• 간호행정학회지
• /
• 제14권3호
• /
• pp.352-363
• /
• 2008

Purpose: The purpose of this study was to investigate nursing services of Oncology Advanced Practice Nurses(OAPNs) from the view point of structure and process. Methods: Roles and practices of OAPNs for cancer patients on chemotherapy were investigated by semi-structured interview and survey. Subjects were 14 OAPNs in 3 hospitals. Results: OAPNs had high level of education and certification than registered nurses. Most subjects of OAPNs were patients on chemotherapy and OAPNs used most of their time in education and expert nursing practice. 57.1% of OAPNs used delegated order. They were satisfied with their job in general, but satisfaction in communication with nurse manager or resident doctor was low. Conclusion: These results will be the concrete explanation for the nursing services of OAPNs. On the basis of theses results, more study about effects of OAPNs will be needed.

• 종양간호연구
• /
• 제6권2호
• /
• pp.93-103
• /
• 2006

Purpose: With accumulated necessity to develop Advanced Practice Nursing (APN) in Korea, various types of Nurse Practitioner (NP) programs have been recently developed. Unlike the origin of the NP programs in the U.S., in which the lack of primary health care provider preceded the creation of NP education, NP programs in Korea are currently in an early stage in which the scope of practice and educational boundaries are still evolving. Just imitating American models may result in culturally inappropriate and practically non-feasible APN programs in Korea. This article was aimed to evaluate the top-ranked Oncology NP (ONP) programs in U.S. with those in Korea. Method: Using the Donabedian paradigm, the educational structure, process, and outcome were compared and contrasted between two countries. Results: The findings of this paper demonstrated that many aspects of structure of the Korean program are similar to those of the Americans with minor differences. Three strategies for future development of ONP program in Korea are suggested. Conclusion: Practical and feasible scope of practice for ONP in Korea should be determined. It needs to embrace every aspects of cancer experience. Also, nursing-oriented and culturally competent practice needs to be identified and incorporated into the ONP practice.

• 간호행정학회지
• /
• 제5권1호
• /
• pp.113-136
• /
• 1999

There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.

• 간호행정학회지
• /
• 제15권4호
• /
• pp.527-538
• /
• 2009

Purpose: The purpose of this study was to reclassify the advanced nursing practices of critical care nurse practitioners(CCNPs) in intensive care unit and measure the time and frequency of CCNP's activities. Method: Practices of ICU nurses are divided into RN's and CCNP's practices by a panel of ICU nursing experts. Each practice of CCNP is defined and CCNP's working time and service frequencies are monitored in general hospitals. Result: Practices of CCNP were classified into 4 domains and 32 practices. Fourteen practices by CCNPs were completed in 10 minutes and the other 12 practices consumed 10-30 minutes. A priority of practice in respiratory therapy was given to artificial airway management, management of tracheostomy patient, lower respiratory care, and the priority of CRRT was management of anticoagulation. Conclusions: Advanced nursing practices of CCNPs were recognized from those of RNs. A further research of CCNPs practices should be extended to other advanced practices and it is required to evaluate economic value of advanced nursing practice in the national health insurance system.

• 의료법학
• /
• 제15권2호
• /
• pp.285-316
• /
• 2014

As the number of medical disputes regarding nurses has increased after medical disputes have increase, there is a need for a study on it. However, the legal relationship between nurses and patients has not yet been analyzed. Recently, the role and function of nurses are expanded according to the development of the science of nursing; moreover their activity and limitation of responsibility are also expanded. For this reason, the medical disputes regarding nurses have been increasing. However, the majority of these kind of dispute are just passed over because their practice is usually considered to be a mere action to assist doctor's role. In addition, nurse practice is not a secondary action of doctor's role, but forms part of a medical treatment. Of course, nurses handle many secondary tasks after doctors finish their medical treatment. But this is only part of the whole tasks of nurses. Furthermore, the general details of their medical treatment are not different from those of doctors because they also belong to the medical service personnel. Considering these features of nurse and the medical condition in South Korea, their task is becoming increasingly developed and specialized and they are also establishing their own field. With this stream of times, there is a growing interest in enacting a Nursing Practice Act, in other words, the independent law on nurse for the sake of patient safety and national health promotion. Then, their responsibility will distinctly be expanded as much more. That is, the time that nurses practice their medical care by following doctors' order and also pass over their responsibility to doctors is closed. Thus, this study examines the features and responsibilities of nursing practice, and discusses an institutional framework to efficiently cope with the legal disputes between nurses and patients. It aims to throw light on the decision making on nurse-patient disputes in future.

• 대한간호학회지
• /
• 제39권5호
• /
• pp.709-719
• /
• 2009

Purpose: The study was done to investigate physical assessment skills used by, and educational needs of, advanced practice nurses (APNs) and nurse specialists in Korea. Methods: A total of 123 APNs and nurse specialists working in five major hospitals in Seoul were surveyed from July 15 to August 20, 2007. Results: Fourteen skills out of 126 items were reported as being performed on a regular basis by participants. The majority of these skills involved general observation. Forty-six skills were rarely used. Some participants showed a lack of confidence in certain assessment skills, such as in doing a rectal or pelvic exam, and the use of some assessment equipment. Over 90% of participants required in-depth education on health assessment provided by specialists or nursing professional organizations. Conclusion: More educational opportunities in physical assessment should be provided including education programs based on the nurses' skill levels and needs. This effort will help to increase confidence of APNs and nurse specialists in physical assessment skills, ultimately resulting in better nursing outcomes.

• 부모자녀건강학회지
• /
• 제3권2호
• /
• pp.81-93
• /
• 2000

The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.

• 임상간호연구
• /
• 제16권1호
• /
• pp.131-143
• /
• 2010

Purpose: The purpose of this survey was to identify a set of performance indicators for Korean APNs (Advanced Practice Nurses). Methods: A convenience sample of 78 APNs working in 2 leading hospitals in south Korea participated in the three-round Delphi survey. In the first round, subjects were asked to propose performance indicators to evaluate the effectiveness of their practice. They rated the relevancy of each indicator during the second round. In the final round of survey, subjects rated the relevancy of indicators again in the light of second round's overall results and they also were asked to check on current and future use of indicators. Results: After 5 months of three-round Delphi survey, 60 performance indicators were identified. In regard to relevancy, the 10 highly ranked indicators were patient satisfaction, self-care ability, expertise of service, family satisfaction, nurse satisfaction, satisfaction in nursing education, advanced nursing service count, education for patient/ family, education for nurse, and compliance. Advanced nursing service count, education for patient/ family, and education for nurse are currently used as indicators by more than 70% of respondents. Conclusion: Additional research is needed to identify subsets of performance indicators for specialized areas and to determine the validity and sensitivity of indicators.

• 간호행정학회지
• /
• 제13권4호
• /
• pp.553-561
• /
• 2007

Purpose: This study aimed to assess needs of training programs for APN practice courses and continuing education programs for APNs to provide baseline data to improve APN education and practice. Methods: A total of 98 questionnaires were distributed to professors in 38 nursing institutions and 64 (65.3%) were returned. Data collection was performed in November and December, 2007 through email. Results: Professors in charge of geriatric and home care nurse practitioner programs constituted 43.7% of the study participants. Forty-one percent answered that they were satisfied with the practice programs they currently have operated, while 36.5% responded to have difficulty in appointment of institutions for practice programs and 56.3% had problems in assignment of preceptorship. In case of developing training programs for APN practice courses, 58.7% answered that they are willing to participate, and 90.6% felt needs for development of continuing education programs for APNs. Regarding liability insurance for APN students, only 11.5% provided insurance policy. Conclusion: The study results indicated that standardized training programs are needed to assure quality of APN education, and continuing education programs are required to provide opportunities for APNs to improve competencies.

• 여성건강간호학회지
• /
• 제5권1호
• /
• pp.133-145
• /
• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.