• Perspectives in Nursing Science
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• v.14 no.1
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• pp.10-20
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• 2017

Purpose: The aim of this study was to explore the patients' perspectives on nursing students' clinical practices in the wards, and to investigate their willingness for allowing students to practice on them. Methods: This was a descriptive study. 116 inpatients were recruited from the S University Hospital. A 60-item questionnaire was applied to collect the data. The participants were 19 years and older with sound judgement, and were not in special or intensive care units. Data analysis was done in SPSS/WIN 22.0 using descriptive statistics, Fishers exact test, and the ANOVA test. the participant answered to questionnaire from April 29th 2016 to May 10th. Results: 40 participants (34.5%) stated they would allow students' practice, while 72 (61.2%) said they would allow only under staff supervision. 5 participants (4.3%) stated they would not allow whatsoever. The 3 most allowed were emotional support, oral care, and vital signs measurement while the 3 least allowed were gastric feeding, intravenous catheterization, and urinary catheterization. Conclusion: Patients were more inclined to allow students to practice on them when a member of the medical team was present. A fair number of participants said they would be more inclined to allow students' practice if they felt the student was competent; hence, reinforcing simulation sessions is vital in enhancing students' competency and ultimately practice allowance.

• Journal of Digital Forensics
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• v.12 no.3
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• pp.83-96
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• 2018

Electronic medical records in the hospital information system are the important evidence related to the crime and are subject to search and seizure. In the case of a large general hospital, it is possible to search for seizures through cooperation of the staff, but it is impossible in small hospitals. The investigation agency copies the database of electronic medical records and then selects relevant content. This approach has an issue of excessive search and seizure. In this paper, we propose field selection procedures and methods for electronic medical records while ensuring integrity, reproducibility, and chain of custody. Currently, it is necessary to study the procedures and methods of search and seizure of medical information system so that it can respond to next changing cloud hospital information system.

• Health Policy and Management
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• v.17 no.2
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• pp.68-90
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• 2007

Nurse staffing level is an important factor that influences the quality of health service and patient outcomes. This study was carried out to examine the current state of acute hospital nurse staffing and find out factors that affect the nurse staffing level. Nurse staffing of individual hospitals was measured using the number of registered nurses per 100 beds. Descriptive and multiple regression analyses were conducted using 592 acute care hospitals' data. Regression model included structure factors such as referral level, ownership, medical and general staffing, and financial outcome factors such as occupancy rate, inpatient and outpatient revenues. Market characteristics included strength of competition, supply of nurses, and income and health status level of consumers. The average number of nurses per 100 beds was 28 and showed a great variation according to the referral level. Regression model explained this variation as much as 76.87%. Hospital structure variables which affecting the hospital nurse staffing level positively were ICU bed ratio, the staffing level of specialist, training doctor and employees except doctor and nursing personnel, while the negative factor was nurse aid staffing level. General hospitals employed more nurses than hospitals. Among outcome characteristics, occupancy rate and the amount of health insurance inpatient revenue affected positively on the hospital nurse staffing level. The more supply of the new nurse and the higher consumer income and health status in the medical service markets, the more nurses were employed by the medical institutes. According to the study result, hospitals employed more nurses when they had more financial incentive by increasing nurses. This means appropriate hospital incentive policy and regulation policy, which hospital violate nurse staffing level have to pay penality, should be needed. Clarifying job description between nurses and nurse aids and the reentry program for unemployed experienced nurses will be helpful to increase nurse staffing level.

• Journal of Korean Medical Science
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• v.33 no.50
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• pp.326.1-326.10
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• 2018

Background: This retrospective study analyzed the causes of failure in the management process from the identification of brain-dead potential organ donors to actual donation in Korea over the past 5 years. Methods: Data of 8,120 potential brain deaths reported to the Korea Organ Donation Agency were used, including information received at the time of reporting, donation suitability evaluation performed by the coordinator after the report, and data obtained from interviews of hospital medical staff and the donor's family. Results: From January 2012 to December 2016, the total number of brain-dead potential organ donors in Korea was 8,120, of which 2,348 (28.9%) underwent organ procurement surgery with designated recipients. While the number of transplant donors has increased over time, the ratio of transplant donors to medically suitable brain-dead donors has decreased. The common causes of donation failure included donation refusal (27.6%), non-brain death (15.5%), and incompatible donation (11.6%); 104 potential donors (7.8%) were unable to donate their organs because they were not pronounced brain dead. Conclusion: The rate of successful organ donation may be increased by analyzing the major causes of failure in the brain-dead organ donation management process and engaging in various efforts to prevent such failures.

• Healthcare Informatics Research
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• v.24 no.4
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• pp.317-326
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• 2018

Objectives: The demand for hospice has been increasing among patients with cancer. This study examined the current hospice referral scenario for terminally ill cancer patients and created a data form to collect hospice information and a modified health information exchange (HIE) form for a more efficient referral system for terminally ill cancer patients. Methods: Surveys were conducted asking detailed information such as medical instruments and patient admission policies of hospices, and interviews were held to examine the current referral flow and any additional requirements. A task force team was organized to analyze the results of the interviews and surveys. Results: Six hospices completed the survey, and 3 physicians, 2 nurses, and 2 hospital staff from a tertiary hospital were interviewed. Seven categories were defined as essential for establishing hospice data. Ten categories and 40 data items were newly suggested for the existing HIE document form. An implementation guide for the Consolidated Clinical Document Architecture developed by Health Level 7 (HL7 CCDA) was also proposed. It is an international standard for interoperability that provides a framework for the exchange, integration, sharing, and retrieval of electronic health information. Based on these changes, a hospice referral scenario for terminally ill cancer patients was designed. Conclusions: Our findings show potential improvements that can be made to the current hospice referral system for terminally ill cancer patients. To make the referral system useful in practice, governmental efforts and investments are needed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.8
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• pp.162-170
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• 2017

This study analyzed the current situation of medium and small-sized hospital nursing staff and related policies, and identified the factors that affect staffing level to provide evidence for planning and adopting policy. By analyzing the statistical data published by public institutions such as the Ministry of Health and Welfare and Health Insurance Review and Assessment Service, the result was viewed based on the understanding of various internal and external health care environments. The number of active nurses was less than 50% of the number of licensed nurses and has decreased every year. This means that the cost-effectiveness of increases in nursing college enrollment should be reconsidered. Inpatient nursing fees by staffing grades has caused nurses to move from medium and small-sized hospitals, where there is a severe lack of staff, to more advanced general hospitals. As a result, the lack of nursing staff in medium and small-sized hospitals has worsened. In conclusion, reexamination is needed to improve effectiveness of inpatient nursing fees by staffing grades as a policy to secure the workforce of medium and small-sized hospitals. Furthermore, the tracking management system of licensed nurses must be able to solve the imbalance between demand and supply of nursing staff.

• Korea Journal of Hospital Management
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• v.12 no.3
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• pp.47-67
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• 2007

This paper aims at suggesting several ways lo change financial vulnerability and to improve managerial capability of local public hospitals (LPHs) in Korea through the identification of factors affecting profitability. Several findings of the research are as follows: To begin with, LPHs exhibited a statistically significant difference in their profitability from one another, according to tile analyses of their profitable margins from tile general characteristics. It depends on the number of hospitals in the area, the population of the hospital-built area, the number of competing hospitals, the number of staff per 100 beds, the opening of special clinic, the educational function, and the capacity of rooms. However, there was no variable in the managerial characteristics, presenting a significant difference, in contrast with hospitals which have been managed by private companies and made a great amount of profits. Second, according to the analyses of profit differences in behavioral effort-characteristics, a statistically significant difference was revealed upon the basis of the efforts to improve the clinic service, invite special patients, and shorten the period of being hospitalized. Third, the result of analyses about the difference of profitability from medical care and finance is statistically significant in the rate of labor cost, the rate of management cost, bed-occupancy rate, and the period of being hospitalized. Fourth, according to the analyses of the factors influencing the net profit ratio of the entire capital, Adjusted explanatory power(Adjusted $R^2$) was shown up to 65.2%, which is high. To compare the adjusted explanatory power stage by stage, the first stage model applying only two variables such as structural and strategic characteristics exhibited 23.8%, and the second stage model adding financial characteristics showed 51.5%. The explanatory power was much improved up to 65.2% when the third stage model incorporated the outcome of medical care performance. When the return on investment(ROI) was examined by using the multi-variate linear regression analysis at the final model of third stage, it was found that ROI had a positive relationship with the increase rate of patients, labor costs per doctor, and medical care rate of socially protected inpatients. However, it revealed that ROI had a negative relationship with the ratio of labor costs, the number of patients per managerial staff, and occupancy rate of rooms, respectively. The research suggests that in order for LPHs to increase profitability, LPH, should make efforts not only to attract patients to the hospitals without any discrimination of the patients depending on their financial status, but also to develop efficient management methods to reduce labor costs.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.372-387
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• 1995

One-hundred eighty four medical doctors and 349 nurses out of 6 university hospitals and 1 general hospital were surveyed from Mar. 3, to Mar. 31, 1995, in order to appreciate the extent of their understandings on the clinical nurse specialist system. The difference was analyzed by the subjects' age, their position and department, the expected benefits of the system. the assigned department, the position and qualification, the required special educational organization and program, and the extent of autonomy of the function of clinical nurse specialists and the special nursing field. The results were as follows ; 1. The perception about the expected benefits of the introduction of clinical nurse specialist system was significantly different among the age groups of medical doctors, and the age group of 40s among them showed the most positive perception. 2. The extent of acquaintance with clinical nurse specialist was the higher in the older age groups of respondent nurses. Meanwhile, the experience of participation with clinical nurse specialists was the more in the older age group of medical doctors. 3. The opinion about the required position of clinical nurse specialists was significantly different by the age and position of the respondent nurses. The rank of head nurse was suggested by the respondent nurses of older age and higher positon, while the level of in-charge nurse was suggested by the staff nurses. Also, the duration of clinical experience required of clinical nurse specialists was the most frequently responded as 6 to 10 years by nurses, as 2 to 5 years by medical doctors. 4. The degree of educational background required of clinical nurse specialists was differently responded by the various position of medical doctors and nurses. Of the medical doctors, professors frequently responded bachelor degree and medical residents frequently responded master degree as the required educational background. Of the nurses, nursing administrators more frequently responded that master degree was required of clinical nurse specialists than staff nurses and clinical nurse specialists did. 5. The extent of acquaintance with clinical nurse specialist system was different among the various department of medical doctors, which was the highest in the doctors of psychiatry, internal medicine and pediatrics, respectively. The doctors of surgery were the least acquainted of clinical nurse specialist. 6. The nurses of special parts, of surgery and of obstetrics & pediatrics responded more frequently that clinical nurse specialists should belong to the nursing department than the nurses of internal medicine and of others did. 7. The Special parts that necessitate clinical nurse specialists were responded to be the more important by nurses than by medical doctors. Clinical nurse specialists were responded to be the more necessary in the parts of diabetics, oncology, pyschiatry, dialysis, organ transplantation, intensive care, and in cardiovascular part. They were responded to be the less important in the parts of intravenous therapy, computer informatics, nursing administration, the improvement of nursing quality.

• Journal of Korean Academy of Nursing
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• v.26 no.2
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• pp.399-412
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• 1996

Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current nursing productivity of nurses is not desirable unless the quality of care considered. Moreover. nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. As for the nurse scheduling, the critical problem of it in the hospital is determining the day-to-day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. Nurse scheduling, however, involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. Under these backgrounds, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. This study was performed to develop a system computerizing nurse staffing and scheduling based on the patient classification. As a preliminary step for the system development, nursing workload in a secondary hospital was measured from Sep. to Oct. 1994. On the grounds of this result, computerization of nurse staffing and scheduling was proceeded with three options. First one is based on the current medical law. Second one is based on the assigned number of nursing staff. And the last is based on the request by patient classification. Computer languages used in this study were MS Visual Basic 3.0 for the staffing and Access 2.0 for the scheduling, respectively. Prospective users may operate this system easily because icons and mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurse administrators manage nursing manpower efficiently and nurses develop quick and easy schedule generation and allow more time for the patient care.

• Journal of Korean Academy of Nursing
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• v.39 no.2
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• pp.186-197
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• 2009

Purpose: This study was done to investigate nurses' knowledge of, and compliance with the multidrug-resistant organism (MDRO) infection control guidelines. Methods: A survey questionnaire was developed based on the institutional and national guidelines and was administered to a convenience sample of 306 nurses in a university hospital. Results: The mean score for knowledge was 33.87 (percentage of correct answers: 82.61%). The percentages of correct answers for basic concepts, route of transmission, hand washing/protective devices and environment management were 74.27%, 94.29%, 92.90% and 75.54% respectively. The mean compliance score was 4.15 (range: 1-5). The compliance scores for education, communication, contact precaution, disinfection, surveillance culture, and hand washing were 3.29, 4.05, 4.20, 4.50, 4.40 and 4.48 respectively. Nurses indicated "lack of time (30.06%)", "lack of means (10.78%)" and "lack of knowledge (9.48%)" as reasons for noncompliance. Conclusion: While most educational programs have focused on hand washing or use of protective devices to prevent transmission of MDRO in acute care settings, hospital nurses' knowledge of the basic concepts of MDRO and environmental management has remained insufficient. Nurses are relatively non-compliant to the guidelines in the areas of education (staff, patient, family) and communication. Comprehensive educational programs are needed to decrease hospital infection rates and to improve the health of patients.