The Impact of Nurse Staffing on In-Hospital Mortality of Stroke Patients in Korea

Chung, Wankyo; Sohn, Min

doi:10.1097/jcn.0000000000000415

Cited by 19 publications

(32 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In terms of type of insurance, the 30-day post-discharge mortality risk was highest in Medical Aid dependents and was lowest in workers who paid for National Health Insurance themselves. This is in accordance with previous findings that the ORs for unplanned readmission under Medicaid for some people with limited income and resources were higher than those of patients who received health coverage from health maintenance organizations in the USA [2] and that the ORs for in-hospital mortality among stroke patients with Medical Aid were higher for some people with limited income and resources in Korea [10]. Based on these findings, participants' engagement in economic activities and social characteristics can be inferred to have a significant influence on post-discharge mortality and in-hospital mortality.…”

Section: Hospital and Patient Characteristics And 30-day Postdischargsupporting

confidence: 93%

“…Studies of the associations between inpatient or postdischarge patient mortality and nurse staffing for patients with various conditions-treated medically or surgically-have been conducted in many countries, and the likelihood of patient mortality has been found to be reduced by increased nurse staffing in several settings, including general wards, emergency departments, and intensive care units (ICU) [5][6][7][8]. Furthermore, in a Korean study of patients with diseases such as stroke and cardiovascular disease, it was found that in-hospital or 30-day mortality had statistically significant associations with the nurse staffing level [9][10][11]. Although many studies have investigated these patient outcomes, less research has investigated cases where patients die in the community setting, such as at home or a nursing home without appropriate safeguards, due to a health problem that occurred after they were discharged post-surgery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association between the bed-to-nurse ratio and 30-day post-discharge mortality in patients undergoing surgery: a cross-sectional analysis using Korean administrative data

Kim

Cho

2020

BMC Nurs

View full text Add to dashboard Cite

Background: The likelihood of inpatient mortality has been found to be reduced by increased nurse staffing in several settings, including general wards, emergency departments, and intensive care units. However, less research has investigated cases where patients die in the community setting due to a health problem that occurred after they were discharged post-surgery, because it is difficult to integrate hospital data and local community data. Therefore, this study investigated the association between the bed-to-nurse ratio and 30-day post-discharge mortality in patients undergoing surgery using national administrative data. Methods: The study analyzed data from 129,923 patients who underwent surgery between January 2014 and December 2015. The bed-to-nurse ratio was categorized as level 1 (less than 2.5), level 2 (2.5-3.4), level 3 (3.5-4.4), and level 4 (4.5 or greater). The chi-square test and GEE logistic regression analyses were used to explore the association between the bed-to-nurse ratio and 30-day post-discharge mortality. Results: 1355 (0.01%) patients died within 30 days post-discharge. The 30-day post-discharge mortality rate in hospitals with a level 4 was 2.5%, representing a statistically significant difference from the rates of 0.8, 2 and 1.8% in hospitals with level 1, level 2, and level 3 staffing, respectively. In addition, the death rate was significantly lower at hospitals with a level 1 (OR = 0.62) or level 2 (OR = 0.63) bed-to-nurse ratio, using level 4 as reference. Conclusion: The results of this study are highly meaningful in that they underscore the necessity of in-hospital discharge nursing and continued post-discharge nursing care as a way to reduce post-discharge mortality risk. Furthermore, the relationship between nurse staffing levels and 30-day post-discharge mortality implies the need for a greater focus on discharge education. Policies are required to achieve proper nurse staffing levels in Korea, and thereby to enhance patient outcomes.

show abstract

Section: Hospital and Patient Characteristics And 30-day Postdischargsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Association between the bed-to-nurse ratio and 30-day post-discharge mortality in patients undergoing surgery: a cross-sectional analysis using Korean administrative data

Kim

Cho

2020

BMC Nurs

View full text Add to dashboard Cite

show abstract

“…The results showed that the staffing of nurses was related to mortality, incidence of falls, length of hospital stay, and medication errors [11]. Chung and Sohn [12] studied the relationship between the staffing of nurses and in-hospital mortality of stroke patients in 615 hospitals in South Korea. The results showed that the staffing of nurses was a barrier factor in the mortality of stroke patients [12].…”

Section: Introductionmentioning

confidence: 99%

“…Chung and Sohn [12] studied the relationship between the staffing of nurses and in-hospital mortality of stroke patients in 615 hospitals in South Korea. The results showed that the staffing of nurses was a barrier factor in the mortality of stroke patients [12]. Zhu et al [13] analysed the relationship between the staffing of nurses and patient outcomes in 181 hospitals in China.…”

Section: Introductionmentioning

confidence: 99%

Nurse staffing in large general hospitals in China: an observational study

Shen

Jian

Qiu-fen³

et al. 2020

Hum Resour Health

View full text Add to dashboard Cite

Background: The appropriate staffing of nurses not only reflects the situation of nursing management of human resource, but also is related to the nursing quality in hospitals. This study investigated the staffing of nurses in large general hospitals in China. Methods: In this study, a database established by the National Centre for Nursing Care Quality Control, which conducted a national survey of the staffing of nurses in China mainland in 2017, was analysed. The time-point survey data of 20 375 departments in 668 large general hospitals in China were obtained, including the information of nurses and patients during the day (10:00 am) and at night (10:00 pm). Then, the staffing of nurses was evaluated by calculating the nurse to patient ratio (the average number of patients assigned to a nurse, NTP ratio). The Kruskal-Wallis test was performed to compare the NTP ratios during the day and at night among different regions and departments. Results: In large general hospitals, a nurse takes care of eight patients (NTP ratio = 1:8.0) during the day and 23 patients at night (NTP ratio = 1:23) on average. There were significant differences between day and night. In terms of different regions, a nurse in the hospitals in the western region takes care of 7.8 patients during the day (NTP ratio = 1:7.8) on average, and the nursing resource in the western region is more adequate than that in the eastern (1:8.0) and central (1:8.0) regions. At night, the eastern region has a higher level of NTP (1:23.0). In terms of departments, a nurse working in the ICU takes care of two patients during the day (NTP ratio = 1:2.0) and 2.9 patients at night (NTP ratio = 1:2.9). The level of NTP in the oncology department is relatively higher: 9.3 during the day and 34.0 at night. Other departments including internal medicine, surgery, obstetrics and gynaecology, paediatrics, and geriatrics have NTP ratios of 1:7-8 during the day and 1:18-25 at night. Conclusions: In China, the nurse staffing of large general hospitals has some regional and departmental patterns. The low level of nurse staffing at night may be a problem worthy of attention; the Chinese government needs to establish standards for different periods and departments to improve efficiency and quality of nursing.

show abstract

“…Based on our data, the overall PBR in rural hospitals is 1:11.1, and the overall NBR is 1:13.6, which is significantly lower compared with most hospitals in urban areas of China and other developed countries [7][8][9]. Heavy workload directly causes fatigue, which is associated with increased medical errors [10,11].…”

Section: Discussionmentioning

confidence: 83%

Respiratory healthcare resource allocation in rural hospitals in Hunan, China: a cross-sectional study

Jiang

Yin

et al. 2019

Preprint

View full text Add to dashboard Cite

Background Rural hospitals in China provide respiratory health service for about 600 million people, but the current situation of respiratory healthcare resource allocation in rural hospitals has never been reported.Methods In the present study, we designed a survey questionnaire, and collected information from 48 rural hospitals in Hunan Province, focusing on their respiratory medicine specialty, basic facilities and equipment, clinical staffing and available medical techniques.Results The results showed that 58.3% of rural hospitals established an independent department of respiratory medicine, 50% provided specialized outpatient service, and 12.5% had an independent respiratory intensive care unit. Among these hospitals, 72.9% were equipped with pulmonary function test laboratories, 54.2% had bronchoscopy rooms, 64.6% had non-invasive ventilators, 43.8% had invasive ventilators, while less than 15% had set up sleep laboratories and atomization therapeutic rooms. The overall physician-to-bed ratio and nurse-to-bed ratio were 1:11.1 and 1:13.6, respectively. Mechanical ventilation, diagnostic bronchoscopy, therapeutic bronchoscopy, thoracoscopy, percutaneous lung biopsy, transbronchial needle aspiration and bronchial artery embolism were applicable in 66.7%, 47.9%, 6.3%, 18.8%, 20.8%, 8.3% and 8.3% of rural hospitals, respectively. Rural hospitals without an independent department of respiratory medicine showed significant disadvantages in facilities and equipment, clinical staffing and medical techniques over the other hospitals.Conclusions Respiratory healthcare system in rural areas of China are facing great challenges, including a serious shortage of basic facilities and equipment, necessary medical techniques and high-quality workforce. Besides, disparity of respiratory healthcare resources has been increasing among rural hospitals. More financial and political support from the government are needed to improve the access to and the quality of respiratory health service for rural residents.

show abstract

The Impact of Nurse Staffing on In-Hospital Mortality of Stroke Patients in Korea

Cited by 19 publications

References 24 publications

Association between the bed-to-nurse ratio and 30-day post-discharge mortality in patients undergoing surgery: a cross-sectional analysis using Korean administrative data

Association between the bed-to-nurse ratio and 30-day post-discharge mortality in patients undergoing surgery: a cross-sectional analysis using Korean administrative data

Nurse staffing in large general hospitals in China: an observational study

Respiratory healthcare resource allocation in rural hospitals in Hunan, China: a cross-sectional study

Contact Info

Product

Resources

About