J Korean Acad Nurs Adm.  2020 Sep;26(4):365-377. 10.11111/jkana.2020.26.4.365.

Estimation of Expected Nursing Hours Based on Patients’ Nursing Care Needs and a Comparison with Actual Nursing Hours in Comprehensive Nursing Care Wards

Affiliations
  • 1Professor, College of Nursing ․ Research Institute of Nursing Science, Seoul National University
  • 2Assistant Professor, Department of Nursing, Semyung University
  • 3Assistant Professor, School of Nursing, Yeungnam University College
  • 4Associate Professor, College of Nursing ․ Research Institute of Nursing Science, Seoul National University
  • 5Director, Seoul-Gangwon Regional Headquarters, National Health Insurance Service
  • 6Director, Incheon-Gyeonggi Regional Headquarters, National Health Insurance Service
  • 7Assistant Professor, College of Nursing ․ Research Institute of Nursing Science, Seoul National University

Abstract

Purpose
To compare actual versus expected nursing hours based on patients’ nursing care needs.
Methods
The nursing care needs of 898 inpatients in 20 wards at 11 hospitals were measured using the 14 items developed by the National Health Insurance Service (NHIS). Nursing activities from 474 nursing personnel were observed every 10 minutes for 24 hours. Actual hours indicated direct care hours per patient day provided by registered nurses according to 3 types: (1) standard hours based on staffing standards approved by the NHIS, (2) scheduled hours excluding overtime hours, and (3) observed hours including overtime. Expected hours were estimated from the linear mixed effect model including hospital type, nursing care need items and their interaction terms.
Results
Standard hours ranged from 0.92 to 2.15; scheduled hours from 0.88 to 1.95; observed hours from 1.00 to 2.40; expected hours from 0.88 to 2.33. Eight hospitals had standard hours not meeting the expected hours and 2 hospitals did observed hours not meeting the expected hours due to nurses’ overtime. In 3 hospitals, all types of actual hours exceeded the expected hours.
Conclusion
Staffing needs to be determined based on patients’ care needs and to be improved to minimize nurses’ overtime work.

Keyword

Hospitals; Nurses; Nursing care needs; Nursing hours; Staffing
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