Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the
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medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses´ productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services.
Under this background, the necessity of more efficient management of nursing manpower occupying 1 /3 of total hospital workers has been recognized by many nursing administrators. Many nursing -researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals.
This study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses. Subjects were patients, patients´ family members and nursing personnels.
Results are as follows
1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class It (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class 1, 29% of class 11, 12% of classdl, and 36% of class IV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and +average patients number per day was 37.4 (total 42beds) in the medical nursing, unit, 32.9 (total 37beds) in the surgical nursing unit.
2. Direct care hours per day measured as 2.8hrs for class I , 3.3hrs for class II , and 3.5hrs for class III in the medical nursing unit, while 3. Mrs for class I , 3hrs for class H , 2.7hrs for class M, and 2.2hrs for classN in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients´ family members were llmins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit.
3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order.
4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nurs-
ing unit.
5. checking activities including doctor´s order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26,x, recording 23. 8%, commurkation and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order.
6. On the ground of these results, nursing man-power needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.
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