• 제목/요약/키워드: Number of job experience

검색결과 162건 처리시간 0.02초

병원 간호행정 개선을 위한 연구 (A Study for Improvement of Nursing Service Administration)

  • 박정호
    • 대한간호학회지
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    • 제3권1호
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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제주지역 학교급식 조리종사자의 HACCP 관련 지식 및 수행도 분석 (The Analysis of the School Foodservice Employees' Knowledge and Performance Degree of HACCP System in Jeju)

  • 송임숙;채인숙
    • Journal of Nutrition and Health
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    • 제41권8호
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    • pp.870-886
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    • 2008
  • 본 연구는 학교급식 조리종사자들의 HACCP 관련 지식과 수행도에 대한 분석을 통하여 현재 학교급식에서 HACCP의 적용 실태를 파악하고, 조리종사자에게 필요한 교육 내용 및 방법을 규명하여 향후 학교급식에서 보다 체계적인 HACCP 시스템이 실행될 수 있는 방안을 모색하기 위한 기초 자료를 제공하고자 시도되었다. 영양사의 연령은 30대가 60.8%로 절반 이상을 차지하였고, 경력은 10${\sim}$15년 미만이 31.9%, 학력에 있어서는 4년제 대학 졸업자가 60.4%로 나타났는데, 이는 영양교사화로 인하여 전문학사 자격소지 영양사들이 방송통신대학 및 4년제 대학교의 편입을 통하여 학사자격을 취득하였기 때문인 것으로 분석된다. 고용상태는 정규직영양사가 62.6%로 나타났고 근무학교는 초등학교가 50.5%로 절반을 차지하였으며, 급식유형은 도시형이 59.3%이고, 급식관리 방식은 단독관리가 80.2%로 나타났다. 조리종사자의 연령은 만 41${\sim}$50세가 60.7%, 근무기간은 5${\sim}$10년 미만 (34.2%), 학력은 고졸 (77.2%), 고용상태는 비정규직 조리사 (42.2%)가 가장 많았고, 조리종사자의 53.3%가 자격증을 소지하고 있었다. 위생교육 실시횟수는 주 1회 이상 (48.4%)이, 교육방법은 구두교육 (40.7%)의 비율이 가장 높았고, 위생교육에서 HACCP이 차지하는 비중은‘많이 포함된다’가 53.8%로 나타났다. 조리종사자의 대부분 (98.1%)이‘위생교육 경험이 있다’고 응답하였고 HACCP 이해정도에 있어서는‘잘 이해한다’가 47.0%로 나타났으며 HACCP 관련 교육현황에서 모든 항목에 대하여 92% 이상의 높은 교육 실시율을 보였다. 조리종사자의 HACCP 지식수준은 평균 84.2점 (100점 만점)으로 나타나 보통 이상의 수준인 것으로 나타났으며 급식유형 (p < .001), 근무기간 (p < .05), 학력 (p < .01), 고용상태 (p < .001), 자격증 유무 (p < .001), 학교별 (p < .01)에 따라 유의한 차이를 보였다. 또한 영양사의 교육 실시 횟수가 많을수록 (p < .01), 조리종사자가 교육 경험이 있고 (p < .01), 교육 경험횟수가 많을 경우 (p < .05), HACCP에 대하여‘매우 잘 이해한다’고 응답한 경우 (p < .05)에 지식 수준이 유의적으로 높았다. 조리종사자의 HACCP 수행도는 평균 4.40점 (5점 만점)으로 잘하고 있는 것으로 나타났고, 영양사의 조리종사자의 HACCP 수행도에 대한 인지도 평균은 4.13점으로‘잘한다(4점)’에 근접한 것으로 조사되어, 영양사의 인지도가 유의적으로 낮았다 (p < .001). 조사대상자의 수행도는 급식유형 (p < .05), 고용상태 (p < .05), 자격증유무 (p < .01), 학교별 (p < .01)에 따라 유의한 차이를 보였다. 위생교육 실시횟수가 증가할수록 (p < .01), 교육방법에서 실연교육인 경우 (p < .05)에 수행도가 유의적으로 높았고, 조리종사자가 교육 경험이 있고 (p < .01), HACCP에 대하여‘매우 잘 이해한다’고 응답한 경우(p < .001) 유의적으로 높은 수행도를 보여주었다. 이러한 결과를 토대로 살펴볼 때, 학교급식에서 위생교육을 실시하는 영양사의 인지도와 교육받은 내용을 실천에 옮겨야 하는 조리종사자의 실제 수행도간의 차이를 올바르게 인식하여 효과적인 HACCP 교육매체 개발 및 교육방법의 활용, 조리종사자의 수준 등을 고려한 체계적인 교육실시를 통한 위생관리가 이루어져야 할 것으로 사료된다.