• 간호행정학회지
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• 제3권2호
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• pp.109-122
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• 1997

This Study was dosigned to test the relationship between effectiveness of nursing organization and related variables of organization on the perspectives of total quality management, The data were collected through self reported questionnaires from 138 nurses working in, 288 patients hospitalized in one tertiary hospital in Seoul from May 30 to October 10 in 1996. The data were analyzed by using the pc-SAS program. The information was obtained of descriptive statistics, correlation analysis, multiple regression, ANOVA & Tukey's multiple comparison test. Results showed that the managing change, the managing job design, the managing conflict, the formation and the centralization of nursing organization structure were shown to be relating variables for nurses' job satisfaction. Especially the managing change was the predictor of nurses' job satisfaction, It explained 57% of total variance. According to clustor analyses of the variables of the managing change, the managing job design, the managing conflict, the nursing units were divided three clusters and according to ANOVA, there was significint difference in nurses' job satisfaction The nurses' job satisfaction was higher in the nursing units revealed to have high job management score. But there was no significant difference in patient satisfaction among three clusters.

• 한국병원경영학회지
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• 제25권3호
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• pp.14-28
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• 2020

Purpose: The purpose of this study was to calculate the total daily nursing workload and the optimum number of nurses per intensive care unit (ICU) based on the nursing intensity and the direct nursing time per inpatient using the patient classification. Methods: Two ICUs at one general hospital were investigated. To calculate the nursing intensity, patient classification according to the nursing needs was conducted for 10 days in each unit during September 2018. We performed patient classifications for a total of 167 patient-days in the Medical Intensive Care Unit (MICU) and 86 patient-days in the Surgical Intensive Care Unit (SICU). The total number of person-days for nurses who responded to the Nursing Time survey was 151 for MICU and 85 for SICU. In each unit, direct and non-direct nursing hours, nursing intensity score, and direct nursing hours were analyzed using descriptive statistics such as frequency, percentage, and average calculated using Microsoft Excel. The amount of nursing workload and the optimum number of nurses were calculated according to the formula developed by the authors. Findings: For the MICU, the average direct nursing time per patient was 5.59 hours for Group 1, 6.98 hours for Group 2, and 9.28 hours for Group 3. For the SICU, the average direct nursing time per patient was 5.43 hours for Group 1, 7.21 hours for Group 2, 9.75 hours for Group 3, and 12.82 hours for Group 4. Practical Implications: This study confirmed that the appropriate number of nurses was not secured in the nursing unit of this study, and that leisure time such as meal time during nursing work hours was not properly guaranteed. The findings suggest that to create working environments where nurses can serve for extended periods of time without compromising their professional standards, hospitals should secure an appropriate number of nurses.

• 임상간호연구
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• 제20권3호
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• pp.384-394
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• 2014

Purpose: To improve professional intensive care by analyzing admission causes, causes of death, disease conditions, and treatment processes in patients with hematological malignancies admitted to intensive care units (ICUs) in South Korea. Methods: This was a retrospective study approved by IRB, and conducted on admission with 559 adults, in the hematology ICU of a hospital located in Seoul. The study was carried out from April 2009 to March 2012. Data were analyzed using SAS. Results: Pneumonia was the most frequent cause of ICU admission and death, followed by sepsis. The condition at discharge was death (53.6%), recovery (39.9%), or hopeless (5.1%). Mortality of patients in states of incomplete remission was higher than that of patients with complete remission and of patients with multiple myeloma, severe aplastic anemia, and lymphoma. Conclusion: Results show that pneumonia and sepsis are the most frequent causes of ICU admission and for the death of patients with hematological malignancies. The most frequent status at discharge of patients with hematological malignancies was death (53.6%), with mortality of patients at Incomplete Remission status, of mechanically ventilated patients, and of patients on continuous renal replacement therapy (CRRT) being higher than others.

• 임상간호연구
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• 제25권3호
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• pp.323-332
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• 2019

Purpose: This study aimed to identify the factors affecting the terminal care stress of nurses in intensive care units in terms of their death perception, attitude toward terminal care, and mental health. Methods: This descriptive study collected data from 118 nurses in intensive care units in one tertiary referral hospital and three general hospitals. The instruments used in the study were the Terminal Care Stress Assessment Tool, the View of Life and Death Scale, the Frommelt Attitudes toward Nursing Care of the Dying Scale (FATCOD), and the Mental Health Assessment Tool. The data were analyzed by t-test, ANOVA, Pearson's correlation coefficient, and multiple regression. Results: There was a significant positive correlation between terminal care stress and death perception (r=.31, p<.001). The factors significantly influencing the terminal care stress of the participants included gender (β=.33, p<.001), religion (β=.24, p=.004), and death perception (β=.35, p<.001), and the overall explanatory power was 23.1% (F=12.73, p<.001). Conclusion: To decrease terminal care stress among nurses, establishing the death perception of nurses based on value clarification about death may be necessary. Furthermore, this study suggests an intervention study examining the effect of an education program on terminal care stress among ICU nurses.

• 임상간호연구
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• 제23권1호
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• pp.64-72
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• 2017

Purpose: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. Methods: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. Results: The staffing grade for the general wards improved during 2008-2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. Conclusion: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing.

• 간호행정학회지
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• 제19권4호
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• pp.470-479
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• 2013

Purpose: This study was conducted to investigate and compare the characteristics and relations of nursing practice environment, professionalism and job satisfaction among nurses in general hospitals according to hospital size. Methods: The participants included 314 staff and charge nurses who were working in the general medical/surgical nursing units in one large hospital, three medium sized hospitals, and four small hospitals. Data collected through using self-report questionnaire were analyzed using the SPSS and SAS statistical programs. Results: Nursing practice environment and job satisfaction had significant differences according to hospital size. Both of these scales were highest for medium hospitals and lowest for small hospitals. For all hospital sizes there were positive correlations between each of the variables. Multiple regression analysis showed that both nursing practice environment and job satisfaction were affected by hospital size, but professionalism was not. Conclusion: The results of this study indicate that nursing practice environment and job satisfaction vary with the size of the hospital. Therefore, further study is necessary to identify the work environment variables of nurses for performance management and to implement appropriate policies.

• 간호행정학회지
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• 제5권1호
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• pp.5-21
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• 1999

Nursing organization culture is common patterns of believing, thinking and behaving resulted from a variety of experiences and interaction nurses in the same setting. This study was performed based on the assumption of existence of different subcultures within meta-culture, to identify the differences of subculture among 5 nursing units and to analyze the relationship between nursing organization culture and organizational commitment In this study, two kinds of instruments were used. One was the instrument of nursing organization culture developed by researcher through literature review and interview with nurses. The other one was Mowday's Organizational Commitment Questionnaire to measure organizational commitment of nurses. Both of them were structured with 5 scale. The answers were analyzed using SPSS program. The results were as follows : The meta-culture of the nursing organization culture was the people stable culture. There were significant differences in people development culture and people stable culture among 5 nursing units and all 5 units had different culture score. Especially, emergency room had strong development culture, and stable culture was dominant in operating room. Other units except emergency room and operating room had high scores in people stable culture than other culture types, but revealed different distribution. There were significant differences of the nursing organizational culture types -people development, task development, people stable, task stable-among 5 units. Four types of nursing organizational culture consisted of competing values in one organization. Nurses's organizational commitments were sign ificantly different among the units. The score per ceived by nurses who work in emergency room, operating room and leu was higher commitment score than that of medical/surgical nursing units Nurse's commitment to nursing organization was also related to total work period as nurse in any setting and work period in this hospital. Organizational commitment was significantly different among the nursing culture types, indicating that the scores of developmental culture were higher than stable culture. In conclusion, there were many different subcultures in nursing organization. In subculture, the organizational commitment was different. Therefore, the change of nursing organization culture or nursing unit culture needs to be considered to hire, give orientation, teach. and reallocate nurses efficiently. Research on nursing organization culture using both qualitative and quantitative method needs to be further considered. Furthermore, the strategy in nursing organization culture for nursing administrator to manage human resources efficiently and to change nursing unit effectively, needs to be developed.

• 임상간호연구
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• 제21권1호
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• pp.127-142
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• 2015

Purpose: The purpose of this study was to develop the adapted standard items of situation, background, assessment, recommendations (SBAR) processing for handover between nursing units in Korean hospitals and evaluate the validity and relevance of the standard items. Methods: A delphi method with 33 experts was used to evaluate content validity of the standard items. Then, 1,175 nurses working in general hospitals of more than 500 beds were recruited to evaluate the validity and relevance of the standard items for clinical implication. Results: Content validity was higher than 0.8. The highest scores for relevance among items in handover standards were state of consciousness in the assessment domain for a ward to a ward transfer ($3.82{\pm}0.40$), for a ward to an ICU ($3.85{\pm}0.38$), an ICU to a ward ($3.81{\pm}0.39$) and an ER to a ward ($3.85{\pm}0.37$). Congenital malformation was the highest relevance score for handover from a delivery room to a neonatal unit ($3.91{\pm}0.30$). Conclusion: This study evaluated validity and relevance of the essential contents for handover standards between units to improve communication quality among nurses. The findings of this study should also be applied in clinical nursing areas and the quality of information and effectiveness of usage of the standard should be evaluated.

• 임상간호연구
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• 제25권3호
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• pp.314-322
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• 2019

Purpose: The purpose of this study were to identify the influential factors of bullying of intensive care nurses and to suggest a final structural model based on identified relationships between nursing organizational culture, authentic leadership, self-esteem, and bullying in the workplace. Methods: Data were collected from 221 nurses at intensive care units in eight general hospitals using structured questionnaires and analyzed by structural equation modeling. Results: In this study, the average of bullying in the workplace was 1.34±0.40, nursing organizational culture was 3.31±0.47, self-esteem was 2.79±0.44, and authentic leadership was 3.61±0.60. The factors affecting nursing organizational culture were authentic leadership (β=.54, p<.001) and self-esteem (β=.24, p=.002) that had direct positive effects on the nursing organizational culture. The nursing organizational culture had also a direct effect on reducing workplace bullying (β=-.45, p<.001). Authentic leadership (β=-.24, p=.004) and self-esteem (β=-.11, p=.004) had indirect effects on workplace bullying, which was mediated by the nursing organizational culture. Conclusion: To understand and reduce workplace bullying, evaluating a nursing organizational culture should be preceded. Based on the finding of this study, an intervention for increasing authentic leadership and self-esteem of nurses can positively help to create the nursing organizational culture and then reduce workplace bullying.

• 대한간호학회지
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• 제37권6호
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• pp.924-931
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• 2007

Purpose: The purpose of this study was to describe the essence of the experiences of patients in an ICU, and to understand them from the patients' point of view. Methods: Participants in this study were six patients in P hospital. Data collection consisted of in-depth interviews and an observation method done from January to April in 2005. The method was analysis using the phenomenological method proposed by Colaizzi(1978). Results: The themes were classified into eight theme clusters. The eight theme clusters were finally grouped into four categories, 'shock', 'pain', 'gratefulness' and 'pleasure of revival'. Conclusion: The ICU patients had negative experiences in physical mental critical situations, but also positive experiences in consolation and nurses and families' encouragement. Therefore, ICU nurses must support patients and their families to minimize the negative experiences and maximize the positive experiences.