• Korea Journal of Hospital Management
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• v.24 no.3
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• pp.61-71
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• 2019

Purposes: The purpose of this study is to analyze nurses' perception on the clinical career ladder system which was introduced to enhance the nursing capabilities in general hospital. Methods: Research data has been collected for approximately 30 days since March 28, 2017 from 171 nurses who had been involved in the clinical career ladder system, 177 nurses who had not participated, and a total of 348. Finding: The study results showed that nurses' perception on the cost effectiveness of clinical career ladder system is significantly different depending on the sex, age, program experience, personal stage in the clinical career ladder system and the individual's health condition. In addition, the nurses' willingness to pay for the clinical career ladder system was significantly associated with their department and the needs for the system. With adjusted age, gender, position, education and marital status, nursing competency was 8.71(95% Confidence Interval; 4.79 to 12.63) in the presence of system experience, but the perception on clinical career ladder system was 4.34(95% Confidence Interval; -6.84 to -1.84). Practical Implications: Based on the study results, we expect that more hospitals introduce the clinical career ladder system and also use these study results as basic data for securing excellent nurses.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.4
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• pp.501-512
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• 2013

Purpose: This study was done to develop a nursing competency scale according to a clinical ladder system for intensive care nurses. Methods: Index of content validation was done by 20 clinical experts and 80 nurses in Intensive Care Units (ICU). Results: The process and results of study are as follows. First, 12 nursing competencies were used in the establishment of the clinical ladder system (Jang, 2000). Second, the first draft of the competency lists was developed. It was based on the clinical nurses' behavioral indicators of nursing competency by Jang (2000), and was modified and supplemented through various literature reviews including competency standards for specialist intensive care nurses in Australia and consultation with 2 clinical nurses with over 10 years experience in the ICU. Third, the draft was examined by 20 clinical experts for content validity. Finally, the final draft was analysed using clinical validity where 20 nurses in each ladder participated. The final number of items was fixed at 309. Conclusion: The tool represents expected nursing competency of nurses working in ICU. Intensive care nurses can recognize their strengths and weaknesses, and identify directions for their professional growth by analysing results of their competency evaluation using this tool.

• Journal of Korean Academy of Nursing Administration
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• v.21 no.3
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• pp.233-242
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• 2015

Purpose: This was a correlational study to identify effects of perception of clinical ladder system on job satisfaction and intention to leave in perioperative nurses. Methods: Participants were 154 of perioperative nurses from larger general hospitals in Seoul. Data were collected from April, 16 to 22, 2013 using self-report questionnaires which included items on perception of clinical ladder system, job satisfaction, and intention to leave. Data were analyzed using frequency, t-test, ANOVA, $Scheff{{\acute{e}}$ test, Pearson correlation coefficients, and multiple stepwise regression. Results: The average mean score for perception of clinical ladder system was midline at 2.69 point out of 4 point. Perception of clinical ladder system correlated positively with job satisfaction (r=.38, p<.01) and negatively with intention to leave (r=-.88, p<.01). Perception of clinical ladder system was the factor which most influenced job satisfaction explaining 17.1% of the variance, also perception of clinical ladder system was the factor which most influenced intention to leave, explaining 12.7% of the variance. Conclusion: Results of this study suggest that there is a need to enhance the perception of the clinical ladder system and to find ways to fulfill the expected effects for improving perioperative nurses' job satisfaction and reducing the intention to leave.

• The Journal of Korean Academic Society of Nursing Education
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• v.12 no.1
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• pp.60-69
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• 2006

Purpose: This study was to explore the clinical competence according to clinical ladder of operating room nurses. Method: The subjects were 125 the operating room nurses working at five university hospitals in four city. The instrument to measure the clinical competency and clinical performance of OR nurses was developed by researcher. It consisted of 12 domains of clinical competence and 23 items of clinical performance. Results: Clinical competence and clinical performance of OR nurses group devided into 4 groups by clinical ladder such as 0-12month, 13-36 mon. 37-84 mon. over 85 month were significantly different. More experienced nurses performed higher level of clinical performance and competency in 23 items and 12 domains. Conclusion: It will be needed to add concrete behavioral patterns and behavioral indicators of nursing competencies, per stage of the clinical ladder, by repetitive studies on nurses of various hospitals and to confirm the validity.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.3
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• pp.301-314
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• 2011

Purpose: This study was a methodological research conducted to develop a clinical ladder system for operating nurses. Methods: Participants were 20 OR nurses, working in C Hospital, who had a mean tenure of 6 years and 10 months. Data collection consisted of 4 focus group interviews during May and June 2009. The content analysis method of Kim and Lee (1986) was used to analyze the data. Two clinical expert groups consisting of 16 nurses verified the content validity of the preliminary system from September 16 to 26, 2009 using Kim's tool (1999). Results: The final clinical ladder system consisted of goals, core values, and 4 domains of practice related to core values, which were defined as professional value, perioperative nursing practice, education/research, and collaboration/leadership. Eleven nursing competencies and 44 behavior indicators were included in accordance with the 4-step ladder. The 4 operation systems for the clinical ladder system were the promotion system, continuous learning system, reward system, and support system. Conclusion: The results indicate that nursing managers need to pay more attention to developing a clinical ladder system for nurses.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.481-494
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• 2003

Purpose: This study was to develop nursing competencies, sub-competencies and behavior indicators according to the clinical ladder of emergency nurses. Method: index of content validation was used by 21 clinical experts. Results: This study had three phases to develop nursing competencies, sub-competencies and behavior indicators. In first phase: 12 nursing competencies and 33 sub-competencies were developed through the literature review on nursing competency and emergency nurses' job description. The content of 12 competencies and 33 sub-competencies were reviewed by 3 nursing professors. The 12 competencies and 33 sub-competencies were followed: clinical judgement and measures(6 sub-competencies), processing ability of ward works(2 sub-competencies), flexibility(2 sub-competencies), resources management(2 sub-competencies), confidence(3 sub-competencies), cooperation(2 sub-competencies), professional development power(2 sub-competencies), patient service orientation(3 sub-competencies), inclination toward ethical value(5 sub-competencies), influence power(2 sub-competencies), developing others(2 sub-competencies), self control(2 sub-competencies). In second phase, 132 behavior indicators were developed according to nurse clinical ladder: novice, advanced novice, competent, proficient. In Third phase, content validity was examined on 132 behavior indicators by 21 clinical experts. 126 among 132 indicators had over 70% agreement among experts and 6 indicators under 70% were revised. Conclusion: nursing competencies, sub competencies and behavior indicators can be used nurses' clinical performance as well as establishing proper directions for professional growth related to reward system.

• Journal of Korean Critical Care Nursing
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• v.3 no.1
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• pp.1-13
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• 2010

Purpose: This study was designed to evaluate ICU nurses' clinical competence according to clinical ladder by job analysis tool for the evaluation tool development of clinical ladder development program, Methods: Data was collected using the ICU nurses job analysis tool from 148 ICU nurses who work for 6 ICUs of A hospital in S city, Results: The mean clinical competence score of the subjects was 3.03 on a 4 point scale, Competence score was increasing as ICU clinical ladder was higher (F=35.18, p<.001). Step_1 was the lowest and step_4 was higher than step_3 from Scheffe post hoc test, Result of multiple regression showed that ICU clinical ladder and ICU clinical nursing education explained 52.1% (F=38.83, p<.001) of ICU nurse's clinical competence. Conclusion: ICU nurses' clinical competence can be evaluated using ICU nurse's job analysis tool. Further researches is needed on job description according to clinical ladder for performance and evaluation.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.4
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• pp.624-632
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• 2006

Purpose: This study is performed to develop the contents of career ladder program for nurses in a hospital. And this study present the appropriate strategies of career ladder program using the clinical ladder in clinical nursing field in Korea. Methods: The method of the study were modified Delphi technique with professional group for identifying nursing domains, steps of career ladder system and managerial strategy. Result: We identified tool of the nursing domains; nursing patient, quality approvement and research, development of human resources, leadership and qualifications of promotion and contents of ladder of each level. We created expected role consisted of clinical ladder and classified 4 steps; novice, competent, proficient, expert. And finally managerial principles and application process are presented in this study. Conclusions: Development of career ladder program at a hospital was not need many time consumption but very important tool of nursing profession. And it is needed to validate and refine the tool developed continuously.

• Journal of Korean Clinical Nursing Research
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• v.21 no.3
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• pp.277-292
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• 2015

Purpose: The purpose of this study was to develop a Clinical Ladder System (CLS) model for staff nurses working in inpatient units of tertiary care hospitals in Korea. Methods: The study was carried out in 2 steps. First, a nursing competence evaluation scale was developed. Second, evaluation of the nursing competences, qualifications, and professional activities of 230 nurses from five tertiary care hospitals was done by 49 head nurses between Feb. and Dec., 2014. Nurses were selected by head nurses according to their clinical experience and expected behavioral characteristics at each level of the ladder. Results: A nursing competence scale was developed consisting of 5 subcategories (clinical practice, ethical practice, education, leadership, and professional development) and 11 elements, and 5 levels of behavioral indicators for each element. Cronbach's alphas for the entire tool and subcategories were over .853 and stability of the scale was confirmed. There were significant differences in nursing competence according to the 5 levels of the ladder. Conclusion: The findings indicate that the proposed CLS model with a standard score for nursing competence, recommended or obligatory criteria for qualifications and professional activities provides a good tool for developing nurses' competences and retaining excellent nurses in clinical practice.

• The Journal of the Korea Contents Association
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• v.18 no.12
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• pp.503-515
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• 2018

The aim of this study was to develop a list of nursing competency for nurses' continuing education, and to propose a competency-based continuing education system according to nurses' clinical ladder. The definition of nursing competency was extracted by analyzing 10 studies. Also, the knowledge base of each nursing competency was confirmed through Carper and Chinn & Kramer's research. Nurses' clinical ladder and preliminary items of nursing competency behavior indicators were verified by seven experts for content validity. The results of this study were as follows; Nursing competencies were defined as 'evidence-based patient care', 'education and counseling', 'nursing management and leadership', 'law and ethics', 'professional value and development', 'research and policy development'. In addition, the validity of the 4 stages of clinical ladder and the 24 indicators of nursing competency were confirmed by experts. These findings suggest that the competency-based continuing education system according to the clinical ladder will be utilized as an effective human resource development strategy for improving the professionalism of nurses.