• 임상간호연구
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• 제28권1호
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• pp.1-12
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• 2022

Purpose: The purpose of this study is to investigate the association between the nurse staffing level and the patient mortality using Korean National Health Insurance data. Methods: The data of 1,068,059 patients from 913 hospitals between 2015 and 2016 were analyzed. The nurse staffing level was categorized based on the bed-to-nurse ratio in general wards, intensive care units (ICUs), and hospitals overall. The x² test and generalized estimating equations (GEE) multilevel multivariate logistic regression analyses were used to explore in-hospital mortality and 30-day mortality after admission. Results: The in-hospital mortality rate was 2.9% and 30-day mortality after admission rate was 3.0%. Odd Ratios (ORs) for in-hospital mortality were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.72, 95% CI=0.63~0.84) and in ICUs with a bed-to-nurse ratio of less than 0.88 compared to that with 1.25 or more (OR=0.78, 95% CI=0.66~0.92). ORs for 30-day mortality after admission were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.83, 95% CI=0.73~0.94) and in ICUs with a bed-to-nurse ratio of less than 0.63 compared to that with 1.25 or more (OR=0.85, 95% CI=0.72~1.00). Conclusion: To reduce the patient mortality, it is necessary to ensure a sufficient number of nurses by improving the nursing fee system according to the nurse staffing level.

• 임상간호연구
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• 제26권3호
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• pp.285-295
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• 2020

Purpose: The purpose of this study was to develop and validate a education nurse specialist-led educational satisfaction scale for nurses working at comprehensive nursing care service wards. Methods: A methodological study was conducted. A total of 237 nurses working at comprehensive nursing care service wards in a general hospital participated in this study. The scale was developed through literature reviews, in-depth interview, development of preliminary items, verification of content validity, development of secondary items, evaluation of construct validity, and extraction of final items. Analysis included exploratory factor analysis, pearson's analysis, and reliability analysis using cronbach's α. Results: The education nurse specialist-led educational satisfaction scale for nurses working at comprehensive nursing care service ward consisted of 21 items. Two factors (critical thinking disposition and clinical competency) were identified which explained 63.5% of the total variance. Cronbach's α of each factors were >.95. Conclusion: The results suggested that the education nurse specialist-led educational satisfaction scale for nurses working at comprehensive nursing care service wards demonstrated acceptable validity and reliability. Items of the instrument can assess the level of satisfaction with regards to education led by education nurse specialist among nurses working at comprehensive nursing care service wards.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권4호
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• pp.61-69
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• 2022

Purpose: In response to the rapid spread of COVID-19 in 2020, the government supported facilities and equipment through the 'Urgent Isolation Ward Expansion Project'. Design and remodeling of efficient negative pressure isolation facilities had to be done in a short period of time, and the performance gap between facilities was very large because the types of hospitals and wards of existing medical facilities were diverse. In order to secure the stability of isolation wards between medical facilities and reduce the facility gap, guidelines for planning isolation wards considering the diversity of each hospital should be appropriately presented. In consideration of these points, this study aims to provide basic data for future remodeling guidelines for each plan type of the negative pressure isolation ward first. Methods: We analyzed the plans before and after the change of 13 case hospitals that performed the urgent care bed expansion project for COVID-19 confirmed patients. Before the remodeling, the current status of the facility was analyzed according to the type of corridor, the location of the nursing station, and the location of the elevator. After remodeling, the flow of medical staff and patients, the flow of entry and exit of clean and contaminated items, and the space of negative pressure and non-negative pressure areas. Results: The ward type was divided into three types according to the corridor type and room arrangement: double loaded corridor type with two side wards, race track type with one side ward, and race track type with two side wards. Based on these three types, the standard floor plan type of the isolation ward was proposed in terms of the location of the elevator bank and Nurse station. Implications: When the existing general ward is converted into a negative pressure isolation ward, this study can be a basic data to present customized guidelines for each ward type.

• 임상간호연구
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• 제28권2호
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• pp.122-136
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• 2022

Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion: The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.

• 한국직업건강간호학회지
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• 제20권1호
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• pp.24-34
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• 2011

Purpose: The purpose of this study was to examine factors related to burnout of nurses at hemato-oncology wards. Methods: The participants were 134 nurses working at hematology-oncology wards in three tertiary general hospitals in Seoul and Gyeonggi Province. Data were collected using a structured questionnaire that consisted of personal characteristics, occupational stress, satisfaction and burnout. Using a SPSS/WIN 12.0 program, descriptive statistics, t-test, ANOVA, and stepwise multiple regression procedures were employed. Results: The mean score of burnout reported by the participants was $3.15{\pm}0.50$ (range 1~5), showing the highest scores in the area of physical burnout ($3.53{\pm}0.57$). The satisfaction with nursing profession was found to be the most impact on the burnout of the hematology-oncology ward nurses (${\beta}$=-.533), followed by occupational stress (${\beta}$=.351) and years of clinical experiences (${\beta}$=-.154). Conclusion: Given the findings, the sorts of strategies to increase the satisfaction with nursing profession and decrease their occupational stress are required, particularly for newly employed nurses.

• 한국직업건강간호학회지
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• 제30권3호
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• pp.110-119
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• 2021

Purpose: The purpose of this study was to explore the factors affecting turnover intention of nurse who work in comprehensive nursing care service wards. Methods: The study design was a cross-sectional study. We recruited participants in 5 general hospitals located in Gyeonggi. Data were collected using structured questionnaires. Data of 150 nurses were included in the final analysis. Multiple regression analysis was used to identify the influencing factors on turnover intention. Results: Work in the thoracic surgery department (β=.158, p=.045), Emotional labor (β=.282, p=.004), occupational stress (β=.222, p=.004), and burnout (β=.249, p=.003) were identified as factors influencing turnover intention. These factors explained 39.1% of the variance of turnover intention. Conclusion: The findings suggest that it is important to reduce emotional labor and occupational stress to reduce turnover intention for nurse in comprehensive nursing care service wards.

• 한국직업건강간호학회지
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• 제32권4호
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• pp.185-194
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• 2023

Purpose: This study aimed to prepare basic data for the development of a nursing intervention program to improve nursing performance by identifying the factors affecting nursing performance in an integrated nursing care service ward. Methods: Participants were 166 nurses who had worked for more than six months in the integrated nursing care service wards of three general hospitals located in B city. Data were collected from July 15 to August 30, 2022 using structured questionnaires and analyzed by T-test, ANOVA, Scheffé test, Pearson's correlation coefficients and multiple linear regression using the IBM SPSS/WIN 25.0 statistical program. Results: Factors affecting the nursing performance of participants were age (β=.58, p<.001), positive psychological capital (β=.41, p<.001), and social support (β=.28, p<.001). The total explanatory power of these variables for nursing performance was 55.8%. Conclusion: The results of this study suggest the need for programs that improve psychological capital and social support while considering nurse's age to enhance their performance in nursing integrated service wards.

• 한국임상약학회지
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• 제32권1호
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• pp.20-26
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• 2022

Background and objective: The Seoul National University Bundang Hospital (SNUBH) implemented ward-based clinical pharmacy system with designated pharmacists in 10 general wards. Designated pharmacists conduct inpatient medication review, medication intervention, and medication consultation, and provide drug information for health care providers. This study aimed to evaluate the clinical pharmacy services and to examine the perception and expectations of health care providers on the services provided by the designated pharmacists in general wards. Methods: A survey was constructed to include questions on the health care providers' recognition, satisfaction, and perceived needs of designated pharmacists. We determined the frequency and type of interventions of ward pharmacist and their acceptance rate through a retrospective observational study using electronic medical records. Results: A total of 59 health care providers responded the questionnaire and 79.7% of the respondents reported moderate to high levels of satisfaction. Satisfaction with the services was positively associated with clinical interventions and nutrition support team (81.4%). Of 59 respondents, 88.1% agreed that preventing drug-related problems by designated pharmacists' activities were effective. The most common interventions included inadequate dosage (27.4%), omission and additional prescription (14.6%) and inadequate drug form (9.6%). The acceptance rate of intervention was 91.5%, and 151 potentially serious risks and 523 significant risks were prevented by the intervention. Conclusion: Positive results were confirmed in the awareness, satisfaction, and perceived needs of the health care providers for designated pharmacists. Expansion of the ward-based clinical pharmacy system with designated pharmacists to other wards may be considered.

• 융합정보논문지
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• 제7권6호
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• pp.25-33
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• 2017

본 연구의 목적은 간호 간병통합서비스병동의 간호사와 일반병동 간호사의 직무만족, 간호전문직관, 간호근무환경을 비교분석하여 기초융합자료를 제공하기 위함이다. 연구는 2016년 5월 1일부터 7월 30일까지 서울 경기지역 임상간호사를 대상으로 실시하였다. 자료는 SPSS WIN 23.0으로 분석하였다. 연구결과는 일반병동 간호사 100명과 간호 간병통합서비스병동 간호사 92명을 비교하였을 때, 일반병동에서 간호근무환경 점수(t=3.027, p=.003)와 직무만족 점수(t=2.451, p=.015)가 통계적으로 높게 나타났다. 일반병동간호사는 간호전문직관이 높을수록 직무만족(r=.605, p<.001)에 정적인 상관이 있는 것으로, 간호간병통합서비스병동 간호사 또한 간호전문직관이 높을수록 직무만족 (r=.642, p<.001)에 정적인 상관이 있는 것으로 나타났다. 향후 간호 간병통합서비스의 질적 보장을 위해서는 간호 간병통합서비스병동의 간호근무환경과 간호전문직관의 확립을 위한 전략이 필요하다.

• 간호행정학회지
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• 제9권4호
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• pp.559-569
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• 2003

Purpose: The purpose was to investigate nurse staffing levels and patient outcomes(nosocomial infection, patient fall, pressure ulcer). Method: The subjects of this study were 305 nurses from 20 general hospitals who worked at 39 medical and surgical wards. Self-reporting questionnaire which was developed by the writer through preceding study was used. In data analysis, SPSS WIN 10.0. program was utilized for descriptive statistics, ANOVA. Result: The mean of patient-to-nurse ration was 5.2:1. 65% among 20 hospitals was over 300 beds, 90 was located in urban area and 55 was private hospitals. Patient-to-nurse ration of hospitals in under 300 beds or rural area or private ownership was lower than hospitals in 300 beds or urban area or public ownership. 89.9 among 39 wards was medical or surgical wards. The mean of length of stay, 8-14 days got a majority and showed higher patient-to-nurse ration. Of the general characteristics, rural was significantly hight to patient fall(F=3.205, p<.05), medical unit was significantly high to patient fall, pressure ulcer(patient fall: F=8.890, p<.001, pressure ulcer: F=3.399, p<.05) and over 15 days was significantly higher than under 14 days of the mean of length of stay. And there was significant relationship between over 6.0:1 and over 4.0:1 to less than 5.0:1(F=4.817,p<.01). Conclusion: This study has shown a relationship between patient-to-nurse ration and patient fall using not objective research tool but self-reporting questionnaire. Therefore further research is needed to study using objective research tool. Based on this study, the effect of nurse staffing levels on patient outcome also has to be studied.