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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.

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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    • 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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Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals (요양병원의 간호사와 간호조무사 확보수준과 이직률이 입원환자의 건강결과에 미치는 영향)

  • Kim, Yunmi;Lee, Ji Yun;Kang, Hyuncheol
    • 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.

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.

Development of Standarized Staffing Indices in School Foodservice System (학교급식시스템 유형별 표준 조리인력 산정모델 개발)

  • 이보숙
    • 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).

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An Analysis of Staffing of Public Librarians and Staffing Standards for Public Libraries (공공도서관 사서배치현황과 법정 배치기준의 타당성 분석)

  • Kwon, Nahyun
    • 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.

Inpatient Outcomes by Nurse Staffing Grade in Korea (간호관리료차등제 등급별 입원 환자의 건강 결과)

  • Cho, Su-Jin;Lee, Han-Ju;Oh, Ju-Yeon;Kim, Jin-Hyun
    • 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.