KSNS
E-SUBMISSION
Search
- Page Path
- HOME > Search
Review Article
- Nurse Staffing and Health Outcomes of Psychiatric Inpatients: A Secondary Analysis of National Health Insurance Claims Data
- Park, Suin , Park, Sohee , Lee, Young Joo , Park, Choon-Seon , Jung, Young-Chul , Kim, Sunah
- J Korean Acad Nurs 2020;50(3):333-348. Published online June 30, 2020
- DOI: https://doi.org/10.4040/jkan.19203
-
Abstract
PDF - Purpose
The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Koreaby assessing National Health Insurance claims data.
Methods
The dataset included 70,136 patients aged 19 years who were inpatientsin 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: registerednurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomesincluded 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 systemcharacteristics using multilevel modeling.
Results
Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatientsper 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 hypnoticsuse but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injectedpsycholeptics for chemical restraint.
Conclusion
Lower nurse staffing levels are associated with negative health outcomes of psychiatricinpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatricinpatients in Korea. -
Citations
Citations to this article as recorded by
- The Association Between Nurse Staffing and Conflict and Containment in Acute Mental Health Care: A Systematic Review
Samuel Woodnutt, Simon Hall, Paula Libberton, Jane Ball, Chiara Dall'Ora, Peter Griffiths
International Journal of Mental Health Nursing.2025;[Epub] CrossRef - Comprehensive Symptom Prediction in Inpatients With Acute Psychiatric Disorders Using Wearable-Based Deep Learning Models: Development and Validation Study
Minseok Hong, Ri-Ra Kang, Jeong Hun Yang, Sang Jin Rhee, Hyunju Lee, Yong-gyom Kim, KangYoon Lee, HongGi Kim, Yu Sang Lee, Tak Youn, Se Hyun Kim, Yong Min Ahn
Journal of Medical Internet Research.2024; 26: e65994. CrossRef - Changing the focus of adverse incident reporting in mental health nursing
Samuel Woodnutt
Mental Health Practice.2024; 27(2): 20. CrossRef - Factors associated with readmissions in psychiatric inpatient care: a prospective cohort study based on hospital registers
Marianna Virtanen, Laura Peutere, Mikko Härmä, Annina Ropponen
BMC Psychiatry.2024;[Epub] CrossRef - Workload and psychosocial risks among nurses in mental health and psychiatry in Chile
Daniela Fuentes‐Olavarría, Matías E. Rodríguez‐Rivas, Javiera Romo‐Neira
International Journal of Mental Health Nursing.2024; 33(4): 869. CrossRef - NEAT: Nurse Effort Assessment Tool—Human Factors Considerations in Designing for Appropriate Staffing
Scott Good, Michael W. Boyce, Leigh V. Evans, Mark Sevilla
Proceedings of the Human Factors and Ergonomics Society Annual Meeting.2024; 68(1): 1680. CrossRef - Developing nurse‐sensitive outcomes in acute inpatient mental health settings—A systematic review
Irene Ngune, Helen Myers, Amanda Cole, Peter Palamara, Robina Redknap, Michael Roche, Diane Twigg
Journal of Clinical Nursing.2023; 32(17-18): 6254. CrossRef - An Exploratory Study on Current Nursing Issues in the COVID-19 era through Newspaper Articles: The Application of Text Network Analysis
Young Joo Lee
Journal of Korean Academy of Nursing Administration.2022; 28(3): 307. CrossRef - Time to readmission in psychiatric inpatients with a therapeutic leave
Tiziana Ziltener, Julian Möller, Lukas Imfeld, Roselind Lieb, Undine E. Lang, Christian G. Huber
Journal of Psychiatric Research.2021; 144: 102. CrossRef - Physical Comorbidity According to Diagnoses and Sex among Psychiatric Inpatients in South Korea
Suin Park, Go-Un Kim, Hyunlye Kim
International Journal of Environmental Research and Public Health.2021; 18(8): 4187. CrossRef
- The Association Between Nurse Staffing and Conflict and Containment in Acute Mental Health Care: A Systematic Review
- 877 View
- 40 Download
- 7 Web of Science
- 10 Crossref
Original Articles
- The Development of a Client Health Status Outcome Evaluation Instrument in Home Care
- Hyun Tae Park
- Journal of Korean Academy of Nursing 2004;34(3):552-564. Published online March 28, 2017
- DOI: https://doi.org/10.4040/jkan.2004.34.3.552
-
Abstract
PDF
Purpose This study was to develop a client health status outcome evaluation instrument, and examine content validity, reliability, construct validity, and the acceptability of this instrument.
Method A preliminary list was made of such key information as standards, criteria, indicators and measures, by means of a broad review of literature within the field. After determining the preliminary instruments, the study sought to obtain examination, consensus, and modification of two groups of experts in the home-care field. Finally, the instrument examined content validity, reliability, construct validity, and the acceptability of this instrument.
Result The tool was considered of 13 criteria, 48 indicators, and 167 detail measures. The content validity index of the tool was above 0.8 according to the expert group. Regarding the reliability of the evaluators of standards 1 and 2, the degree of agreement between evaluators was high(96.4% through 98.2%). Construct validity in this study, the difference in the mean score between the baseline point and the follow up point of each of standards 1 and 2 was significant, and the mean score of the follow up point was more than that of the baseline point. After examining the acceptability of this instrument with practice managers and home care nurses in home care institutions, a positive opinion was given of this instrument, and it was indicated that to be useful and applicable in home care practice.
Conclusion The results of evaluating client outcome will contribute to overall outcome-based quality improvement and service marketing in home care by providing a constant gauge of home care effectiveness.
-
Citations
Citations to this article as recorded by- Identifying core nursing sensitive outcomes associated with the most frequently used North American Nursing Diagnosis Association—International nursing diagnoses for patients with cerebrovascular disease in Korea
Eunjoo Lee, Hyejin Park, James Whyte, Youngae Kim, Sang Youn Park
International Journal of Nursing Practice.2014; 20(6): 636. CrossRef
- Identifying core nursing sensitive outcomes associated with the most frequently used North American Nursing Diagnosis Association—International nursing diagnoses for patients with cerebrovascular disease in Korea
- 143 View
- 2 Download
- 1 Crossref
- Analysis of Direct Nursing Activity and Patient Outcomes Related to Graded Fee of Nursing Management for Inpatient
- Seong Hi Park
- Journal of Korean Academy of Nursing 2003;33(1):122-129. Published online March 28, 2017
- DOI: https://doi.org/10.4040/jkan.2003.33.1.122
-
Abstract
Purpose The purpose of this study is to examine the difference of direct nursing activity and patient outcomes as mortality rate, complication rate, readmission rate and length of stay related to graded fee of nursing management for inpatient.
Method The subjects of this study were 44 general hospitals with more than 500 beds. Data totaled to 86,044 claims provided to inpatients in Jan. 2001 requested by an electronic data interchange from a Health Insurance Review Agency. The data was analyzed by SPSS win(ver.10.0) and statistical methods used were frequency, one-way ANOVA, χ2-Test and regression.
Result Synthetic judgment through performance index and 95% confidence interval, direct nursing activity showed to provided adequate quality of nursing care on 2nd, 3rd, 4th and 6th nursing degree. Also, patient outcomes showed difference by graded fee of nursing management for inpatient. Mortality rate of 2nd was the lowest with P.I. 67.9, 3rd, 5th, 6th, 4th in order. In case of complication rate, 2nd, 3rd and 4th were lower than other nursing degree. Readmission rate of 4th and 5th was the lowest. Length of stay of 2nd was the shortest with P.I. 88.3, 3rd, 4th, 5th, 4th, 6th in order.
Conclusion The findings from this study showed that, the higher nurse-to-patient ratio, the greater amount of direct nursing care activity for the patient. Also, the more direct nursing activities influenced a lower mortality rate, complication rate and readmission rate, shorter length of stay.
-
Citations
Citations to this article as recorded by- Differences in Medical Use and Patient Outcomes between Patients Admitted to the Integrated Nursing Care Ward and the General Ward
Jeong Eun Mun, Bohyun Park
Journal of Korean Academy of Nursing Administration.2024; 30(5): 439. CrossRef - Impact on health outcomes of hemodialysis patients based on the experience level of registered nurses in the hemodialysis department: a cross-sectional analysis
EunYoung Jeong
Frontiers in Health Services.2023;[Epub] CrossRef - Relationship between nurse staffing level and adult nursing-sensitive outcomes in tertiary hospitals of Korea: Retrospective observational study
Chul-Gyu Kim, Kyun-Seop Bae
International Journal of Nursing Studies.2018; 80: 155. CrossRef - Differences of Upgrading Nurse Staffing in Nursing Care Activity, Work Performance Outcomes, and Job Satisfaction
Ju Yeun Kim, Young Whee Lee, Mi Kyoung Chung
Korean Journal of Adult Nursing.2016; 28(3): 256. CrossRef - Nursing outcomes of inpatient on level of nursing staffing in long term care hospitals
Eun Hee Kim, Eunjoo Lee
Journal of the Korean Data and Information Science Society.2015; 26(3): 715. CrossRef - Study on Factors Associated with the Rise in Grade of Nursing Management Fee among Korean Hospitals
Hyun-Min Choi, Nam-Kyung Han, Sang-Kyu Lee, Han-Sung Kim, Sungkyoung Choi, Woojin Chung
Health Policy and Management.2015; 25(1): 40. CrossRef - Determinants of Registered Nurse Skill Mix & Staffing Level in Korea
Su-Jin Cho, Jinhyun Kim
Journal of Korean Academy of Nursing Administration.2014; 20(1): 10. CrossRef - Analysis on Satisfaction of Nursing Services for Elderly hospitalized in Attended Ward and General Ward
Mee-Suk Wang, In Deok Lee, M.S. Kang, Eun-Kwang Cha, Dae-Ho Choi, Hyeon-Cheol Jeong
Journal of the Korea Academia-Industrial cooperation Society.2014; 15(5): 3014. CrossRef - Activity-Based Costing Analysis of Nursing Activities in General Hospital Wards
Ho-Soon Yoon, Jinhyun Kim
Journal of Korean Academy of Nursing Administration.2013; 19(4): 449. CrossRef - A Proposal to Improve Nursing Fee Differentiation Policy for General Hospitals Using Profitability-Analysis in the National Health Insurance
Sungjae Kim, Jinhyun Kim
Journal of Korean Academy of Nursing.2012; 42(3): 351. CrossRef - Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients
Yunmi Kim, Sung-Hyun Cho, Kyung Ja June, Soon Ae Shin, Jiyun Kim
Journal of Korean Academy of Nursing.2012; 42(5): 719. CrossRef - Maternal and Hospital Factors Impacting the Utilization of Rooming-in Care in South Korea: Secondary Analysis of National Health Data
Yunmi Kim, Eun-Young Kim
Journal of Korean Academy of Nursing.2011; 41(5): 593. CrossRef - Inpatient Outcomes by Nurse Staffing Grade in Korea
Su-Jin Cho, Han-Ju Lee, Ju-Yeon Oh, Jin-Hyun Kim
Korean Journal of Health Policy and Administration.2011; 21(2): 195. CrossRef - The Effects of Medical Staffing Level on Length of Stay
Hanju Lee, Yu Kyung Ko, Mi-Won Kim
Journal of Korean Academy of Nursing Administration.2011; 17(3): 327. CrossRef - Comparison of Nursing Records of Open Heart Surgery Patients before and after Implementation of Electronic Nursing Record
Insil Lee, Hyeoun-Ae Park
Journal of Korean Society of Medical Informatics.2009; 15(1): 83. CrossRef
- Differences in Medical Use and Patient Outcomes between Patients Admitted to the Integrated Nursing Care Ward and the General Ward
- 187 View
- 0 Download
- 15 Crossref
- Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals
- Yunmi Kim, Ji Yun Lee, Hyuncheol Kang
- J Korean Acad Nurs 2014;44(1):21-30. Published online February 28, 2014
- DOI: https://doi.org/10.4040/jkan.2014.44.1.21
-
Abstract
PDF
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.
-
Citations
Citations to this article as recorded by- The Experience of turnover to long-term care hospital nurse: A phenomenological qualitative research
Inhee Choo, Milim Cho, Eunha Kim
Journal of Korean Gerontological Nursing.2024; 26(4): 392. CrossRef - Physical Therapy Provider Continuity Predicts Functional Improvements in Inpatient Rehabilitation
Mitchell D. Adam, Debra K. Ness, John H. Hollman
Journal of Neurologic Physical Therapy.2023; 47(2): 91. CrossRef - The effect of the reformed nurse staffing policy on employment of nurses in Korea
Jinhyun Kim, Sungjae Kim, Eunhee Lee, Hyunjeong Kwon, Jayon Lee, Hyunji Bae
Nursing Open.2021; 8(5): 2850. CrossRef - Nurses’ Clinical Work Experience during Pregnancy
Hyunjung Lee, Hyoung Eun Chang, Jiyeon Ha
Healthcare.2020; 9(1): 16. CrossRef - Exploring Nurses' Perceptions of Nursing Home Care in South Korea: A Qualitative Study
Eunhee Cho, Hyejin Kim, Soo Jung Chang, Hyang Kim, Jeongah Kim
Journal of Korean Gerontological Nursing.2020; 22(2): 85. CrossRef - The Effects of Long-term Care Hospitals' Nurse Staffing Level on Patient Outcomes: Differences according to Region
Kyung Jin Hong
Journal of Korean Academy of Nursing Administration.2020; 26(4): 354. CrossRef - A Comparative Study on the Job Stress, Burnout and Nursing Performance of Nurses in Comprehensive Nursing Care Service Wards and Nurses in General Wards
Youn Sil Kim, Jung Ae Park, Eun Koung Seo
Stress.2019; 27(1): 46. CrossRef - Experiences of Long-term Care Hospital Nurses Caring for Elders with Dementia
Eun Kyoung Suh, Hye Ryoung Kim
Journal of Korean Gerontological Nursing.2019; 21(2): 99. CrossRef - Longitudinal associations of nursing staff turnover with patient outcomes in long-term care hospitals in Korea
Yoonseo Kim, Kihye Han
Journal of Nursing Management.2018; 26(5): 518. CrossRef - Influence of Nurses' Work Environment, Organizational Commitment, and Nursing Professionalism on Turnover Intention of Nurses in Long Term Care Hospitals
Hyun Suk Joo, Won Hee Jun
Journal of Korean Academy of Nursing Administration.2018; 24(4): 265. CrossRef - Importance, Performance and Rates of Nurse Performance of Nursing Interventions in Long-term Care Hospitals
Sunmi Kim, Seok Hee Jeong, Myung Ha Lee, Hyun Kyung Kim
Journal of Korean Academy of Nursing Administration.2017; 23(4): 359. CrossRef - Comparative Analysis Research of Inpatient Satisfaction with Nursing on Comprehensive Nursing Service Units & General Units and Nurses' Work Stress
Su Mi Jung, Sook Hee Yoon
Journal of Korean Academy of Nursing Administration.2017; 23(3): 229. CrossRef - Delegation of Nursing Activities in Long-term Care Hospitals
Eun Ju Jang, Su Hyun Kim
Journal of Korean Gerontological Nursing.2017; 19(2): 101. CrossRef - Effects of Empathy and Attitude in Caring for Elders by Nurses in Geriatric Nursing Practice in Long-term Care Hospitals
Young Kyoung Kim, Suhye Kwon
Journal of Korean Gerontological Nursing.2017; 19(3): 203. CrossRef - Predictors of Turnover among New Nurses using Multilevel Survival Analysis
Suhee Kim, Kyongeun Lee
Journal of Korean Academy of Nursing.2016; 46(5): 733. CrossRef - Factors Influencing Nurse Turnover Intention of Senior Convalescence Hospitals in the Metropolitan Area
Youn Sun Hwang, Eunyoung Cho
Korean Journal of Occupational Health Nursing.2016; 25(3): 156. CrossRef - Nursing outcomes of inpatient on level of nursing staffing in long term care hospitals
Eun Hee Kim, Eunjoo Lee
Journal of the Korean Data and Information Science Society.2015; 26(3): 715. CrossRef - The Effects of Emotional Labor and Job Involvement on Turnover Intention of Nurses in Long-term Care Hospitals
Su-Jeong Kang, Suhye Kwon
Korean Journal of Occupational Health Nursing.2015; 24(4): 290. CrossRef
- The Experience of turnover to long-term care hospital nurse: A phenomenological qualitative research
- 237 View
- 3 Download
- 18 Crossref
First
Prev
