• 임상간호연구
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• 제16권1호
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• pp.131-143
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• 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.

• 대한간호학회지
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• 제53권1호
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• pp.39-54
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• 2023

Purpose: This study aimed to investigate the nationwide intention to delegate clinical practice of medical specialists in accordance with the enactment of the scope of practice for advanced practice nurses (APNs). Methods: Data were collected from October to December 2021 using Google Surveys. In total, 147 medical specialists from 12 provinces responded to the survey. The survey questionnaire was categorized into four legislative draft duties, according to the scope of practice (a total of 41 tasks): Twenty-nine tasks on treatments, injects, etc., performed under the guidance of a physician and other activities necessary for medical treatment (treatment domain); two tasks on collaboration and coordination; six tasks on education, counseling, and quality improvement; four regarding other necessary tasks. Participants were asked whether they were willing to delegate the tasks to APN. Results: The intention to delegate tasks to APN was higher for non-invasive tasks such as blood sampling (97.3%) or simple dressing (96.6%). Invasive tasks such as endotracheal tube insertion (10.2%), sampling: bone marrow biopsy & aspiration (23.8%) showed low intention to delegate in the treatment domain. Participants who were older, male, and had more work careers with APN, showed a higher intention to delegate tasks. Conclusion: To prevent confusion in the clinical setting, a clear agreement on the scope of APN practice as APN delegated by physicians should be established. Based on this study, legal practices that APN can perform legally should be established.

• 한국산학기술학회논문지
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• 제14권12호
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• pp.6146-6154
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• 2013

본 연구는 국내 전문간호사의 직무개선을 위한 기초자료를 제공하기 위해 전문간호사의 직무만족 및 직무수행에 관한 실태를 파악하기 위한 서술적 조사연구이다. 자료는 한국간호교육평가원에서 시행된 '2009년 전문간호사 직무만족도 조사' 원시자료를 이용하여 2005년부터 2008년까지 전문간호사 자격시험에 합격한 452명으로부터 얻었다. 자료분석은 SPSS 14.0 프로그램을 이용하여 평균, t-test 또는 ANOVA를 실시하였다. 전문간호사의 직무만족도는 평균 2.94점/5.00점으로 나타났다. 전문간호사의 자격분야와 동일한 직무를 수행하는 전문간호사가 그렇지 않은 전문간호사에 비해 직무만족(t=.23, p<.001), 임금상승(t=2.23, p<.05), 직급변화(t=2.56, p<.05), 전문적인 직무수행(t=10.52, p<.001), 상사와 동료와의 신뢰감 상승(t=5.31, p<.001), 직무수행에 대한 자신감 상승(t=5.07, p<.001) 등에서 각각 유의하게 높게 나타났다. 그러므로 정부와 간호계는 전문간호사들이 자격분야와 동일한 직무를 수행할 수 있도록 전문간호사의 적절한 인력수급, 보험수가 정책 마련 및 직무개선 등과 같은 노력이 요구될 것으로 사료된다.

• 성인간호학회지
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• 제22권4호
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• pp.395-407
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• 2010

Purpose: This study was to explore the process of belongingness experienced during the apprentice course for advanced practice nurses. Methods: Data were collected through in-depth interviews with 15 people, who attended the apprentice course for advanced practice nurse, from three schools in Seoul from Jan. 19 until Feb. 25, 2010. The constant comparative method was adapted for data analysis. Results: The core category of this study was the 'learning-connected process' and this process was categorized into three stages. These stages were: going along with the atmosphere, exchanging, and integrating. During the course, the 'uncomfortable participation' as the central idea meant a sense of responsibility and a tension about practice learning of the participant and was influenced by the quality of interaction and the distinct instruction of learning contents. Belongingness was characterized by the Joyful and happy participation which linked to the motivation of new learning opportunities. Conclusion: The findings indicate that there is a process to belongingness and a close relationship between belongingness and learning. Further studies would suggest exploring the components of belongingness, a concept analysis and incorporating the belongingness scale with other qualitative research on this topic.

• 중환자간호학회지
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• 제16권3호
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• pp.1-10
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• 2023

Purpose : This study explores the professional status of Advanced Practice Nurses (APNs) in Korea, who, despite being legally certified, face instability in their professional standing, including their scope of practice and compensation. Method : The study uses Flexner's professional characteristics as a framework to analyze and project the future trajectory of Korean APNs. Results : First, to ensure social accountability, professional bodies need to establish uniform nursing policies related to job roles, and healthcare institutions must adhere to these policies. Second, nursing leaders should spearhead the creation of nursing knowledge essential for the profession's advancement, aiming to establish it as the foundation for nursing practice through a consensus process within the nursing community. Third, the curriculum for APNs should enhance the quantitative and qualitative aspects of practice in response to societal needs. Fourth, professional bodies should formulate consistent nursing policies based on a thorough analysis of the healthcare environment and legal considerations, and guide their implementation in clinical practice through a consensus process within the nursing community. Lastly, guidelines should be established for professional standards suitable for the Korean context. Conclusion : Based on this review, it is recommended that all APNs adhere to the professional standards set by their respective organizations, actively participate in personal quality improvement initiatives, and fulfill their duties and roles as members of these professional bodies. Furthermore, these organizations should devise practical strategies to solidify the APN system and should spearhead a systematic consensus process that garners the agreement of all members within the nursing community.

• 간호행정학회지
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• 제5권1호
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• pp.113-136
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• 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.

• 임상간호연구
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• 제26권2호
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• pp.240-253
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• 2020

Purpose: This study was conducted to provide basic data for the systematization of 13 areas related to Advanced Practice Nurses (APN). Methods: The three-phase study was conducted as follows. 1) review of APN system and curriculum, 2) Focus Group Interviews (FGI) with 9 APNs, 6 physicians, and 3 nursing professors on the APN system, 3) analysis of clinical practice of the 13 APN areas, and of the accreditation and certification system for APNs, medical board, and medical subspecialty board. Based on the above data, a systematic plan was drawn. Results: The 13 APN areas could be divided into 7 groups based on a review of the APN system and curriculum for the 13 areas. Analysis based on clinical practice showed that the 13 APN areas could be divided into 4 groups. Two themes and seven categories emerged in FGI. The two themes were 1) 13 APN areas that need to be discussed, 2) improving the curriculum for APN. Considering these themes from FGI and the system of the medical subspecialty board, results could be integrated into 2 groups - clinical area and non-clinical area. Conclusion: The 13 APN areas need to be integrated in order to activate the APN system. For that, further discussions on improvements and a standard curriculum according to legislation related to APN should be carried out.

• 한국산학기술학회논문지
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• 제20권11호
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• pp.44-55
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• 2019

본 연구는 간호사를 대상으로 초기 심정지 5분 간 수행능력, 자신감 향상을 위해 전통적 시뮬레이션 교육 방법과 Rapid Cycle Deliberate Practice(RCDP) 시뮬레이션 교육 방법을 받은 전·후 변화를 확인하고 두 그룹 간의 수행 능력, 자신감, 만족도를 비교 하고자 시도되었으며 연구 대상자는 서울 소재 병원의 간호사로 그룹 1은 62명으로 RCDP 시뮬레이션 방법을 그룹 2는 60명으로 전통적 시뮬레이션 교육 방법으로 총 122명의 간호사에게 전문 소생술 교육을 진행 하였다. 2019년 3월 18일부터 29일 까지 자료 수집을 하였으며 자료 분석은 SPSS Version 23.0 프로그램으로 서술적 통계, Fisher's exact test, t-test, Wilcoxon sign rank test, Mann-Whitney U-test를 활용하여 분석하였다. 연구 결과 RCDP와 전통적 시뮬레이션 교육의 두 그룹 간에는 수행 능력의 일부 항목(z=-2.02, p=0.044 / z=-2.42, p=0.015 / z=-3.03, p=0.002)은 유의한 차이를 보였으나 수행 자신감(z=0.388, p=0.699)과 만족도(t=.72, p=0.476)에서 두 그룹간의 차이는 없었다. 본 연구는 전통적 시뮬레이션 교육 방법과 RCDP 시뮬레이션 교육 방법 모두 간호사의 전문 소생술 수행 능력 및 자신감을 높이는데 효과적인 교육 방법임을 확인하였다. 따라서 간호사 대상 전문 소생술 교육시 교육 대상 및 내용에 따라 적절한 시뮬레이션 방법을 적용하고 다양한 분야에 RCDP 시뮬레이션 교육 방법을 활용하여 효과성을 확인 해 볼 것을 제언한다.

• 지역사회간호학회지
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• 제31권2호
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• pp.143-155
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• 2020

Purpose: This study aimed to explore the difficulties and coping that advanced practice nurses (APNs) experience in home health nursing field. Methods: The participants were 12 APNs who had experience in home health nursing for over 5 years. Data were collected through two focus group interviews between August and September, 2017. The results were analyzed using a qualitative content analysis. Results: Out of 10 sub-categories and 29 codes, 4 categories emerged: "crushed by the responsibilities as the only healthcare professional", "worn out by family who interfere with work", "anxiety about my safety being threatened" and "using self-learned know-hows". Conclusion: APNs face difficulties due to the environmental characteristics of the homes, the characteristics of chronically critically ill (CCI) patients and their families, and legal or systematical limitations when dealing with problems based on their personal competence. In order to ensure that professional nursing care is more readily provided to CCI patients through home health nursing services in local communities, it is imperative that support systems at the organizational and institutional levels be established in a systematic way to resolve the issues faced by APNs.

• 임상간호연구
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• 제21권3호
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• pp.335-346
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• 2015

Purpose: The purpose of this study was to identify patient satisfaction about nursing care provided by Advanced Practice Nurses (APN) using the La Monica-Oberst Patient Satisfaction Scale (LOPSS). Methods: The investigation was conducted including 263 patients who experienced care provided by 41 APNs at a tertiary hospital in Korea. Patient satisfaction with nursing care was measured using 41-item LOPSS. We analyzed the data using descriptive statistics, independent t-test and one-way ANOVA. Results: Overall patient satisfaction with APN care was high. The LOPSS scores for APNs were 52.26 for good impression, 61.75 for interpersonal support, 81.32 for dissatisfaction and 195.93 for total score. "APNs talk down to me" was a reverse coding item which demonstrated the highest score for patient satisfaction. Among patients' characteristics, age and type of main caregiver were independent factors related to patients's satisfaction. Among APN's characteristics, work experience was significantly related to patients' satisfaction. Conclusion: This study identified patient satisfaction regarding nursing care provided by APNs. High patient satisfaction in APN services demonstrated APNs' contribution to quality improvement in health care services. It is recommended that various outcome research about APN service needs to be performed.