• 간호행정학회지
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• 제10권1호
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• pp.1-9
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• 2004

Korean health insurance has adopted preliminary DRG payment system through 8 DRGs from 1997. But present DRG payment system gives economic incentives for hospitals to hire less nurse. This study was attempted to develope DRG adjust index to differentiate DRG price by nurse staffing level for nursing care quality. Method: We analyzed inpatient care cost by medical institute and developed DRG adjust index to differentiate DRG price by nurse staffing level. Results: Among same medical institute, inpatient care cost are very different according to hospital's nurse staffing level. In the case of casarean section, inpatient care cost of the 1st grade general hospital are more expensive 85,732won than the 6th grade hospital. The cost difference are 8.24% of total casarean section DRG price and 16.48% of DTG variable price. We developed DRG adjust index-a to apply DRG variable price and index-b to apply DRG total price for compensation cost difference of hospitals. Conclusions: DRG price adjust index will give economic incentive for hospitals to hire more nurse and improve nursing care quality.

• 한국병원경영학회지
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• 제21권2호
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• pp.13-23
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• 2016

Purpose: The purpose of this study is to compare the user satisfaction between 4-bedrooms and 5/6-bedrooms in a single general hospital. Methodology: To measure and compare multiple-bed ward user satisfaction between 4-bedrooms and 5/6-bedrooms, questionnaires were collected from 916 inpatients and 129 nurses in a single general hospital. The patient satisfaction questionnaire categories included environmental conditions, protection of privacy, and medical services. The nurse satisfaction questionnaire categories included space, infection control, patient safety, work load and psychologic view point. Findings: Satisfaction of patient who admitted in 4-bedroom to the environmental conditions and protection of privacy was higher than that of 5/6-bedroom group (3.91 vs. 3.25, p<0.001). Satisfaction of nurse who worked in 4-bedroom was higher than that of 5/6-bedroom (3.05 vs. 1.92, p<0.001). By the multiple linear regression analysis, patient satisfaction to the environmental conditions and protection of privacy was related with multi-bedroom type and location of beds; 4-bedrooms were higher than 5/6-bedrooms(p<0.001), window side bed were higher than hallway side bed(p=0.001). There was no satisfaction difference in comparing medical services between the two groups. By the multiple linear mixed regression analysis, nurse satisfaction who were assigned for 4-bedrooms were higher than that of 5/6-bedrooms in all categories(p<0.001). Practical Implications: Even though no difference has shown in medical services satisfaction between the two patient groups, multi-bedroom type may affect patient satisfaction in environmental condition, protection of privacy and may also affect overall nurse satisfaction. This result suggests that to improve multi-bedroom user satisfaction, 4-bedroom is recommended over 5/6-bedroom.

• 간호행정학회지
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• 제17권1호
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• pp.96-105
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• 2011

Purpose: This study was performed to investigate the perceived relationship among professional self-concept, head nurse's leadership, and nursing clinical competency by clinical nurses. Methods: This study was a cross-sectional survey. Participants were 601 nurses working at the five general hospitals in four provincial cities, Gyeungbuk, Korea. Data were collected from July 14, 2010 to August 31 and analyzed by SPSS/PC ver 18.0 programs. Results: Professional self-concept and head nurse's leadership were slightly above the middle average, but nursing clinical competency was good. According to participants' age, marital status, job satisfaction, and length of service, there were perceptional differences in professional self-concept, head nurse's leadership, and nursing clinical competency. Nursing clinical competency could be explained by head nurse's leadership, professional self-concept, job satisfaction and length of service. Head nurse's leadership was independent variable affecting nursing clinical competency, professional self-concept was partial mediating variable, and job satisfaction and length of service were extraneous variables. Conclusion: It is concluded that head nurse's leadership is more important than professional self-concept to improve nursing clinical competency. Nursing managers should plan various strategies to improve head nurse's leadership and professional self-concept, to increase clinical nurses' job satisfaction and length of service.

• 대한간호학회지
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• 제42권3호
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• pp.351-360
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• 2012

Purpose: The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. Methods: A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. Results: The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. Conclusion: Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.

• 대한간호
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• 제17권4호통권96호
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• pp.74-80
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• 1978

This study was designed to evaluate nurse''s knowledge on English Medical terminology and it''s problems in hospital patient care. Four hundred nurses were sampled from 7 University(College) hospitals and 2 general hospitals in Seoul, Korea, during, Feb.

• 임상간호연구
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• 제18권1호
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• pp.29-38
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• 2012

Purpose: The purpose of this study was to examine the accuracy of general nurses' assessments of pressure ulcers in hospitalized patients. Methods: A total of 129 nursing records of assessments on pressure ulcers were analyzed. Assessment records of pressure ulcers by general nurses were compared to those by Wound, Ostomy, Continence Nurses (WOCN) on the same pressure ulcers. A WOCN of a nursing unit was a nurse certified by the hospital after completion of a formal WOCN course and passing a cyber education course, both offered by the hospital. The formal WOCN course was taught by an internationally certified WOCN. The inter-rater reliability among WOCNs was 98.2%. General nurses in this study did not receive a structured pressure ulcer education. Results: The accuracy for nursing assessment of pressure ulcers by general nurses compared to WOCNs' were evaluated in various ways and resulted in as follows; the existence of pressure ulcer 91.4%, site of pressure ulcer 85.3%, stage of pressure ulcer 85.3%, Braden scale 36.3%, size of pressure ulcer 51.9~64.3%, details of pressure ulcer 0~100%. Conclusion: The structured education about pressure ulcer assessment is important to enhance the accuracy of pressure ulcer assessment of hospitalized patients by general nurses.

• 대한간호학회지
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• 제54권2호
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• pp.237-249
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• 2024

Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

• 한국병원경영학회지
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• 제15권3호
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• pp.1-16
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• 2010

As a cross-sectional study, this study was aimed to investigate and compare the job efficiency and satisfaction of nurses according to the hospital grade. Survey was conducted by mail on June 2009, and the respondents were 1,016 nurses working in 15 hospitals which are 9 high-grade general hospitals and 6 general hospitals. The percent of nurses acknowledging their hospital grades is 34.5%, and that is 20.5% at high-grade general hospitals. As the result of review of studies, it is concluded that under the circumstance that differential rates are contracted to calculate fees for hospital services and copayment of patients are according to nursing grades and hospital grades, the degree of nurses' awareness of insurance fees impact on their performance like recording of care and prescription. In order to improve nurses' performance, they need to be educated about the national insurance fee system. In hospitals with higher nursing grade and more beds, the levels of nursing quality and faithfulnes and their job satisfaction were higher. Nurses' awareness of their hospital nursing grade was related to the quality of nursing but not the faithfulness. Nurses working in higher nursing-grade hospital are more self-respect and satisfied at their jobs, and their job efficiencies are not significantly different. The current nursing fees based on the proper number of nurses per beds of nursing units should be changed to be based on the amount of job per nurse by their nursing protocol, and the nurse staffing standard should be differentiated between nursing grades. As the aspect of nursing, 24-hours patient care, it is difficult to improve nurses' job satisfaction, and in the other hand, that tends to depend on their income level. In the current circumstance, comprehensive research is required to investigate the propriety of 25% of the inpatient fees as the nursing management charge.

• 중환자간호학회지
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• 제14권2호
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• pp.1-11
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• 2021

Purpose : The aim of this study was to propose appropriate nurse staffing of adult intensive care units considering patients' nursing care needs according to the Workload Management System for Critical Care Nurses (WMSCN). Methods : In a cross-sectional survey conducted in September 2017, 1,786 patients' WMSCN scores, surveys from 2,145 nurses, and administrative data from 118 units in 41 hospitals were analyzed. The means (standard deviations) of the aforementioned scores and nursing hours per patient day were presented. Nurse-to-patient ratios and nurse-to bed ratios for staffing to meet patients' nursing care needs were calculated. Results : The mean WMSCN scores were 109.50±17.17 in tertiary hospitals and 96.38±19.26 in general hospitals. Nursing hours per patient day were 12.47±2.80 in tertiary hospitals and 11.01±2.45 in general hospitals. Nursing hours per patient day correlated with WMSCN scores. Nurse-to-bed ratios required for the provision of ICU nursing care ranged from 1: 0.36 to 1: 0.48. Conclusion : Our findings provide evidence that current ICU nurse staffing is insufficient for meeting patients' nursing care needs. We suggest adjusting the legal standards for adequate nurse staffing considering these needs.

• 한국의류학회지
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• 제26권1호
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• pp.168-178
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• 2002

This study is aimed at investigating and comparing the differences in the uniform of nurses according to regions and hospital size in Korea. This study takes two large regions as its survey area; one is Seoul, Incheon and Gyeonggi Province, and the other is Daejon and Chungcheong Province. The hospital size is divided into general hospitals and neighborhood hospitals. The survey was conducted among the nurses working in 12 randomly-selected hospitals and its statistical results are analysed firm 818 respondents'questionnaires. The results are divided into 3 categories as follows; 1) Results of analysis of survey on the uniform of nurses : Nurses usually wear two-piece suits and more than half of the hospitals choose a white-color pattern. And the nurse's uniform with color varying according to their position and ward is considered to be desirable; 2) Analysis on regional differences : In the case of Daejon and Chungcheong Province, there is a relatively high ratio of respondents who answered questions with 'high percentage of young nurses', 'position differentiation by means of different design and fabric according to ward'. In case of Seoul, Incheon and Gyeonggi Province, questions with 'use of a patterned textile in nurses'uniform', 'ready-made size system'are higher; 3) Analysis of the differences in accordance with hospital size : In the case of general hospitals, there is relatively a high ratio of respondents who answered questions with 'use of different design and fabric according to a nurse's position', 'use of patterns in nurses'uniform'. In the case of neighborhood hospitals, there is a high ratio of respondents with'use of classical one-piece or two-piece type wear', 'ready-made type size system', 'obligatory use off nurse's cap'.