• 간호행정학회지
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• 제7권3호
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• pp.439-446
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• 2001

The purpose of this study was to identify the relationship of nursing service satisfaction and nurse's nursing activity styles in a hospital settings. The subjects of this study were 150 admitted patients in a hospital. The data was collected with Nursing Service Satisfaction Scale developed by Tomas(1996) and modified Nurse's Nursing activity styles Scale developed by Coeling(1993). The results were as follows: 1. The mean score for the level of nursing service satisfaction was 65.00(SD=14.10). The mean score for subcategories of nurse's nursing activity styles were as follow; work difficulties management 9.47(SD=2.02), effective work attitude 23.53(SD=3.14), interpersonal relationship 48.82(SD=6.18), keep regulation 23.24(SD=3.62), professional values 48.28(SD=5.27), and professional development 24.41(SD=3.07). 2. The correlations of nursing service satisfaction and subcategories of nurse's nursing activity styles were revealed a positive significant correlation; work difficulties management(r=0.17, p=0.03), effective work attitude(r=0.44, p=0.00), interpersonal relationship(r=0.51, p=0.00), keep regulation(r=0.44, p=0.00), professional values(r=0.31, p=0.00), professional development(r=0.30, p=0.00). 3. Stepwise multiple regression analysis revealed that the most powerful predictor of nursing service satisfaction was effective interpersonal relationship. A combination of effective work attitude, work difficulties management account for 38% of the variance in nursing service satisfaction of the patient in a hospital. In conclusion, this study revealed that the effective work attitude, interpersonal relationship, and work difficulties management in nursing activity were important factors to improve the level of nursing service satisfaction.

• 간호행정학회지
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• 제2권1호
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• pp.17-33
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• 1996

The primary purpose this descriptive study was to identify, describe, and compare the patterns of shared governance and nursing unit culture in the hospital settings. The secondary purpose of the research was to identify, describe whether the participation style or responsibility style of nursing management activities shared through nurses in a consistent way. Methodology included survey and in-depth interviews with a total 145 members of 15 nursing units in 3 hospitals. One was a national hospital, another was a corporation hospital and the other was a teaching hospitals. Conclusions from this research included the following: 1. The degree of shared governance in nursing management activities was the highest in the corporation hospital. 2. In the participation style of nursing management activities, 'all participation' was the highest in the corporation hospital. 'Nursing administration only' was the highest in the national hospital. 3. Distribution of responsibility style differed from that of participation style. Three hospitals showed high in nursing management activities such as 'nursing administration only' and 'head nurse only' style. 4. Five experts surveyed showed that the ideal level of nurses' participation in nursing management activities was a traditional nursing governance pattern. 5. There was a distinct difference in the nursing unit culture throughout the institutions in the professional growth. 6. There was no significant difference in the same nursing units of three hospitals in nursing unit culture. According to these results, the following implications can be made; 1. In nursing administration, there should be an emphasis on preparing staff nurses' potential decision-making ability through continuing education so that staff nurses' autonomy and responsibility will be developed and increased. 2. It is necessary to develop a strategic nursing unit for improving nursing quality in hospital setting. 3. The relationship of shared governance, nursing unit culture and nursing outcome should be researched further.

• 간호행정학회지
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• 제22권5호
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• pp.448-460
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• 2016

Purpose: The study was done to verify evidence-based practice (EBP) readiness and factors contributing to EBP competency in general hospital nurses. Methods: Participants were 219 nurses working in 7 general hospitals in G-city and J Province. Data were collected from May 12 to May 28, 2015 and analyzed using one-way ANOVA, Pearson's correlation and stepwise multiple regression. Results: Mean score for EBP competency was $3.89{\pm}0.83$, for critical thinking disposition, $3.35{\pm}0.36$, for EBP attitude, $3.53{\pm}0.66$, for beliefs about value of EBP, $3.42{\pm}0.56$, for ability in research performance, $2.86{\pm}0.57$, for time to devote to EBP, $2.57{\pm}0.69$ and for organization support for EBP, $3.36{\pm}0.46$. EBP competency was significantly correlated with critical thinking disposition (r=.37, p<.001), beliefs about value of EBP (r=.43, p<.001), ability in research performance (r=.44, p<.001), and time to devote to EBP(r=.33, p<.001). Factors influencing EBP competency in general hospital nurses were research performance (${\beta}=.29$, p<.001), beliefs about value of EBP (${\beta}=.24$, p<.001), critical thinking disposition (${\beta}=.15$, p=.014), recognition of EBP (${\beta}=-.18$, p=.002), which together explained 35% of total variance. Conclusion: Findings indicate that introduction and activation of EBP in general hospitals is essential and development of systematic training programs to strengthen critical thinking disposition and EBP competency are needed.

• 간호행정학회지
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• 제22권5호
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• pp.496-506
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• 2016

Purpose: This study was conducted to examine the adaptation experience of male nurses working in general wards. Methods: Experiential data was collected from 16 general ward nurses through in-depth interviews. Participants were selected from male nurses working in the general wards with over one year of clinical experience at a tertiary university hospital. The main question was "Can you describe your adaptation experience in the general ward as a nurse?" All interviews were recorded and transcribed, then analyzed using Colaizzi's method. Results: Four categories were derived from the analysis: 'difficulties from task adaptation by characteristics', 'limited nursing situation and circumstance as a male nurse', 'efforts to adapt at general nursing unit', and 'self-worth, and worry about something as a male nurse'. Conclusion: Male nurses had a difficulty adapting to work in wards due to lack of multi-tasking skills, as well as some social prejudice or negative views on male nurses. Establishing reasonable guidelines for male nurses in practice, promoting their responsibilities to patients, developing mentoring programs, and reassessing the policy of assigning male nurses to general wards are recommended to help in better adaptation.

• 보건행정학회지
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• 제23권2호
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• pp.103-111
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• 2013

Seven diagnosis-related groups (DRGs) prospective payment system is going to expand to all hospitals including university hospitals this year. However there are few studies on the change of practice pattern under prospective payment system in the university hospital setting. So This study was intended to predict the practice pattern change after the introduction of 7 DRGs prospective payment system in a university hospital setting. To predict the change of practice pattern, this study used simulation technique. Five hundred and nineteen patients classified as 5 DRGs in a university hospital were selected for simulation. The change of practice pattern were predicted based on clinicians' opinion. We also predicted payment change by service items. Major findings of this study are as follows. First, the total medical payment was reduced by 14.4%. The drug payment change (8.8%) took most of total payment reduction. The followings are the change of treatment material cost (3.2%), the change of laboratory tests cost (1.8%), the change of room charge (0.5%), and other payment change (0.1%), respectively. Second, most of the reduction in total medical payment resulted from the decreased amount of medical services themselves. The transfer of medical services to outpatient setting took up only 4.9% of the total payment reduction. The change of unit price or composition took up 5.5% of the total payment reduction. In this study we found that it is possible to reduce the inpatient services through practice pattern change in university hospital setting. However, it needs to be careful to adjust DRG payment after the reduction of provided services, because most of reduction was not due to service transfer but to service volume reduction. It is desirable to utilize the saving from practice pattern change as incentive to improve quality of care.

• 보건행정학회지
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• 제27권4호
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• pp.315-323
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• 2017

Background: This study was purposed to analyze the effect of spatial accessibility to the psychiatry department in general hospital on the outpatient visit of mental patients. Methods: Data was provided from the Statistics Korea and Statistical Geographic Information Service, National Health Insurance Service, Health Insurance Review and Assessment Service, and Korea Transport Institute in 2015. The study regions were 103 administrative regions such as Si and Gu. The 103 regions had at least one general hospitals with a psychiatry department. The number of outpatient visit of mental patients in regions was used as the dependent variable. Spatial accessibility to mental general hospital was used as the independent variable. Control variables included such as demographic, economic, and health medical factors. This study used network analysis and multi-variate regression analysis. Network analysis by ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA) was used to evaluate the average travel time and travel distance in Korea. Multi-variate regression analysis was conducted by SAS ver. 9.4 (SAS Institute Inc., Cary, NC, USA). Results: Travel distance and time had significant effects on the number of outpatient visits in mental patients in general hospital. Average travel time and travel distance had negative effects on the number of visits. Variables such as (number of total population, percentage of aged population over 65, and number of mental general hospital) had significant effects on the number of visit in mental patients. Conclusion: Health policy makers will need to consider the spatial accessibility to the mental healthcare organization in conducting regional health planning.

• 간호행정학회지
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• 제2권2호
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• pp.5-16
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• 1996

The purpose of this study is to identify the handwashing knowledge and attitudes of resistered nurses on general wards. Subjects for this study include 182 nurses working in general wards of a hospital in Seoul area. Data were collected by a questionnaire from July 30 to August 10,1996. Statistical analyses were done by the SPSS/PC program. The techniques used in this sudy included frequencies, chi-square test. The results of this study are summarized as follows. 1. 34.6% of the respondents reported that they washed their hand an average of 5 to 7 times during the work day. 2. 38.5% of the respondents reported always washing after each patient contact. Only 9.9% always washed before contact with a patient. 3. 56.6% of the respondents reported a washing time of 10 to 20 seconds, whereas 29.1% washed 21 to 30 seconds. Chi-square tests were employed to determine any differences in handwashing frequency and duration by age, working years, work position. There were no satistically significant differences among the variables. 4. 95.6% of the subjects used water and plain soap during the washing process. The respondents washed the palms of the hands, the backs of their hands and between their fingers(33%). Only 17.6% removed rings before handwashing. Similarly, 11% removed their wristwatch. The majority(96.2%) reported that they used communal textile towel to dry their hands. When asked what method they used to turn off the water faucet after washing, 98.4% reported using direct hand-to-faucet contact. 5. Nursing activities that showed the highest handwashing rates was after wound dressing(22.9%), followed by suctioning(21.4%), injection(21.2%), inserting catheter(18%). 6. Reasons cited for reduced handwashing frequency included being too busy to wash more often(74.7%), no need to wash more often(11.0%) and dry skin caused by frequent handwashing(3.3%). 7. When asked where they obtained their current knowledge of handwashing techniques, they reported professors(73.6%), resisted nurses(14.8%) and supervisor(6.6%). 8. Nursing staff thought that proper handwashing was important factor in decreasing nosocomical infections(72.4%).

• 보건행정학회지
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• 제4권2호
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• pp.1-26
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• 1994

As the hospital environment is changing rapidly, management is therefore obligated to use new ways to provide better service to patients. For example information system is introduced to some hospitals in Korea. Information system has several benefits such a soperational efficiency by on-line delivery and processing of data, accurate and rapid information production, continuous monitoring of performance and feedback, improvement of work process and better service quality. Still, many hospitals cannot be sure that information system is useful for improving organization performance. Because only one or two area of hospital information system were considered for development and with limited development hospital information system cannot be used effectively. The purpose of this study is to suggest the model of information system utilizaton and to analyze the hospital in formation system in Korea. The results are following; 1. In Korea, proportion of operating system of comuter is 31% of UNIX, 11% of IBM OS and 10% of PC LAN. 2. As we expect, scope of application software and amounts of heardware and software invest ments are affected by concern of CEO. 3. Many CIO(chief information officer) say that the biggest problems are lack of after-service and obsolescence of computer equipments in terms of hardware and shortage of application software for hospital in terms of software. 4. Personnel of information system department is so small that hospital information system can't be improved. 5. During the development of information system, full-time participation of end user is only 20% hospital with almost less than 12 person-month. This study was accomplished by survey through mail questionnaires. Response to the survey was only 55% and it was hard to generalize all the result obtained from this survey. However, We hope that this study would be helpful for helth care organization to acknowlege hospital information system in korea and to design the future architecture and frame of information system.

• 보건행정학회지
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• 제3권2호
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• pp.130-158
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• 1993

This study was written to discover the changes that may exist in the contents of medical services after introduction of health insurance system, and to identify the net-effect of health insurance system on medical services. Uncomplicated nornmal delivery and appendectomy patients were divided into 4 groups, the non-insured in pre-NHI periods(group A), the insured of health insurance for employees in pre-NHI periods(group B), the insured of regional health insurance for city residents in post-NHI periods(group C) and the insured of health insurance for employees in post-NHI periods(group D). The mehtod of matching was applied to control for major demographic differences among these 4 groups of each disease. In pre-NHI period, the medical services and the variation of medical services of the non-insured were compared with those of the insured. The difference between the change of medical services from group A to those of group C, and the change of medical services from group B to those group D is defined as the net-effect of health insurance. The results are as follows. First, in length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients, frequency of sitz bath in delivery patients, there was net-effect of health insurance in increasing direction. Second, length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients and frequency of sitz bath in delivery patients were significantly more in the insured than in the non-insured group in pre-NHI period. Third, the variation of medical services of post-NHI period was not less then those of pre-NHI period. Fourth, antenatal care on which the third party does not pay and the patient pays for all, was diffrerent by socioeconomic and educational level of patients.

• 보건행정학회지
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• 제15권1호
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• pp.1-29
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• 2005

This study examined the antecedents of psychological empowerment at hospital organizations, and also examined their differential effects among occupational groups within hospitals: doctors, nurses, engineers, and administrative workers. Various variables for multi-level factors were examined as antecedents: tenure, income, work centrality, and career goal as personal factors, job variety, job clarity, job significance, and job fitness as job factors, and security, reward justice, and organizational support as organizational factors. Data were collected from 8 national university hospitals, and 1,289 data were used for final analysis. For the whole groups, all antecedents except reward justice had significant effects on, and explained large amount of variance of empowerment. Results from the analysis for each occupational group showed that income, career goal, and job significance had significant effects on empowerment at all occupational groups, while reward justice had not at any groups. The effects of other variables depended on occupational groups. 1bis study found some important antecedents of empowerment which have been less considered in previous research: career goal, work centrality, security, and organizational support. The finding that differential effects of antecedents on empowerment by occupational groups suggests that group characteristics should be considered for studying empowerment. In this study, for example, personal factors rather than both job factors and organizational factors were more effective for empowerment in the engineering group whose job is relatively simple and clear, while job factors were most effective in other groups. The differential effects of antecedents on empowerment by occupational groups also have practical implications for improvement of empowerment at hospitals. For empowerment, personnel management efforts would be more required for administrative workers than other occupational groups, because they perceived least job clarity, job significance, job fitness among the groups, all of which were found to be important determinants of empowerment for them.