• 임상간호연구
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• 제24권1호
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• pp.67-73
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• 2018

Purpose: This study was done to explore the relationship between expectations of the clinical ladder system (CLS), career commitment and turnover intention in nurses employed in small-medium sized hospitals. Methods: Participants were 154 nurses from 3 small-medium sized hospitals in Gyeonggi Province and Gwangju City. From February, 8 to April, 14, 2017, self-report questionnaires were collected and analyzed using frequency, t-test, ANOVA, $Scheff{\acute{e}}$ test, and Person correlation coefficients. Results: Of the participant nurses, 61% perceived the CLS as needed. The mean score for expectation of CLS, career commitment, and turnover intention on 5-point scale were 3.38, 3.17, 3.21, respectively. There were no significant differences in expectation of CLS according to general characteristics, but career commitment and turnover intention did show significant differences depending on age, position, type of work shift. Expectation of CLS correlated positively with career commitment (r=.23, p=.005), and career commitment correlated negatively with turnover intention (r=-.49, p<.001). Conclusion: The results of this study show that there is a need to adopt the clinical ladder system to improve career commitment.

• 중환자간호학회지
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• 제15권3호
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• pp.51-61
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• 2022

Purpose : This study aimed to verify the effectiveness of the clinical ladder system (CLS) by identifying the perception of the CLS, professional self-concept, self-efficacy, and organizational commitment among intensive care unit (ICU) nurses. Methods : Data were collected through a questionnaire survey of 173 nurses working in 11 ICUs at a tertiary hospital in Seoul. Results : The perception of the CLS, self-efficacy, and organizational commitment showed significant difference according to the CLS level. As a result of the partial Spearman correlation analysis after adjusting for demographic difference according to CLS (age, marital status, education, and clinical career), CLS positively correlated with the perception of the CLS (r=.16, p=.045), professional self-concept (r=.24, p=.001), and self-efficacy (r=.21, p=.007). On the contrary, organizational commitment negatively correlated with the perception of the CLS (r=-.43, p<.001) and self-efficacy (r=-.32, p<.001). Conclusion : The CLS is effective for professional self-concept and self-efficacy. However, specialists 2 nurses, who had high professional self-concept and self-efficacy, showed low level of organizational commitment. Thus, it is necessary to examine the factors of work burden and career plateau that are imposed after promotion and improve experience and planning according to the growth needs. Moreover, regular evaluation of the CLS will require hospital support to ensure that ICU nurses appreciate and actively participate in the support.

• 임상간호연구
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• 제23권3호
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• pp.281-292
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• 2017

Purpose: The purpose of this study was to verify the validity and applicability of the Clinical Ladder System(CLS) Model for nurses and to suggest a model for nurses in general hospitals as well as tertiary hospitals. Methods: After refining questionnaires through focus group participation, a survey was carried out with 50 nurse managers and 500 staff nurses from 6 tertiary hospitals and 4 general hospitals. S-CVI and i-CVI for validity and applicability were calculated. Differences in validity and applicability by the type of hospitals and characteristics of respondents were analyzed using t-test and ANOVA. Results: S-CVI for validity and applicability of the CLS model were over 0.8 in two types of hospitals and the validity and applicability of the CLS model were confirmed. No differences were found in the total score for validity between the 2 types of hospitals, but in applicability, general hospitals had significantly lower applicability than tertiary hospitals. Some items showed difference according to characteristics of the respondents. CLS models were postulated based on the study results. Conclusion: The CLS model refined through this study can be used for nurses. In application, modifications are needed according to the conditions of each hospital.

• 임상간호연구
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• 제21권3호
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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.

• 임상간호연구
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• 제24권3호
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• pp.324-335
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• 2018

Purpose: The purpose of this study was to propose a revised Clinical Ladder System(CLS) Model for nurses based on the evaluation of clinical competence and professional activities of nurses working in general hospitals. Methods: Data were collected between September 10 and October 30, 2017. Participants were 50 head nurses from 10 general hospitals with over 400 beds located in Seoul City and Gyeonggi Province. Each head nurse evaluated clinical competence, qualifications, and professional activities of 5 staff nurses at each of the 5 levels of CLS in her unit. The total number of the nurses evaluated was 245. Data were analyzed with descriptive statistics and t-test, one-way ANOVA, and $Scheff{\acute{e}}$. Results: Over 80% of the nurses were university graduates. As the CLS levels increased, clinical competence, qualifications, and professional activities also increased significantly. Education material development and quality improvement activities were carried out by nurses from level 2, research and evidence based practice activities were carried out from level 3, and nurses at level 4 or 5 participated in most of the professional activities as leaders. Conclusion: In order to retain excellent nurses in general hospitals, recognizing and rewarding nurses according to the revised model of the CLS are recommended.

• 간호행정학회지
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• 제16권3호
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• pp.314-325
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• 2010

Purpose: The purpose of this study was to investigate how nurses perceive the Career Ladder System(CLS). Methods: This study was a descriptive survey using questionnaires. Questionnaires were developed by an expert group. Participants included 161 nurses working in the Children's Hospital. The data were analyzed using factor analysis, Cronbach's alpha, descriptive statistics, $x^2$-test and ANCOVA. Results: This study revealed that nurses who advanced in their career ladders have a significantly higher perception of participation in their professional activities and a general comprehension of the CLS more than the nurses who did not advance in their career ladders. However, nurses who advanced in their career ladders have a significantly lower perception of the expected outcome of the CLS more than nurses who did not. Conclusions: This result showed that nurses who had experienced in clinical advancement and recognition were highly motivated with their professional activities via the CLS as well as they considered it to allow professional growth.