Integrative literature review of patient classification tools for nursing intensity evaluation: Focusing on comparison of South Korean and international tools

Abstract

Many studies have already shown that ensuring proper nurse staffing positively influences the quality of nursing services and patient safety. Countries such as the US, Australia, and Japan have mandated the minimum required level of nursing staffing by law. In South Korea (hereafter Korea), a graded fee system for nursing care-in which different fees are applied depending on the number of patients per nurse-is being implemented. In an attempt to encourage hospitals to employ more nurses, the higher the grade, the higher the fee that is charged for inpatients. For tertiary hospitals, if one nurse takes care of four or more patients, the criteria for the lowest grade-grade six-is satisfied. For the highest grade, grade one, one nurse takes care of less than two patients (Ministry of Health & Welfare, 2017). However, this does not address the number of patients being taken care of by nurses working together in a shift. If the criteria were to be converted to the number of patients per shift, one nurse takes care of approximately 15 patients in grade six, and seven to eight patients in grade one. Given that the criteria for assessing nursing services, such as Korea's grading system, address only the

Measuring patient acuity and nursing care needs in South Korea: application of a new patient classification system

“…The classification of caring needs and intensity of inpatient nursing is a challenging task for nursing managers and healthcare organizations [ 19 ]. The existing prototype PCS in South Korea might not be optimal for efficiently measuring the direct nursing care activities provided to inpatients with moderate-to-severe conditions.…”

“…In other words, there are growing calls to reflect changes in patients’ psychosocial status, medical status, and treatment transition, and a nursing intensity that varies according to the needs of nursing education, nursing intervention, and psychosocial needs in addition to medical diagnosis should also be developed [ 36 , 40 ]. Ko and Park (2020) suggested that the optimal nursing workforce level placement is to use both (1) patient classification, which classifies patients according to their nursing needs and focuses on direct nursing work, and (2) nursing intensity, a concept of nursing workload that reflects the nurse's proficiency [ 19 ].…”

Comparação do nível de dependência de Enfermagem e dimensionamento entre unidades de internação clínica e cirúrgica

“…1,3,7 Internacionalmente, a mensuração da carga de trabalho de Enfermagem em unidades de internação médico-cirúrgicas se baseia em ferramentas de classificação de pacientes, além da relação paciente/profissional e julgamento de experts. [8][9][10] Isso não é tão diferente no Brasil, 1,3,7 porém, sabe-se que, ao contrário de países mais desenvolvidos, o panorama de provimento de pessoal na Enfermagem brasileira, além de potencialmente problemático, é também muito difuso, reconhecendo a inegável característica continental e amplamente desigual do país.…”

Comparison of Nursing dependency levels and sizing between clinical and surgical inpatient units

“…1,3,7 Internationally, the measurement of nursing workload in medical-surgical inpatient units is based on patient classification tools, in addition to the patient/professional relationship and expert judgment. [8][9][10] This is not so different in Brazil, 1,3,7 but it is known that, unlike more developed countries, the panorama of staffing in Brazilian nursing, in addition to being potentially problematic, is also very diffuse, recognizing the undeniable continental and widely unequal characteristic of the country. In addition to discussing the situation of nursing human capital provision in contrast to the international scenario, it is important to learn more about the level of patient dependency and the relationship between nursing staff sizing and the actual availability of workers in different units of the same institution, as this can lead to improvements in the quality of care by enhancing the assertiveness of any staff reallocation processes.…”