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ƩƌŝbƵƟŽn 3.0 License 5 ƉĂƟĞnƚ ƌĂƟŽ of 1:1 or 1:2, depending on ƉĂƟĞnƚƐ͛ severity of need, was accepted in MĂƐƐĂcŚƵƐĞƩƐ͘ California has reached outstanding achievements in nursing law; since the 2004 enactment of nursing law, no medical center violated the law or closed because of the enactment of nursing law, and the number of those obtaining nurse licenses increased to more than 60,000. Medical centers in California did not report having ĚŝĸcƵůƚy hiring [23]. One year ĂŌĞƌ the establishment of the nursing law, California reported that the nurse-license rate grew by more than 60% compared to other states [23]. The enactment of nursing law is ĞīĞcƟvĞ in reducing mortality, increasing ƌĞƚĞnƟŽn of nurse ƐƚĂĸnŐ [24], and maintaining the job ƐĂƟƐĨĂcƟŽn of nurses [25]. From 2004 to 2008, nurses reported increased job ƐĂƟƐĨĂcƟŽn and a decline in turnover rate. The state also reported ĞīĞcƟvĞ problem solving related to the imbalance between supply and demand in the workforce caused by aging nurse ƐƚĂĸnŐ and ƌĞƟƌĞmĞnƚ of baby boomers [25]. A common feature of nursing law in the United States is a minimum nƵƌƐĞͲƐƚĂĸnŐ plan that must include direct-care nurses, with ĞxcĞƉƟŽnƐ for ĂĚmŝnŝƐƚƌĂƟvĞ ƐƚĂī and ĂƐƐŝƐƟvĞ personnel. Each state has to organize a ƐƚĂĸnŐ cŽmmŝƩĞĞ and must establish a ƐƚĂĸnŐ plan suited for each hospital and unit. Nursing law in Illinois, Oregon, Washington, and Texas mandates inclusion of at least 50~60% direct-care nurses on cŽmmŝƩĞĞƐ [16,22]. Some states, such as Vermont, mandate public nŽƟĮcĂƟŽn of ŝnĨŽƌmĂƟŽn about nurse ƐƚĂĸnŐ to ensure the public’s right to know [21]. The available nursing ƐƚĂī in health care ŽƌŐĂnŝnjĂƟŽnƐ varies, even among KƌŐĂnŝnjĂƟŽn for Economic ŽͲŽƉĞƌĂƟŽn and Development [26] countries. For example, the ƉƌŽƉŽƌƟŽn of nurses in nursing homes varies from the United States (53.6%), to Germany (27.1%), Japan (15.3%), and Korea (0.1%). In previous studies, a suitable workload for nurse ƐƚĂĸnŐ showed a ƉŽƐŝƟvĞ ĞīĞcƚ for working cŽnĚŝƟŽnƐ and ƉĂƟĞnƚ outcomes [27]. The current shortage of nurses who take responsibility for public health and their excessive workload is a burgeoning issue [25]. To ĞīĞcƟvĞůy plan nƵƌƐĞͲƐƚĂĸnŐ management, the nursing skill mix must include cŽnƐŝĚĞƌĂƟŽn of ĞĚƵcĂƟŽnĂů background, clinical experience, professionalism, and the competence and cƌŝƟcĂů thinking of personnel. To improve public health and safety, the role of professional nurses is very important. Professional nurses (RNs) provide high-quality nursing services, ĚŝƐƟnŐƵŝƐŚĞĚ from nursing ƐƵbƐƟƚƵƚĞ workers. This study provides baseline data for cƌĞĂƟnŐ ƉƌĂcƟcĂů resources for the establishment of ŽƉƟmĂů nurse ƐƚĂĸnŐ in healthcare. By using evidence of health and welfare policies, this study contributes to improving global health by visualizing improvement in nƵƌƐĞͲƐƚĂĸnŐ standards and ůĞŐŝƐůĂƟŽn for ĞĸcŝĞnƚ nursing services. At the nĂƟŽnĂů level, ůĞŐŝƐůĂƟŽn should establish a system for supervising the quality of nursing regularly and for urgently introducing a management system. Therefore, states must enact a law about nurse ƐƚĂĸnŐ͕ taking into cŽnƐŝĚĞƌĂƟŽn ƉĂƟĞnƚƐ͛ severity of need, length of stay, required treatment, diversity of healthcare-team members, preferences of medical teams, techniques, and the possibility of support ƐƚĂī for public health and safety. Conclusion This study propose future ƉĞƌƐƉĞcƟvĞƐ for professional nurses by reviewing 14 works of literature and nursing laws of 11 states in the United States. Currently, it is ƟmĞ to establish the role and vision of the professional nurse, ĚŝƐƟnŐƵŝƐŚŝnŐ between the roles of RNs and nursing ƐƵbƐƟƚƵƚĞ workers worldwide. Nursing laws worldwide require minimum nurse ƐƚĂĸnŐ͕ the ŽƌŐĂnŝnjĂƟŽn of ƐƚĂĸnŐ cŽmmŝƩĞĞƐ including ĞƐƐĞnƟĂů nursing ƐƚĂīƐ in medical centers, and public nŽƟĮcĂƟŽn of ŝnĨŽƌmĂƟŽn on nurse ƐƚĂĸnŐ to improve the quality of nursing care. The nursing laws are necessary for the global cŝƟnjĞnƐ to improve health care for global cŝƟnjĞnƐ͘ To develop a health-management plan and meet public demand, legal systems are urgently needed that can strengthen standards for arranging nursing ƐƚĂīƐ and expand the role and ĨƵncƟŽn of nurses. Acknowledgement This research was supported by Basic Science Research Program through the NĂƟŽnĂů Research &ŽƵnĚĂƟŽn of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (grant # 2017R1A2B4003282: ĞĮnŝƟŽn and cŚĂƌĂcƚĞƌŝƐƟcƐ͘ 2. 3. Wiltse Nicely KL, Sloane DM Aiken LH (2013) Lower mortality for abdominal ĂŽƌƟc aneurysm repair in high-volume hospitals is cŽnƟnŐĞnƚ upon nurse ƐƚĂĸnŐ͘ Health Serv Res J 48: 972-91. 4. Ƶĸn C (2014) Increase in nurse numbers linked to bĞƩĞƌ ƉĂƟĞnƚ survival rates in ICU. Nurs Stand 28: 10. 5. Weech-Maldonado R, Meret-Hanke L, NĞī MC, Mor V (2004) Nurse ƐƚĂĸnŐ ƉĂƩĞƌnƐ and quality of care in nursing homes. Health Care Manage Rev 29: 107-116. 6. Bates-Jensen BM, Schnelle JF, Alessi CA, Al-Samarrai NR, LevyStorms L (2004) The ĞīĞcƚƐ of ƐƚĂĸnŐ on in-bed ƟmĞƐ of nursing home residents. J Am Geriatr Soc 52: 931-938. 7. Spilsbury K, ,ĞwŝƩ C, ^ƟƌŬ L, Bowman C (2011) The ƌĞůĂƟŽnƐŚŝƉ
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