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A Study for Improvement of Nursing Service Administration (병원 간호행정 개선을 위한 연구)

  • 박정호
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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Nurse's Attitudes on Organ Donation in Brain Dead Donors (뇌사자 장기기증에 대한 간호사의 태도)

  • Kim, Sang-Hee
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.11-16
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    • 2006
  • Purpose: This study is aimed to confirm nurse's attitudes and to investigate the factor analysis on organ donation in brain dead donors. Methods: This survey were collected from 198 nurses in three university hospitals and four general hospitals in B city with questionnaires developed by the author. The consent for this research was obtained from nursing managers, head nurses, and staff nurses after explaining the purpose of this research. Results: In questionnaires, 45 items about attitudes were included and positive and negative attitude were analyzed. The contents of factors are 'legal permission of brain death', 'one's will of organ donation at the brain death', 'need for educational program about brain dead during college curriculum', 'organ donation is good presents for others', 'connection with professional institutes', 'necessity of brain death', 'convenient to control of brain death' and 'the goods for organ transplantation in brain dead donors' as positive attitudes. Meanwhile, 'contrast to certain religion and dignity to life', 'negative dangers on brain dead permission', 'unbelief to the medical teams', 'burdens to ask organ donation to brain deads/families' and 'economical compensation' are factors as negative attitudes about organ donation in brain dead. The total mean point score of positive attitudes about organ donation in brain dead donors was $3.753{\pm}3.398$. The total mean point score of negative attitudes about organ donation in brain dead donors was $2.915{\pm}0.472$. Conclusion: The results of this study may be of help for the nurses who concern organ sharing and make effective interventions and educations to facilitate the decision making process for organ donation in brain dead donors or families.

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An investigational study on telephone calls to the pediatric nursing unit (외래 및 퇴원환아 부모의 전화상담요구와 간호중재에 대한 조사연구)

  • Kang Hwa Ja;Han Kyung Ja;Choe Myoung Ae;Park Seung Hyun;Kim Young Mi;Kwon Won Kyoung;Kim Sun Gu;Ahn Hye Young;Heo Mi Young
    • Child Health Nursing Research
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    • v.2 no.1
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    • pp.112-126
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    • 1996
  • The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.

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Analysis of Nursing Activities and Cost of Nursing Service Based on the ABC System (활동기준원가계산(ABC)을 이용한 간호활동 분석 및 간호서비스 원가분석;일 산부인과 간호단위를 중심으로)

  • Kang, Kyeong-Hwa
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.389-400
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    • 1999
  • The purpose of this study is to examine a possibility of applying the ABC system to analyze the cost of nursing service on one obstetrics and gynecology (OB/GYN) unit in a major medical center. The activities of nurses on an OB/GYN unit were analyzed for 4 days for 96 hours. 2 week days and 2 days on weekend. Total cases included in the study were activities of 12 charge nurses and 12 staff nurses. Activities were categorized into direct and indirect activities in order to calculate the cost of activities. Nursing activities were defined multidimesionally in order to utilize the ABC system. The 60 nursing activities were classified into the direct nursing activities and the indirect nursing activities based on a literature review, interview, and survey results. The direct activities were further categorized into the single nursing activities and the multiple nursing activities. The indirect activities were classified into the indirect nursing service activities and the general management activities. The major findings of this study were as follows : 1. There were differences in activities according to the positions and duties of the nurses. The charge nurses mostly performed the indirect nursing service activities and the general management activities. Almost all of their indirect nursing activities spent on each patient were similar. The staff nurses performed the single nursing activities and the multiple nursing activities. 2. The activities of staff nurses included medication, patient assessment, rounding and organizing the unit. patient education, nursing treatment, admission and discharging of patients. There was no differences in types and amount of time spent between the nurses on day-time duty and evening-time duty, but the patient assessment activity increased during the night-time. 3. The cost of post partum nursing services for women who had a normal vaginal delivery using the ABC system included the cost incurred by direct nursing activities provided by the staff nurses (85.9%), indirect nursing activities incurred by the staff nurses(19.0%) and the nursing activities by the charge nurses and the head nurse(14.1%). The ABC system is a relatively new method of cost analysis. The results of this study can provide the nursing and hospital managers with useful information on cost control. It is suggested that more studies should be done using the ABC system and extend the scope of studies to include value analysis to aid the Activity-Based Management(ABM) and/or the reengineering of hospital process.

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A Study on the Rank of Stressful Events Related to the Experience of Hospitalization (입원환자가 경험한 입원스트레스 순위에 관한 연구)

  • 이소우;하양숙;박은숙
    • Journal of Korean Academy of Nursing
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    • v.15 no.1
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    • pp.17-29
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    • 1985
  • This study was to explore on the rank of stressful events related to the experience of hospitalization. 180 hospitalized patients on surgical and medical wards were asked to rate 49 stress-producing events associated with the experience of hospitalization. Two university hospitals was used as the setting for this study. Because the nature of the events in the stress scale pertain mainly to general short term hospitalizations, patients in the rehabilitation and psychiatric units of the hospital were not included. Prior to the beginning of the study, three times meeting were held with 12 head nurses and 3 investigators for discussing with the ethics subject related to the study. The pretest was done to determine whether items to use were pertinent or not. According to the result of the pretest, Volicer's Hospital Stress Rating Scale was selected as a study tool for this study. Data collection was used an interview and a card-sorting method. The interviewing was done by two authors and three graduate nursing students. A total 125 completed the card-sorting procedure. The stressful items were ordered from most to least stressful within the categories. Additional information such as: age, sex, marital status, and diagnosis was obtained from the kardex file. The ordered list of items, with mean values, as scored by the total of 125 respondents was significantly accepted at 1% level by Friedman test. (X²=1448.339) The event,“knowing you have a serious illness.”was rated highest stressful and (M=41.54) “Being awakened in the night by the nurse”least stressful. (M=14.73) Highly rated items were orderly “Thinking you might have cancer”“Thinking you might lose a kidney or some other organ”“Not being told what your diagnosis is. “Not knowing for sure what illness you have,”five lowerly rated items were orderly “Having to eat at different times than you usually do”“net being able to call family or friends on the phone”“Not having friends visit you,”“Having strangers sleep in the same room with you.”Futher analysis of the data was done to ascertain tao degree of similarity of judgment between different groups in the sample as to how events should be rated. The sample was divided into two groups according to the demographic characteristics and the degree of seriousness of illness. The rank order correlation was calculated for the two sets of ranks as a measure of consensus between the two groups. The correlations ranged from .85∼.99 all indicating a high degree of consensus.

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간호 업무 실태 분석 및 합리적인 병실 관리 개선 방향

  • 방용자;강흥순
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.111-132
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    • 1970
  • An analysis of nursing activities in a in-patient ward and its management was observed in order to assess necessary number of nursing hands and find out reasonable work management with them. The study was performed with two wards of St. Mary′s Hospital, Catholic Medical Center, for the period from July to December 1970. The results and conclusions were as the following 1. The role of the nurses are determined by doctor′s order in 57.7% in kind, 80.0% in amount. and by nurses decision 20.0% in amount. 2. Works related to patient care are found to be 20.6% in the internal medicine ward and 20.4% in the surgical ward while works related to treatment are 4.7% in the former and 27.2% in the letter. Medication occupies 40.0% in the internal medical ward while 26.6% in the surgery ward, and observation occupies 34.7% in the former while 25.8% in the letter. These can be said to reflect characteristic differences bet ween the two wards. 3. When nursing functions were evaluated by importance "A" level in the amount of works to be done occupied 67.6% in the surgical ward and 62.8% in the internal medical ward. In the kind of the important works, "B"level is found to be most frequent with 50% while "A"level 43%. When evaluated by difficulty, "B"level was found to be most frequent in amount in both internal medicine and surgical wards (52.6%, 38.2%). 4. Works needing professional knowledge and skills occupied 92% in the both wards while unprofessional works 2.8% and 4.2% respectively. There are indications, however, that unprofessional works have an increasing tendency. 5. When evaluated by the amount of works, the surgical ward has 11 nurses less and the internal medicine ward 3 nurses less then the necessary number of nursing staffs. There are shortage of 12 and 6 nurses respectively when evaluated by the number of patients and 18 nurses in the both wards when evaluated by the medical regulations of the Government. 6. The ratio of the nursing staff to patient was found to be 1:11.5, 1:23.0 and 1:34.5 in the morning, evening and night turn in the surgical ward. In the medical word the ratio was 1:9.4, 1:22.0 and 1:33.0. 7. The deficiency of necessary equipment and tension accompanying management of those equipment were found to lower the effective functioning of the head nurse who is a junior manager of the ward. They also consume much of the time and energy of the nurses at work who are over burdened in most of the cases. 8. The high rate of the number of nurses who leave the job impairs the functioning of team work which is considered to be most important in the effective performance of nursing activities and thus contributes to lower the efficiency of nursing functions.

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Concept Development of Service Marketing Promotion in Nursing (간호서비스 마케팅에 관한 연구;'촉진(Promotion)' 개념 개발)

  • Kang, Yoon-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.1
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    • pp.63-76
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    • 1999
  • The main objective of this study was to develop a concept of service marketing promotion in nursing that is derived from the concepts of service marketing theory. This research was a descriptive study, at the factor isolation level. The principle of concept derivation suggested by Walker and Avant (1988) and the Hybrid model suggested by Schwarz-Barcott and Kim (1993) were employed as the research method. The data were collected from December, 1997 to April. 1998 at a large general hospital located in Seoul. The procedures of this study were as follows: First. at the theoretical phase: the meaning, attributes, and definition of service marketing promotion were identified through an extensive review of the literature. Second, at the empirical phase: fieldwork was done to identify the promotional activities and events in nursing. Top nurse managers from 4 units (Director of Nursing, Head nurses of inpatient nursing unit, outpatient nursing unit. and home care nursing unit) were interviewed and the content of the interview was analyzed to identify the meaning and attributes of promotion in nursing. Other methods such as brochures and other audio-visual materials which were relevant to nursing promotion were used to supplement the interviews. Finally, the results of the theoretical and empirical analyses were intergrated to develop a concept of service marketing in nursing practice. A final definition of service marketing promotion in nursing was identified as follows. 1. Promotion as a marketing function in nursing service is concerned with communication to target markets on all information related to nursing service in order to satisfy the objectives of both a nursing service organization and the target markets. 2. The goals of nursing service promotion include: 1) increasing visibility of nursing services and delivering the information on nursing services, 2) affirming the value of nursing services, so it can contribute to formulation of reimbursement policy for nursing services. 3) advancing the general image of the nursing profession and nursing services. 4) achieving and attaining a desirable positioning for nurses among health care professionals. and 5) creating and stimulating the demand for nursing services. 3. In order to obtain these goals it is necessary to provide information on nursing services, to persuade target markets. to remind them about nursing services. and to establish a collaborative relationship with related departments. 4. The tools used to carry out the above functions of promotion in nursing are the providing nursing services, public relations and publicity. QA of nursing, advertising, and sales promotion. 5. The target markets of nursing service include the nursing customer markets. the internal markets, the influence markets. the recruitment markets. the supplier markets. and the nursing referral markets. In conclusion, the concept of promotion in other service marketing areas can be applied to the promotion of nursing service marketing. The promotion of nursing service is more than just effective communication in nursing service. it is the effective use of the concepts of service marketing promotion. Promotion of nursing service will contribute to create and expand nursing services.

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A Study of Nurses' Knowledge, Attitude on the Nurses' Law and Nurses' Perception on the Causes, Coping Patterns with the Nursing Accidents (간호사의 간호관련법에 대한 지식$\cdot$태도 및 간호사고에 대한 원인$\cdot$대처양상에 관한 연구)

  • Mun Heui Ja;Lee Mi Aie
    • Journal of Korean Public Health Nursing
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    • v.13 no.1
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    • pp.41-62
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    • 1999
  • Recently the request of the patients to participate in the medical courses has been expanding due to elevated sense of right on the people's health. merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurses has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accidents. The following is the conclusion based by the above examination. 1) The general characters of the subjects of this study is that they are mostly single in their twenties and graduate from nursing college. Their total clinical career is above 5 years$(44.8\%)$ and their current clinical parts' career is between 1-3 years$(40.1\%)$. So these facts suggest that most hospitals has taken the working rotation policy on nurses. 2) The level of nurses' knowledge on the nursing law is accurate partially but isn't it patially. So it is suggested that nurses need the accurate information and education about the nursing law. But the nurses' attitude is very approved of the establishment of a unilateral nursing law. 3) The relation between the demographic characters of the subjects and their attitudes on the nursing law shows that there is no significant differences except the relation between the attitude 6(the sufficient level of education on nursing law in formal education course) and age. total clinical career. 4) The perception of the nurses shows that the cause of the nursing accident has been due to the heavy work$(78.2\%)$. short of professional knowledge and skill$(60.2\%)$, discordance with Doctors. patients and patients' families. They report the accident to the head nurse first$(81.8\%)$ and within 30 minute$(75.1\%)$. The hour of nursing accident frequently happened is regardless of service hour with $49.4\%$ in response rate. the highest rate. and the nursing accident happens in the night more than the daytime. Even though most nurses think that they are themselves responsible for nursing accident. it is found that the chief cause of the nursing accident is due to the nurses' heavy work$(78.2\%)$. So the causes of nursing accidents is analysed. it may be suggested that the endeavor of hospital and nursing organizations to decrease nursing accidents is very important. 5) The coping patterns of patients with nursing accidents are mostly active attitude such as a violent words$(69\%)$. sue or accusation$(36.4\%)$, monetary compensation $(35.6\%)$ except a understanding cases$(38.7\%)$. But the coping patterns of hospitals with nursing accidents are mostly to investigate the accurate cause.

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The Job Satisfaction and Self-assessment of Public Health Nutritionists (보건 영양사의 직무만족도 및 자기진단평가)

  • 박혜련;권지영
    • Korean Journal of Community Nutrition
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    • v.4 no.1
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    • pp.83-94
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    • 1999
  • This study was carried out to investigate the general characteristics of public health nutritionists, the current status of nutrition services operation, the recognition about nutrition services of public health center related man power, the job satisfaction and self-assessment and the need for a retraining course of public health nutritionists. The subjects were 58 public health nutritionists who responded to the questionnaire distributed at the annual retraining program in 1998. The results of this study are summarized as follows. 1) 46.5% of the nutritionists were 26-30 years old, 62.1% were 4 year university graduates 74.1% were food and nutrition majors and 51.7% were daily workers. 2) Among the public health center-related manpower, the recognition about nutrition services was the highest for the manager of family health section, followed by the head of public health centers, and then the general nurse in public health centers. 3) The ranking of the reasons for job satisfaction of the public health nutritionists was, relationship with colleagues(3.84), inhabitants response after nutrition counselling(3.53), specialized value realization/conviction about duty(3.35), contents of the work(3.10), value achievement(3.08), self achievement/development(3.00), self discretion(2.92), participation in policy decisions(2.90), work load(2.75), chance of retraining and acquisition of new information(2.73), working environment(2.69), supervisio $n^port by superiors(2.67), salary(2.38), supply of necessary education material, technique(2.37), and budget security(2.22). 4) The satisfaction of the inhabitant's responses after nutrition counseling was the highest among the 4 year university graduates(p<0.05), the satisfaction of the specialized value realization/conviction about duty was the highest among the nutritionists 26-30 years old(p<0.05). Food and nutrition majors(p<0.05) and those having worked less than 3-5years at public health centers also showed much satisfaction(p<0.05). Satisfaction with the salary was the lowest among the food and nutrition majors(p<0.01) and daily workers(p<0.001). The satisfaction with the participation in policy decisions was the lowest among the daily workers(p<0.01). 5) The ranking for the level of self-assessment were, nutrition and dietetic practice(2.92), communication(2.80), management(2.77), public health science and practice(2.66)(p<0.01). The general characteristics such as the level of education, major, employment condition, current public health center's tenure, and charge experience of the nutrition guidance work were not significantly related to self-assessment except the management part(p<0.05). The higher the satisfaction of specialized value realization/conviction about the duty, the better the total score on the self-assessment(p<0.05)..

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A Study of Health Condion and Shift Service of the Nurse in (종합병원 간호사의 교대근무와 건강상태에 관한 연구)

  • Kim, Soon-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.119-133
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    • 1997
  • Continuing shift service of clinical nurses can be not only the cause of occupational dissatisfaction by being connected with the change of circadian rhythm and the burden of duties to be applicable to such changes. But also of inviting the lowering of nursing quality by being affected to the resignation of the nurses as the threat to the health of the nurses. This study has selected 500 nurses at random under non-probability sampling who have been serving by shift in 7 general hospitals which have over 400 sickbeds for the purpose of cross-sectional survey design from Sep. 7 through 20, 1996. Standardized modification of the CMI has been used which was designed for Koreans with Cornell Medical Index developed by Broadman and his fellow workers as the study device. The structure of the device was composed of 35 questions on physical appeal(Chronbach's ${\alpha}=8507$) and 22 questions of mental appeal(Cronbach's ${\alpha}=.8166$ totalling 57 questions. The collected data has been computerrized by using SPSS. General character, present symptom, perceived symptom and others are sought by practical number and percentage, and the health condition comparison followed by general characters was conducted by t-test and ANOVA. The post test was by Duncan's test by the level of p<.05. 1) The items of the answer that they have the physical symptom presently by 50% or over of the nurses were as "Do you often have spells of severe dizziness", "Are your eyes often red or inflamed", "Does press or pain in the head often make like miserable", "Are your ankles often badly swollen", "Do pains in the back make it hard for you to keep up with your work". 2) The items of the answer by over 50% of the nurses as the mental symptom at present were "do you fell bad when criticized?", "Do you get angry when everything is against your will?", "do you get angry when ordered to do this and that?", "do you feel uneasy by such a trifle thing?", "do you tremble or are you freightened by sudden sound?". The mental and physical symptoms which have appeared presently in connection with the shift service have been agreed with each other. But the physical condition has been worse than the mental one. 3) In the physical health conditions followed by demosociological character, there were the significant differences by sex, religion and place of residence(p<.05), and in the mental health conditions, there were the significant differences by age, marital status, residence place and the required time for attending hospital(p<.05). 4) There was significant difference by the degree of satisfaction about the duty in both the physical and mental health conditions. In short, the higher the degree of duty satisfaction, the better the health conditions. 5) There were the significant difference according to the times of night duty and whether they take the drug or not or the kinds of the drugs in the physical health conditions related with the characters of night shift. Mental health conditions in the night shift case showed significant differences according to their taking drug or not or the kinds of the drugs(p<.05). I can confirm that the nurses have been affected continuously by the shift service mentally and physically. The maintenance of the physical and mental health of the nurses and its promotion are very important problem to guarantee the quality nursing in the performance of the nursing service continuously and effectively, so the hospital should make every effort to improve the duty conditions by finding out the causes affecting to their health. In the nursing management viewpoint, I think that elevating the satisfaction degree about the duty would be a great help to the promotion of physical and mental health conditions. But what is most important is that the nurses themselves should take care of themselves in maintaining the good conditions in their service in the hospital.

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