• Health Policy and Management
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• 제3권1호
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• pp.146-168
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• 1993

The study was conducted to project supply and demand of the nurses till year 2010 based on analysis of supply and demand of nurses up to year 1991. Results of the study will provide invaluable information for nurses manpower planning as well as overall health manpower planning for the 21th century. It is projected that nurses will be oversupplied based on the current prductivity which is undesirable situation if the quality of care is considered, and undersupplied based on the the medical law as well as optimal productivity. Thus, it is desirable to increase active supply of nurses. One of the ways of increasing active supply would be increasing the size of training and education. But, considering low employment rate of nurses which is about 59% better way of solving problems related to nurses shortage would be improvement in nurses' employment rate. According to simulation study done as part of this study, if nurses' employment rate goes up to 80%, there is no need for increasing the size of training to meet the demand at the level of medical law.

• The Journal of the Korea Contents Association
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• 제14권7호
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• pp.302-311
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• 2014

The purpose of this study was to investigate on parenting stress, parenting guilt feelings and separation anxiety and alternative care in nurses. Data were collected from nurses with preschooler at 2 hospitals from August 2013 to January 2014. Self reported questionnaires were used to collect data from 163 nurses. There were significant differences according to the age, satisfaction of work place and co-worker, spouse support of parenting in parenting stress, parenting guilt feelings and separation anxiety in common. The majority type of alternative care was surrogate foster home when they went to work. However, there were significant differences according to type of alternative care in parenting stress, parenting guilt feelings and separation anxiety. Particularly, those who use child day-care center and surrogate foster home showed more parenting guilt feelings and separation anxiety in Scheffe post-hoc comparison. As a result, it is needed to be improvement of working conditions and policy for nurses' parenting support to continue work.

• 한국노년학
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• 제31권2호
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• pp.371-380
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• 2011

This study was to address changes on hospital-based home care utilization after long-term care insurance(LTCI) was launched. National electronic data information(EDI) on hospital-based home care from Health Insurance Review Agency in 2007.7~2008.6(prior to LTCI) and in 2009(posterior to LTCI) was analyzed. After the launch of long-term care insurance, 40 hospital-based home health care agencies(HHCA) were diminished and regions not having any HHCA were increased from 53% to 59%. Hospital-based home care utilization was decreased in the elderly(clients 13.4%, visits 20.9%) as well as non-elderly(clients 3.5%, visits 3.9%). It is presumed that diminished HHCAs result in decreased accessibility to hospital-based home health care for non-elderly. The clients, visits, and reimbursed cost per agency were not changed. It is presumed that small agencies were closed already. The total reimbursed cost per agency in 2009 was 121,850,000 won. Results suggest that the government has to give support to open more HHCA to increase the accessibility for non-elderly. Also, hospital-based home care services utilization has to be monitoring regularly.

• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.243-247
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• 2008

Neonatal intensive care in Korea has improved remarkably since the 1990s, but there is still a shortage of facilities and equipment in NICUs. Only 71.1% of the beds needed for neonatal intensive care are available. Mechanical ventilators are not appropriately distributed to the NICUs that are equipped to handle neonatal intensive care. The number of doctors is far too small, making the number of patients per doctor very high. Nurses, too, need to take care of 7.7 patients per nurse, making it very difficult to provide adequate intensive care. All this is caused by insufficient investment by the hospitals, which, in turn, is caused by inadequate reimbursement from health insurance. Therefore, a government-sponsored effort is necessary to bring the level of neonatal intensive care up to par.

• Journal of the Korea Academia-Industrial cooperation Society
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• 제19권6호
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• pp.240-251
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• 2018

This study was conducted to evaluate the moral distress, moral sensitivity, and the factors that influence moral distress and the experience of moral distress among nurse working in a long-term care hospital. Overall, 180 nurses working in long-term care hospital in G Province were evaluated. Date were collected from March 21 to April 8, 2016 and analyzed using the SPSS/WIN 23.0 program. The mean of moral distress among nurses was 3.57 and the moral sensitivity was 4.82, and these factors was significantly and positively correlated (r=0.494, p<0.001). Regression analysis revealed that the factors that significantly influenced moral distress were moral sensitivity and ethical dilemmas when conducting nursing practices. Situations that caused nurses to experience moral distress included inappropriate care behavior was not guaranteed the quality of nursing care, conditions related to unethical the human rights, conditions related to the lack of nursing staff and conditions related to the lack of support at the organizational and national level. Therefore, to reduce moral distress, nursing intervention programs that improve the moral sensitivity and ability to solve ethical-problems are needed for nurses working in long-term care facilities.

• Journal of Hospice and Palliative Care
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• 제12권3호
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• pp.132-138
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• 2009

Proper education of hospice professionals is essential for ensuring quality of end-of-life care. In 2005, 'End-of-life Care Task Force Team' by Ministry of Health and Welfare established '60 hours of hospice education' as basic requirement for hospice professionals. This study is aimed to determine how many of the hospice professionals meet with the criteria and whether there are significant regional variations. Methods: We analyzed the data from 46 hospice organizations, which submitted the application to the 2008 designation program of Ministry of Health, Welfare, and Family Affairs. Data included details of the educational records of each hospice professionals. Results: Total 673 hospice professionals were included in the analysis. Overall, only 41.5% (279/673) met the requirement. Nurses (46.8%; 177/378) were more likely to meet the requirement than doctors (35.8%; 38/106), social workers (32.0%; 24/75) and clergies (35.1%; 40/114). Hospice professionals of the organizations in metropolitan area received more education than those in small cities or rural area (52.4% vs. 25.0% for doctors, 50.6% vs. 43.9% for nurses, 42.9% vs. 25.5% for social workers). By geographic areas, hospice professionals in southeast regions received less education than other part of Korea (28.1% vs. 43.0${\sim}$48.8%, respectively). Conclusion: Less than half of the Korean hospice professionals has received proper amount of hospice education, and significant regional variations existed. National programs to promote the education of hospice professionals and eliminate its disparities are greatly warranted. Implementation of the 60-hour currirulum for hospice professionals, based on the train-the-trainer model, would be regarded as one potential solution.

• Journal of Digital Convergence
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• 제11권5호
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• pp.347-354
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• 2013

In contrast to the increase in demand for high quality healthcare, there is limited medical human resources such as doctors and nurses so an excessive amount of workload is being forced to them. Therefore, a patient monitoring system using USN(Ubiquitous Sensor Network) is becoming a solution. This paper proposes a patient monitoring system applying USN in maternity hospital to reduce the workload of nurses. According to the efficiency evaluation test based on the model of two university hospitals(S, K University Hospital) and their doctor's diagnosis, the results showed that under the circumstances that one nurse is in charge of 12 patients(6 normal delivery patients and 6 cesarean delivery patients), a total of 1,260 minutes of workload was saved during hospitalization period(5 days). Also, we compared the workload of nurses with or without our proposed system, and the figures showed that in case of normal delivery patients, the workload of nurses decreased by 50 minutes per patient, whereas in case of cesarean delivery patients, the workload of nurses decreased by 130 minutes per patient.

• Research in Community and Public Health Nursing
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• 제11권1호
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• pp.289-316
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• 2000

우리나라의 경우 지역사회 재난 관리계획과 훈련이 보건의료적 모형이라기 보다는 민방위 모형에 입각하기 때문에 사고 현장에서의 환자 중증도 분류, 합리적 환자배분 및 이송, 병원 응급실에서의 대처 등이 체계적으로 이루어지지 못하고 있으며, 지역사회가 이에 즉각적으로 반응할 수 없다. 본 연구는 삼풍 붕괴사고 시에 대응방식과 그 후의 우리나라 응급의료 체계를 분석함으로써 대형사고 예방과 재난관리를 위한 우리나라 응급의료체계의 개선방안과 간호교육에서의 준비부분을 제시하고자 한다. 1 삼풍 사고 발생시에는 이를 관장할 만한 법적 근거인 인위적 재해에 관한 재난관리법이 없었다. 따라서 현장에서는 의학적 명령체계를 확보하지 못했기 때문에 현장에서의 응급 처치는 전혀 이루어지지 못하였다. 현장에서의 중증도 분류. 응급조치와 의뢰, 병원과 현장본부 그리고 구급차간의 통신 체계 두절, 환자 운송 중 의료지시를 받을 수 있도록 인력, 장비, 통신 체계가 준비되지 못하였던 점이 주요한 문제였다. 또한 병원 응급실에서는 재난 계획이 없거나 있었더라도 이를 활성화하여 병원의 운영 체계를 변환해가지 못하였다. 2. 삼풍백화점 붕괴사고 한달 후에는 인위적 재해에 대한 재난관리법이 제정되고, 행정부 수준별로 매년 지역요구에 합당한 재난관리 계획을 세우도록 법으로 규정하였다. 재난 관리법에는 보건의료 측면에서의 현장대응, 주민 참여, 응급 의료적 대처, 정보의 배된. 교육/훈련 등이 포함되어 있어야 한다. 그러나 법적 기반이 마련된 이후에도 한국 재난 계획 내에는 응급의료 측면의 대응 영역은 부처간 역할의 명시가 미흡하며, 현장에서의 응급 대응과정을 수행할 수 있는 운영 지침이 없이 명목상 언급으로 그치고 있기 때문에 계획을 활성화시켜 지역사회에서 운영하기는 어렵다. 즉 이 내용 속에는 사고의 확인 /공고, 응급 사고 지령, 요구 평가, 사상자의 중증도 분류와 안정화, 사상자 수집, 현장 처치 생명보존과 내과 외과적 응급처치가 수반된 이송, 사고 후 정신적 스트레스 관리, 사고의 총괄적 평가 부분에 대한 인력간 부처간 역할과 업무가 분명히 제시되어 있지 못하여, 사고 발생시 가장 중요한 연계적 업무 처리나 부문간 협조를 하기 어렵다. 의료 기관과 응급실/중환자실, 시민 안전을 책임지고 있는 기관들과의 상호 협력의 연계는 부족하다. 즉 현재의 재난 대비 계획 속에는 부처별 분명한 업무 분장, 재난 상황에 따른 시나리오적 대비 계획과 이를 훈련할 틀을 확보하고 있지 못하다. 3. 지방 정부 수준의 재난 계획서에는 재난 발생시 보건의료에 관한 사항 전반을 공공 보건소가 핵심적 역할을 하며 재난 관리에 대처해야 된다고 규정하고 있다. 그러므로 보건소는 지역사회 중심의 재난 관리 계획을 구성하고 이를 운영하며, 재난 현장에서의 응급 치료 대응 과정은 구조/ 구명을 책임지고 있는 공공기관인 소방서와 지역의 응급의료병원에게 위임한다. 즉 지역사회 재난 관리 계획이 보건소 주도하에 관내 병원과 관련기관(소방서. 경찰서)이 협동하여 만들고 업무를 명확히 분담하여 연계방안을 만든다. 이는 재난관리 대처에 성공여부를 결정하는 주요 요인이다. 4 대한 적십자사의 지역사회 주민에 대한 교육 프로그램은 연중 열리고 있다. 그러나 대부분의 교육주제는 건강증진 영역이며. 응급의료 관리는 전체 교육시간의 8%를 차지하며 이중 재난 준비를 위한 주민 교육 프로그램은 없다. 또한 특정 연령층이 모여있는 학교의 경우도 정규 보건교육 시간이 없기 때문에 생명구조나 응급처치를 체계적으로 배우고 연습할 기회가 없으면서 국민의 재난 준비의 기반확대가 되고 있지 못하다. 5. 병원은 재난 관리 위원회를 군성하여 병원의 진료권역 내에 있는 여러 자원을 감안한 포괄적인 재난관리계획을 세우고, 지역사회를 포함한 훈련을 해야 한다. 그러나 현재 병원은 명목상의 재난 관리 계획을 갖고 있을 뿐이다. 6. 재난관리 준비도를 평가할 때 병원응급실 치료 팀의 인력과 장비 등은 비교적 기준을 충족시키고 있었으나 병원의 재난 관리 계획은 전혀 훈련되고 있지 못하였다 그러므로 우리나라 재난 관리의 준비를 위해서는 현장의 응급의료체계, 재난 대응 계획, 이의 훈련을 통한 주민교육이 선행되어야만 개선될 수 있다. 즉 민방위 훈련 모델이 아닌 응급의료 서비스 모델에 입각한 장기적 노력과 재원의 투입이 필요하며, 지역사회를 중심으로 대응 준비와 이의 활성화 전략 개발, 훈련과 연습. 교육에 노력을 부여해야 한다. 7. 현장의 1차 응급처치자에 대해서는 법적으로 명시하고 있는 역할이 없다. 한국에서는 응급구조사 1급과 2급에 대한 교육과 규정을 1995년 이후 응급의료에 관한 법률에서 정하고 있다. 이 교육과정은 미국이 정하고 있는 응급구조사 과정 기준과 유사하지만 실습실이나 현장에서의 실습시간이 절대적으로 부족하다. 덧붙여 승인된 응급구조사 교육 기관의 강사는 강사로서의 자격기준을 충족할 뿐 아니라 실습강사는 대체적으로 1주일의 1/2은 응급 구조차를 탑승하여 현장 활동을 끊임없이 하고 있으며, 실습은 시나리오 유형으로 진행된다. 그러므로 우리나라의 경우 응급 구조사가 현장 기술 인력으로 역할 할 수 있도록 교과과정 내에서 실습을 강화 시켜야하며, 졸업생은 인턴쉽을 통한 현장 능력을 배양시키는 것이 필요하다. 8. 간호사의 경우 응급전문간호사의 자격을 부여받게 됨에 따라, 이를 위한 표준 교육 지침을 개발함으로써 병원 전 처치와 재난시 대응할 수 있는 역량을 보완해야 한다. 또한 현 자격 부여 프로그램 내용을 고려하여 정규자격 간호사가 현장 1차 치료자(first responder)로 역할 할 수 있도록 간호학 교과과정을 부분 보완해야한다.

• Journal of Digital Convergence
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• 제13권2호
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• pp.205-213
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• 2015

This study is a survey and research attempted to seek the ways of effective human resource management and improving the quality of nursing - targeting the nurses working for the general hospitals - by analyzing the impact of job satisfaction and job stress factors on exhaustion and turnover intentions, so as to find the nurses' turnover factors and remove those factors in advance. Although we cannot raise job satisfaction to the level we are satisfied by monetary compensation, i.e. salary alone, but as seen in this study, it is worth considering such ways as the subjects with high salaries showed relatively higher job satisfaction. Finally, in order to prevent the turnover of the competent nursing staff at an early stage, active systematic supplements and efforts are required; it is also necessary to provide constant job training, by taking into account of the specificity of nursing units and to secure and place adequate nursing staff, and to establish fair and objective promotion criteria.

• Journal of forensic and investigative science
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• 제2권2호
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• pp.30-49
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• 2007

An autopsy is a postmortem assessment or examination of a body to determine cause of death or manner of death. The author had surveyed Personnel's perception toward conducting an autopsy in general hospital with autopsy at YeungNam University Medical Center, Daegu, Korea from April, to May, 2007. The total number of 286 personnel consisted of 121 men(42.3%), 165 women(57.7%). There were 57 doctors(19.9%), 71 nurses(24.8%), 83 medical technicians (29.0%), 58 office workers(20.3%), and 17 others(5.9%). 61.4% of doctors had an experience of education for autopsy more than 2 times, but nurses(1.4%), medical technicians(15.7%), office workers(1.7%), and others(5.9%) had little experience. Response of conducting an autopsy for sudden death of respondent or respondent's family member was 59.6% of doctors, 22.5% of nurses, 39.8% of medical technicians, 41.4% of office workers, and 35.3% of others. Response of conducting an autopsy for sudden death of respondent's companion was 66.7% of doctors, 33.8% of nurses, 39.8% of medical technicians, 43.1% of office workers, and 17.6% of others. Response of conducting an autopsy for sudden death of patients in general hospital was 50.9% of doctors, 8.5% of nurses, 19.3% of medical technicians, 24.1% of office workers, and 17.6% of others. Survey about a proper institution for autopsy showed 73.7% of doctors for department of forensic medicine in medical school, and 62.0% of nurses, 59.0% of medical technicians, 46.6% of office workers, and 58.8% of others for National Institute of Scientific Investigation. Most of the respondents agreed with the forensic pathologist as the director of autopsy:98.2% of doctors, 94.4% of nurses, 96.4% of medical technicians, 89.7% of office workers, and 88.2% of others. Survey for necessity for autopsy showed responsiveness of doctors, 23.9% of nurses, 47.0% of medical technicians, 34.5% of office workers, and 23.5% of others. Survey for donation of him- or herself after death to the medical school or institution for the death investigation revealed responsiveness of 22.8% of doctors, 11.3% of nurses, 24.1% of medical technicians, 22.4% of office workers, and 23.5% of others. The result of the survey questionnaire showed more negative awareness for autopsy in nurses, medical technicians, office workers, others and than doctors. To improve the negative awareness for autopsy and settle proper postmortem inspection system, education of professional manpower for forensic medicine and inaction of law which is adequate for the actual circumstance of Korea should be considered.