Journal of Korean Clinical Nursing Research (임상간호연구)

Hospital Nurses Association (병원간호사회)
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Nursing Hours and Nurse Staffing according to Korean Triage Acuity Scale and Patient Dependency

한국형 응급환자 분류도구 및 환자의존도에 따른 환자군별 간호시간과 간호사 배치수준

  • Jung, Eun Hee (Department of Nursing, Seoul National University Hospital) ;
  • Cho, Sung-Hyun (College of Nursing.Research Institute of Nursing Science, Seoul National University) ;
  • Lee, Sang Lim (Department of Nursing, Seoul National University Hospital) ;
  • Choi, Min Jin (Department of Nursing, Seoul National University Hospital) ;
  • Kim, Sung Sook (Department of Nursing, Asan Medical Center) ;
  • Choi, Eun Kyung (Department of Nursing, Asan Medical Center) ;
  • Han, Kyeong Hwa (Department of Nursing, Ajou University Hospital) ;
  • Jeon, Mi Young (Department of Nursing, Ajou University Hospital)
  • Received : 2020.09.29
  • Accepted : 2020.10.23
  • Published : 2020.12.31
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Abstract

Purpose: The purpose of this study was to analyze nurse staffing according to patients' acuity and dependency by measuring nursing hours. Methods: The study sample included patients who visited the adult emergency departments (EDs) of three tertiary referral hospitals and nurses who worked on shifts for 48 hours from October 24 to 26, 2019. Hourly patient census and nurse staffing were analyzed. Patient acuity was measured using the Korean Triage and Acuity Scale (KTAS), ranging from Level 1 (highest) to Level 5 (lowest). Patient dependency was measured using six items (e.g., clinical attention and communication) and classified into four groups. Nursing activities were observed every 10 minutes and nursing hours per patient and nurse staffing were analyzed according to acuity and dependency. Results: Nurse-to-patient ratio ranged from 1:1.8 to 1:4.2 during the 48 hours of observation. The average work hours of nurses, excluding breaks and meals, was 8.57 hours; 42.5% of which was spent providing direct care. Higher acuity and dependency were associated with higher nursing hours and staffing level. Patients with KTAS Level 1 were provided 74.3 minutes per hour, 5.02 times higher than Level 5 (14.8 minutes). Patients in the highest dependency group were provided 87.4 minutes per hour, 5.75 times higher than the lowest group (15.2 minutes). Newly arrived patients received more nursing hours than continuously stayed patients within the same KTAS Levels. Conclusion: Large variations were found in hourly patient census, acuity, and dependency. Nurse staffing in EDs should be determined based on patient acuity and dependency.

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References

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