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Pursuing an Evidence Base to Change Nurse Staffing Policy in China

The policy-making process is different in China than in the United States. In China, the government is the sole policy maker. Administrators play an important role in policy making by influencing government with relevant data. This study was planned to provide relevant data with implications for evaluating nursing workload. Updated data was needed because 1978 standards based on the number of hospital beds were being used to determine nurse-patient workload ratios. Because of the rapid development of health sciences and technology in Chinese hospitals over the last 2 decades, the previously established standards did not meet current needs. This study explored patient diagnosis and length of stay (LOS) in 2 urban hospitals in China as a first step toward adjusting workload ratios. The study occurred within a social context that demanded updated evidence. The social context was defined by adoption of new economic marketing principles, changing nursing practice, and increasing family demands. Economic marketing principles became dominant in the healthcare delivery system after China opened to the outside world in the early 1980s, when it started economic reforms. One result was that costs of healthcare increased leading to healthcare reform. Hospitals and healthcare providers no longer get full financial support from the Chinese gov-