교대제 개선 시범사업 병동의 대체 간호사 근무 여건과 적정 대체 간호사 배치 수준 산정 = Working Conditions of Substitute Nurses in the Shift Improvement Pilot Project and Measurement of Adequate Staffing Level of Substitute Nurses

다국어 초록 (Multilingual Abstract)

Purpose: To examine the working conditions of substitute nurses and suggest an adequate staffing level for them. Methods: A cross-sectional design was employed, and data were collected from 30 institutions between December 1 and 31, 2024. A total of 86 substitute nurses and 780 ordinary shift nurses participated. Results: Among the participating medical institutions, only two-thirds provided prior training for substitute nurses. The mean satisfaction with adequacy of rewards was lowest among the seven items related to substitute nurses’ satisfaction with working conditions. The mean of turnover intention score was lower, and the mean work-life balance score among substitute nurses was significantly higher than that among nurses on ordinary shifts. The results of measuring substitute nurses’ staffing levels using various methods revealed that there were 2.57 substitute nurses per 100 ordinary shift nurses, and the substitute nurse-to-patient ratio was 59.74. The average substitute nurse-to-patient ratio of institutions with above average satisfaction with the substitute nurse system was 52.10, which was significantly lower than the 67.38 observed among institutions with lower satisfaction (p=.020). Moreover, the mean substitute nurse-to-patient ratio was 55.85 for institutions perceived to have better working conditions. Conclusion: Pre-training for substitute nurses is essential to enable them to work in various wards, and adequate rewards should be provided for sudden replacements. Additionally, maintaining substitute nurse-to-patient ratio of 55 or lower is recommended to enhance shift nurses’ working conditions and improve the quality of nursing care.