A nursing care classification system for assessing workload and determining optimal nurse staffing in a teaching hospital in China: A pre-post intervention study

Authors

  • Dongmei Yu MS,

    Senior Lecturer
    1. Nursing Department, Changzheng Hospital, Second Military Medical University, Shanghai, China
    Search for more papers by this author
    • These authors contributed equally to this paper.
  • Yuqin Ma PhD,

    Associate Professor
    1. Department of Health Administration, Faculty of Health Service, Second Military Medical University, Shanghai, China
    Search for more papers by this author
    • These authors contributed equally to this paper.
  • Qingwen Sun PhD,

    Associate Professor
    1. Department of Physics and Mathematics, College of Basic Medical Sciences, Second Military Medical University, Shanghai, China
    Search for more papers by this author
  • Gendi Lu MS,

    Professor, Corresponding author
    1. Nursing Department, Changzheng Hospital, Second Military Medical University, Shanghai, China
    • Correspondence: Ping Xu, Department of Health Administration, Faculty of Health Service, Second Military Medical University, #800 Xiangying Road, Shanghai 200433, China. Email: xupingsh@126.com

      Co-correspondence: Gendi Lu, Nursing Department, Changzheng Hospital, Second Military Medical University, #415 Fengyang Road, Shanghai 200003, China. Email: lugd2006@sina.com

    Search for more papers by this author
  • Ping Xu PhD

    Professor, Corresponding author
    1. Department of Health Administration, Faculty of Health Service, Second Military Medical University, Shanghai, China
    • Correspondence: Ping Xu, Department of Health Administration, Faculty of Health Service, Second Military Medical University, #800 Xiangying Road, Shanghai 200433, China. Email: xupingsh@126.com

      Co-correspondence: Gendi Lu, Nursing Department, Changzheng Hospital, Second Military Medical University, #415 Fengyang Road, Shanghai 200003, China. Email: lugd2006@sina.com

    Search for more papers by this author

Abstract

We aimed to evaluate the effectiveness of a nursing care classification system for re-assessing nurse workload and determining staffing needs. Adequate bed–nurse ratios help manage hospital cost-efficiency, quality of care and patient safety. A prospective pre-post intervention study was conducted from January 2010 to December 2012 in 16 medical-surgical units of a tertiary teaching hospital. Nursing tasks were classified into four grades of care reflecting actual workload. Units were re-staffed accordingly and bed–nurse ratios compared with government-authorized bed–nurse ratios. Patient satisfaction, hospital stays and mortality were evaluated pre- and poststaffing changes. Average bed–nurse ratio (1:0.41) exceeded the national standard (1:0.40) in 16 units, but was inadequate in five units. Re-staffing increased average bed–nurse ratio from 1:0.41 to 1:0.48. Patients' satisfaction increased from 96.9% to 97.6%, and hospital stays decreased significantly. Nursing care classification effectively distributes nurse staffing to match patients' care levels, improving patient outcomes.

Ancillary