• Journal of Korean Clinical Nursing Research
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• v.25 no.1
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• pp.55-66
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• 2019

Purpose: This study was done to assess development and postnatal care interventions in postnatal care intervention records for maternity ward nurses in tertiary hospitals and women's hospitals in South Korea. Methods: This mixed-method research was a Time-Motion (TM) study. Data were collected through external observation of 12 nurses in 4 wards over 24 hours. Mann-Whitney U test and independent t-test were employed for the analysis of frequency and provision time of direct/indirect care activity. $x^2$ (Fisher's exact test) was utilized to determine the difference in frequency between two groups. IBM SPSS 22.0 statistical program was employed for calculation. All statistical significance levels were at ${\alpha}=.05$. Results: According to the KPCS-1 (Korean Patient Classification System-1), women's hospitals are group 3 and tertiary hospitals, group 4. With respect to time difference in direct care, tertiary hospitals showed 791 minutes and women's hospitals, 399 a difference of 392 minutes. For time difference in indirect care, women's hospitals had 2,415 minutes while tertiary hospitals, 2,080, a difference of 335 minutes for women's hospitals. No difference was found in the average total care workload between the two institutions. Individual time also showed no difference (p>.05). Conclusion: High-risk maternal care strength in tertiary hospitals and breast-feeding strength in women's hospitals need to be benchmarked with each other.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.48-61
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• 2023

Purpose : This study aimed to identify and describe the leadership experience of advanced practice nurses (APN). Methods : Data were collected through five focus group interviews in 2022 with a total of 24 APNs in groups of 4-6 participants. All interviews were recorded, transcribed, and data were analyzed using qualitative content analysis. Results : Nine categories emerged from three main themes. First, "Roles of APN leadership" comprised a trusted clinical expert, a moderator for the entire team, a resource person for nurturing the next generation, and a change agent for improving clinical practice. Second, "Facilitators and barriers to APN leadership" included ambiguity of APN role, support system, and institutional backing. Third, "Strategies for strengthening APN leadership competencies" comprised systematic leadership education and speaking up for APNs. Conclusion : APNs are passionate about their expertise and practice, but lack the legal and organizational authority and support to provide successive leadership. Systematic education including leadership and organizational advocacy will enable APN to provide leadership that benefits patients, institutions, and the wider healthcare system.

• Korean Journal of Occupational Health Nursing
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• v.19 no.2
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• pp.268-277
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• 2010

Purpose: To examine the relations among occupational satisfaction, stress, and customer orientation of upper-scale general hospital nurses. Method: We studied with structured questionnaires with total 66 questions for 218 nurses working at university hospitals in Gangwon-do from February 2 to 22, 2010. Result: Occupational satisfaction and customer-oriented character increased when nurses' ages and career experiences were higher, married, working in daytime without shift and in higher positions. Occupational stress increased when nurses were younger, not married, with three shifts, and when they were general nurses. However, there was no statistical difference. Customer-oriented character had positive correlation with occupational satisfaction and stress while occupational satisfaction had negative correlation(r=-0.358) with occupational stress. Conclusion: As occupational stress and satisfaction of nurses in university hospitals showed significant relations with customer-oriented character, t is necessary to reduce occupational stress of nurses, and strengthen occupational satisfaction of them.

• The Korean Journal of Health Service Management
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• v.6 no.4
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• pp.83-98
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• 2012

The objective of this study is to analyze the utilization patterns of national health insurance and medical aid inpatients in tertiary hospitals. For the analysis, the study utilize the nationwide data on '2010 Survey of Patients' of Ministry of Health & Welfare. The statistical methodology used in the study is the logistic regression model. This study has three major findings. First, utilization rate of national health insurance inpatients was higher than medical aid inpatients in tertiary hospitals. Second, the significant affecting demographic factors in utilizing tertiary hospitals were sex, age, surgery case, treatment result, inpatients residence region and short length of stay. Third, compared to other disease groups, the inpatients on 'congenital malformation, deformity and chromosomal abnormalities', 'factors influencing health status and contact with health services' and 'neoplasm' groups are more likely to utilize tertiary hospitals. Finally, according to residence region, Seoul residence inpatients in both of national health insurance and medical aid more likely to utilize tertiary hospitals than other region inpatients.

• Journal of the Korean Society of Radiology
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• v.79 no.5
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• pp.247-253
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• 2018

The purpose of this study was to summarize the results of a survey for physicians with specialties other than radiology about imaging studies of patients referred from other institutions. The survey was promoted through individual contacts or social network service and physicians who voluntarily responded to the survey were the subjects of the study. The questionnaire consisted of 11 questions about basic information and referrals about medical imaging. A total of 160 physicians from 30 specialties participated in the survey and 95.6% of the respondents worked in tertiary care center or general hospital. Patients were frequently referred with outside medical images. The most frequently referred imaging modalities were computed tomography and magnetic resonance imaging. However, radiological reports from outside institutions were rarely referred. Most physicians thought that reinterpretation for outside imaging is necessary to acquire a secondary opinion. In conclusion, considering that outside radiological reports are frequently missing and there are high demands on reinterpretation for outside imaging, guidelines for referral of radiological reports with medical imaging, basic elements of radiological reports, and reinterpretation need to be developed.

• Women's Health Nursing
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• v.18 no.3
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• pp.200-208
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• 2012

Purpose: This study was aimed to examine the gap between predicted cesarean section rate and real cesarean section rate and it's determining factors of 44 tertiary hospitals. Method: This study is a cross-sectional analysis using the data of 25,623 deliveries in 2009 drawn from homepage of Health Insurance Review and Assessment Service. Data were analyzed with t-test, F-test, Scheff$\acute{e}$ test, and logistic regression. Result: There were statistically significant differences in the gap of cesarean section rate (more gap indicates higher quality of delivery) by grade of nurse staffing and delivery cases. Hospitals with nurse staffing grade 1 to 2 had more possibility to be classified into higher grade in quality of delivery (OR 5.67, 95% CI 1.07-30.08). Also hospitals with over 500 delivery cases had more possibility be classified into higher grade in quality of delivery (OR 4.92, 95% CI 1.14-21.23, respectively). Conclusion: The finding suggests that grade of nurse staffing may influence the real cesarean section rate because nurses do a vital role to prevent unnecessary cesarean section. Further study is required to provide evidence that nurse staffing influence on patient outcome and cost-effectiveness in order to obtain adequate number of nursing staffs.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.179-188
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• 2017

Purpose: This study examined post-traumatic stress (PTS) and the factors affecting it among general hospital nurses after the MERS(Middle East Respiratory Syndrome) epidemic. Methods: Data were collected from 170 nurses who worked at general hospitals since the first reported MERS outbreak. The IES-R-K assessed PTS. Data were analyzed using SPSS. Results: The mean PTS level was 7.80 points (range: 0~88); 7.1% of the participants were at a high risk. Nurses who had been in contact with patients suspected or diagnosed with MERS had high post-traumatic levels; those who had been quarantined during the MERS outbreak had relatively higher PTS levels. Shift-work nurses had higher PTS levels than those with fixed working hours. Above charge' nurses stress levels were higher than staff nurses' stress levels. The results showed that factors including contact with an MERS-suspected or diagnosed patient, position at work, and working status of MERS-affected nurses explained 16% of the PTS. Among the main variables, nurses' above charge position was the greatest factor affecting PTS. Discussion: It is necessary to develop intervention studies and programs considering these variables. Furthermore, development and implementation of differentiated programs should be done considering the position of above charge nurses.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.202-210
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• 2017

Purpose: In this study an investigation was done of injuries from inpatient falls and diagnostic tests and treatment after falls to identify what factors affect the occurrence of injury from inpatient falls in a tertiary hospital. Methods: Data for this cross-sectional study were retrieved for 428 fall events from data reported between January 1 and December 31, 2015 and were retrieved from the patient-safety reporting system in the hospital's electronic health records. A multivariate logistic regression model was developed with STATA 13.0. Results: Of the patients, 197 (46.0%) had physical injuries due to falls, 119 (27.8%) were given further diagnostic tests, and 358 (83.6%) received treatment including close observation after inpatient falls. Logistic-regression results identified that age, department, and risk factors had significant impact on injuries from falls. Conclusion: Findings indicate that to reduce the severity of injury after inpatient falls, each hospital should regularly evaluate identified factors, design fall-prevention practices specialized for elders and vulnerable patients, and initiate environmental and equipment innovations.

• Journal of Korean Clinical Nursing Research
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• v.24 no.2
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• pp.235-244
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• 2018

Purpose: This study aimed to examine nurses' knowledge levels and educational needs related to an artificial pacemaker. Methods: Participants were 100 nurses working in cardiovascular departments from two university hospitals in Seoul. This study was a descriptive study using a survey for estimating knowledge levels and educational needs related to an artificial pacemaker among nurses. Data were analyzed by SPSS 23.0 program using frequency, percentage, mean and standard deviation, t-test, and ANOVA. Results: Nurses' knowledge levels were significantly different depending on working units (F=3.32, p=.014) and years of clinical experience (F=2.85, p=.042). Nurses who received education about an artificial pacemaker were higher in the knowledge level of complications after an implantation procedure (t=3.45, p<.001) than nurses who did not receive the education. Conclusion: Discharge education is critical for patients with artificial pacemaker implantation to go back to their daily activities. When developing artificial pacemaker education program for hospital nurses, factors such as nurses' working department and years of clinical experience years and updated information of an artifical pacemaker need to be considered.

• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.128-140
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• 2021

Purpose : This study aimed to identify the incidence of peripheral cyanosis and the characteristics and clinical results of patients with therapeutic hypothermia after a cardiac arrest. Methods : Data were collected from April to June 2021 via the electrical medical records of 95 patients with therapeutic hypothermia for 72 hours after a cardiac arrest admitted to an acute care unit at a tertiary hospital between January 1, 2016, and December 31, 2019. The data were analyzed using descriptive statistics and a t-test, Mann-Whitney U test, Chi-squared test, Fisher's exact test, and logistic regression using SPSS/WIN. Results : The incidence of peripheral cyanosis was 20%. In the peripheral cyanosis group, peripheral vascular disease, fibrinogen, vasopressor, infection, disseminated intravascular coagulation, acute physiology, chronic health evaluation II score on the second hospital day, nursing intervention, and mortality on the seventh hospital day were higher. The level of fibrinogen and use of vasopressors affected the occurrence of peripheral cyanosis. Conclusion : Considering the influencing variables, careful observation is necessary for patients with high fibrinogen levels and vasopressor use. These results provide basic data to recognize the need for nursing intervention for peripheral cyanosis and encourage nurses to deliver them during therapeutic hypothermia.