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

Abstract

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.

Access to Maternal Health Services During the COVID-19 Pandemic: Experiences of Indigent Mothers and Health Care Providers in Kilifi County, Kenya

“…According to the health workers in this study, integration of traditional midwives during pandemics such as COVID-19 and other crises is necessary. This recommendation from the health workers concurs with findings from a recent study in Kenya by Kimani et al (2020) , who argued that integrating community health workers by expanding existing midwifery centers and creating new ones run by qualified midwives (“skilled birth attendants”) that are closer to or in rural communities could be a viable long-term plan that can reduce the burden on hospitals, and minimize infections and maternal deaths during pandemics such as COVID-19.…”

“…This concurs with recent findings from other studies that also report an increase in maternal deaths globally due to COVID-19 ( Hussein, 2020 ; Takemoto et al, 2020 ). Supporting my own findings, Kimani et al (2020) also noted for Nairobi, Kenya that fear of contracting COVID-19 likely kept many women from attending reproductive health services. Relatedly, Delamou et al (2017) showed that fear of infection at health facilities was also reported by women in Guinea during the recent Ebola epidemic there (see also Strong and Schwartz 2016 ).…”

Employment anxiety and its relationship with student nurse interns’ social support and job-seeking efficacy : a path analysis

“…Both existing nurses and nal year nursing students who will soon be on the job market are important human resources for health in the long term. There has been a greater demand from health institutions for nurses, especially for nurses with higher educational levels [33],Judging from the growth rate of nurses in the past 10 years, the importance of nurse supplement has attracted the attention of the national government in China [34].…”

A cross‐sectional observational study of missed nursing care in hospitals in China

“…A survey of 300 hospital nurses across nine European countries revealed that MNC and understaffing significantly increased the 30‐day mortality rate and post‐surgical admissions (Ball et al., 2018). In China, nurse staffing is improving, but the shortage of nurses remains the primary concern (Shen et al., 2020). Indeed, inadequate staffing was the most commonly cited significant contributor to MNC (Griffiths et al., 2018).…”