• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.321-332
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• 2013

Purpose: Korean health insurance extended application of the Diagnosis Related Groups (DRG) payment system to tertiary and general hospitals from July, 2013. This study was done to develop a DRG fee adjustment mechanism applied to levels of nurse staffing to assure quality nursing service. Methods: Nurse stafffing grades among hospitals in Korea were analyzed. Differences and ratio of inpatient costs by nurse staffing grades in DRG fees and differences of DRG fee between tertiary and general hospitals were compared. Results: In 2013, nurse staffing grades in tertiary and general hospitals had improved, but other hospital nurse staffing grades remained at the 2001 level. Gaps of inpatient costs between first and seventh nurse staffing grades were over 10% in 4 out of 7 DRG diagnosis; However differences of DRG fee between tertiary and general hospitals were only 4.51% and 4.72% respectively. A DRG fee adjustment mechanism was developed that included nurse staffing grades and hospitalization days as factors of the formula. Conclusion: Current DRG fees motivate hospitals to decrease nurse staffing grades because cost reduction is bigger than compensation. This DRG fee adjustment mechanism reflects nurse staffing supply to motivate hospitals to hire more nurses as a reasonable compensation system.

• Journal of Korean Critical Care Nursing
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• v.12 no.2
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• pp.61-72
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• 2019

Purpose : The aim of this study was to explore the attributes, antecedents, and consequences of patient-centered care (PCC) for older adults with multimorbidity in acute care hospitals. Methods : The concept analysis performed by Walker and Avant was used to analyze PCC. Fifteen studies from the literature related to PCC appear in systematic literature reviews in the fields of theology, medicine, psychology, and nursing. Results : PCC in acute care hospitals was defined according to the five attributes of 'maintaining patient autonomy', 'empowering self-care', 'individualized and relationship-based care', 'shared decision-making', and 'creating a homelike environment'. Antecedents of PCC were found to be a respect for patients' preferences, qualifications of the nursing staff, care coordination and integration, and organizational support. Consequences of effective PCC were a functional status; health-related quality of life; satisfaction with care, mortality, and medical costs from the perspective of the patient and family; and quality of care and therapeutic relationships from nurses' viewpoints. Conclusion : PCC as defined by the results of this study will contribute to the foundation of institutionalization and the creation of a safe and healthy acute care hospital culture focused on patients' preferences and values.

• Journal of Korean Biological Nursing Science
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• v.24 no.4
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• pp.209-218
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• 2022

Purpose: This study aimed to investigate the relationships between the characteristics of nurses' work schedules, health outcomes, and work-life balance. Methods: This was a secondary data analysis that included 422 nurses in Korean hospitals. Descriptive analysis, independent sample t-test, one-way ANOVA, Pearson correlation analysis, and multiple linear regression analysis were used to identify the associated factors. Results: Multiple linear regression analysis showed that work-life balance was lower when atypical work was performed (β=-.14, p=.010). Nurses who did not work overtime showed a higher level of work-life balance than those who worked overtime infrequently (β=-.11, p=.002) or frequently (β=-.28, p<.001). The work-life balance level increased when nurses had better subjective health status (β=.16, p<.001) or higher sleep quality (β=.29, p<.001). It was verified that the work-life balance level was higher for single-person households than for households with two (β=-.18, p=.003), three to four (β=-.16, p=.022), or five or more (β=-.21, p<.001) persons. Conclusion: This study suggests that government and hospital organizations should provide high-quality care and consideration to nurses who do atypical or overtime work as well as their subjective health status and sleep quality. Further research should focus on the development of a policy that improves the work-life balance of nurses, especially for those who work during atypical hours.

• Journal of Korean society of Dental Hygiene
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• v.22 no.6
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• pp.563-572
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• 2022

Objectives: The purpose of this study is to provide basic data for elucidating the clinical experiences of nursing assistants working at dental clinics and for establishing the bases necessary for building a safe working environment for the staff at dental clinics. Methods: From March 28 to August 20, 2022, the study conducted in-depth interviews with nursing assistants working with dental hygienists in dental clinics. The collected data were analyzed using the phenomenological method. Results: The study analyzed the meanings associated with the dental clinical assistance work experiences of nursing assistants in dental clinics. A total of 98 semantic words and 9 sub-categories were extracted, which were ultimately categorized into 4 central meanings: 'imperfect reality', 'work without boundaries', 'putting oneself in someone else's shoes', and 'symbiosis'. Conclusions: The nursing assistants were exposed to an environment where they needed to perform delegated treatment procedures even when they lacked dental work competency. They recognized their gaps in learning and the necessity for designated roles as clinical assistants. Thus, it is necessary to review the allocation and expansion of the work roles of dental practitioners based on the practical and rational realities in dental practice.

• Journal of Home Health Care Nursing
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• v.30 no.3
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• pp.298-310
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• 2023

Purpose: This study synthesized the literature on non-pharmacological interventions for chronic pain in older adults in long-term care facilities. Methods: Scoping review and thematic analysis methods were combined. On June 1, 2023, searches of primary electronic databases, including PubMed, Embase, PsycINFO, CINAHL DBpia, KMbase, NDSL, and RISS, were performed, restricting the publication date from January 1, 2010 to December 31, 2022. Guidelines from the Joanna Briggs Institute were used as a framework to set and conduct the scoping review. Results: The review identified 1,095 abstracts, from which 14 studies were included in the review. Consequent to the study, there were 10 randomized controlled experimental study designs, and 6 out of 14 studies were conducted in China. The numeric rating scale was widely used for pain assessment. Exercise intervention was provided in 7 studies and physiotherapy was provided in three studies. The outcome variables measured were pain self-efficacy, physical functions, and depression. Conclusion: This comprehensive overview guided nursing staff in long-term care facilities for planning and intervention of effective non-pharmacological interventions for chronic pain in the elderly.

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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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.

• Journal of Korean Critical Care Nursing
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• v.6 no.2
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• pp.65-77
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• 2013

Purpose: The purpose of the study was to analyze the nursing activities related to continuous renal replacement therapy (CRRT) in the intensive care units (ICU). Methods: We developed a list of 31 CRRT related nursing activities based on literature review and reviewed by expert group. A total of 109 direct time measurement records by 43 ICU nurses were collected and analyzed in terms of total time per shift, frequency, standard time, difficulty and performance levels of each CRRT nursing activity. Results: The mean time for CRRT nursing activity was 85.60 minutes per 8 hour shift. Nurses have spent average $9.46{\pm}6.98$ minutes in a shift for "waste fluid bag change" activity. In addition, "check catheter location" was the most time consuming single activity. The most difficult activity was "counseling-answer" and the most competent one was "dialysis solutions change". Conclusion: The CRRT nursing activities accounted for a significant portion of total nursing workload. Practical allocation of nursing staff for CRRT patient along with development of a new nursing cost system need to be considered. Continuous nursing educational and training programs on CRRT should be developed.

• Journal of Korean Clinical Nursing Research
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• v.16 no.1
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• pp.95-105
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• 2010

Purpose: The purpose of this study was to examine the difference between direct and indirect nursing activity times according to the grade of nursing management fee. Methods: The subjects of this study were 324 working nurses at the time of 3rd grade and 319 working nurses at the 2nd grade of nursing management fee in one university hospital. Nursing activity time was measured in April and May, and in September and October of 2008 for comparison. The data were analyzed by SPSS win using frequency and t-test. Results: Direct nursing care activity time per one patient was significantly higher at 2nd grade than 3rd grade in day shift (t=-2.55, p=.012). Direct nursing care workload per one nurse was significantly lower at 2nd grade than 3rd grade in evening shift (t=2.21, p=.030), whereas indirect nursing care workload was lower at 2nd level in night shift (t=2.43 p=.016). Conclusion: The findings from this study showed that higher nurse-to-patient ratio can provide greater amount of direct nursing care activity for the patient. Also, it decreased workload of nurses. The higher nurse-to-patient ratio will be beneficial for promoting quality of nursing care as well as decreasing nurse's heavy workload.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.1
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• pp.23-31
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• 2006

Purpose: The purpose of this study was to test the empowerment structural model based on Kanter's work empowerment theory. Method: A predictive, nonexperimental design was used in a sample of 279 nurses from 3 university affiliated hospitals. Data were collected with self-administered questionnaires and analyzed using mean, standard deviation, pearson correlation coefficient and path analysis. Results: The results showed that the overall fitness of the hypothethical model to the data was good(chi-square=.7751, df=4, p=.942, GFI=.999, AGFI=.996, RMSEA=.000). Both formal power and informal power directly influenced on nurses' perceived empowerment level and empowerment directly influenced on nurses' organizational commitment and indirectly influenced on nurses' intent to stay. Conclusion: The results imply that hospital and nurse managers should provide the empowering working condition for nurses to be stayed in hospitals.

• Korean Institute of Interior Design Journal
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• v.13 no.6
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• pp.184-195
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• 2004

The purpose of this study was to clarify the space use pattern and the daily living activities of the elderly with dementia in the common space (dining room, day corner) of nursing home in Japan. The subjects were six units of the 2 nursing homes in Tokyo. For this, researcher visited from September 5 to December 5 and collected data by observations of behavior of the elderly with dementia in common space and interviews with staff for the information about basic characteristics of the elderly with dementia and administration and operation of the facilities. The data were analyzed using the frequency and percentage with SPSS 11 program and recorded in the form of behavior map. The results revealed as follows: first, 6 types (self-concentration type, physical environment-interest type, passive others-interest type, staffs-interaction type, other elderly-interaction type, visitors-interaction type) of the daily living activities of the elderly with dementia in common space were founded. Second, the daily living activities of the elderly with dementia in common space tended to focus on self-concentration type and physical environment-interest type. Third, physical environmental characteristics of common space affected space usage pattern of the elderly with dementia. And it was perceived like as living oriented space, social interaction space, facility space, staff oriented space. Conclusively it was suggested to plan dining space as semi-private space, day comer as semi-public space.