{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T07:03:16Z","timestamp":1785394996647,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":209,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72174135"],"award-info":[{"award-number":["72174135"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004912","name":"Sichuan University","doi-asserted-by":"publisher","award":["HXHL20049"],"award-info":[{"award-number":["HXHL20049"]}],"id":[{"id":"10.13039\/501100004912","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012542","name":"Sichuan Province Science and Technology Support Program","doi-asserted-by":"publisher","award":["2024JDKP0097"],"award-info":[{"award-number":["2024JDKP0097"]}],"id":[{"id":"10.13039\/100012542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patient classification systems (PCSs) are frequently used to estimate hours of nursing care to support budgeting and guide staffing decisions. However, despite a clear clinical need, there is as yet no validated and reliable PCS designed specifically for gastroenterology wards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop a PCS tailored to gastroenterology wards that can accurately quantify nursing workload and support evidence\u2010based nurse staffing decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used Orem\u2019s self\u2010care theory and Henderson\u2019s human needs theory as a foundation and applied machine learning techniques to construct a PCS for a gastroenterology ward in a general tertiary hospital. Patients were enrolled using convenience sampling, and information on their demographic characteristics, together with daily nursing activities and frequencies, was retrospectively extracted from the hospital information system (HIS) between July 1, 2019, and June 30, 2020. A workload measurement method was used to calculate the amount of nursing care received by each patient over a 24\u2010hour period, thereby forming the study database. A decision tree model was developed to classify patients. The PCS was subsequently refined and validated using a prospective observational study of 357 patients conducted from December 1, 2022, to March 31, 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final PCS included two primary categories and five subcategories, each of which was defined by specific patient characteristics and their corresponding 24\u2010hour nursing time requirements: Category 1: \u201cDay of surgery and first postoperative day,\u201d in which patients were subdivided into three levels based on surgical complexity, self\u2010care capacity, and illness severity (Surgery 1, Surgery 2, and Surgery 3), requiring 1.66, 2.82, and 4.15 nursing hours per 24\u2009h, respectively, and Category 2: \u201cOther days\u201d patients, who were subdivided into two groups based on critical illness, self\u2010care ability, and disease severity (Category 1 and Category 2), with each requiring 0.96 and 3.42 nursing hours per 24\u2009h, respectively. Internal and external validation demonstrated good model fit and acceptable predictive performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients could be rapidly classified using defined indicators, enabling accurate prediction of their 24\u2010hour nursing care requirements. The PCS exhibited strong internal consistency, stability, and generalizability, thereby supporting the reliability of its results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing Management<\/jats:title>\n                    <jats:p>This PCS provides a scientific basis for nurse staffing decisions and may support hospital administrators and health authorities in the development of data\u2010driven nurse workforce allocation policies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/2039402","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:52:13Z","timestamp":1785394333000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a Machine Learning\u2013Based Patient Classification System for a Gastroenterology Ward"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9288-6333","authenticated-orcid":false,"given":"Hong-Fei","family":"Ren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Fang","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0439-1802","authenticated-orcid":false,"given":"Ming","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6739-6340","authenticated-orcid":false,"given":"Yao","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You-Ping","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8612-5880","authenticated-orcid":false,"given":"Chang-Qing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9813-3738","authenticated-orcid":false,"given":"Yan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_12_1_2","unstructured":"State of the World\u2019s Nursing 2025: Investing in Education Jobs Leadership and Service Delivery World Health Organization 2025."},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2023.104601"},{"key":"e_1_2_12_3_2","first-page":"4","article-title":"Understanding Patient Classification Systems","volume":"9","author":"Giovannetti P.","year":"1979","journal-title":"The Journal of Nursing Administration"},{"key":"e_1_2_12_4_2","first-page":"637","article-title":"Research Progress of Patient Classification System at Home and Abroad","volume":"17","author":"Ding K.","year":"2017","journal-title":"The Journal of Nursing Administration"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2015.04.005"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/01939459251367529"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1891\/JNM-D-18-00101"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-5985.25.03976-2"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006216-198500940-00003"},{"key":"e_1_2_12_10_2","article-title":"Orem and Self-Care Theory","volume":"22","author":"Wang B. 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