• Title/Summary/Keyword: Night duty

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Effect of Shift Interval for the Clinical Nurse on the Circadian Rhythm (임상 간호사의 교대근무 기간이 circadian rhythm 변화에 미치는 영향)

  • 황애란;정현숙;임영신;이혜원;김조자
    • Journal of Korean Academy of Nursing
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    • v.21 no.2
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    • pp.129-149
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    • 1991
  • Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entrainment of the pacemaker timing the human circadian sleep - wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. This study was a quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to a weekly shift group and another ten to a biweekly shift group engaged in a semi -continuous shift schedule(sunday off) with a backward direction, that is, morning -evening - night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking tim, sleep - wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep- wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep -wake cycle for subjects on the morning, evening, and night shift in both of the shift groups(weekly shift group : λ=0.121, p<0.01, λ=0.112, p<0.01, biweekly shift group : λ=0.116, p<0.01, λ=0.084, p<0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group. In the weekly shift group, physical fatigue was significantly different for the first day and the sixth day of the night shift(t=-2.28, p<0.05). Physical fatigue and total fatigue on the first day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=5.79, p<0.01, F=4.56, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05), Physical fatigue, neurosensory fatigue and total fatigue on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=12.65, p<0.01, F=7.77, p<0.01, F=9.68, p<0.01). There was a significant difference between the shift groups and the control group(p<0.05). 4. No difference in mental performance was seen between the first day and the last day of work in each case. An arithmatic test on the first day of the night shift revealed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.79, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05) . The digital symbol substitution test and the arithmetic test on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.68, p<0.05, F=5.55, p<0.01), and both showed a significant difference between the shift groups and the control group(p<0.05). Accordingly, this study showed that during night duty, the waking time, sleep- wake cycle, and fatigue increased and mental performance decreased compared with morning and evening duty. It was also found that the weekly shift group had a higher fatigue score on the sixth day of night duty as compared to the -first day, but the waking time, sleep- wake cycle, and mental performance revealed no difference for the duration of the night duty or between shift groups, and complete adaptation of temperature rhythm was achieved between the sixth and ninth day of night duty. It is possible to conclude from these results that for intermediate circadian type in a healthy young woman, a biweekly shift system is more compatible with the circadian timing system than weekly shift system.

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Job Experiences of Nurses Participating in Pilot Project of Fixed Night Shift Nursing by a Tertiary Hospital (상급종합병원의 야간전담 간호제도 시범사업에 참여하는 간호사의 직무 경험)

  • Kim, Su-Jung;Ha, Yeongmi
    • Korean Journal of Occupational Health Nursing
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    • v.32 no.2
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    • pp.49-57
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    • 2023
  • Purpose: This study aimed to explore the meaning of job experiences of fixed night shift nurses participating in a pilot project by a tertiary hospital, and to provide basic information for improving their night shift working environment. Methods: A descriptive qualitative study was conducted using individual interviews in September 2022. Three female nurses who worked fixed night shifts were recruited from a tertiary hospital. Data were analyzed using content analysis. Results: By analyzing the meaning of job experience as a fixed night shift nurse, four categories and nine subcategories were identified. The four categories of job experience of fixed night shift nurses were: expecting an improvement physical health due to predictable working hours, enjoying leisure time due to long off-duty hours, regretting for loosened relationships, and considering a successful settlement of fixed night shift nursing. Conclusion: As night shift work is essential for nurses to provide continuous nursing to patients, it is necessary to develop various strategies to improve the physical health of night shift nurses through fatigue management and good sleep quality, mental health through work-life harmony, and social health through intimate relationships between patients and coworkers.

Analysis of the Productivity and Influence Factor for Special-Plant Formwork (특수 플랜트 형틀공종의 생산성 및 영향요인 분석)

  • Huh, Young-Ki;Lim, Jin-HO;Oh, Jae-Hoon
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2013.11a
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    • pp.90-91
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    • 2013
  • In the field of nuclear power construction, management and the systematic construction is very necessary. For more efficiently managing, analysis of influence factors and productivity is indispensable now. On this research, we collected the data from the nuclear power plant which is located in Korea. We analyzed the productivity and influence factors. As a result, productivity was 0.75(㎡/man·hour).On one hand, the productivity should be personnel, weather and whether there is a night duty or not. On the other hand, work crew depends upon operators, formwork amount, the presence or absence of night duty.

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Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital (일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정)

  • Kim, Kyeong-Uoon
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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Analysis of PCAs' Activity Classification System and Time of Personal Care Attendants(PCAs) Who Works in Wamco(Workers Accident Medical Corporation) (산재의료관리원 간병인의 간병활동분류체계 및 간병시간 분석)

  • Kim, Chunmi;Oh, Jin Joo;Choi, Jeong Myung
    • Korean Journal of Occupational Health Nursing
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    • v.17 no.1
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    • pp.64-75
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    • 2008
  • Purpose: The purpose of this study was to analyze of PCAs' activity classification system and time of PCAs who worked in Wamco. Method: The data were collected from 2 WAMCO and 308 subjects between February and August, 2007, by questionnaire and 24 time survey. The data were processed with SPSS Win 12.0. Result: In activity analysis, PCAs' activities were classified into 20 domains and 76 activities, which were hygiene, bathing, feeding & nutrition, elimination, respiration, skin care, exercise & transfer, problematic behavior control, communication, observation & measurement comfort, medication, assisting test & treatment, reporting, environment management, patient belongings care, education attendance, indirect caregiving weekly/monthly PCAs' activity. And the PCAs' time analysis showed the average of 24hrs PCAs' time were 798.8 minutes, in which 46.8% were used in day-duty, 33.6% in evening-duty, and 19.6% in night-duty. There were no statistically significant difference in total PCAs time according to the type of industrial accidents and PCAs' type and qualification. But there were statistically significant difference in total PCAs time according to the type of PCAs (day-duty/all-night vigil. Conclusion: The results of this study can be utilized usefully and reasonally in deciding of PCAs staffing and PCAs' type and grade in WAMCO.

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Problems of Working Hours and Shift Work Systems, and Propsed Methods for Their Improvement (근로시간 및 교대근무편성의 문제점과 개선방향)

  • Seo, Yu-Jin;;Park, Yeong-Man;Mun, Se-Geun
    • Journal of the Ergonomics Society of Korea
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    • v.22 no.3
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    • pp.13-26
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    • 2003
  • The purpose of this study is to investigate the present conditions of the night work and shift work systems in the heavy chemical industrial complexes found in Changwon, Masan, and Chinhae. Korea. We will attempt to define and classify their problems; and to discover further ways to improve their systems. Fifty production factories were carefully selected as the subjects for this study. The shift systems were classified into five categories. The consecutive night shifts were long in almost all cases with 6 days (36 factories) and 7 days (13 factories). It was found that the night work of about] 2 hours continues for a long period in the weekly rotation full-day shift systems and the night-including non-full-day shift systems, and there was no holiday during a shift cycle in the continuous full-day shift systems. The work time in most shift systems was longer than the 44-hours/week permitted by Korean law. Considering the characteristics of these various types of shift systems, the most essential thing to reduce the shift workers' work load may be to shorten their working hours and improve the schedule of shift systems. It is highly recommended as a fundamental solution. to reduce the portal-to-portal hours from 12 to 8 in the night-including non-full-day shift systems and the weekly rotation full-day shift systems, and at least to employ a 4-team 3-shift system in the continuous full-day shift systems. In addition to this, it should from now on be taken as a goal to restructure the types of shift systems by taking such measures as avoiding continuous night work if possible, providing sufficient off-duty intervals both before and after night shift, providing increased opportunities for workers to nap during night work. and increasing the number of holidays.

The Effects of Humanistic Knowledge and Emotional Intelligence on Communication Skills of Nurses (간호사의 인문학적 소양과 감성지능 및 의사소통능력)

  • Ha, Ju Young;Jeon, So Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.22 no.3
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    • pp.264-273
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    • 2016
  • Purpose: The purpose of this study was to investigate humanistic knowledge, emotional intelligence, and communication skills among nurses and to identify factors influencing the communication skills of nurses in five hospitals. Methods: Data were collected from 248 nurses in hospitals from August 25 to September 9, 2015. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlations and enter method regression analysis using the SPSS/Win 22.0 program. Results: There were significant differences in humanistic knowledge according to religion, education, work department, number of night duty, pay level satisfaction, job satisfaction, and job performance. There were significant differences in emotional intelligence according to all general characteristics. There were significant differences in communication skills according to education, position, number of night duty, and job performance. Communication skills showed positive correlations with humanistic knowledge and emotional intelligence. Emotional intelligence correlated positively with humanistic knowledge. Emotional intelligence was a significant predictor and accounted for 32% of variance in the communication skills. Conclusion: To strengthen communication skills, programs need to be complemented in order to promote humanistic knowledge and emotional intelligence for nurses.

Predictive Factors Influencing Turnover Intention of Nurses in Small and Medium-Sized Hospitals in Daegu City (일 지역 지방중소병원 간호사의 이직의도에 영향을 미치는 예측요인)

  • Yoo, Seong-Ja;Choi, Yeon-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.1
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    • pp.16-25
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    • 2009
  • Purpose: This study was to identify the factors influencing turnover intention of nurses in small and medium-sized hospitals. Method: The participants in this descriptive survey on causal relations were 192 nurses who were working at small and medium-sized hospitals in Daegu city. The data were collected by self-reporting questionnaires and analysed by the SPSS Win 14.0 program using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and stepwise multiple regression. Result: The mean for job characteristics scores were 2.90, the job satisfaction scores were 3.00, the organizational commitment scores were 3.00, job stress scores were 2.42, the turnover intentions scores were 3.08. Turnover intention according to general features were shown as following; age, marital status, clinical career, work schedule type, frequency of night duty. The relationship between turnover intention and job stress had positive correlation. But the relationship between turnover and other factors that job satisfaction, organizational commitment had negative correlation. The causal factors of turnover intention were organizational commitment, job satisfaction, job stress, and job characteristics, frequency of night duty. $R^=.39$. The organizational commitment were the highest significant predictors of turnover intention. Conclusions: The findings of study suggest that broad intention program should be provided to prevent problems of turnover.

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