• 대한간호학회지
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• 제37권3호
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• pp.373-380
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• 2007

Purpose: The objective of our study was to figure out costs of nursing services in ICU based on the PCS in order to determine an appropriate nursing fee schedule. Method: Data was collected from 2 hospitals from April 15-16 to April 22-23, 2003. The costs of nursing services in the ICU were analyzed by nursing time based on the nursing intensity. The inpatients in the ICU were classified by a PCS tool developed by the Korean Clinical Nurses Association(2000). Results: The distribution of patients by PCS in the ICU ranged from class IV to Class VI. The higher PCS in ICU consumed more nursing time. As a result, the higher nursing intensity, the more the daily average nursing costs in the ICU. Conclusion: Our study provides evidence to refine the current nursing fee schedule that does not differentiate from the volume of nursing services based on nursing time. We strongly recommend that the current reimbursement system for nursing services should be applied not only to the general nursing units but also to the ICU or other special nursing units.

• 간호행정학회지
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• 제2권2호
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• pp.73-83
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• 1996

Scheduling for nursing personnel involves many factors and requirements. Therefore, manual scheduling requires much time and effort to produce an adequate schedule. This paper introduces a PC based nurse scheduling support system which was developed in Microsoft Access 2.0, an easy to use data base management tool. First step of this system is to determine necessary number of nursing personnel by medical law or by patient classification. Current Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization. In addition, necessary nursing personnel by patient classification was determined four nurses for seven patients in this system based on the authors' preliminary study. And the second step is to assign daily duty type for each nurse at every nursing unit automatically. The introduced system fully utilizes the GUI environment of Microsoft Windows and even makes the computer-novice nurses feel comfortable in using the system. This system can help nursing administrators improve nurse scheduling in a way of quick and easy schedule generation for the future, and allow nurses more time for patient care.

• 임상간호연구
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• 제24권1호
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• pp.113-126
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• 2018

Purpose: The purpose of this study was to revise the KPCS-1 and to standardize the three patient classification systems for general ward, ICU and NICU. The actual utilization of the KPCS-1 score and each nursing activity was evaluated and the relationships between KPCS-1 score and nursing related variables were reviewed. Methods: The 47,711 KPCS-1 scores of 6,931 patients who discharged from $1^{st}$ to $30^{th}$ April 2017 were analyzed and the statistical significance between KPCS-1 score and nursing related variables was reviewed by Generalized Estimating Equation. The revision of the KPCS-1 was carried out by Partial Least Square model. The 3 patient classification systems (KPCS-1,KPCSC and KPCSN) were standardized by professional reviews. Results: KPCS-1 was a valid instrument to express nursing condition adequately and was revised as a new version which has 34 nursing activity items. The names and terminologies of pre-existing 3 patient classification systems developed by KHNA were standardized as KPCS-GW, KPCS-ICU, KPCS-NICU. Conclusion: KPCS-1 was a valid instrument to represent diverse nursing conditions precisely and was revised as a 34-item KPCS-GW. The terminologies of the other patient classification systems by KHNA were standardized as KPCS-ICU and KPCS-NICU.

• 간호행정학회지
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• 제12권3호
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• pp.444-453
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• 2006

Purpose: The purpose of the study was to identify critical indicators for the development of efficient patient classification system in a emergency room. Method: This study involved following five steps. Step 1. Selection of the lists direct nursing services in the ER. Step 2. Measurement of the time of direct nursing services from Aug. 31st to Nov. 30th, 2005. Step 3. Classification of the patients according to the nursing care time. Step 4. The determination the critical indicators for different patient classes. Result: Determinate indicators were as follow: 3 items in the first group (vital sign checking, IV route starting, blood sampling), 3 items in the second group (vital sign checking, fluid infusion, blood sampling), 9 items in the third group (I/O checking, $O_{2}$ inhalation, suction, fluid infusion, IV bolus, Central catheter preparation & management, blood sampling, intubation preparation & management, postmortem management), 7 items in the fourth group (EKG monitoring, BP monitoring, $O_{2}$ inhalation, fluid infusion, using the specific drugs, CPR, postmortem management). Conclusion: This study can help future studies which measure nursing services standard time or assigns value to emergency nursing services.

• 간호행정학회지
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• 제13권1호
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• pp.5-16
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• 2007

Purpose: This study is to verify the validity and reliability of classified items and criteria of the patient classification system(PCS) based on Park's definition of nursing intensity. Methods: An expert group of 8 persons verified the content validity of the tools. The 1817 inpatients at a tertiary hospital in Seoul, Korea were classified into 4 groups according to two tools for verifying concurrent validity and interraters' reliability. These verifications were performed from September to October, 2004. Results: Nursing domains of the tools have been divided into 12 items: hygiene, nutrition, elimination, exercise & activity, education & counseling, emotional support, communication & consciousness, treatment & examination, medication, measurement & observation, coordination of multidisciplinary team, admission & discharge & transfer management. Content validity was verified by the content validity index(above 0.75 in all 12 areas). Interraters' reliability was no significant difference in the results of the patient classification between the two raters(A group 93.75%. B group 88.24%). Concurrent validity was also verified by the agreement of two tools(73.7%). Conclusion: These results showed that the reliability and validity of the PCS based on the nursing intensity were verified. These will use an data for nursing productivity in the future.

• 중환자간호학회지
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• 제10권1호
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• pp.1-12
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• 2017

Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.

• 임상간호연구
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• 제28권2호
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• pp.198-209
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• 2022

Purpose: The purpose of the study was to shorten the KPCS-1 (Korean Patient Classification System-1) for predicting nursing care need level and to explore whether the patients can be clustered by their acuity and dependency. Methods: The participants were inpatients in two surgical wards and two internal medicine wards at a teritory hospital during 14 days investigations. The KPCS-1 was evaluated once a day for all inpatients and 2,082 cases of data from a total of 411 patients were analyzed. Results: The items were reducted from 50 items to 26 items by partial least squares analysis and expert review. Through factor analysis, it was confirmed that hygiene, diet, elimination, and exercise were categorized as dependence factors. Patients were clustered with low acuity/low dependency (average score: 7.68±2.81/1.05±1.33), high acuity/low dependency (average score: 17.20±4.15/1.94±2.40), medium acuity/high dependency (average score: 13.56±5.30/9.66±2.64) through cluster analysis. The total score of the three groups for their nursing care needs was 8.73±3.36, 19.14±5.74, and 23.24±6.31 in order, and the results showed a statistically significant difference (F=1712.12, p<.001). Conclusion: The shortening of the KPCS-1 and the new criteria for categorizing patients according to acuity and dependence will increase clinical utility and be useful for manpower assignment criteria in detail.

• 임상간호연구
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• 제21권3호
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• pp.401-411
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• 2015

Purpose: This study was performed to develop a valid and reliable Korean Patient Classification System for Critical Care Nurses (KPCSC). Methods: Tertiary and general hospitals with various levels of ICU nurse staffing were included. To verify interrater reliability, data collectors and staff nurses of 15 ICUs in 11 hospitals classified 262 patients. To verify construct validity, the staff nurses classified 457 patients according to KPCSC comparing difference by medical department and type of stay in ICU. For conversion index, 195 patients from 10 ICUs in 7 hospitals were classified and nursing time was measured by 174 nurses, 7 head nurses, 18 charge nurses, 37 nurse aids and 1 secretary. Results: The developed KPCSC has 11 categories, 82 nursing activities and 115 criterias. Reliability was found to have high agreement (r=.96). Construct validity was verified by comparing differences in medical department and type of stay in ICU. According to scores, four groups in the KPCSC were identified. One score on the KPCSC indicates 6.12 minutes of nursing time. Conclusion: The findings show that the KPCSC can be used to measure new and complex nursing demands including rehabilitation and the safety of ICU patients.

• 간호행정학회지
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• 제9권3호
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• pp.379-389
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• 2003

Purpose: The objective of our study was to figure out costs of nursing services in general nursing units based on the PCS in order to determine an appropriate nursing fee schedule. Method: The data were collected from 8 hospitals from September 9 to October 8, 2002. The costs of nursing services in general nursing units was analyzed by nursing hours based on the nursing intensity. The inpatient in the general nursing units were classified by Park's PCS tool(2000). Results: The distribution of patients by PCS ranged from class I to Class III in general nursing units. The higher PCS in general nursing units consumed more nursing hours. As a result, the higher nursing intensity, the more the daily average nursing costs in general nursing units. Conclusion: We found that the higher PCS, the more the daily average nursing costs in general nursing units. In conclusion, our study provides the evidence to refine the current nursing fee schedule that it does not differentiated from the volume of nursing services based on the nursing hours.

• 임상간호연구
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• 제18권3호
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• pp.354-367
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• 2012

Purpose: This study was done to verify validity and reliability of a neonatal patient classification system (NeoPCS-1). Methods: An expert group of 8 nurse managers and 40 nurses from 8 Neonatal Intensive Care Units in Korea, verified content validity of the measurement using item level content validity index (I-CVI). The participants were nurses caring for 469 neonates. Data were collected from November 11 to December 14, 2011 and analyzed using descriptive statistics, ANOVA, intraclass correlation coefficient, and K-cluster analysis with PASW 18.0 program. Results: Nursing domains and activities included 8 items with 91 activities. I-CVI was above .80 in all areas. Interrater reliability was significant between two raters (r=.95, p<.001). Classification scores for participants according to patient types and nurses' intuition were significantly higher for the following patients; gestational age (${\leq}29$ weeks), body weight (<1,000 gm), and transfer from hospital. Six groups were classified using cluster analysis method based on nursing needs. Patient classification scores were significantly different for the groups. Conclusion: These results show adequate validity and reliability for the NeoPCS-1 based on nursing needs. Study is needed to refine the measurement and develop index scores to estimate number of nurses needed for adequate neonatal care.