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Aim: This study aimed to calculate the total daily nursing workload and the optimal number of nurses per general unit based on the nursing intensity., Design: This study was conducted using a cross-sectional study., Methods: Three units at one general hospital were investigated. Patient classification according to nursing needs was performed for over 10 days in each unit in September 2018. The direct and non-direct nursing time and nursing intensity scores were analysed using descriptive statistics., Results: For the internal medicine unit, the average direct nursing time per patient was 1.0, 1.5, 2.2 and 2.9 h for Groups 1, 2, 3 and 4, respectively. For the surgical unit, the average direct nursing time per patient was 0.9, 1.4, 2.1 and 2.6 h for Groups 1, 2, 3 and 4, respectively. 5 and 9 additional nurses were needed in the internal medicine and surgical nursing units., Patient Contribution: This study confirmed that the optimal number of nurses was not achieved and that the nursing intensity was very high. Long-term efforts, such as improving the nursing environment, should be made to ensure an optimal number of nurses in various nursing units., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aim: This study aimed to review the literature on patient classification tools (PCTs) for assessing nursing strength and to compare South Korean and international tools., Design: Integrative literature review., Methods: We searched the relevant literature published from 2000-2017 in PubMed and two electronic databases in Korea in March 2017. Twenty-five published studies were reviewed., Results: In most Korean studies, patients were classified by PCT, which were tested to ensure validity and reliability, followed by measurement of nursing time and development of the conversion index. In international studies, PCTs used were simpler than those in Korean studies; the results of estimation for optimum nurse staffing were reported. Most studies insufficiently reflected indirect nursing needs and patients' non-clinical factors. The current PCTs used in Korean studies inadequately reflect the reality of nursing field. Therefore, development of new PCTs reflecting nursing intensity based on direct and indirect nursing activities is necessary., (© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aim: To develop a new general wards patient classification tool based on the nursing intensity level that reflects patients' clinical characteristics and indirect nursing activities., Design: A cross-sectional design was adopted. This methodological study developed a patient classification system to sort general ward patients based on the intensity of their nursing needs and verified the validity and reliability of this classification system., Methods: Thirteen experts verified the tools' content validity. Data collectors and head nurses classified 150 patients from two hospitals with four general wards and various nurse staffing levels. Inter-rater reliability was analysed. Staff nurses classified 846 patients following the Korean patient classification system on nursing intensity scores that reflected patients' clinical status. Content validity was verified based on the classification results. Using K-group cluster analysis, score ranges for four groups were identified., Results: The developed tool includes 8 domains, (symptom management, infection control, nutrition and medication, personal hygiene and secretion, activity, sleep and rest, guidance in nursing/emotional support, nursing activity planning and coordination, indirect activity), 24 subdomains, 66 nursing activities and 124 criteria. Inter-rater reliability showed high agreement., (© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aim: To assess the relationship among perceived nursing group power, organizational trust and patient orientation and identify patient orientation predictors., Background: Nurses and nursing organizations should use all resources to give care., Methods: Survey data were collected from 193 nurses at six acute care hospitals in South Korea. Characteristics of hospitals and nurses were analysed using t tests, one-way ANOVAs and regression models., Results: The means for perceived nursing group power, organizational trust and patient orientation were 3.71 ( SD ± 0.58), 3.22 ( SD ± 0.83) and 3.94 ( SD ± 0.53), respectively. Multiple regression analysis revealed that 40% of the variance in patient orientation was explained by perceived nursing group power, organizational trust and work experience., Conclusion: Hospitals should increase nursing group power and improve organizational trust to enhance patient orientation. Hospital executives and nurse managers should work to enhance nursing group power and positive perceptions of organizational trust, which could contribute to patient orientation., Competing Interests: No conflict of interest has been declared by the authors., (© 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd.)