Abstract
BackgroundThe 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.MethodsIn 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.ResultsIn 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.ConclusionsIn 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.
Highlights
The appropriate staffing of nurses reflects the situation of nursing management of human resource, and is related to the nursing quality in hospitals
The results showed that when the nurse to patient ratio increased to 0.5~0.6, the outcomes of most patients were improved significantly [13]
Setting and samples For this cross-sectional 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
Summary
The appropriate staffing of nurses reflects the situation of nursing management of human resource, and is related to the nursing quality in hospitals. Aiken et al [10] analysed the relationship between the (2020) 18:3 staffing of nurses and patient mortality in nine European countries. The results showed that the staffing of nurses was related to mortality, incidence of falls, length of hospital stay, and medication errors [11]. 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. The rational allocation of nursing resources helps to solve the main problems of nursing at present, and provides the reference and support for the establishment of national applicable standards, so as to further guide the rationalization of staffing of nurses [14]
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