• Title/Summary/Keyword: Hospital nursing units

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Determination of Nursing Costs for Hospitalized Patients Based on the Patient Classification System (종합병원에 입원한 환자의 간호원가 산정에 관한 연구)

  • 박정호;송미숙
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.16-37
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    • 1990
  • A cost analysis for hospitalized patients was carried out based upon Patient Classification System(PCS) in order to determine an appropriate nursing fee. The data were collected from 21 nursing units of three teaching hospitals from April 1 to June 30, 1989. first, all of the 22,056 inpatients were classified into mildly ill(Class Ⅰ), moderately ill(Class Ⅱ), acutely ill(Class Ⅲ), and critically ill(Class Ⅳ) by the PCS which had been carefully developed to be suitable for the Korean nursing units. Second. PCS cost accounting was applied to the above data. The distribution of inpatients, nursing costs, and nursing productivity were as follows : 1) Patient distribution ranged from 45% to class Ⅰ, 36% to class Ⅱ, 15% to class Ⅲ, and 4% to class Ⅳ, the proportion of class Ⅳ in ‘H’ Hospital was greater than that of the other two hospitals. 2) The proportion of Class Ⅲ and Ⅳ in the medical nursing units was greater than that of surgical nursing units. 3) The number of inpatients was greatest on Tuesdays, and least on Sundays. 4) The average nursing cost per hour was W 3,164 for ‘S’ hospital, W 3,511 for ‘H’ hospital and W 4,824 for ‘K’ hospital. The average nursing cost per patient per day was W 14,126 for ‘S’ Hospital, W 15,842 for ‘H’ hospital and W 21,525 for ‘K’ hospital. 5) The average nursing cost calculated by the PCS was W 13,232 for class Ⅰ, W 18,478 for class Ⅱ, W 23,000 for class Ⅲ, and W 25,469 for class Ⅳ. 6) The average nursing cost for the medical and surgical nursing units was W 13,180 and W 13,303 respetively for class Ⅰ, W 18,248 and W 18,707 for class Ⅱ, W 22,303 and W 23,696 for class Ⅲ, and W 24,331 and W 26,606 for class Ⅳ. 7) The nursing costs were composed of 85% for wages and fringe benefits, 3% for material supplies and 12% for overhead. The proportion of wages and fringe benefits among the three Hospitals ranged from 75%, 92% and 98% for the ‘S’, ‘H’, ‘K’ hospitals respectively These findings explain why the average nursing cost of ‘K’ hospital was higher than the others. 8) According to a multi- regression analysis, wages and fringe benefits, material supplies, and overhead had an equal influence on determining the nursing cost while the nursing hours had less influence. 9) The productivity of the medical nursing units were higher than the surgical nursing units, productivity of the D(TS) - nursing units was the lowest while the K(Med) - nursing unit was the highest in 'S' hospital. In ‘H’ hospital, productivity was related to the number of inpatients rather than to the characteristics of the nursing units. The ‘K’ hospital showed the same trend as ‘S’ hospital, that the productivity of the medical nursing unit was higher than the surgical nursing unit. The productivity of ‘S’ hospital was evaluated the highest followed by ‘H’ hospital and ‘K’ hospital. Future research on nursing costs should be extended to the other special nursing areas such as pediatric and psychiatric nursing units, and to ICU or operating rooms. Further, the PCS tool should be carefully evaluated for its appropriateness to all levels of institutions(primary, secondary, tertiary). This study took account only of the quantity of nursing services when developing the PCS tool for evaluating the productivity of nursing units. Future research should also consider the quality of nursing services including the appropriateness of nursing activities.

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Development a Tool for Evaluating Nurses' Performance in Hospital Units (간호단위 성과평가도구 개발)

  • Park, Sung Ae;Kim, Jin Hyun;Park, Kwang Ok;Kim, Myoung Sook;Kim, Se Young
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.5-21
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    • 2009
  • Purpose: This study was aimed to develop a tool for evaluating nurses' performance by using Balanced Score Card (BSC) in hospital units. Methods: Preliminary survey was done in 10 hospitals to investigate evaluation criteria for nurses' performance. For the main study, each of 14 nursing managers evaluated 2 nursing units (total of 28 nursing units) to verify the sensitivity of the tool criteria. The evaluation result drawn from the preliminary BSC tool was analyzed to verify the sensitivity and validity of the tool. Results: As a result, nurses' performance evaluation tool consisted of 4 categories, 8 objectives, and 14 criteria was developed. Conclusion: The BSC tool for nurses' performance evaluation provides meaningful data in evaluating nursing performance in hospital units.

Nurse Staffing Level Relating Factors of the General Nursing Units, ICU, ER and OR in Acute General Hospitals (종합병원의 일반병동, 중환자실, 응급실, 수술장간호사 확보수준 관련 요인)

  • Kim, Yun-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.4
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    • pp.404-412
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    • 2008
  • Purpose: To analyse hospital nurse staffing level of the general nursing unit, ICU, ER and OR in general hospitals. Method: The study sample was 105 acute general hospitals which had reported the bed size and number of nurses by the nursing units. Number of bed per nurse was analysed by the hospital characteristics and the staffing levels of the doctors and the nursing assistant personnels using t-test or ANOVA and Pearson's correlation. Results: Number of bed per nurse was 3.86 in general nursing units and 0.95 in ICU. Tertiary hospitals employed more nurses in general nursing units and ICU than general hospitals. Hospitals located in Seoul and public hospitals employed more ICU nurses. OR nurse staffing level was higher in academic hospitals. Hospital size was positively correlated with nurse staffing level of the general nursing unit, ICU, ER and OR respectively. Total nurse staffing level of the hospital was positively correlated with doctor and nursing assistant personnels staffing levels. Conclusion : Differentiated nursing fee schedule was needed to implement in ER or OR. Regulation policy should be needed for the hospitals which violated hospital nurse staffing level of the law.

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Comparing Satisfaction with Nursing Care and Factors Relevant to Hospital Revisit Intent among Hospitalized Patients in Comprehensive Nursing Care Units and General Care Units (포괄간호서비스 병동과 일반병동 입원 환자의 간호만족도와 병원재이용의도 영향요인 비교)

  • Shin, Sa-Rang;Park, Kyung-Yeon
    • Journal of Korean Academy of Nursing Administration
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    • v.21 no.5
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    • pp.469-479
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    • 2015
  • Purpose: The purpose of this study was to compare hospitalized patients in comprehensive nursing care units and general care units as to satisfaction with nursing care and factors influencing their intent to revisit the hospital. Methods: A cross-sectional study was conducted with 178 patients who had been hospitalized in a comprehensive nursing care unit and a general care unit in one hospital. Participants completed self-report questionnaires. Data were analyzed using SPSS 21.0. Results: There was a significant difference between the comprehensive nursing care unit and general care unit for intent to revisit the hospital (p=.036). Factors influencing intent to revisit the hospital for patients in the comprehensive nursing care unit were 'satisfaction with nursing care' (p<.001) and 'use of additional costs for comprehensive nursing care' (p=.041). The factor influencing intent to revisit hospital for patients in the general care unit was 'satisfaction with nursing care' (p<.001). Conclusion: Findings indicate that comprehensive nursing care service in which all care is provided by nursing staff only, without family or private caregivers, increases intent to revisit the hospital. These results can be used as the foundation of reviewing the operation and expansion of comprehensive nursing care service.

Development of Performance Measure Indicators in Hospital Nursing Units (균형성과표를 이용한 병원 간호단위의 조직성과 평가지표 개발)

  • Kang Kyeong-Hwa;Kim In-Sook
    • Journal of Korean Academy of Nursing
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    • v.35 no.3
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    • pp.451-460
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    • 2005
  • Purpose: The purpose of this study was to develop performance measure indicators for hospital nursing units based on a Balanced Scorecard (BSC). Method: This study was a methodological study, The development process consisted of 3 stages. The first stage was setting up strategies for nursing units from a nursing department's mission and vision. The second stage was developing performance measure indicators after a validity check. The third stage was modifying developed performance measure indicators and classifying them. Results: 7 strategies were set up according to 4 perspectives of a BSC. 15 performance measure indicators for hospital nursing units were developed, and the indicators were divided into 8 independent indicators and 7 shared indicators according to the degree of performance responsibility. In addition, they were classified into two groups, 7 leading indicators and lagging indicators. Conclusions: The result of this study suggests that performance measure indicators for hospital nursing units provide a framework and method for nursing organizations' performance management. Also, the developed indicators are expected to provide valuable information for successful organization management.

A Survey for Developing Strategies to Improve the Fees for Nursing Care (건강보험 간호관리료 수가체계 개선의견 조사분석)

  • Kim, Yun Mi;Nam, Hye Kyung;Sung, Young Hee;Park, Kwang Ok;Park, Hae Ok
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.1
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    • pp.5-14
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    • 2008
  • Purpose: To examine the current fees for nursing care and propose the strategies for improvement. Method: The number of subjects for this study was 86, including 36 chief executives of the nursing department, 14 of the health insurance department and 33 nursing managers. Data were analyzed by SPSS WIN 12.0 program. A researcher-developed questionnaire with 30 items was utilized. Results: 61% hospital had improved the nursing management fee grade after adoption of the differentiated nursing management fee schedules. After grade improvement, the time for direct nursing care increased. Also, the patient health outcome, nurse's job satisfaction were improved and more nurses were employed in general nursing units. Many subjects addressed that ICU and more nursing units were needed to adopt the differentiated nursing management fee schedules and "bed to nurse ratio" needed to be changed to "patients to nurse ratio" and specialized by the nursing units. Conclusion: The health policy in reference to fees for nursing care needs to get improved further in order to provide the quality-assured nursing care.

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Evaluation of the Efficiency of General Nursing Units using Data Envelopment Analysis (DEA) (일 종합병원 병동 간호단위의 간호효율성 평가-자료포락분석의 적용)

  • Lee, Soo-Youn;Lim, Ji-Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.18 no.2
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    • pp.118-125
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    • 2011
  • Purpose: The aim of this study was to evaluate the efficiency of nursing units in a hospital using DEA. Methods: Data were collected using the medical information system of a general hospital in a city. Input variables were number of nurses, number of nurse-aides, number of beds, and overhead costs. Output variables included number of admitted patients, rate of bed utilization, satisfaction of discharged patients, and prevention rate of safety accidents and sores. EMS Window version 3.1 was used to measure the efficiency score and descriptive statistics were applied to analyze the general characteristics of variables. Results: The average efficiency score of 18 general nursing units was approximately .99. Nine nursing units had a 1.00 efficiency score. Conclusion: Our findings reveal that nursing units operated very efficiently. To increase efficiency of inefficient nursing units, we recommend results of the DEA slack analysis as a benchmark of the most efficient nursing unit.

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A study of the Consumer's Satisfaction and the Marketing Strategies of a General Hospital (일 종합병원의 소비자 만족과 마케팅 전략에 관한 연구)

  • Lee, Mi-Aie
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.25-40
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    • 2001
  • As the medical market has gradually changed from supplier-centered market to consumer-centered one, it makes hospital managers seek the consumer's satisfaction and the various marketing strategies for survival. Under the these changes, this study was accomplished to measure the consumer's satisfaction about the medial services which a general hospital provided, to identify the marketing strategies that a general hospital could establish for survival. For these purposes, a questionnaire was developed and distributed to 200 patients in general units and 100 patients in oriental units of a general hospital in Seoul. Among them, 163 reponses in general units and 71 reponses in oriental units were turned out to be useful. they were used for final analysis. The results of the survey were as follows : First, among all items of medical services which the hospital provided, patients were most satisfied by nursing services. Second, to Improve the hospital's medical service quality, it was very important for hospital staffs to be courtesy and to explain about a process of treatment or care sufficiently. Third, to decrease cost of medical service, it was very important to develop the various items and premiums of medical insurance especially in field of oriental medicine. Fourth, to make people come to the hospital easy, it was very important of fully utilize the public transportation such as subway. Fifth, to make hospital's image good, it was very important to develop well-prepared public relationship and to continuously provide the diverse medical service in the community.

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Rates for Handwashing Adherence Before and After Nursing Contact in Intensive Care Units (중환자실 간호사의 간호행위 전.후 손씻기 수행율 비교)

  • Kim, Young-Jung;Kim, Hee-Seung;Chang, Yun-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.2
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    • pp.195-200
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    • 2011
  • Purpose: The purpose of this study was to assess rates for handwashing adherence before and after nursing contact in intensive care units (ICU). Methods: The participants included 90 nurses working in intensive care units of an 800-bed university-affiliated hospital in Gyeonggi Province and 2000-bed university-affiliated hospital in Seoul. Time for handwashing was calculated using the average number of handwashings during an 8-hour day shift. Nursing contact was based on indications as defined by the Centers for Disease Control and Prevention (CDC, 2002). Data were analyzed using frequency, percent, t-test and ${\chi}^2$-test. Results: During an 8-hour day shift, the average number of times that hands were washed was 25.0. The rates were significantly lower before the nursing contact than after the nursing contact when it involved sectioning, observation or contact with a wound, cleaning enteric feeding bag, physical exam, use of gloves, or contact with contaminants. Conclusions: The results indicate that as handwashing rates were significantly lower before nursing contacts than after nursing contacts, there is need to develop strategies to address this deficiency in handwashing.

Determinants of Organizational Creativity at Nursing Care Units of University Hospitals in Korea (대학병원 간호부서의 조직창의성 결정요인)

  • Kang, So-Young;Seo, Young-Joon
    • Korea Journal of Hospital Management
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    • v.9 no.4
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    • pp.1-20
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    • 2004
  • This study was aimed at examining the determinants of organizational creativity at nursing care units of university hospitals. Using some items of the Creative Nursing Practice Index(CNPI), the Nursing Work Index-Revised(NWI-R), and the Work Preference Inventory(WPI), an empirical study was conducted with a sample of 543 nurses at 49 nursing care units in two university hospitals in Korea. Data collected from the individual respondents were aggregated and transformed into the secondary data at organizational level. The data were analyzed, using Pearson correlation and hierarchical multiple regression method. The results of the study showed that organizational creativity has positive relationships to task motivation, including enjoyment and challenge to work, and work environment supporting nurses' autonomy and collaboration. Task motivation of the units and autonomous work environment explained 16.3% and 7.9% respectively in the variance of the organizational creativity. Organizational creativity was found to be significantly influenced by challenge and autonomous environment. This result implies that nursing managers should make an efforts to enhance the organizational creativity of nursing units by motivating their staff to challenge to a novel way of doing at work and making the work environment more autonomous.

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