• 대한간호학회지
• /
• 제19권2호
• /
• pp.212-222
• /
• 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.

• 간호행정학회지
• /
• 제5권1호
• /
• pp.113-136
• /
• 1999

There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.

• 한국병원경영학회지
• /
• 제7권2호
• /
• pp.52-79
• /
• 2002

The hospital is characterized by it's remarkable labor industry and human resources input by unit. Recently, the administrative personnel are recognized as an important staff to provide a hospital guidance to consumer and also easiness for consumer's visit to hospital. The purpose of this study is to find the organizational effectiveness of the administrative personnel in hospitals. The survey data involved in the study was derived from 229 personnels working in 3 medium and small sized hospitals and 1 university hospital in Inchon area. The major finding are as follows; 1. The organizational efficiency in accordance with the general characteristics of subjects in order of over 31 years of age, university graduates, long-term tenure and high position is higher, whereas, in as much as wage and well trained personnels in are higher, general hospital's organizational efficiency is higher in comparison with those of university hospital. 2. The organizational efficiency in accordance with satisfaction and the psychological motive contributional factors is higher as much as the high satisfactory level in every hospitals in general. 3. The organizational efficiency in accordance with the factors of job characteristics is higher in as much as difficulty of the jobs is lesser, however there was not statically significance. In as much as job standard level is higher and the more job responsibility the higher organizational efficiency. It was obvious that the higher professional expertise as well as the training and application level are improving the organizational efficiency. 4. The organizational efficiency in accordance with the factors of structural characteristics was higher in as much as the intercommunication was smooth and the structural formalization level are higher, however there was not statically significance between the participation level of decision making and the organizational efficiency. 5. In as much as older age, management of organization and the job level are satisfied, the higher structural formalization level, the smooth intercommunication have affected as major influence factors of organizational efficiency. 6. In the university hospitals is satisfied in the management and job level of hospital organization as there are no difficult jobs while the level of hospital's organizational formality is high and the intercommunication is smooth, which are improving the organizational efficiency. In the general hospitals is also satisfied the management and job level of hospital organization and psychological motive contributional factors is higher, it was apparent that the organizational efficiency is higher in as much as the level of job standardization is high and the intercommunication is smooth. As a result of this study, in order for improving the organizational efficiency of administrative personnel in hospitals, the management and job level as well as personal relation are preferably satisfied, whereas formalization of organization, intercommunication and etc. should be satisfied, and, therefore, it is advisable to buildup discriminated organizational management and environment for different division on the basis above factors. Since this study is carried on four hospitals in Inchon area, there is a certain limit to generalize its result to all domestic hospitals, nevertheless the gallop poll was made by developing the questionnaires with reasonability and reliability. Especially. as the study was carried by analyzing the comparison of influence factors' difference of organizational efficiency in accordance with the divisional characteristics of the university and general hospitals.

• 간호행정학회지
• /
• 제6권2호
• /
• pp.281-290
• /
• 2000

The purpose of this study was to identify the relationship between the head nurses' leadership style the and the autonomy perceived by nurses and to provide the basic data for developing strategies of the effective nurse staff management. The subjects were 177 nurses who were working at the 3 general hospitals in Seoul. The data were collected from December 1999 to January 2000 by the structured questionnaires. For data analysis, descriptive statistics, ANOVA, Pearson correlation coefficient, and stepwise multiple regression with $SPSS-PC^+$ version 8.0 were used. The results of this study were as follows : 1. The score of 'the head nurses' transformational leadership perceived by nurses' was highier than that of 'the head nurses' transactional leadership'. Among 5 subdimensions of 'the leadership styles perceived by nurse', the scores of the 'charisma' and 'intellectual stimulation' were highest and the lowest one was that of 'extra management'. 2. Only 'the head nurses' transformational leadership perceived nurses' and 'the situatuational reward' showed a significant difference according to the married status ; nurses who were married showed higher scores than who were not. 3. 'The autonomy perceived by nurses' showed a significant difference according to the educational background ; nurses who had master degree showed higher score than who had diploma. 4. 'Charisma' was positively related to 'intellectual stimulation', 'individual consideration', and 'situational reward'. 'Intellectual stimulation' was positively related to 'individual consideration' and 'situational reward'. 'Individual consideration' was positively related to 'situational reward'. But 'extra management' was negatively related to all of variables. 'Autonomy' was significantly related to 'individual consideration' and 'the transformational leadership'. 5. The determinents of 'the autonomy perceived by nurses' were 'individual consideration' and the educational background, and they explained 15.4% of the total variance of it. The key determinent variables was 'individual consideration'. It explained 11.5% of the total variance of the autonomy. According to the results of this study, the suggestions were as follows: 1. It is necessary to develop strategies for exercising the head nurses' transformational leadership in nursing department : It should to be considered the difference in the leadership style perceived by nurses according to demographic variables. 2. The further studys on the individual consideration of head nurses' transformational leadership and the opportunity of self-development such as education for enhancing nurses' autonomy is needed.

• 간호행정학회지
• /
• 제10권1호
• /
• pp.25-36
• /
• 2004

Purpose: Nursing puts much weight en the organization of hospital. Therefore it is necessity to improve nursing care. One of the most important things is to secure confident nurses and to develop nurse' potentiality. It directs nurse evaluation system. The concept of "performance appraisal tools" is extremely important in evaluation system. Therefore, the purpose of this study aims to define performance appraisal process. Method: In order to do this, two main study has been observed interviewing appraisers and employees in-depth and analyzing performance appraisal tools of seven hospitals and analysed validity, reliability, acceptability and practicability. Result: The result of this study can be summarized as follows; Firstly, the result of analysis of performance appraisal tools. Regard to validity, Hospitals had a typical goal, but had not put to practice use. Regard to reliability, 1) Appraisal rule had been focused on appraiser's error, how to avoid. 2) 5 hospitals accessed nurses with relative rating and 2 hospitals with absolute rating both in practice. 3) 3 hospitals informed nurses the result of performance appraisal but 4 hospitals did not. 4) All hospitals in this study had conducted superiors rating. Regard to acceptability, 1)Rating scale method had been implemented by 6 hospitals and among those conducted beth ranking method and descriptive method. 2) Most hospitals had focused on personal traits in performance appraisal factors. Regard to practicality, The term of appraisal took $10{\sim}14$ days; performance appraisal happened 1 or 2 times per year; appraisal factors were based on 10 different items. Secondly, the result of in-depth interview with head nurses and staff nurses Regard to validity, head nurses and nurses wared that the goal of performance appraisal is to develop nurse's ability. Regard to reliability, head nurses pointed out that they were doubt of the justice of performance appraisal and they should have got training. Nurses insisted that raters should have been trained due to lack of qualification of appraiser; Head nurses and nurse proposed to convert form relative rating to absolute rating; to inform the result of appraisal; to implement peers rating. Regard to acceptability, One of the critical problems of performance appraisal tools was abstract of appraisal factors ; Lack of job analysis. Regard to practicality, Head nurses used to take overtime for appraisal. There was only a little respond despite of their efforts. Nurses questioned that appraisal tools exist for only appraisal; there was less cost-effectiveness. Conclusion: Based en these findings, it could be suggested to improve the performance appraisal tools for nurses evaluation. Firstly, it is necessary to describe goal of performance appraisal clearly set up, so that nurses could improve their positive word performance and develop their potentiality. Secondly, it is necessary to obtain various training on raters, implement absolute rating and inform the result of appraisal to nurses and use peers rating. Thirdly, it is necessary to convert from rating scale method to management by objectives or behaviorally anchored rating scale and take measurable appraisal factors based en job analysis. Finally, it is necessary to reduce the appraisal cost but increase effectiveness of performance appraisal.

• 임상간호연구
• /
• 제18권2호
• /
• pp.284-295
• /
• 2012

Purpose: This study was done to clarify effects of bispectral index monitoring sedative administration, compared to MOAA/S (Modified Observer's Assessment of Alertness and Sedation), on conscious sedation, physiological stability and recovery time for patients undergoing endoscopic submucosal dissection. Methods: Participants In this study were patients who underwent endoscopic submucosal dissection because of early gastric cancer. Participants were assigned randomly to an experimental group receiving sedatives based on bispectral index monitoring or to a control group with the MOAA/S instrument. Movements, belching, memory, pain, discomfort, physiological stability (MBP, PR, $SpO_2$), and recovery time were measured during the treatment and recovery. Data were analyzed using Spearman partial correlation coefficient analysis, Mixed model and Wilcoxon rank sum test to determine differences in the parameters. Results: There were no statistically significant differences between the two groups for conscious sedation(movement, belching, memory, pain, or discomfort), physiological stability and recovery time. Conclusion: The results of this study indicate that no differences were found between the two types of monitoring. Thus, use of a bispectral index monitor in clinical practice enabling medical staff to readily assess the conscious sedation of for these patients is expected to be increasingly used as an objective assessment tool for conscious sedation for patient safety.

• 동서간호학연구지
• /
• 제10권1호
• /
• pp.11-26
• /
• 2004

The purpose of this study is to investigate the present conditions of nursing investment contents, its conversion process, and output in Oriental University Medical Center, Korea to get good qualified Oriental nursing result which is the ultimate purpose of the Oriental nursing management, and to develope a matrix of Oriental nursing management system on the basis of that project. The subjects for nursing investment and output contents were eighteen nursing directors in eleven Oriental University Medical Center and two hundred thirty-nine nurses with three years and over experience in Oriental medical center. The subjects for Oriental nursing organization, human affair management, and control function were nineteen Oriental medical center in Oriental University Medical Center, Korea. Data were collected from November, 2002 to February, 2003 with questionnaire. Data analysis was done by SPSS PC+ 12 program. Frequency, percentage, and minimum/maximum values were used for investment contents, and frequency and percentage were used for conversion process and output contents. 1. The input factors of oriental nursing management system The objective's western hospital career was over five years of one hundred and seventy-five(73.2%) persons. Nursing in-service education was performed in fourteen hospitals(77.8%). Two hundreds(83.7%) were pro to oriental nurse system. Only four hospitals(22.2%) had independent budget in nursing division. Nursing staff allocation to the bed was from 2.8:1 to 9.06:1 respectively, with a big gap of the rate following the hospitals. 2. The conversion factors of oriental nursing system 1) Oriental nursing system Oriental hospital nursing system was organized independently in ten hospitals among eighteen hospitals. The recruitment of nurses which was a vital role of the nursing division of the hospital was mostly(79%) opened. The education to develope nursing personnels was through in-service one in 97.4%. Education for oriental nursing and management was performed in 42.1%(eight hospitals) and that for reserves was done in 36.8%(seven hospitals). Administration for nursing education by nursing division was 68.5%(thirteen hospitals). The post education evaluation was performed by report submission in 36.8%(seven hospitals), by written examination in 26.3%, by questionnaires in 21.1%, and by lecture presentation in 15.8% subsequently. The directorial meeting for the nursing directors was attended by 84.2%(sixteen hospitals), and the meeting type was the medical executive and support division executive meeting in 55.6%(ten hospitals) and the personnel management in 39.6%(seven hospitals). 2) The actual conditions of oriental nursing personnel management The reason of working in oriental hospital was by voluntary in 67.1%(a hundred and sixty persons), by nursing department order in 28.0%(sixty-seven persons), and by others in 5.0%(twelve persons) respectively. The shift form was a three-shifts one in 94.7%(eighteen hospitals), a two-shift one in only one hospital. Duty assignment was functional in 52.6%(ten hospitals), team and functional in 26.3%(five hospitals) and no team alone. Promotion manual was present at 68.4%(thirteen hospitals) and the competency essentials comprised of performance evaluation in 79%, interview, written examination, training result, study result subsequently. No labor union existed in 79%(fifteen hospitals) 3) Oriental nursing preceptor system There were five oriental hospitals(27.7%) administering the preceptor utilization model, which showed lower rate than the twenty-two medical university hospitals in Seoul in which fifteen hospitals (72.7%) were having the system. To the question of necessity of oriental nurse system asked to the objectives of two hundred and thirty-nine with more than three year-experience in oriental hospital, two hundred persons(83.7%) answered positively. 4) The control of oriental nursing The evaluation results from the target hospitals were mostly not opened in 89.4% of oriental hospitals. Thirteen hospitals(68.3%) had evaluation system of direct managers and the next were three hospitals(15.8%) of direct managers and selves. There was one hospital(5.3% each) where fellows and superiors, fellows, and inferiors' evaluation was performed and no hospital where superiors, fellows, inferiors and selves, and superiors, fellows and selves' evaluation was performed. The QI activity of nursing was 42.1%(eight hospitals) for nursing service evaluation, 36.8% for survey of ECSI, 26.3% for survey of ICSI, 15.8% for medical visit rate, 10% for hospital standardization inspection in sequence. 3. The output factors of oriental nursing management system The job satisfaction appeared good in general, indicating very good in thirty-seven persons (15.7%), good in one hundred and fourteen persons (48.3%) and fair in eighty-five persons(36.0%).

• 한국산학기술학회논문지
• /
• 제12권5호
• /
• pp.2163-2171
• /
• 2011

본 연구는 간호사들의 근골격계 자각증상을 파악하고, 인구사회학적 특성, 건강행태 및 직업관련 특성과의 관련성을 규명하고자 시도하였다. 조사대상은 대전광역시의 한 대학병원의 병동근무 간호사 249명으로 하였으며, 조사는 2010년 8월 1일부터 8월 31일까지의 기간에 자기기입식 설문조사(self administration questionnaire)를 실시하였다. 연구결과 근골격계증상이 1개 이상 있는 경우는 66.3% 2개 이상 있는 경우는 45.8%를 차지하고 있었으며, 신체부위별 호소율은 어깨 44.2%, 허리 33.7%, 다리/발 33.3%, 목 29.7%, 손/손목/손가락 14.9%, 팔/팔꿈치 4.8%의 순위였다. 연령을 보정한 로지스틱회귀분석을 실시한 결과, 목, 어깨, 허리, 다리/발 부위 증상의 위험비는 주관적 건강 상태가 좋다는 군보다 좋지 않다는 군, 교대근무를 하지 않는 군보다 한다는 군, 책임/수간호사 군보다 평간호사 군. 업무에 대한 육체적 부담정도가 견딜만하다는 군보다 힘들다는 군에서 유의하게 증가한 것으로 나타났다. 결론적으로 근골격계 자각증상은 개인의 인구사회학적 특성이나 건강상태 및 직업관련 특성에 따라 호소율이 다르게 나타남을 시사하고 있다.

• 대한방사선기술학회지:방사선기술과학
• /
• 제32권1호
• /
• pp.1-15
• /
• 2009

진단용엑스선장치의 방사선방어 관한 내용을 중심으로 국내 외 규격을 살펴보고 신-구 IEC규격을 비교하여 본 결과는 다음과 같다. 가장 최근에 발표된 IEC 60601-1-3 ; 2008 2nd Edition에 담긴 철학은 크게 두 가지로서, 제조된 진단용 엑스선장치에 의하여 촬영 받게 될 환자를 위하여 어떤 종류의 방사선(선질 : Radiation Quality)을 얼마나 주었는지(선량 : Radiation Dose)를 확실히 해야 한다는 것이며 또 그 장치를 이용하는 작업자를 위하여 누설방사선(Leakage Radiation), 잉여방사선(Residual Radiation), 떠돌이 방사선(Stray Radiation)을 최소화해야 한다는 것이다. 진단용 엑스선장치에 관한 국내규격을 개정하거나 다시 제정할 경우 다음과 같은 내용과과정이 필요하다고 사료된다. 1. 가급적 최신 개념이 담긴 국제규격(IEC Publication)에 맞추되 우리나라의 실정에 맞는 규격을 채택하여야 할 것이다. 즉 IEC 60601-1-3 ; 2008을 근간으로 하고 미국의 CFR, 일본의 JIS도 참고한다면 지금 보다 한층 진보한 규격을 만들 수 있을 것이다. 2. 방사선안전부분을 중점적으로 고시하는 것이 간결하다. 즉 전기 기계적 안전에 관한 사항(IEC 60601-1)은 식품의약품안전청 고시 제 2006-7호 "의료기기의 전기 기계적 안전에 관한 공통기준규격"을 준용해야 한다. 3. 급격한 고시의 변화는 바람직하지 않다. 즉 최근에 개정된 IEC 60601-1-3 ; 2008을 도입하여 바로 적용하지 않고, 일단 현 규격을 일부 개정하여 사용하면서 적응기간을 가질 필요가 있다.

• 대한간호
• /
• 제33권1호
• /
• pp.65-79
• /
• 1994

The purpose of this study was to describe the job retainment factors and the level of job satisfaction, and to identify the relationship between job retainment and the level of job satisfaction among the registered nurses working in hospitals. Four hundred eight registered nurses currently employed at 8 hospitals in Seoul were surveyed for the study. The 39 item, 5 point likert scale questionnare was developed by the researcher. The internal consistency of job satisfaction was. 86 and that of job retainment was. 90 in Cronbach's alpha test. The data sas collected from July 15 to July 30, 1993. The SPSS/PC+statistical program was used for data analysis. The descriptive analysis of the characteristics of the subjects, the level of job satisfaction and the job retainment factors was done. The relationship between the job satisfaction level and the job retainment factors was tested with. the Pearson Correlation Coefficient analysis, and thd differences of job retainment scores among the sample was tested with t-test and ANDVA. The results of the study were summarized. 1. The mean age of the subjects was 29.7 years, 41.7% of them were married. 71.1% of them were 3 years course graduates, 71.8% of them were staff nurses, and the mean duration of experience was 6 years. 2. The factors related to professionalism(3.43), society(3.31), and interpersonal relationship(3.29) were significant in job retainment. The maximum score was 5.0 Two other factors, personal(3.05) and organization(2.83) factors, also showed relatively high scores. 3. The factors to the job satisfaction showed similar pattern as job retainment: professionalism (3.47), society (3.33), finance(3.31), interpersonal relationship(3.02), and organization(2.72). 4. Society related factors(r=.7420, p<.00l) and professionalism(r=.7249, p<.00l) had high correlation with job retainment. Personal(r=.6372, p<.001) and organizational(r=.3597, p<.001) factors had moderate relationship to job retainment. Finance(r=.3597, p<.00l) had significant but weak relationship to job retainment. 5. Age, marital status, job position, departmental involvement, experience, and continuity of employment of the sample showed significant differences in job retainment. However, the period of job retainment, number of children, educational level, type of hospital, previous employment experience were not significant. 6. lndiviuals older than 40 years of age, who were married, who held the position of charge or head nurse position, who worked in central supply or nursing administration showed significantly high job retainment score. This research indicates that the professionalism is the most significant factor in job retainment. In order to retain more experienced nurses, it is important to improve the profesionalism among nurses.