• Women's Health Nursing
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• v.11 no.2
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• pp.169-175
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• 2005

Purpose: This study was designed to investigate the relationships of the types of nurse staffing, the competency of nursing performance and job satisfaction by analyzing the types of nurse staffing in operating room. Method: The subjects were 472 nurses who work in operating room. The instruments used in this study were three tools: competency of nursing performance, job satisfaction and type of nurse staffing. Result: Type 4 was most in the type of nurse staffing of the subjects. According to the type of nurse staffing, the competency of nursing performance was significantly different. There was significant difference in the competency of nursing performance according to age, marital status, bachelor, employ, position, and career, and job satisfaction according to age, position, and career. In opinion about the ideal type of nurse staffing, type 2 was most regardless of career. Conclusion: Type 4 which has lower competency of nursing performance was adopted in many hospitals now but, type 2 which has highest competency of nursing performance was selected by many nurses as the best one. So, it should be considered the type of nurse staffing of in operating room and change it.

• Journal of Korean Clinical Nursing Research
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• v.23 no.1
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• pp.64-72
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• 2017

Purpose: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. Methods: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. Results: The staffing grade for the general wards improved during 2008-2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. Conclusion: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing.

• 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 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.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.3
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• pp.327-335
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• 2011

Purpose: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. Methods: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. Conclusion: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients.

• 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.

• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.99-109
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• 2010

Purpose: This study was aimed to examine changes of hospital nurse staffing by hospital characteristics during 2008-2010. Methods: The study sample included 44 tertiary hospitals, 226 general hospitals, and 532 non-general hospitals that were operating during 2008-2010. Grade of nursing management fee was categorized from Grade 1(highest) to 6 (lowest) in tertiary hospitals, l or Grade 7 in general hospitals and non-general hospitals based on the nurse-to-bed ratio. For data analysis, ${\chi}^2$ and GEE were conducted. Results: For three years, the number of tertiary hospitals below Grade 2 were increased from 8 to 12, the number of those above Grade 4 were decreased from 15 to 6. The number of general hospitals above Grade 6 decreased from 123 to 86. Tertiary hospitals and general hospitals had more possibilities to improve nurse staffing grade than general hospital (OR 79.69, 95% CI 50.77~125.09, OR 11.25, 95% CI 8.15~15.53, respectively). Greater likelihood of improvement in grade of nursing management fee was found in university hospital or hospitals with 300 or more beds than other types of hospitals. Conclusion: Differentiating nurse staffing system by hospital type and increasing financial incentives according to the grades are needed to improve hospital nurse staffing.

• Korean Journal of Occupational Health Nursing
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• v.33 no.3
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• pp.129-139
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• 2024

Purpose: This study aimed to examine the differences in nurses' psychosocial work environment (PWE) in integrated nursing care wards (IWs) with higher nurse staffing and general wards (GWs) with lower staffing, and to analyze the effect of PWE on their health outcomes. Methods: Data were collected from 151 nurses in IWs and 156 nurses in GWs at a tertiary hospital in Seoul in 2023. The Korean version of the Copenhagen Psychosocial Questionnaire III was used to measure PWE and health outcomes. Regression analyses were conducted to examine the effect of PWE on health outcomes. Results: The most negative aspects of the nurses' work environment were found in the work demand domain. IW nurses (vs. GW nurses) reported lower work demand, better work organization and job contents, and a more positive work-individual interface. Nurse health outcomes were also better in the IWs. Lower work demand and better work-individual interfaces were positively associated with improved health outcomes, while ward type (IW vs. GW) was not significantly related to health outcomes. Conclusion: Reducing work demand by expanding integrated nursing care services nationwide and improving nurse staffing in GWs is crucial for improving health outcomes.

• Journal of Korean Academy of Nursing
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• v.47 no.5
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• pp.676-688
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• 2017

Purpose: The purpose of this study was to analyze the migration patterns of new nurses and experienced nurses and to identify the factors influencing inter-regional migration for solving regional imbalances of clinical nurses in South Korea. Methods: This study involved a secondary analysis of data from the Health Insurance Review and Assessment Service (HIRA). Data were analyzed using descriptive statistics and multiple logistic regression analysis. Results: New nurses tended to migrate from Kyunggi to Seoul. However, experienced nurses tended to migrate from Seoul and Chungchung to Kyunggi. Significant predictors of inter-regional migration among new nurses were location and nurse staffing grade of hospitals. Significant predictors of inter-regional migration among experienced nurses were location, hospital type, nurse staffing grade, ownership of hospitals and age of nurses. Conclusion: Inter-regional migration occupied a small portion of total hospital movement among clinical nurses. The regional imbalances of nurses were not caused by the migration from non-metropolitan areas to Seoul. Nurse shortage problems in the small and medium hospitals of the non-metropolitan area can be solved only through improvement of work environment.

• Korea Journal of Hospital Management
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• v.21 no.2
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• pp.24-36
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• 2016

The aims of this study is to investigate the status of nursing care delivery systems and nurse staffing levels and to analyze differences in the quality of nursing care by the type of nursing care delivery system. This research was based on data from 723 nurses working in 55 medical and surgical units in 26 general hospitals. Descriptive statistics on nurse staffing levels and the nursing care delivery system, and multi-level logistic regression were used to estimate the determinants of quality of nursing care. The number of patients per nurse is 17.74 patients in functional nursing care and 15.56 patients in total nursing care. In comparison to hospitals adopting total nursing care, hospitals with functional nursing care had greater patients. The nurses rated units using total nursing care as significantly better quality of nursing care than the units with functional nursing care. Total nursing care or modified total nursing care, rather than functional nursing care, could lead to improvement in the quality of care(total nursing care OR=3.895, modified total nursing care OR=2.475). Patient-centered approaches under proper circumstances can be successfully implemented and the positive effects demonstrated.