Status of nurse staffing and nursing care delivery in Pudong, Shanghai

Abstract

Aim: To evaluate nurse staffing levels and nursing care delivery in adult general medical or surgical wards of hospitals in the Pudong district of Shanghai, China.

Background: Rapid economic development and improved Chinese living standards have spurred increased demands for high-quality health care. Thus, the quality of nursing services has become a focus of attention.

Design: A cross-sectional, descriptive design was used for the study.

Methods: We used an anonymous survey to collect data from 1614 nurses from 98 wards in seven general hospitals in Pudong, Shanghai.

Results: During day shifts, the nurse-to-patient ratios were >1:10. However, these ratios were much higher during evening and night shifts. The clinical frontline nursing workforce primarily consisted of nurses with junior college degrees that had limited working experience. Junior nurses with different educational backgrounds, professional levels and work experiences were assigned almost similar nursing care work as senior nurses.

Conclusions: In the surveyed hospitals in the Pudong district, nurse staffing levels and skill mix may be inadequate to meet the increasing demands of patient care. The clinical nursing workforce needs to be strengthened and used effectively to enhance the quality and safety of patient care.

Relevance to clinical practice: We should focus on the quantity and quality of the nursing workforce, as well as nursing skill utilisation.

Keywords:

• China
• nurse staffing
• inpatient nursing care
• nursing management
• questionnaire survey

Acknowledgements

The authors are grateful to all the participating nurses, the research nurses for data collection and directors of the nursing departments for their cooperation. The authors would also like to thank the funding support for this project from the Department of Health in Pudong and the Shanghai health and family planning commission. The views expressed in this paper are those of the authors.

Source of Funding

This project was funded by the Scientific Development Research Funds founded by Pudong New Area Health Bureau [Grant-in-Aid No. PW2012A-3] and the Shanghai Health Bureau [Grant-in-Aid No. 20134061].