Abstract

• This study investigated a process to estimate the need for nursing staff on the basis of a patient classification system and the required care needs and activities. The investigation was carried out in the following four steps. Step 1. Patients were classified according to the amount of nursing care need on each shift as class I(mildly ill), class II (moderately ill), class III (acutely ill), and class IV (critically ill). Step 2. Measurement of the direct nursing care hours needed for each patient class, and measurement of indirect nursing care hours and personal time of the nursing staff. Step 3. Calculation of the total nursing workload in a nursing nuit. Step 4. Estimation of the nursing staff needed. The investigation was carried out from July 17th to 30th, during 24hours over other day. The subjects were the patients and the nursing staff on two units of Seoul National University Hospital, Korea. Some of the results from the investigation are as follows : 1) Distribution of patient classification On the neuro surgical(N.S.), the distribution was class I, 22 patients, class II, 27 patients, class III, 26 patients, and class IV, 25 patients, For the orthopedic surgical unit (O.S.), it was class I, 43 patients, class II, 43 patients, class III, patients, and class IV, 3 patients. 2) Direct nursing care hours per day On the N.S. unit, 3.2 hours of direct nursing care were needed for class I, 3.9 hours for class II, 5.1 hours of class III, and 6.2 hours for class IV patients, while 2.0 hours for class I, 2.5 hours for class II, 3.5 hours for class III, 5.0 hours class IV patients were needed on the O.S. units. 3) Analysis of direct nursing care activities Activities were classified into assessment and observation(47%), medication(38.7%), communication(5.1%), exercise(2.4%), elimination and irrigation(1.3%), treatment(1.1%), hygiene(0.8%), nutrition(0.8%), and hot and cold compress(0.1%). 4) Average hours of indirect nursing care per day. On the N.S. unit 4.2 hours, and on the O.S. unit, 3.5 hours of RN indirect care was needed. 5) The average personal time used by the of nursing staff was 17 minutes for both RNs and nursing assistants in the N.S. unit, and 32 minutes for both RNs and nursing assistants in the O.S. unit. 6) Estimation of nursing staff needed on two specialized units of a university hospital For the N.S. nursing unit of 43 beds, 31 nursing staff would be indicated. For the O.S. nursing unit of the same number of beds, 19 nursing staff would be indicted.

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