• 동서간호학연구지
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• 제19권2호
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• pp.138-149
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• 2013

Purpose: The purpose of this study is to understand experience of self-esteem by exploring and describing the clinical nurses' lived experiences. Methods: The qualitative research method of phenomenology was utilized in this study. In-depth personal interviews of 8 clinical nurses with more than three years of experience in the clinical setting were conducted using a records from October, 2012 to March, 2013. Results: Content analysis was done using the Colaizzi' phenomenological method. The results based on the data analysis, 19 descriptive statements and 7 themes were confirmed. The 7 themes were as followed; 'recognition of nurse's role', 'recognition of nursing as a profession', 'secure jobs', 'close relationship with the clients', 'sense of existence perceived by others', 'considerations between coworkers', and 'opportunity for self-improvement. Conclusion: This study may be helpful to understand the experience of self-esteem. The results can be used to develop the effective interventions for the improvement of nurse's self-esteem.

• 임상간호연구
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• 제14권2호
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• pp.71-81
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• 2008

Purpose: The objective of this study was to determine the cause-effect and dynamic change mechanism among factors that affect calculation of the nursing workforce in the hemodialysis room and to establish a system dynamics model and create a strategic simulation to be used to increase efficiency in the clinical situation. Method: The system dynamics approach was adapted to build a simulation model for calculating the nursing workforce. The model was built using Vensim 5.0b DSS. Results: The results were as follows for Scenario A: The highest level of nursing service quality, patient satisfaction, and nurse satisfaction, and the lowest level of turnover intention is maintained when the ratio of patients to nurse is 3.5:1 compared to all other situations. Scenario B: At the ratio of patients to nurse 4.0:1 nursing service quality, patient satisfaction, and nurse satisfaction dropped slightly, and turnover intention also rose slightly. However with time the results showed improvement. Conclusion: In terms of economic efficiency in the hemodialysis room, the ratio of patients to nurse for the best nursing workforce should not exceed 4.0:1.

• 임상간호연구
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• 제17권2호
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• pp.138-149
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• 2011

Purpose: The objective of this research was to explore levels of patient safety and safe nursing activities depending on the level of nurse staffing, in order to provide effective management of nurse personnel. Methods: The research was conducted with 455 nurses from eight hospitals in B city. Data were collected according to the level of nurse personnel from second (nurse vs. patient ratio of 2.0-2.5) to fifth (ratio of 3.5-4.0) rank. The survey tools were, 'Questionnaire on Patient Safety, a Hospital Survey on Patient Safety Culture developed by AHRQ (2007), and 'Questionnaire on Patient Safety Nursing Act, in which the questions were selected from nursing-related items (Medication 6 & Safety Nursing Assurance Act 4) in the Safety Evaluation developed by Evaluation Institute of Medical Institution. Data were analyzed with SPSS PC 12.0 program using descriptive statistics, $x^2$ test, ANCOVA and $Scheff{\grave{e}}$. Results: The nurses' overall cognition level on patient safety and safe nursing activities showed that nurses who are in the second and third rank had higher scores than those in lower ranks. Conclusion: The results of this study indicate that hospitals need a higher ratio level for nurse personnel in order to assure patient safety and safe nursing activities.

• 임상간호연구
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• 제19권3호
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• pp.321-332
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• 2013

Purpose: Korean health insurance extended application of the Diagnosis Related Groups (DRG) payment system to tertiary and general hospitals from July, 2013. This study was done to develop a DRG fee adjustment mechanism applied to levels of nurse staffing to assure quality nursing service. Methods: Nurse stafffing grades among hospitals in Korea were analyzed. Differences and ratio of inpatient costs by nurse staffing grades in DRG fees and differences of DRG fee between tertiary and general hospitals were compared. Results: In 2013, nurse staffing grades in tertiary and general hospitals had improved, but other hospital nurse staffing grades remained at the 2001 level. Gaps of inpatient costs between first and seventh nurse staffing grades were over 10% in 4 out of 7 DRG diagnosis; However differences of DRG fee between tertiary and general hospitals were only 4.51% and 4.72% respectively. A DRG fee adjustment mechanism was developed that included nurse staffing grades and hospitalization days as factors of the formula. Conclusion: Current DRG fees motivate hospitals to decrease nurse staffing grades because cost reduction is bigger than compensation. This DRG fee adjustment mechanism reflects nurse staffing supply to motivate hospitals to hire more nurses as a reasonable compensation system.

• 한국간호교육학회지
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• 제28권2호
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• pp.179-192
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• 2022

Purpose: The purpose of this study is to identify the effects of a standardized educational program to improve nursing competency on newly graduated nurses in a children's hospital after developing and applying a pediatric nurse education program. The effectiveness of the program was confirmed by evaluating the clinical competency and field adaptation. Methods: In the first step, an education program was developed using the analysis, design, development, implementation and evaluation (ADDIE) model. As a second step, a similar experimental study of a single group repeat measures design was conducted to evaluate the clinical competency and field adaptation over time after application of the program. Additionally, a focus group interviews were conducted to collect subjective data on the effects and improvement points of the program. Results: As a result of applying the program, there was a significant change in the clinical competence and the field adaptation of newly graduated nurses in a children's hospital. The categories derived from the focus group interviews were "getting special guidance," "better care," "becoming a nurse at a children's hospital" and "winning together." Conclusion: It was confirmed that the education program enhances the clinical competency of new nurses in children's hospitals. In addition, it provided the necessary data to understand the experiences of new nurses, help them adapt effectively, and establish appropriate interventions.

• 임상간호연구
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• 제23권2호
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• pp.248-257
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• 2017

Purpose: This study was aimed to compare nursing competency, self-esteem, and job stress between floating nurses and clinical nurses. Methods: The data were collected between October $1^{st}$ and December $31^{st}$, 2015, from 43 floating nurses and 57 clinical nurses working at a tertiary care hospital in Seoul. The collected data were analyzed with SPSS/WIN 23.0, using descriptive statistics and the t-test, $x^2$ test, ANCOVA, ANOVA, $Scheffe{\acute{e}}$ test, Pearson correlation coefficients, and Stepwise multiple regression. Results: The nursing competency of clinical nurses was significantly higher than that of floating nurses (F=4.370, p=.039). For both floating and clinical nurses, nursing competency was positively correlated with self-esteem (floating nurses, r=.47, p=.002; clinical nurses, r=.62, p<.001). Also, For both floating and clinical nurses, the most significant predictor of nursi ng competency was self-esteem(floating nurses, ${\beta}=0.45$, p=.001; clinical nurses, ${\beta}=0.60$, p<.001). Conclusi on: Efforts are needed to increase the nursing competency of the floating nurse through the improvement of the floating system, the nursing work environment, and continuous education. Also, as self- esteem is the most effective predictor of nursing competence, nursing intervention is needed to improve self-esteem of the floating nurse.

• 임상간호연구
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• 제22권3호
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• pp.352-358
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• 2016

Purpose: This study was a methodological research implemented to establish basic data for controlling the job rotation stress of nurses and effectively managing human resources by reflecting the Nurse Job Rotation Stress Scale (NJRS) developed by Huang and others into the domestic nursing environment and verifying the use of measurement tools. Methods: The study selected nurses working at four hospitals, with over 300 beds, in Seoul, Gyeongi-do, and Busan, as its research subjects and verified the content validity, construct validity, concurrent validity, and internal consistency reliability of the measurement tool. Results: The results ultimately formed eight questions from three sub-factors (3 emotional response questions, 2 daily life questions, and 3 communication questions). In terms of reliability, emotional response issued a Cronbach's of .78, daily life issued a Cronbach's of .75, and communication issued a Cronbach's of .86. Conclusion: This study is expected to be used as basic data for achieving effective human resource management by calculating the stress of clinical nurses resulting from job rotation, but the researcher believes that the measurement tools must be expanded by confirming additional job rotation stress questions which reflect the organizational culture of Korea.

• 간호행정학회지
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• 제15권3호
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• pp.391-402
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• 2009

Purpose: The purpose of this research was to describe the decision making experience of VIP ward nurses in the clinical practice adjustment process. The research question was about "how nurses adjust their clinical practice to nursing situations and develop decision making process in a VIP ward." Method: The methodology of collecting and analyzing the data was based on the grounded theory of Strauss and Corbin(1998). The data was collected through in-depth interviews with 10 nurses from July to November, 2007. Results: The core category of nursing care decision making process was named as "adjusting with flexibility and deepened insight." The clinical practice adjustment process in nursing care decision making has progressed through four preceding interlocking phases: 1) dependent phase, 2) defensive phase, 3) independent phase, 4) integrative phase. These phases were classified by the level of nurses' dependency, proactivity, presupposition and integration. Conclusion: The result of this study indicated that nurse's decision making depended on their experiences and the nature of social context in which nursing occurs. Therefore, it is important to elaborate an effective training program for nurses to develop the phases of nursing care decision making.

• 한국융합학회논문지
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• 제13권3호
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• pp.379-390
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• 2022

본 연구의 목적은 COVID-19 팬데믹 상황에서 임상 간호사가 경험하는 생명윤리의식 딜레마를 깊이 분석하고 이해함으로써 임상 간호사의 대처 능력을 향상시키기 위한 기초자료를 제공하는 것이다. 본 연구는 COVID-19 상황 속 임상간호사가 겪는 생명윤리의식 딜레마의 본질을 이해하기 위해 임상간호사를 직접 면담한 뒤 Colaizzi(1978)의 현상학적 방법을 이용해 분석하였다. 연구 결과 '인간 존중의 원칙이 위배된 상황을 마주해야 하는 괴로움 ', '선행 및 악행금지 원칙을 지킬 수 없는 안타까움과 혼란', '정의의 원칙 이행 및 불이행에 대한 회의감' 총 3가지 주제모음을 도출하였다. 연구결과를 바탕으로 임상간호사가 팬데믹 상황에서 겪는 생명윤리의식 딜레마에 대한 대처능력을 높이기 위해서는 임상간호사 교육과 정책 수립, 간호사 처우개선 노력 등이 필요하다.

• 중환자간호학회지
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• 제11권1호
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• pp.15-27
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• 2018

Purpose : This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS). Method : The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others. Results : Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics. Conclusion : To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.