• Title/Summary/Keyword: Staffing

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Policy Implications of Nurse Staffing Legislation (간호사 배치기준에 대한 정책적 함의)

  • You, Sun-Ju
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.380-389
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    • 2013
  • The nurse staffing level in the acute care hospitals affects patient safety and performance, and the nurse staffing legislation can be an important tool to guarantee the minimum nurse staffing. In Korea, although the medical law suggests the nurse staffing standards, it is necessary to revise the medical law for quality of nursing care and patient safety. Firstly, the nurse staffing standards in the current medical law enacted in 1962 needs to be revised to reflect changes in health care environment. Secondly, legal nurse staffing standards in the medical law are the minimum nurse staffing that medical institutions should comply with and thus must be managed so that all medical institutions should abide by them. Thirdly, the nurse staffing standards should apply on the basis of RN-to-patient ratios per shift in order to help patients understanding and ensure the easy management. Fourthly, the information of nursing staff level by the nursing unit and nursing shift in hospitals shall be released.

Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients (의료기관 간호사 확보수준이 수술환자의 사망, 폐렴, 패혈증, 요로감염에 미치는 영향)

  • Kim, Yunmi;Cho, Sung-Hyun;June, Kyung Ja;Shin, Soon Ae;Kim, Jiyun
    • Journal of Korean Academy of Nursing
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    • v.42 no.5
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    • pp.719-729
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    • 2012
  • Purpose: This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance. Methods: Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes. Results: An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)=2.99, 95% CI (confidence interval)=1.94-4.60], those with Grades 4-5 (OR=1.78, 95% CI=1.24-2.57) and those with Grades 2-3 (OR=1.57, 95% CI=1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis. Conclusion: Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.

Analysis of the factors that influence on the RN staffing level in the Specified general Hospitals (종합전문병원 간호사 확보수준에 영향을 미치는 요인)

  • Kim, Yun-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.1
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    • pp.147-159
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    • 2000
  • This paper studied the factors that influence on RN staffing level in the 43 Specialized general hospitals. Market structure was analysed using the monopsony model. The degree of competition was estimated by Herfindal Index and market was defined as Great medical zone. As the result of the estimation, in the more competitive hospital market hospitals employed the higher level of RN staffing, so monopsony model was supported. Hospitals with above 1001bed employed more RN than hospitals with below 700bed did. Hospital type, hospital union and the number of medical doctor did not affect the level of RN staffing. There was positive correlation between the level of RN staffing and the number of nurse's aid. The structure of RN market in Specified general hospitals was proved monopsony market, it seems that government regulation will be needed to improve social efficiency and equity.

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Variations in Nurse Staffing in Adult and Neonatal Intensive Care Units (의료기관 및 중환자실 특성에 따른 간호사 배치수준)

  • Cho Sung-Hyun;Hwang Jeong-Hae;Kim Yun-Mi;Kim Jae-Sun
    • Journal of Korean Academy of Nursing
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    • v.36 no.5
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    • pp.691-700
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    • 2006
  • Purpose: This study was done to analyze variations in unit staffing and recommend policies to improve nursing staffing levels in intensive care units (ICUS). Method: A cross-sectional study design was used, employing survey data from the Health Insurance Review Agency conducted from June-July, 2003. Unitstaffing was measured using two indicators; bed-to-nurse (B/N) ratio (number of beds per nurse), and patient-to-nurse (P/N) ratio (number of average daily patients per nurse). Staffing levels were compared according to hospital and ICU characteristics. Result: A total of 414 institutions were operating 569 adult and 86 neonatal ICUs. Tertiary hospitals (n=42) had the lowest mean B/N (0.82) and P/N (0.76) ratios in adult ICUs, followed by general hospitals (B/N: 1.34, P/N: 0.97). Those ratios indicated that a nurse took care of 3 to 5 patients per shift. Neonatal ICUs had worse staffing and had greater variations in stafnng ratios than adult ICUs. About 17% of adult and 26% of neonatal ICUs were staffed only by adjunct nurses who had responsibility for a general ward as well as the ICU Conclusion: Stratification of nurse staffing levels and differentiation of ICU utilization fees based on staffing grades are recommended as a policy tool to improve nurse staffing in ICUs.

Impact of Increased Supply of Newly Licensed Nurses on Hospital Nurse Staffing and Policy Implications (신규면허간호사 공급량 증가가 의료기관 간호사 확보수준에 미친 영향과 정책적 함의)

  • Kim, Yunmi;You, Sunju;Kim, Jinhyun
    • Journal of Korean Academy of Nursing
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    • v.47 no.6
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    • pp.828-841
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    • 2017
  • Purpose: This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. Methods: Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression. Results: An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870). Conclusion: To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future.

Investigation on the Manpower Staffing Plan Utiling Density Analysis Method (밀도분석에 의한 공동주택 현장관리 인력 배치계획 분석)

  • Kwon, Gi-Deoc;Kim, Sun-Kuk;Sohn, Hyo-Won;Choi, Jae-Hwi;Lee, Dong-Hoon
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2010.05a
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    • pp.119-123
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    • 2010
  • Recent economic slump has highlighted the needs for the construction industry to develop strategies to improve productivity and overhaul organization structure. Notably, it is urgent to improve productivity of apartment building construction projects that account for about half of the aggregate revenue of building construction projects in Korea. As construction site management manpower staffing plan has close relation with the productivity of building construction, it is essential to staff construction sites adequately in consideration of site conditions and characteristics. However, construction companies of Korea are still far from developing site management manpower staffing plan in reference to quantitative standards. Therefore, this research aims to analyze site management manpower staffing plan of apartment building construction project by means of density analysis. To be more specific, site organization charts and staffing plans of apartment building construction projects put together by large construction companies in Korea are studied and essential resources and their mobilization time of apartment building construction projects are examined. Conclusions herein will provide basic inputs to subsequent studies of apartment building construction site management manpower staffing standards.

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A Study on Appropriate Nurse Staffing Levels in Intensive Care Units and Improvement of the Critical Care Nursing Fee Schedules (중환자실 적정 간호사 배치수준과 간호관리료 차등제 개선 연구)

  • Lee, Hyo Jin;Cho, Sung-Hyun;Shim, Mi Young;Kim, Jung Yeon;Song, Yu Gil;Kim, Jin;Kim, Young Sam
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.3
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    • pp.312-326
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    • 2023
  • 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.

Field Perceptions on the Staffing Situation of Academic Libraries (대학도서관 인력 현황에 관한 현장 인식 조사)

  • Eun Youp Rha;Sangoh Na;Jongwook Lee
    • Journal of Korean Library and Information Science Society
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    • v.55 no.1
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    • pp.123-143
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    • 2024
  • In this study, we analyzed the trends in staffing changes in academic libraries over the past ten years and surveyed staff working there to assess their perceptions of staffing levels and the current criteria for staffing allocation in academic libraries. We utilized statistical data from academic libraries to analyze staffing changes from 2014 to 2023. The survey was conducted through an online questionnaire targeting library staff, and responses from 216 respondents from 4-year universities and junior colleges were analyzed. The analysis of staffing changes revealed a decrease in the average number of employees in large 4-year universities and junior colleges, with a decrease in regular positions and an increase in non-regular positions. Survey results suggest causes such as declining school-age population and admissions quotas, budget shortages in universities, and structural adjustments. The perception of staff from 4-year universities and junior colleges regarding the criteria for staffing allocation was mainly negative, suggesting improvements such as increasing and refining criteria numbers, specifying standards for full-time librarians, clarifying criteria for compliance, and enhancing enforcement of standards. The results of this study can enhance understanding of staffing situations in academic libraries and serve as fundamental data for improving staffing criteria in the future, based on an understanding of librarians' perceptions on the ground.

Analysis of Factors Related to Mortality in Adult ICU Patients: Focusing on Nurse Staffing Level (성인중환자실 이용 환자의 사망률 관련 요인 분석: 간호등급을 중심으로)

  • Lee, Jeong Mo;Lee, Kwang Ok;Hong, Jeong Hwa;Park, Hyun Hee
    • Journal of muscle and joint health
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    • v.29 no.1
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    • pp.41-49
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    • 2022
  • Purpose: The purpose of this study was to assess the influence of nurses staffing level on patient health outcomes in intensive care units (ICUs) in Korea. Methods: The study was retrospective in nature. Information on patients and their outcomes, as well as nurse cohort data, were obtained from Korea's National Health Insurance Service Database. The observation period was from January 1, 2008 to December 31, 2018, and data for 2,964,991 patients were analyzed. Independent variables included patient' age and sex and hospital type, intensivist, and nurses staffing level. Results: The mortality rate in ICUs was significantly higher at tertiary hospitals with a level 3~4 (HR, 1.21; 95% confidence interval, 1.19~1.22) or level 5~9 nurse staffing (HR, 1.31; 95% confidence interval, 1.27~1.34) compare to that of tertiary hospitals with a 1~2 level. 28-day mortality rate was also higher at general hospitals with a level 3~4 (HR, 1.13; 95% confidence interval, 1.12~1.14), level 5~6 (HR. 1.34; 95% confidence interval, 1.32~1.36), level 7~9 nurse staffing (HR, 1.38; 95% confidence interval, 1.38~1.42), using level 1~2 as reference. Conclusion: Nurses staffing level is a key determinant of healthcare-associated mortality in critically ICUs patients. Policies to achieve adequate nurse staffing levels are therefore required to enhance patient outcomes.

Relationship between Nurse Staffing and Changes in Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes

  • Moon, Mi-Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.14 no.1
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    • pp.62-69
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    • 2011
  • Purpose: The study assessed whether nurse staffing was associated with 3 nursing sensitive outcomes used in intensive care unit (ICU) nursing care plans. Methods: This study was a retrospective and descriptive study using clinical data extracted from the data warehouse of a large acute care hospital in the Midwest. One-way analysis of variance was used to analyze the records of 578 ICU patients admitted from March 25 to May 31, 2010. Results: 79 Nursing Outcomes Classification (NOC) outcomes were used in the nursing care plans. The 3 most commonly used NOC outcomes (Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes) were analyzed to determine their relationship to nurse staffing. As a nurse staffing ratio, the skill mix of nursing caregivers ranged from 0.74 to 1 with an average of 0.90. This skill mix of nursing caregivers significantly differed among the changes in Infection Severity scores. However, the mean difference was only 0.02. Conclusion: The results did not support that greater nurse staffing was associated with better outcomes. More research is still needed to determine the usefulness of Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes in evaluating the impact of nurse staffing.