Speakers - 2026

Title: Applying main framework strategies to establish magnet hospital in taiwan

Abstract

Background and objective: Global nursing shortages has been exacerbated by the COVID-19 pandemic, the impact of the shortages issues needs to be addressed immediately. Recruitment of nurses from low and lower middle-income countries to address the shortfall of nurses in higher income countries to increase the global nursing workforce growing from 27.9 million in 2018 to 29.8 million in 2023 (WHO 2025). However, personnel shortages, insufficient recruitment and retention, unattractive working conditions and poor access to continuing professional development opportunities are blighting health systems. The declining birth rate is reshaping Taiwan's higher education landscape, the number of new university students across Taiwan will fall below 200,000 in the 2025-2026 academic year, Taiwan’s nursing shortage reaches critical levels. The government agreed to implement medium- and long-term policies to solve the nursing shortage with USD$1.46 billion allocated to resolve the problem. However, hospitals must turn to smarter workflows and cultural reform to protect care quality and retain an overstretched workforce. The regional hospital has been applying three main framework strategies to since 2019, including (A)Nurturing Seedlings, (B)Protecting Seedlings and (C)Strengthening Seedlings. Therefore, low turnover rates contribute to sufficient nursing staff of the hospital.

Methods / intervention / approach:
Three Main Framework & Strategies
A. Nurturing Seedlings: Strengthening collaboration between nursing departments of school and the hospital, signing scholarship and financial aid agreements.
Active reinforcement partnership- convene school-hospital collaboration meetings regularly, provide internship opportunities, and arrange for qualified by Ministry-appointed lecturers to assist in clinical teaching guidance.
Provide hospital visits - Invite students and teachers from year two or three nursing students (second or third grade) to visit the hospital, arrange visits to ER, ICU, OR, and ward, selects outstanding in-service nurses from the visiting schools to share their employment and advantages, the nursing director introduced the hospital's welfare and development, the head nurse introduces the unit's equipment and environment.
Sign up for scholarships and grants - provide scholarship for each nursing student USD$ 2,000~8,000 and free accommodation for the last mile (comprehensive elective) internship and provide on-campus work-study (paper work) opportunities from 17:00 to 19:00.
Recruit through multiple channels - participate in school job fairs and promote the welcome of young nurses to return to their hometowns to provide local professional services through community neighborhood leader groups.

B. Protecting Seedlings: Arranging internship units according to student’s wishes, understanding the adaptation situation or difficulties proactively, and provide timely assistance and flexible adjustments.
Based on the wishes of last mile intern and new employee to arrange unit.
Implement NPGY training - Arrange excellent clinical teachers at a ratio of 1:1, use teaching aids and clinical cases to guide in a progressive manner, and conduct regular assessments and feedback; In addition, apply to the Ministry of Health and Welfare for the "Nursing Novice Clinical Mentor System", which will be implemented from August 2025, senior nurses serving as mentors for novice nurses, and they will receive an additional allowance of USD$ 200 per month. It is hoped that mentors will devote more effort and time to support and guide newcomers in terms of work skills and physical and mental well-being, so as to improve the retention rate of newcomers.
The nursing supervisor serves as a Newcomer Care Worker - Understands the adaptation situation or difficulties of new employees, provides timely assistance and flexible adjustments, and (regularly) reports the difficulties and needs encountered by new employees.

C. Strengthening Seedlings: increasing salary, encouraging professional development by providing advanced rewards, increasing monthly performance bonuses, and increasing fixed night shift rewards.
Increase basic salary on June 2025. The increased percentage from 12.9% to 19.6%. Effective utilization of nursing staff - mutual support within the same department, share scheduling ( long service leave scheduling) to maintain an average of day off more than 9 days.
The nurse-to-patient ratio target bonus will be given entirely to the day shift nurses, on Saturdays, Sundays and Public Holidays.
Monthly performance bonuses will be increased based on ward turnover rate.
Encourage the improvement of professional ability - promote Career Ladder System and provide advancement rewards.
Retention of critical care specialists – completed critical care training and 2 years of service in ICU will get more pay USD$134 per month.
Encourage the improvement of teaching ability - pay clinical teachers guidance fees (Beginner level: USD$ 67/person/month, Intermediate level: USD$ 100/person/month, Advanced level: USD$ 134/person/month).

Reduce the workload of nurses:
Hire part time nurses to share responsibility of functional care (eg: check new patient or change dressing or chest care)
Collaborate with the schools long term care department to provide paid internships to assist nurses with ward general affairs (eg: making beds, replenishing medical supplies on work carts, cleaning equipment, etc.)
The thoracic ward is staffed with a dedicated respiratory therapist
Routine blood draws and examinations for all new patients admission (through Outpatient Department) are handled by the inpatient service center.

Encourage takeover the night shift (monthly 15 days)
Maintain the quality and continuity of patient care during night shifts, a night shift bonus has been proposed, including the hospital, the Health Bureau of City and Ministry of Health and Welfare. Total for evening shift up to USD$ 43.3 per shift Night shift up to USD$ 56 per shift.
Reduce shifts extended of the evening shift stop admitting new patients (ER) to the ward at 23:00
Promote lean healthcare - simplify (information) handover and discharge procedure
Optimize the nursing information system - integrate the information systems of the ER → ICU/Ward → HD/OR to reduce repetitive tasks.
Cooperate with Chang Gung University of Science and Technology, establish credit-based classes nearby to provide nursing staff with prerequisite credits for pursuing a Bachelor degree, thereby improving their knowledge and academic qualifications.
The full-day nurse-to-patient ratio in acute wards has been gradually decreased from 10.95 in 2018 (Day shift: 7.8, Evening shift: 13.0, Night shift: 14.8) to 9.6 in October 2025 (Day shift: 7.8, Evening shift: 13.0, Night shift: 14.8).

Results / outcomes / observations
The nurse turnover rate has been decreased from 13.35% in 2018 to 12.05% as of October 31, 2025. The number of nurses has been increased from 378 in 2018 to 423 as of October 31, 2025.