• Journal of Nutrition and Health
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• v.31 no.3
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• pp.354-362
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• 1998

The purposes of this study were to develop standardized indices of staffing needs in each school, foodservice system through work sampling methodology . Conventional school foodservices were classified into 5 groups depending on size of meals served. Commissary school foodservices were also classified into 5 groups by cluster analysis using number of meals served, number of satellite schools, and time for transportation of food. Work measurement through work sampling methodology was conducted in 15 conventional and 21 commissary foodservices during 3 consecutive days from September to October in 1995. Statistical data analysis was completed using the SAS programs for descriptive analysis, cluster analysis, and simple linear regression. The results were as follows : Average points of leveling factors of conventional and commissary foodservices were 1.066 and 1.061 , respectively. Mean labor hours per work force was 328 minutes and 366 minutes in conventional and commissary foodservice , respectively. Standardized work time was calculated using leveling factor, ILO allowance rate (175) , and observational work time. The model for standardized indices of staffing needs was developed based on simple linear regression in each school foodservice system. In conventional school foodservice systems(for 100-1,900 meals per day) standardized staffing needs=3.2497 +0.005267$\times$number of meals served (F=273.1, R-square 0.9750, p<0.001). In commissary school foodservice systems (for 200-1,600 meals per day ) Standardized staffing needs=3.393384 +0.0063$\times$number of meals served (F=30.78, R-square 0.6580, p<0.001).

• Journal of the Korean Society for Library and Information Science
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• v.51 no.4
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• pp.183-201
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• 2017

The purpose of this study was to examine the current staffing practices in public libraries and to analyze the relevance of legal standards of public library staffing. It analyzed the national library statistical data to obtain the national average staffing rate, reviewed related literature to understand the rationales that established the key attributes that construct the current legal standards, and compared the placement rates of the three standards, namely the current legal standards, Korean Library Association's standards, and IFLA staffing standards, to determine the optimacy of the legal standards. It found the current placement rate in the legal standard was only 18.2%, marking the lowest rates among the three compared standards, indicating the current legal standards being unnecessarily high. The study attributes the problem to the structure of the current legal standards that calculate the staffing size based on the building and collection size rather than service populations. The findings of this study suggest a revision of the current standard based on service population while retaining the minimum staffing of three librarians even the smallest public library unit.

• Journal of Korean Academy of Nursing
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• v.44 no.1
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• pp.21-30
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• 2014

Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

• Journal of Korean Academy of Nursing Administration
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• v.22 no.3
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• pp.209-219
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• 2016

Purpose: To analyze the proportion of medical institutions meeting the legal standard for nurse staffing. Methods: Data collected from 29,282 institutions between 1996 and 2013 were analyzed. Nurse staffing was measured as daily patient census per registered nurse (RN). The standard for general hospitals, hospitals, and clinics is 2.5 or less, and that for long-term care hospitals is 6.0 or less of the daily patient census per RN. Clinics may substitute nursing assistants for RNs by 50% or 100% depending on their daily inpatient census; long-term care hospitals may substitute nursing assistants for RNs by two thirds of the required number of RNs. Results: The proportion of general hospitals, hospitals, clinics, and long-term care hospitals meeting the standards was 63%, 19%, 63%, and 94%, respectively, in 2013. While general hospitals had an increase in the proportion during the 1996-2013 period, small changes were found in hospitals and clinics. In 2013, nurses were estimated to care for 16 (interquartile range: 12~24) patients per shift in general hospitals. Three quarters of clinics had no RNs in 2013. Conclusion: Many medical institutions did not meet the legally mandated minimum staffing level. The government must implement policy actions for all medical institutions to meet the legal standards.

• Journal of Korean Academy of Nursing
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• v.50 no.3
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• pp.333-348
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• 2020

Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.

• Health Policy and Management
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• v.21 no.2
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• pp.195-212
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• 2011

Objectives: This study investigates the relationship between nurse staffing levels and differences in patient outcomes in terms of average length of stay, in-hospital mortality rate and 30-day death rate in order to evaluate the effectiveness of a policy that differentiates fees for inpatients on the basis of nurse-to-bed ratios. Methods: We obtained information on inpatients from health insurance claims data published by the Health Insurance Review and Assessment Service(HIRA) in 2008, organizational factors(type of hospital, ownership) from the records of the hospital report system in 2008, and nurse staffing levels, which were graded on a scale of 1 to 7, from data compiled between December 15, 2007, and September 20, 2008. The data were segregated according to type of hospital and quarter and finally 3,517 records of 1,182 hospitals were analyzed using multi-level analysis. Results: The average length of stay in grade 1~6 hospitals was lower than that in grade 7 ones, but the difference was much below one day. No significant difference was found among different grades in tertiary hospitals. Further, variations in staffing levels did not result in any significant difference in the in-hospital mortality rate and 30-day death rate. Conclusions: High nurse staffing levels did not result in better patient outcomes compared with low staffing levels. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving patient outcomes.

• Journal of Korean Academy of Nursing
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• v.43 no.1
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• pp.39-49
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• 2013

Purpose: To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing. Methods: Secondary data were obtained from Statistics Korea, Education Statistics, and Health Insurance Review & Assessment Service and Patient Survey. Intensity of monopsony in the nurse labor market was measured by Herfindahl Hirshman Index (HHI). Hospital nurse staffing level was divided into high and low. While controlling for confounding factors such as inpatient days and severity mix of patients, effects of characteristics of nurse labor markets on nurse staffing levels were examined using multi-level logistic regressions. Results: For characteristics of nurse labor markets, metropolitan areas had high intensity of monopsony, while the capital area had competitive labor market and the unemployed nurse rate was higher than other areas. Among hospital characteristics, bed occupancy rate was significantly associated with nurse staffing levels. Among characteristics of nurse labor markets, the effect of HHI was indeterminable. Conclusion: The Korean nurse labor market has different structure between the capital and other metropolitan areas. But the effect of the structure of nurse labor market on nurse staffing levels is indeterminable. Characteristics such as occupancy rate and number of beds are significantly associated with nurse staffing levels. Further study in support of the effect of nurse labor market is needed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.1
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• pp.104-115
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• 2021

The purpose of this review was to systematically assess empirical studies on the relationship between nurse staffing and patient outcomes through systematic literature review. Peer-reviewed articles published between January 2009 and December 2018 were identified in CINAHL, Pubmed, EBSCOhost, RISS, and Dbpia databases. A total of 13 articles relating to nurse staffing and patient outcomes in Korea were systematically reviewed and analyzed. The review showed that better nurse staffing aligned with better patient outcomes. However, some studies did not directly correlate patient outcomes with nurse staffing. This is because each study examined varied aspects of nurse staffing and different patient outcomes. These inconsistent study results indicate that continuous study is required. There should be continued efforts to establish guidelines and strategies for deploying nurse staff by maintaining optimal patient-to-nurse ratio.

• Journal of the Korean Society for Library and Information Science
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• v.46 no.1
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• pp.55-76
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• 2012

Regardless of which country, all public libraries need facilities, collections, and funds. But how well the library system succeeds depends on the staff committed to providing the highest possible level of service to the community. The public library, therefore, should employ the appropriate number of full-time staff. In order to warrant such a work force, this study analyzed the juridical justification, logical validity, realistic fitness, and usefulness of current legal and recommended staffing standards. This study also suggested the revisions of total space of buildings and collection size as crucial variables for library staffing, division of legal service populations, basic staffing level, and additional staff in proportion to service populations for public libraries in Korea.

• Journal of Korean Academy of Nursing Administration
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• v.21 no.2
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• pp.174-183
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• 2015

Purpose: This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs). Methods: Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients. Results: Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level. Conclusion: In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.