• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.481-494
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• 2003

Purpose: This study was to develop nursing competencies, sub-competencies and behavior indicators according to the clinical ladder of emergency nurses. Method: index of content validation was used by 21 clinical experts. Results: This study had three phases to develop nursing competencies, sub-competencies and behavior indicators. In first phase: 12 nursing competencies and 33 sub-competencies were developed through the literature review on nursing competency and emergency nurses' job description. The content of 12 competencies and 33 sub-competencies were reviewed by 3 nursing professors. The 12 competencies and 33 sub-competencies were followed: clinical judgement and measures(6 sub-competencies), processing ability of ward works(2 sub-competencies), flexibility(2 sub-competencies), resources management(2 sub-competencies), confidence(3 sub-competencies), cooperation(2 sub-competencies), professional development power(2 sub-competencies), patient service orientation(3 sub-competencies), inclination toward ethical value(5 sub-competencies), influence power(2 sub-competencies), developing others(2 sub-competencies), self control(2 sub-competencies). In second phase, 132 behavior indicators were developed according to nurse clinical ladder: novice, advanced novice, competent, proficient. In Third phase, content validity was examined on 132 behavior indicators by 21 clinical experts. 126 among 132 indicators had over 70% agreement among experts and 6 indicators under 70% were revised. Conclusion: nursing competencies, sub competencies and behavior indicators can be used nurses' clinical performance as well as establishing proper directions for professional growth related to reward system.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.4
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• pp.501-512
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• 2013

Purpose: This study was done to develop a nursing competency scale according to a clinical ladder system for intensive care nurses. Methods: Index of content validation was done by 20 clinical experts and 80 nurses in Intensive Care Units (ICU). Results: The process and results of study are as follows. First, 12 nursing competencies were used in the establishment of the clinical ladder system (Jang, 2000). Second, the first draft of the competency lists was developed. It was based on the clinical nurses' behavioral indicators of nursing competency by Jang (2000), and was modified and supplemented through various literature reviews including competency standards for specialist intensive care nurses in Australia and consultation with 2 clinical nurses with over 10 years experience in the ICU. Third, the draft was examined by 20 clinical experts for content validity. Finally, the final draft was analysed using clinical validity where 20 nurses in each ladder participated. The final number of items was fixed at 309. Conclusion: The tool represents expected nursing competency of nurses working in ICU. Intensive care nurses can recognize their strengths and weaknesses, and identify directions for their professional growth by analysing results of their competency evaluation using this tool.

• Quality Improvement in Health Care
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• v.15 no.1
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• pp.73-78
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• 2009

문제: 오늘날 간호사는 과거와 달리 현대적 보건의료 요구를 해결할 수 있는 체계적인 이론과 기술을 습득하도록 훈련된 고급 전문 인력이고, 간호행위를 생산하기 위해서는 서비스의 생산원가 뿐만 아니라 전문 인력으로서의 훈련 및 유지비용 등도 투입되어야만 가능하게 함으로서 2008년 7월부터 시행한 중환자실 간호등급에 따른 간호수가 책정으로 인해 중환자실 내에서 이루어지고 있는 많은 간호행위 중 수가를 받을 수 있는 부분이 생기게 되었고 간호행위의 중요성과 더불어 간호를 시행 후 받을 수 있는 수가에 대한 간호사들의 입력에 대한 의무도 늘어나게 되었다. 이에 빈번히 누락되고 있는 간호수가 관리를 통한 경제적 손실을 방지해야 할 필요성을 느껴 개선활동을 하고자 한다. 목적: 2008년 7월부터 시행한 중환자실 간호등급에 따른 간호수가 책정으로 인해 중환자실내에서 이루어지고 있는 간호 행위의 중요성을 인식하고 구체적인 문제 분석과 간호 현장에서의 개선안을 도출함으로써 경제적 손실을 방지할 수 있는 간호수가 누락률을 감소시키고자 함이다. 의료기관: 대구파티마병원 내과 중환자실. 질 향상 활동: 업무개선의 방법으로 환자 개인별 간호수가 입력 누락 방지 체크 리스트 사용 및 처방 전달 시스템의 간호수가 재입력 화면을 이용하여 입력의 용이성 도모하였고 입력된 간호수가를 처방 전달 시스템 간호수가 조회 프로그램을 이용해 익일 누락여부를 매일 모니터링 하였다. 교육 및 홍보활동으로는 간호수가 입력누락 방지를 위한 간호수가 입력 지침을 제작하여 전체간호사는 년 2회, 신규간호사는 개별 교육을 실시하였으며, 월별 간호수가 누락통계를 실명 공고 하여 간호수가 다 빈도 누락 간호사는 추가 개별교육을 실시하였다. 개선효과: 간호수가 입력 프로세스 개선을 통해 간호수가 평균 누락률이 개선 전 6.5%, 개선 후 1.2%로 5.3%의 누락 감소율을 보였으며 역치 5%를 달성하였고 간호수가 누락금액은 개선 전 2,992,752원, 개선 후 590,787원으로 2,401,965원의 누락 효과 비용을 구할 수 있었다. 본 QA활동으로 중환자실 간호수가 전산입력에 대한 체계적인 교육부재와 신규간호사들의 잦은 전산누락이 있어왔으나 표준화 된 체크리스트 지침과 입력확인 작업으로 전산입력 누락률이 감소하는 효과를 가져왔다. 추후 심평원 청구 작업을 하는 부서와 연계되어 실제 청구 누락률에 대한 비교와 간호사 근무연수와 간호수가 입력 누락률에 대한 상관관계 조사를 제언 해 본다.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.4
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• pp.529-539
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• 2003

Purpose : The objective of this research is to explore the job satisfaction of clinical nurses by the rank of nurse staffing in order to provide effective management for nurses. Method : The research has been conducted on three hundred twenty nurses working at tertiary eight hospitals which were from 2nd rank of nurse staffing to 5th. rank of nurse staffing in Seoul, from August 1 to September 30 of 2003, through survey. For the experimental tools, used Park-Yoon's job satisfaction for nurses(1992) which was modified Stamp's job satisfaction test(1978). The acquired data were analyzed through SPSS program using descriptive method, $x^2$-test, ANCOVA, and LSD. Results : Overall job satisfaction of nurses showed fairly high level of 3.17; in the order of high score, 3.84 for interaction, 3.00 for autonomy, 2.63 for administration. Analysis based of the rank of nurse staffing showed that hospitals of 2nd rank and 3rd. rank of nurse staffing which were higher ratio of patient vs nurse were more satisfied with nurses' job satisfaction than other nurses who were 4th. rank and 5th. rank of nurse staffing. Conclusion : The result of this study revealed that hospital which was higher the rank of nurse staffing was more influenced of nurses' job satisfaction and especially interaction, administration and autonomy which were sub-category of job satisfaction were different among the ranks of nurse staffing.

• Journal of Korean Academy of Nursing Administration
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• v.20 no.3
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• pp.257-271
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• 2014

Purpose: This methodological study was done to develop a Nursing Competency Measurement Scale based on the clinical ladders of nurses working in wards. Methods: Thirty clinical experts and 501 ward nurses evaluated the content validity of the scale. A survey using the Nursing Competency Measurement Scale was conducted with 114 nurses to evaluate reliability and applicability of the instrument. Data were analyzed using SPSS/WIN 21.0. Results: A review of the literature identified 13 components of nursing competencies and 30 core nursing competencies based on each of the 4 grade clinical ladders. Cronbach's ${\alpha}$ coefficient for the total was .92. Cronbach's ${\alpha}$ reliabilities of each clinical ladder grade were .83 for Grade I, .84 for Grade II, .81 for Grade III, and .84 for Grade IV. The Content Validity Index (CVI) of the scale with 120 individual items was 0.976~1.000 for Grade I scale, 0.986~1.000 for Grade II scale, 0.984~1.000 for Grade III scale, and 0.992~1.000 for Grade IV scale. The expert group nurses' average degree of nursing competence measured using the scale was 3.38~3.75 out of 4.0. Conclusion: Through this process, 120 final questions were confirmed to represent items of the Nursing Competency Measurement Scale based on clinical grade.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.9
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• pp.93-102
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• 2019

This study examined the nurse's emotional exhaustion and influencing factors, and the relationship between emotional burnout and hospital nursing workload using multilevel logistic regression analysis. The study subjects were 3,083 nurses of 65 hospitals, who participated in the training conducted by the Healthcare Industry Trade Union in 2010 and responded to the questionnaire. First, 71.6% of nurses experienced emotional exhaustion, and the average score of emotional exhaustion was 33.53. Second, the 'non - nursing work experience' showed a significant effect on emotional exhaustion. Third, the 'sufficient nursing staff' variable increased the emotional exhaustion. Fourth, the nursing grades were correlated significantly with emotional exhaustion compared to those with more than four beds per nurse. Fifth, in the case of working in the internal ward, the shorter the clinical career, the higher the emotional exhaustion. In other words, higher emotional exhaustion was associated with more nursing work experience, more perceived insufficient nursing staff, more nurses per bed, the department of internal medicine, and a shorter clinical career.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.626-634
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• 2018

This retrospective study investigates the accuracy of triage procedures for pediatric patients in emergency departments (EDs) using the Korean Triage and Acuity Scale (KTAS). The study includes 250 randomly selected initial nursing records and clinical outcomes of pediatric patients who visited one regional ED or a local ED from October 2016 to September 2017. The collected data were analyzed by a qualified expert to determine the true triage score. The accuracy of triage was defined as the agreement between the triage score of the emergency nurses (ENs) and the true triage score as determined by the expert. Based on expert comments, the cause of the triage error was analyzed and the KTAS score was compared with the discharge, length of stay (LOS), and medical cost. The results showed that the degree of agreement in the triage score between the experts and the ENs was excellent (weighted kappa=0.77). Among the causes of triage discordance, the most frequent was the incorrect application of vital signs to the KTAS algorithm criteria (n=13). Patients with high severity KTAS levels 1 and 2 were discharged less often (${\chi}=43.25$, p<0.001). There were significant differences in the length of stay (F=12.39, p<0.001) and cost (F=11.78, p<0.001) between KTAS scores when adjusting for age. The results of this study indicate that KTAS is highly accurate in EDs. Hence, the newly developed triage tool is becoming well established in Korea.

• 한국노년학
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• v.32 no.2
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• pp.593-609
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• 2012

The study was performed to identify the functional status change of beneficiaries of Long-Term Care Insurance and its related factors. We conducted the logistic regression with 17,652 beneficiaries during August and September in 2008. As a result, activities of daily living(ADL), behavioral changes, rehab, instrumental activities of daily living(IADL) and cognitive function, followed by nursing care area were improved in a greater degree. For the institutional service, level-1 beneficiaries was significantly improved in rehab area and level-2 beneficiaries was improved in ADL. For the home-visit care service of in-home services, level-1 beneficiaries was improved in ADL, level-2 beneficiaries was improved in ADL and rehab area, level-3 beneficiaries was improved in ADL, cognitive function and behavioral changes. For the day-and-night care service, level-1 beneficiaries was improved in ADL, IADL, behavioral changes and rehab area, level-2 beneficiaries was improved in behavioral changes, level-3 beneficiaries was improved in cognitive function and behavioral changes. For the short-stay service, level-3 beneficiaries was improved in behavioral changes. By the above results, there was a difference in a functional improvement by level and used services. Therefore, government need to provide the personalized service system based on the objective and comprehensive understanding for health and functional status of beneficiaries.

• Journal of Korean Clinical Nursing Research
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• v.18 no.1
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• pp.86-98
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• 2012

Purpose: The present study was conducted with the aim of developing a training manual for operation room nurses through an examination of nursing actions in terms of the frequency of performance, importance, and the levels of difficulty. The participants were recruited from the five university-affiliated hospitals according to one's career ladders, resulting in getting 181 OR nurses enrolled. Methods: Researchers developed a questionnaire using a 5-point Likert scale which measuring OR nurses' actions, importance, and the levels of difficulty. The frequencies of performance, importance and the levels of difficulty of nursing action were compared according to their career ladders using one-way ANOVA. Results: The frequencies of performance showed significant differences in 26 items according to the participants' career ladders; the importance in 6 items; and the levels of difficulty in 19 items among the OR nurses' actions. Conclusion: Given the fact that the significant differences were shown in the frequencies of performance, importance, and the levels of difficulty in nursing action across differing work experience, continuous development and application of job training based on one's work experience seem crucial in practice.

• The Journal of the Korea Contents Association
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• v.12 no.8
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• pp.283-299
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• 2012

The aim of this study is to develop strategies activating long-term care visiting nursing. The research design was a descriptive survey study, and the data were collected from the visiting nursing center managers, customers, and long-term care insurance staffs. The major results were as follows. To activate the long-term care visiting nursing, first, the basic nursing care for ensuring sustainable health management has to be included. Second, the visiting nursing must be designated as mandatory use in standard guideline for using long-term care services. Third, the insurance pricing of visiting nursing must be based on the cost of visiting nursing. And, last, using a visiting nursing must be possible without a doctor's order sheet, when it is required for the assessment of patient's health status.