The development of nursing workforce allocation standards for acute care general wards in Taiwan.
BACKGROUND
Adequate nursing workforce is critical to ensure patient safety and reduce the incidence of adverse events.


OBJECTIVE
This study explores and compares the nursing workforce allocation situation in the acute care general wards of Taiwan's three hospital tiers and, based on findings, develops standards for adequate nursing workforce allocation and nurse-to-patient ratios in acute care general wards at each tier.


METHODS
This study uses multiple research methods, including literature review, questionnaire survey, and expert focus group discussion. Final consensus is achieved using a public hearing and questionnaire survey.


RESULTS
The severity of patient conditions differs among hospital tiers. Therefore, each tier requires a nursing workforce allocation standard appropriate to its situation. Study findings indicate that nurse-to-bed ratios and nursing hours are valid indicators of nursing workforce allocation needs. The results of expert discussions and public hearings recommend 0.53 nurses per bed and 2.8 nursing hours for academic medical centers, 0.49 nurses per bed and 2.6 nursing hours for metropolitan hospitals, and 0.40 nurses per bed and 2.1 nursing hours for local community hospitals for the current stage of healthcare development; 0.57 nurses per bed and 3.0 nursing hours for academic medical centers, 0.53 nurses per bed and 2.8 nursing hours for metropolitan hospitals, and 0.44 nurses per bed and 2.3 nursing hours for local community hospitals in 3 years; and 0.61 nurses per bed and 3.2 nursing hours for academic medical centers, 0.57 nurses per bed and 3.0 nursing hours for metropolitan hospitals, and 0.48 nurses per bed and 2.5 nursing hours for local community hospitals in 5 years.


CONCLUSIONS
Study results may provide a basis for better allocating nursing workforce in hospitals, setting formal standards for minimum nurse-to-patient ratios, and assessing nursing workforce needs at the national level.
1PhD, RN, Associate Professor, School of Nursing, National Taipei University of Nursing and Health Sciences 2PhD, RN, Supervisor, International Cancer Center, Taipei Medical University Hospital 3MSN, RN, Endowed Professor, College of Nursing, Taipei Medical University, and President of National Union of Nurses' Associations.
Chiou-Fen
CF
Lin
Hsiu-Ying
HY
Huang
Meei-Shiow
MS
Lu
D064648:Critical Care Nursing / Q000458:organization & administration*; D017144:Focus Groups; D019538:Health Care Surveys; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D015401:Nursing Administration Research; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000600:supply & distribution*; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D013624:Taiwan; D016526:Workload