• Title/Summary/Keyword: Direct nursing care activity

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Comparison of Nurses' Job Satisfaction, Patients' Satisfaction and Direct Nursing Time according to the Change in Grade of the Nursing Management Fee (입원환자 간호관리료 차등제 변화에 따른 간호사 직무만족, 환자만족도 및 직접간호시간 비교)

  • Kim, Sea Joung;Lee, Ja Yin;Lee, Yun Mi
    • Journal of Korean Critical Care Nursing
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    • v.10 no.3
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    • pp.9-18
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    • 2017
  • Purpose : This study aimed to identify nurses' job satisfaction, patients' satisfaction, and direct nursing time according to the change in grade of nursing management fee. Methods : Descriptive design was used in this study. Nurses (n = 200) and patients (n = 200) were recruited from one university hospital in Busan. Four aspects were measured: direct nursing time, overtime, nurses' job satisfaction, and patients' satisfaction. Data were analyzed using descriptive statistics, ${\chi}^2-tests$, and t-tests. Results : There was a significant difference in patient satisfaction (t = -2.09, p = .038) and direct nursing time (t = -4.77, p < .001) when the nurse staffing grade was changed from the level two to the level one. Conclusion : The findings from this study showed that a higher nurse-to-patient ratio can provide a greater amount of direct nursing time for individual patients and increase patient satisfaction.

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Analysis of Direct Nursing Activity and Patient Outcomes Related to Graded Fee of Nursing Management for Inpatient (입원환자 간호관리료 차등제에 따른 직접간호활동 및 환자결과 비교)

  • 박성희
    • Journal of Korean Academy of Nursing
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    • v.33 no.1
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    • pp.122-129
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    • 2003
  • Purpose: The purpose of this study is to examine the difference of direct nursing activity and patient outcomes as mortality rate, complication rate, readmission rate and length of stay related to graded fee of nursing management for inpatient. Method: The subjects of this study were 44 general hospitals with more than 500 beds. Data totaled to 86,044 claims provided to inpatients in Jan. 2001 requested by an electronic data interchange from a Health Insurance Review Agency. The data was analyzed by SPSS win(ver.10.0) and statistical methods used were frequency, one-way ANOVA, $X^2$-Test and regression. Result: Synthetic judgment through performance index and 95% confidence interval, direct nursing activity showed to provided adequate quality of nursing care on 2nd, 3rd, 4th and 6th nursing degree. Also, patient outcomes showed difference by graded fee of nursing management for inpatient. Mortality rate of 2nd was the lowest with P.I. 67.9, 3rd, 5th, 6th, 4th in order. In case of complication rate, 2nd, 3rd and 4th were lower than other nursing degree. Readmission rate of 4th and 5th was the lowest. Length of stay of 2nd was the shortest with P.I. 88.3, 3rd, 4th, 5th, 4th, 6th in order. Conclusion: The findings from this study showed that, the higher nurse-to-patient ratio, the greater amount of direct nursing care activity for the patient. Also, the more direct nursing activities influenced a lower mortality rate, complication rate and readmission rate, shorter length of stay.

Identification of Nursing Activities for Determination of Nursing Cost (간호수가 산정을 위한 간호행위의 규명 연구)

  • 박정호;황보수자;이은숙
    • Journal of Korean Academy of Nursing
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    • v.22 no.2
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    • pp.185-206
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    • 1992
  • In this study nursing activities were examined to determine the nursing cost. A professional nursing group developed a tool for the investigation. 128 nursing activities were identified by the tool in 16 nursing care areas as referenced in the literature. Each activity was examined for four essential factors to define nursing cost ; time consumed for the care, level of professional skill, degree of independency and performer of the care. The activity was rated by a five point Likert scale. This investigation was conducted with the nursing staffing working in the 21 university hospitals in Korea and having more than four years experience especially in medical or surgical wards. The participating nursing staff were screened on the basic of the recommendation of the nursing director. The data were gathered from June 12th to August 12th, 1989. All the data were analyzed for mean, standard deviation, percent, and correlation coefficients between items. The results are summarized as follows : 1. Direct nursing care was classified into 16 large areas and 128 small activities. 2. No significant correlation was found between the study items of each activity. 3. Among 128 nursing activities, Those performed less than 50% of the time by a nurse were excluded from the nursing cost. Also excluded activities which were given less than 9 marks in all three items, time consumed, level of professional skill, and degree of independency. As a result, 83 activities in 14 nursing care areas were selected for the proposal to estimate nursing cost.

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Nursing Activities on Continuous Renal Replacement Therapy in the Intensive Care Units (중환자실 내 지속적 신대체 요법과 관련된 간호업무 분석)

  • Yun, Seonyoung;Lee, Young Ock;Kang, Jiyeon;Yun, Mi-Jeong;Won, Youn-Hui;Lee, Mi-Young
    • Journal of Korean Critical Care Nursing
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    • v.6 no.2
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    • pp.65-77
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    • 2013
  • Purpose: The purpose of the study was to analyze the nursing activities related to continuous renal replacement therapy (CRRT) in the intensive care units (ICU). Methods: We developed a list of 31 CRRT related nursing activities based on literature review and reviewed by expert group. A total of 109 direct time measurement records by 43 ICU nurses were collected and analyzed in terms of total time per shift, frequency, standard time, difficulty and performance levels of each CRRT nursing activity. Results: The mean time for CRRT nursing activity was 85.60 minutes per 8 hour shift. Nurses have spent average $9.46{\pm}6.98$ minutes in a shift for "waste fluid bag change" activity. In addition, "check catheter location" was the most time consuming single activity. The most difficult activity was "counseling-answer" and the most competent one was "dialysis solutions change". Conclusion: The CRRT nursing activities accounted for a significant portion of total nursing workload. Practical allocation of nursing staff for CRRT patient along with development of a new nursing cost system need to be considered. Continuous nursing educational and training programs on CRRT should be developed.

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Analysis of the Work of the Head Nurse and a Work Model for the Head Nurse in University Hospitals in Korea (대학종합병원 수간호사의 업무분석과 모형연구)

  • 김인숙
    • Journal of Korean Academy of Nursing
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    • v.19 no.2
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    • pp.212-222
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    • 1989
  • When the head nurse who is pivotal in the nursing service administration of the hospital performs efficiently as a first-line manager, the effectiveness of the nursing unit, which includes the quality of nursing care, the jab satisfaction of staff members, and the cohesiveness of staff members is increased. With this point of view in mind, the researcher carried out a study to determine the actual work (the content of the work, the work process, the role of the head nurse, the activity media, and the purpose of the work) of the head nurse in a university hospital in Korea. In addition, this study was also carried out for the purpose of preparing an ideal model for the work of the head nurse. The research subjects were 39 head nurses. This included all the head nurses in two university hospitals except those who were working in outpatient care, operating rooms, central supply, nursing administration, in-service education and emergency care. Data were collected from September 24th to October 21th, 1987 and April 4th to 12th, 1988. A work activity record on which the head nurse recorded directly in a chronological narrative form, was used as the research instrument. The 234 work activity records, 39 head nurse's continuous recording over 6 days(from Monday to Saturday) were collected and analysed. The results were as follows ; 1. With regard to the work content for the total daily work of the head nurse, 45.2% of the activities were managerial activities but 58.1% of the head nurse' s time was spent in direct patient care. 2. With regard to the work process of the head nurse, specifically the location, the size and membership of groups contacted, the results were as follows : 1) Of the total daily work activities 92.4% were carried out in the nursing unit and this occupied 84.5% of total daily work time. Direct patient care was generally performed on the nursing unit and managerial work was performed in other areas. 2) Of the total daily work activities, 73% was with one or more persons and 51.2% of total daily work time was spent in groups. 3) A total of 51 persons, working in different capacities were contacted. These included 21 persons giving patient care, 19 persons working in nursing unit management, and 7 persons working in human resource management. 3. With regard to the head nurse's role in work activity, 53.3% of total daily work activities involved the informational role, 26.9%, the interpersonal role and 19.9%, the decisional role. With regard to time, 57.7% was spent in the informational role, 23.9%, in the interpersonal role and 18.3%, in the decisional role. When the head nurse performed managerial work, she gave nearly equal emphasis to all three roles when she gave direct patient care the informational role was increased. 4. With regard to the activity media, the number of unscheduled activities accounted for 27.1% of the activities, scheduled activities, 24.3%, desk work activity, 22.1%, rounds, 12.5% and telephone calls, made or received, 14.0%. In daily total work time managerial work related to desk work and scheduled activities were high, ranging from 29.8% to 29.9% but for direct patient care time, scheduled activities and unscheduled activities were high, ranging from 23.6% to 35.3%. 5. With regard to the purpose of the work performed, 54.4% of the total daily work was concerned with the team and 41.4% was concerned with the agency. The managerial work was concerned mainly with the team and the direct patient care was concerned mainly with the patient. When the frequency of an activity and time were compared no significant difference was found between the days for which the work was recorded for any of the variables : the work content, the work process, the work role, the activity media and purpose of the work. On the basis of this study the following are proposed as an ideal model for head nurse work in Korea : The managerial work should be increased to 70%. The decisional role activities should be increased to 40%. Twenty percent of the work activity should be allocated to agency, community and profession. It is believed that this model for the head nurse's work can contribute to guidelines for job description development. Finally, educational programs, organizational and structural devices, and administrative support are needed for the proper function of the head nurse in this proposed model.

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A Study of Staffing Estimation for Nursing Manpower Demand in Hospital (병원간호인력의 수요추정에 관한 연구 -환자분류체계에 의한 간호인력 수요추계의 방법을 중심으로-)

  • 김유겸
    • Journal of Korean Academy of Nursing
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    • v.16 no.3
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    • pp.108-122
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    • 1986
  • Changing concepts of health care, are stimulating the demand for health care, thereby orienting society to health care rights to such an extent that they are deemed as fundamental ones inalienable to man. Concomitantly, qualitative as well as quantative improvement is being sought in the nursing service field. Today, efforts are being made in various areas, especially to qualitatively improve nursing services. A second issue concerns proper staffing. It is important to study staffing, in as much as it continues to be the most persistent and critical problem facing hospital nursing administrators today. It involves quantity, quality, and utilization of nursing personnel. A great deal of attention has been focused on this problem since mid 1930's when nursing services began to be felt as an important segment of hospital operation representing the largest single item of hospital budgets. Traditionally, the determination and allocation of nursing personnel resources has relied heavily on gloval approaches which make use of fixed staff-to-patient ratios. It has long been recognized that these ratios are insensitive to variations between institutions and among individual patients. Therefore, the aim of this thesis is to point to the urgent need for the development of methodology and criteria suited to the reality of Korea. The present research selected one place, the W Christian Hospital, and was conducted over a period 10 days from January, and nurses who were them on duty in their unit. The total num-her of patients surveyed was 1,426 and that of 354. The research represents many variables affecting the direct patient care time using the result from the direct observation method, then using a calculation method to estimate the relationship between the patients care time and selected variables in the hospital setting. The amount of direct patient care time varies with many factors, such 89 the patients age. diagnosis and time in hospital. Differences are also found from hospital, clinic to clinic, ward to ward, and even shift to shift. In this research, the calculation method of estimating the required member of nursing staff is obtained by dividing the time of productive patient care activity(with the time of patient care observed), by the sum of the productive time that each the staff can supply, i.e., 360 minutes, which is obtained by deducting the time for personal activities. The results indicate a substantial difference between the time of productive patient care observed directing and the time of the productive patient care estimated using calculating method. If we know accurately the time of the direct patient care on a shift, there required number of staff members calculated if the proper method can be determinded should be able the time of the direct patient care be estimated by the patient classification system, but this research has shown this system to be in accurate in Korea. There are differences in the recommended time of productive patient care and the required number of nursing staff depending upon which method is used. The calculated result is not very accurate, so more research is needed on the patient classification system.

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The effects of the direct nursing care hours with establishment of the nurse substations (Nurse Substation 운영이 직접간호시간 증가에 미치는 효과)

  • Lee, Chug-Hee;Sung, Young-Hee;Kwon, In-Gak;Lee, Soon-Kyu;Jung, Yoen-Yi;Hoe, Sung-Hee;Ryoo, Sung-Suk;Kim, Jung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.2
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    • pp.61-80
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    • 1997
  • The purpose of this study is to measure the direct and indirect nursing care hours with establishment of nurse substations and compare the experimental nursing units with the existing nursing units For this study, two experimental nursing units: (1) a medical nursing unit and (2) a surgical nursing unit with a nurse substation were selected. And two control nursing units : (1) a medical nursing unit and (2) a surgical nursing unit without a nurse substation were selected. After a three-month experimental operation from June 1 to August 31,1996, research data were collected for three days from September 2 to 4, 1996. We investigated the effects of the direct & indirect nursing care hours with establishment of the nurse substations (improved nursing environment) without adding the staff nurses. The effect of establishment of the nurse sub-station was measured for the differences direct & indirect nursing care hours between experimental and control nursing units. An investigator measured the time for a staff nurse to practice each nursing activity and recorded it every minute. Percentage, average, standard deviation, t-test and ANOVA were used for data analysis. The results are as follows: 1. There was no significant difference between the experimental and control nursing units in staffs' working hours during their shift. 2. There were significant diffferences between the experimental and control nursing units in dierct nursing care hours (t=0.0288, p=0.0001) and indirect nursing care hours (t=0.3886, p=0.0103) per patient. 3. There was significant difference between the experimental and control nursing units in direct nursing care hours done by nurses(t=0.0012, p=0.0111) and aids(t=0.3011, p=0.0027). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0051, p=0.0253), nurses(t=0.0071, p=0.0024) and aids (t=0.3227, p=0.0351). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by nurses(t=0.0005, p=0.0015) and aids(t=0.2400, p=0.0013) per patient. There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0005, p=0.0379) and nurses (t=0.0035, p=0.0198) per patient. 4. Thre were significant differences between the experimental and control nursing units in direct nursing care hours (t=0.1134, p=0.0010) and indirect nursing care hours (t=0.7106, p=0.0008) per staff during the day shift. There were significant differences between the experimental and control nursing units in direct nunsing care hours during the day(t=0.0723, p=0.0003) and evening shift (t=0.0004, p=0.0285) per patient, and indirect nursing care hours during the day shift(t=0.5565, p=0.0036) per patient. 5. There were differences between the experiemental and control nursing units in dircet nursing activities including measurement and observation, medication, communication, teratment, hygiene, and nutrition, and in indirect nursing activities including confirmantion, communication, record, computer work, management of goods. But it was not statistically proven. 6. There was difference between the experimental and control nursing units in unmet-need nursing care hours per patient, but not statistically proven.

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Tertiary Hospitals' and Women's Special Hospitals' Postpartum Nursing Intervention Survey (상급종합병원과 여성전문병원 간호사의 산후 간호중재 조사)

  • Park, Hyunsoon;Kim, Ha Woon;Kim, Hee Jeong;Kim, Soon Ick;Park, Eun Hye;Kang, Nam Mi
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.1
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    • pp.55-66
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    • 2019
  • Purpose: This study was done to assess development and postnatal care interventions in postnatal care intervention records for maternity ward nurses in tertiary hospitals and women's hospitals in South Korea. Methods: This mixed-method research was a Time-Motion (TM) study. Data were collected through external observation of 12 nurses in 4 wards over 24 hours. Mann-Whitney U test and independent t-test were employed for the analysis of frequency and provision time of direct/indirect care activity. $x^2$ (Fisher's exact test) was utilized to determine the difference in frequency between two groups. IBM SPSS 22.0 statistical program was employed for calculation. All statistical significance levels were at ${\alpha}=.05$. Results: According to the KPCS-1 (Korean Patient Classification System-1), women's hospitals are group 3 and tertiary hospitals, group 4. With respect to time difference in direct care, tertiary hospitals showed 791 minutes and women's hospitals, 399 a difference of 392 minutes. For time difference in indirect care, women's hospitals had 2,415 minutes while tertiary hospitals, 2,080, a difference of 335 minutes for women's hospitals. No difference was found in the average total care workload between the two institutions. Individual time also showed no difference (p>.05). Conclusion: High-risk maternal care strength in tertiary hospitals and breast-feeding strength in women's hospitals need to be benchmarked with each other.

Circadian Rhythms Characteristics of Nurses Providing Direct Patient Care: An Observational Study

  • Ilknur Dolu;Serap Acikgoz;Ali Riza Demirbas;Erdem Karabulut
    • Safety and Health at Work
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    • v.15 no.1
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    • pp.102-109
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    • 2024
  • Background: In today's modern world, longer working hours, shift work, and working at night have become major causes of the disruption of our natural circadian rhythms. This study aimed to investigate the effects of the type of shift work (rotating vs. fixed day), duty period (on-duty vs. off-duty), and working period within each shift (nighttime vs. daytime) on the circadian rhythm characteristics of nurses who provide direct patient care. Methods: This cross-sectional study used a purposive sampling method. Cosinor analysis was applied to analyze the actigraphy data of nurses providing direct patient care for seven consecutive days. The linear mixed effects model was then used to determine any variances between shift type, duty period, and working period within each shift for the nurses. Results: The mesor value did not differ according to nurses' shift type, duty period, and working period within each shift. The amplitude was statistically higher in on-duty nurses and in daytime working hours. The acrophase was significantly delayed in nighttime working hours. As well as nurses in rotating shift had experience. Conclusion: Our findings revealed that the peak activity of nurses occurs significantly later at night while working and nurses working during nighttime hours may have a weaker or less distinct circadian rhythm. Thus, this study suggests that limits be placed on the number of rotating nighttime shifts for nurses.

A Study on the perception Level of Nursing Activities of Staffing the Nursing Unit (간호인력의 배치에 영향을 미치는 간호사의 간호행위 인지정도에 관한 연구)

  • Park Chung-Ja;Lee Kyung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.1 no.2
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    • pp.193-205
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    • 1994
  • The Study was carried out for the purpose of investigating the degree of perception in nursing activities. The data of this study were collected by self-reported questionnaire composed of 5 point rating scale measure the ideal level and the performance level of nurses activity. For the analysis of the data, percentage, MANOVA and ANOVA were 231 nurses in 3 general hospitals in Taegu. Data was administrated from October 4 through 14, 1994. The results were as follow : 1. The average mean score for the ideal level was 4.19 with a maximum possible score 5points. The highest mean score was Infection Controll and the lowest mean score was nutrition The average mean score for the performance level was 3.75, the highest mean score was fluid and electrolyte, the lowest mean score was nutrition. In the desirable nursing pergormance, Education was found the highest response above charge nurse, Medication was found the highest response above General nurse, environment was found the highest response above aide. 2. In the analysis of the relationship between the ideal level and th performance level, significant defference was found in age, position, career, marital status, occupation satisfaction, Nursing unit, parent. 3. In the analysis of the relationship between the ideal level and the performance level and the general characteristics, significant difference was found in marital status in the ideal level of direct nursing care, significant difference was found in age, position, marital status, nursing unit in the ideal level of indirect nursing care, significant difference was found in age, position, career, marital status, occupation satisfaction, nursing unit in the performance level of direct nursing care. significant difference was found in age (25-29) and above 30 career(4-7 and 7), occupation satisfaction(good and moderate, good and poor) in scheffe test of the performance level of direct nursing care.

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