Kim Yunmi, You Sunju, Kim Jinhyun
College of Nursing, Eulji University, Seongnam, Korea.
Department of Nursing, Mokpo National University, Mokpo, Korea.
J Korean Acad Nurs. 2017 Dec;47(6):828-841. doi: 10.4040/jkan.2017.47.6.828.
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.
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.
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).
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.
本研究旨在分析2009年至2014年期间增加新获得执照护士的供应对提高医院护士人员配备等级的影响。
利用公共行政数据,我们使用广义估计方程(GEE)有序逻辑回归分析了1594家医院中新获得执照护士对人员配备的影响,并使用GEE逻辑回归分析了1042家医院中供应变化对提高人员配备等级的影响。
普通病房每100张床位新增一名新获得执照护士,提高人员配备等级(6至0级与7级相比)的几率显著降低(优势比=0.95,p=0.005)。2009年至2014年,新获得执照护士的供应量增加了32%,人员配备等级提高、不变和恶化的医院比例分别为19.1%、70.1%和10.8%。与2009年相比,2014年新获得执照护士的供应变化与该地区提高人员配备等级的几率增加没有显著关系(OR=1.02,p=0.870)。
为实现医院护士区域供需平衡,需要遵守护士人员配备立法并修订护理费用差异化政策。未来需要制定新毕业护士的留用政策,而不是依赖增加护士供应来建立和维持有能力的护士队伍。