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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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aim: To develop a competency assessment instrument for nurses who have completed an outcome‐based educational program based on national standards and to assess the content‐, construct‐, and criterion‐related validity of that instrument. Methods: In the development stage, the competencies of nurses with 1–3 years' clinical experience after the completion of nursing education and training programs, based on national standards, were identified. A systematic literature review was conducted to derive the competencies in addition to the 12 national standard competencies. In the evaluation stage, the content‐, construct‐, and criterion‐related validity of the developed tool were verified. For verification of the content validity at each stage, the participants were 10 nurse managers of general hospitals and 10 nurse professors. A factor analysis was conducted to assess the construct validity and the Cronbach's alpha coefficients and item‐total correlation were used to assess the reliability of the developed scale. For the factor analysis, the participants were 141 nurses with 1–3 years' clinical experience who were recruited from four general hospitals. In order to evaluate the construct‐ and criterion‐related validity, the correlations between a nursing performance measurement scale, a self‐leadership tool, and the developed scale were examined. Results: A competency assessment instrument, consisting of 19 items on a 4‐point scale, was developed and validated for assessing the competencies among nurses with 1–3 years' experience. Conclusions: Nursing research, policy awareness, and leadership competencies were required by the Korean Accreditation Board of Nursing Education for nursing college graduates, but were removed due to poor content validity, indicating a need for nursing professionals to bridge the gap between educational standards in nursing colleges and clinical settings. [ABSTRACT FROM AUTHOR]