Open Access, Peer-reviewed
pISSN 1225-9330
eISSN 2288-4955
    J Korean Acad Nurs Adm. 2016 Jun;22(3):209-219. Korean.
    Published online Jun 30, 2016.
    https://doi.org/10.11111/jkana.2016.22.3.209
    Copyright © 2016 Korean Academy of Nursing Administration
    Original Article

    Nurse Staffing Levels and Proportion of Hospitals and Clinics Meeting the Legal Standard for Nurse Staffing for 1996~2013

    Sung-Hyun Cho,1 Ji-Yun Lee,2 Kyung-Ja June,3 Kyung Jin Hong,4 and Yunmi Kim5
      • 1College of Nursing · Research Institute of Nursing Science, Korea.
      • 2Seoul National University Department of Nursing, Korea.
      • 3Kangwon National University Department of Nursing
      • 4Soonchunhyang University College of Nursing, Korea.
      • 5Seoul National University College of Nursing, Eulji University, Korea.
    • Corresponding author: Cho, Sung-Hyun. College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Tel: +82-2-740-8821, Fax: +82-2-765-4103, Email: sunghcho@snu.ac.kr
    Received December 08, 2015; Revised February 20, 2016; Accepted May 02, 2016.

    This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    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.

    Keywords
    Nurse; Staffing; Medical institution; Legal standard; Minimum staffing

    Tables

    Table 1
    Proportion of General Hospitals, Hospitals and Clinics Meeting the Legal Standard for Nurse Staffing

    Table 2
    Nurse Staffing Levels in General Hospitals

    Table 3
    Nurse Staffing Levels in Hospitals

    Table 4
    Staffing Levels of Registered Nurses and Nursing Assistants in Clinics

    Table 5
    Staffing Levels of Registered Nurses and Nursing Assistants in Long-term Care Hospitals

    References

      1. Organisation for Economic Co-operation and Development. OECD Health Care Resources [Internet]. France: OECD; 2015 [cited 2015 November 30].
        Available from: http://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_S TAT#..
      1. Cho SH. Who forces patient families and informal caregivers to stay at the patient's bedside?: Providing holistic nursing care by improving nurse staffing; Paper presented at: Seoul National University Nursing Policy Forum; 2015 July 17; Seoul National University, Seoul.
      1. National Health Insurance Service (KR). National Health Insurance comprehensive nursing care service program manual [Internet]. Sejong: Ministry of Health and Welfare (KR); 2015 [cited 2015 November 30].
        Available from: http://www.nhis.or.kr/bbs7/boards/B0040/14050.
      1. Ausserhofer D, Zander B, Busse R, Schubert M, De Geest S, Rafferty AM, et al. Prevalence, patterns and predictors of nursing care left undone in European hospitals: Results from the multicountry cross-sectional RN4CAST study. BMJ Qual Saf 2014;23(2):126–135. [doi: 10.1136/bmjqs-2013-002318]
      1. Kalisch BJ, Landstrom G, Williams RA. Missed nursing care: Errors of omission. Nurs Outlook 2009;57(1):3–9. [doi: 10.1016/j.outlook.2008.05.007]
      1. Kohn LT, Corrigan J, Donaldson MS. In: To err is human: Building a safer health system. Washington: National Academy Press; 2000.
      1. Cho SH, Kim YS, Yeon KN, You SJ, Lee ID. Effects of increasing nurse staffing on missed nursing care. Int Nurs Rev 2015;62(2):267–274. [doi: 10.1111/inr.12173]
      1. International Council of Nurses. Safe staffing saves lives: information and action tool kit. Geneva, Switzerland: International Council of Nurses; 2006.
      1. Kane RL, Shamliyan TA, Mueller C, Duval S, Wilt TJ. The association of registered nurse staffing levels and patient outcomes: systematic review and meta-analysis. Med Care 2007;45(12):1195–1204. [doi: 10.1097/MLR.0b013e3181468ca3]
      1. Needleman J, Buerhaus PI, Stewart M, Zelevinsky K, Mattke S. Nurse staffing in hospitals: Is there a business case for quality? Health Aff (Millwood) 2006;25(1):204–211. [doi: 10.1377/hlthaff.25.1.204]
      1. Kim Y, Cho SH, June KJ, Shin SA, Kim J. Effects of hospital nurse staffing on in-hospital mortality, pneumonia, sepsis, and urinary tract infection in surgical patients. J Korean Acad Nurs 2012;42(5):719–729. [doi: 10.4040/jkan.2012.42.5.719]
      1. Cho SH, Hwang JH, Kim J. Nurse staffing and patient mortality in intensive care units. Nurs Res 2008;57(5):322–322. [doi: 10.1097/01.nnr.0000313498.17777.71]
      1. The National Assembly (KR). Medical service act [Internet]. 2015 [[cited 2015 November 30].
        Available from: http://likms.assembly.go.kr/law/jsp/law/Main.jsp.
      1. You SJ. Policy implications of nurse staffing legislation. J Korea Contents Assoc 2013;13(6):380–389. [doi: 10.5392/JKCA.2013.13.06.380]
      1. Ministry of Health and Social Affairs (KR). Health and social white paper 1984. Gwacheon: Author;
      1. Ministry of Health and Social Affairs (KR). Health and social white paper 1990. Gwacheon: Author;
      1. You SJ, Chang HS, Kim MK, Choi YK. In: The utilization strategy of nursing personnel by types of medical institutions. Seoul: Korea Health Industry Development Institute; 2005.
      1. Ministry of Health and Welfare (KR). Reporting the results of the Healthcare Accreditation 2005 [Internet]. 2006 [cited 2015 November 30].
        Available from: http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=37496&pag e=1.
      1. Ministry of Health and Welfare (KR). Reporting the results of the Healthcare Accreditation 2006 [Internet]. 2007 [cited 2015 November 30].
        Available from: http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=41228&pag e=1.
      1. Oh YH. In: Supply and demand of health care workforce: 2015-2030. Sejong: Korea Institute for Health and Social Affairs; 2014.
      1. Kye HB, Doh SR, Song KY. In: Study on the improvement plan and survey design of patient survey. Seoul: Korea Institute for Health and Social Affairs; 1996.
      1. Doh SR, Jang YS, Jung YH, Choi JS, Oh YH, Oh MA, et al. In: Patient survey 2013. Sejong: Korea Institute for Health and Social Affairs; 2013.
      1. Kim D, Lee HJ. Effects on long-term care hospital staff mixing level after implementing differentiated inpatient nursing fees by staffing grades. J Korean Acad Nurs Adm 2014;20(1):95–105. [doi: 10.11111/jkana.2014.20.1.95]
      1. Aiken LH, Sermeus W, Van den, Sloane DM, Busse R, McKee M, et al. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ 2012;344:e1717. [doi: 10.1136/bmj.e1717]
      1. Spetz J, Donaldson N, Aydin C, Brown DS. How many nurses per patient? Measurements of nurse staffing in health services research. Health Serv Res 2008;43(5 Pt 1):1674–1692. [doi: 10.1111/j.1475-6773.2008.00850.x]
      1. Coffman JM, Seago JA, Spetz J. Minimum nurse-to-patient ratios in acute care hospitals in California. Health Aff (Millwood) 2002;21(5):53–64.
      1. Gerdtz MF, Nelson S. 5-20: a model of minimum nurse-to-patient ratios in Victoria, Australia. J Nurs Manag 2007;15(1):64–71. [doi: 10.1111/j.1365-2934.2006.00657.x1]
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    MeSH Terms
    Censuses
    Hospitals, General
    Humans
    Inpatients
    Long-Term Care
    Nurses
    Nursing
    Metrics
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