Seong Jiyeong, Cho Sung-Hyun, Yoon Hyo-Jeong, Sim Won-Hee, Kim Moon-Sook
College of Nursing, Seoul National University, Seoul, Korea.
College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
Nurs Open. 2024 Dec;11(12):e70109. doi: 10.1002/nop2.70109.
To compare nurse work hours and nursing activities between high-staffed and low-staffed general wards to examine the effects of increased staffing on nurse workload and nursing care.
A secondary analysis was conducted using cross-sectional data collected at a tertiary teaching hospital in South Korea in January 2020.
Nursing activities provided by 350 nurses were observed every 10 min during their shifts for three observation days in four high- and four low-staffed wards. Nurse-to-patient ratios, nurse work hours, nursing activities and the composition of nursing hours (direct care, indirect care and associated work) were analysed.
After excluding non-productive personal time, nurses in the low-staffed wards worked 9.28 h, which indicates 1.28 h of overtime work on average, while the high-staffed wards recorded 7.90 h of productive work time. The nurse-to-patient ratio in the high-staffed wards was 1:4.73, whereas that in the low-staffed wards was 1:8.87. The proportion of direct care hours out of nurse work hours was higher in the low-staffed wards (30.9%) than in the high-staffed wards (25.7%). Nurses in the low-staffed wards provided a greater number of direct care hours, and the largest difference in direct care hours between the two groups was found on night shifts. Nurses in the high-staffed wards spent more time communicating with patients and charting, whereas nurses in the low-staffed wards spent more time on vital signs and medications.
Improved staffing had positive impacts on patients and nurses. Patients benefited from better staffing through increased communication with nurses. Better staffing also reduced overtime work and activities conducted during night shifts.
Adequate staffing is essential to improve patient care quality and reduce nurse workload. Nursing activities must be prioritised and redesigned to maximise the benefits of increased staffing on patient and nurse outcomes.
We have adhered to the STROBE reporting guidelines.
The aim of this study was to compare nurse work hours and nursing activities between high-staffed and low-staffed wards.
比较人员配备充足和不足的普通病房护士的工作时长及护理活动，以研究增加人员配备对护士工作量和护理工作的影响。
采用2020年1月在韩国一家三级教学医院收集的横断面数据进行二次分析。
在四个人员配备充足和四个人员配备不足的病房，对350名护士在其轮班期间每10分钟的护理活动进行了为期三天的观察。分析了护患比、护士工作时长、护理活动以及护理时长的构成（直接护理、间接护理和相关工作）。
排除无效率的个人时间后，人员配备不足病房的护士工作时长为9.28小时，这表明平均有1.28小时的加班时间，而人员配备充足病房的有效工作时长为7.90小时。人员配备充足病房的护患比为1:4.73，而人员配备不足病房的护患比为1:8.87。人员配备不足病房的直接护理时长占护士工作时长的比例（30.9%）高于人员配备充足病房（25.7%）。人员配备不足病房的护士提供的直接护理时长更多，两组之间直接护理时长的最大差异出现在夜班。人员配备充足病房的护士花更多时间与患者沟通和记录，而人员配备不足病房的护士花更多时间在生命体征监测和给药上。
改善人员配备对患者和护士有积极影响。患者通过增加与护士的沟通从更好的人员配备中受益。更好的人员配备还减少了加班工作以及夜班期间进行的活动。
充足的人员配备对于提高患者护理质量和减轻护士工作量至关重要。必须对护理活动进行优先排序和重新设计，以最大限度地提高增加人员配备对患者和护士结局的益处。
我们遵循了STROBE报告指南。
本研究的目的是比较人员配备充足和不足病房的护士工作时长及护理活动。
