse managers and nurses was 1:1.00 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in tertiary hospitals, and it was 1:1.25 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in general hospitals, respectively.
Conclusion
The appropriate staffing level was suggested from 1:1.0 to 1:2.0. The new nursing fee schedules were suggested from 1:1.0 (Grade 1) to 1:3.0 (Grade 5) and recommended to be paid based on the staffing grade, minimum number of nurses, and standard annual working days. It is expected to increase staffing levels and provide a better nursing work environment.
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