간호전달체계 현황 및 간호서비스의 질에 영향을 미치는 요인

The status nursing care delivery system and the influencing factors on quality of nursing care

  • 투고 : 2016.02.22
  • 심사 : 2016.05.02
  • 발행 : 2016.06.30

초록

The aims of this study is to investigate the status of nursing care delivery systems and nurse staffing levels and to analyze differences in the quality of nursing care by the type of nursing care delivery system. This research was based on data from 723 nurses working in 55 medical and surgical units in 26 general hospitals. Descriptive statistics on nurse staffing levels and the nursing care delivery system, and multi-level logistic regression were used to estimate the determinants of quality of nursing care. The number of patients per nurse is 17.74 patients in functional nursing care and 15.56 patients in total nursing care. In comparison to hospitals adopting total nursing care, hospitals with functional nursing care had greater patients. The nurses rated units using total nursing care as significantly better quality of nursing care than the units with functional nursing care. Total nursing care or modified total nursing care, rather than functional nursing care, could lead to improvement in the quality of care(total nursing care OR=3.895, modified total nursing care OR=2.475). Patient-centered approaches under proper circumstances can be successfully implemented and the positive effects demonstrated.

키워드

참고문헌

  1. Brannon RL. Restructuring hospital nursing: reversing the trend toward a professional work force. Int J Health Serve 1996;26:643-654. https://doi.org/10.2190/AERK-G2VH-KMUQ-W5VD
  2. Eastaugh SR., Regan-Donovan M. Nurse extenders offer a way to trim staff expenses. Healthc Financ Manage 1990;44:58-60, 62.
  3. OECD. OECD health statistics. 2014
  4. Ju, YH. Survey on practicing and unemployed nurse, Seoul: The Korean Research Institute for Nursing Policy. 2006
  5. Huber D. Leadership and nursing care management. 4TH Edition, Elsevier Health Sciences. 2009
  6. Gardner DL. Issues related to the use of nurse extenders. J Nurs Adm 1991;21:40-45.
  7. Thomas LH. A comparison of the verbal interactions of qualified nurses and nursing auxiliaries in primary, team and functional nursing wards. Int J Nurs Stud 1994;31:231-244. https://doi.org/10.1016/0020-7489(94)90049-3
  8. Sellick KJ, Russell S, Beckmann JL. Primary nursing: an evaluation of its effects on patient perception of care and staff satisfaction. Int J Nurs Stud 1983; 20(4): 265-273. https://doi.org/10.1016/0020-7489(83)90018-4
  9. Reed SE. A comparison of nurse-related behaviour, philosophy of care and job satisfaction in team and primary nursing. J Adv Nurs 1988; 13: 383-395. https://doi.org/10.1111/j.1365-2648.1988.tb01433.x
  10. Blair F, Sparger G, Walts L, Thompson J. Primary nursing in the emergency department: nurse and patient satisfaction. J Emerg Nurs 1982;8: 181-186.
  11. Chavigny K, Lewis A. Team or primary nursing care? Nurs Outlook 1984;32:322-327.
  12. Roberts LE. Primary nursing Do patients like it Are nurses satisfied Does it cost more? Can Nurse 1980;76:20-23.
  13. Shukla RK, Turner WE 3rd. Patients perception of care under primary and team nursing. Res Nurs Health 1984;7:93-99. https://doi.org/10.1002/nur.4770070205
  14. Wilson NM, Dawson PA. Comparison of primary nursing and team nursing in a geriatric long-term care setting. Int J Nurs Stud 1989;26:1-13. https://doi.org/10.1016/0020-7489(89)90042-4
  15. Kim JJ, Hwang KJ, Kim SH, Rhee KS, Lee JS, Kim IY. A study about developing care delivery system of providing efficient patient care. Korean Nurse, 1996;35(3):61-76.
  16. Kim YJ. Study on the Effectiveness of Nursing Organization of one tertiary Hospital. JKANA 1997;32:109-122.
  17. Kim S.K. The effect of primary nursing implemented to psychiatric inpatients. J Korean Acad Psych Mental Health Nurs 2000;9:525-541.
  18. Kim SS, Chae GS, Kim KN, Park KO, Moon SM. Survey on nursing care delivery systems of university affiliated hospitals in Korea. Journal of Korean Clinical Nursing Research, 2010;16(1): 167-175.
  19. Oh ES. The level of Nurse's Autonomy according to nursing delivery system. Korean J Occup Health Nurs 2000;9:155-165.
  20. Kang SJ. A comparative analysis of nursing care delivery systems[dissertation]. Seoul: Yonsei university, 2002
  21. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse Staffing and Patient Mortality, Nurse, burnout, and Job Dissatisfaction, JAMA 2002;28:1987-1993.
  22. Needleman J, Buerhaus P, Mattke S, Stewart M, Zelevinsky K. Nurse-staffing levels and the quality of care in hospitals. NEJM 2002;346: 1715-1722. https://doi.org/10.1056/NEJMsa012247
  23. Park JH. Patient classification development by nursing intensity: 2000 university research center final report, Seoul: Seoul National University. 2002
  24. Aiken LH, Patrician PA. Measuring organizational traits of hospitals: the Revised Nursing Work Index. Nurs Res 2000;49:146-153. https://doi.org/10.1097/00006199-200005000-00006
  25. Kramer M, Hafner LP. Shared values: impact on staff nurse job satisfaction and perceived productivity. Nurs Resh 1989;38:172-177.
  26. Aiken LH, Clarke SP, Sloane DM. Hospital staffing, organization, and quality of care: Cross-national findings. Nurs Outlook 2002;50:187-194. https://doi.org/10.1067/mno.2002.126696
  27. Park BS. Factors Affecting Profitability of General Hospitals Focused on Operating Margin. Jour. of KoCon.a 2009;9:196-206.
  28. Lee YS, Rhee HS, Choi MK. Factors affecting the profitability of private hospitals in Korea. Korean Journal of Hospital Management, 2004;9(1):22-45.
  29. Kim MA, Park KO, You SJ, Kim MJ, Kim US. A survey of nursing activities in small and medium-size hospital: reasons for turnover. Journal of Korean Clinical Nursing Research 2009;15:149-165.
  30. Gardner KG, Tilbury MA. longitudinal cost analysis of primary and team nursing. Nurs Econ, 1991;9(2):97-104.