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. Purpose: 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 perbed 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 perbed 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.