• 대한간호학회지
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• 제33권6호
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• pp.802-811
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• 2003

Purpose: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. Method: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. Result: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. Conclusion: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.

• 한국간호교육학회지
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• 제24권4호
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• pp.415-423
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• 2018

Purpose: This study was done to examine the relationship between participation motivation, satisfaction and continuance willingness of voluntary activities of nursing students, and to identify factors influencing continuance willingness of voluntary activities. Methods: The research participants were 175 nursing students in the nursing departments of 3 universities located in G city and J province in Korea. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and multiple regression. Results: Participants' scores for participation motivation, satisfaction and continuance willingness of voluntary activities were $3.24{\pm}0.76$, $3.11{\pm}0.83$ and $3.03{\pm}0.85$ respectively. Participation motivation and satisfaction of voluntary activities had positive correlations. Satisfaction and continuance willingness of voluntary activities had positive correlations. Factors influencing nursing students' continuance willingness of voluntary activities included participation motivation and satisfaction of voluntary activities. And these variables explained 74% of the variance in continuance willingness of voluntary activities. Conclusion: The findings show that development and application of educational programs to increase participation motivation and satisfaction of voluntary activities are important and will improve nursing students' continuance willingness of voluntary activities.

• 한국의료질향상학회지
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• 제19권2호
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• pp.68-80
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• 2013

Background: This study investigates improvements in non-value-added nursing activities in clinical work, in order to improve the efficiency and quality of nursing activities. Methods: The study was performed as a quality improvement project at a tertiary general hospital. The nursing activities that needed improvements were categories into admission care, discharge care, supply management, diagnostic work-up related activities, and others. The nursing time and frequency of non-value-added activities were compared across nine nursing units before and after implementation of the quality improvement program. Post-implementation patient and nurse satisfaction were subsequently analyzed. Result: Post-implementation, the time spent on non-value-added nursing activities was reduced and patients and nurses were satisfied with the improvements. Discussion: Reducing non-value-added activities in nursing can increase the work efficiency and ensure time for patient care, thus improving the quality of nursing care. For further study, accurate surveys on nursing activities based on nursing time are required.

• 성인간호학회지
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• 제18권1호
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• pp.102-114
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• 2006

Purpose: The purpose of this study is to develop a set of standardized nursing interventions and their associated nursing activities according to the NIC system to guide home care nurses in performing nursing intervention activities for hospice patients. Method: This study was a descriptive survey that first identified frequently used & specialized hospice nursing interventions based on the NIC systems and next validated a set of standardized nursing interventions and their associated nursing activities. One hundred chart records of home hospice patients were used to identify nursing interventions. Also, thirty-nine hospice specialized nurses participated twice using the Delphi technique to test the content validity of the standards. Results: Among the nursing interventions, 19 important nursing interventions and 418 associated nursing activities were selected after two rounds of Delphi technique by hospice specialized nurses. The mean content validity of the final nursing activities was 0.82. In this paper, only the 3 most frequently used nursing interventions and 3 hospice specialized nursing interventions with their associated nursing activities are presented since space is limited. Conclusion: The nursing intervention standards will be a basis for home hospice nurses to improve quality of hospice care for hospice patients.

• 한국보건간호학회지
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• 제3권2호
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• pp.5-46
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• 1989

The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

• 성인간호학회지
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• 제20권6호
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• pp.960-972
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• 2008

Purpose: The purpose of this study was to validate the nursing intervention standards of home care to home care setting for a guide in giving quality care to home hospice patients. Methods: The developed nursing standards were applied to 79 home hospice patients at K hospital, C university. Data were collected through the developed nursing intervention standards of home care with 19 selected nursing interventions and 418 associated nursing activities from January to June in 2006. Results: The performance frequency was 509 times for total nursing interventions and 7,815 times for total associated nursing activities. The most frequently used nursing activity was 722 times(9.24%) on teaching prescribed medication, followed by surveillance(718 times, 9.18%), and vital signs & neurologic monitoring nursing intervention(701 times, 8.97%). The highest mean nursing activity performance rate showed on Intravenous therapy(82%), followed by dying care(81%), and vital signs & neurologic monitoring (80%). Among 418 nursing activities, there were three classifications: 168 as core activities, 165 as major, and 85 as accessory activities. Conclusion: The final validated nursing intervention standards can guide home care nurses to perform quality care and contribute to computerized nursing services and request of nursing fees.

• 간호행정학회지
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• 제19권4호
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• pp.449-461
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• 2013

Purpose: The purpose of this study was to explore the relationship between cost and revenue for inpatient nursing activities in general wards. Methods: Data were collected from 12 medical-surgical wards in one general hospital from January 1 to December 31, 2010. The nursing activities were categorized into 2 groups according to nursing service payment type in terms of the Korea health insurance system. Descriptive statistics were used to identify nursing activities and nursing activity costs. Results: Of 140 nursing activities identified as performed in general wards, payment for 69 items was included in nursing management fees. The percentage of each cost for the nursing units was 90% for labor, 4% for materials, and 6% for operating expenses. The cost for medical support nursing service accounted for 38% of costs and nursing management fees, 62%. The average profit and loss was -237,257,000 won. The cost recovery rate for nursing service was only 44%. Conclusion: The results indicate a need to measure the economic value of nursing activities performed in general wards and use it as a basis for establishing an adequate reimbursement system for nursing service.

• 임상간호연구
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• 제19권2호
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• pp.218-232
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• 2013

Purpose: This study was aimed to describe Helicopter Emergency Medical Services (HEMS) and analyze the flight nurses' activities in HEMS. Methods: Data were collected retrospectively from the air transportation reports that contained data of 168 patients transported by aircraft to G University medical center in Incheon since June, 2012 to March, 2013. Data were analyzed using descriptive statistics, and Mann-Whitney U test. Results: Average distance of flights was 44.0 km, duration of field treatment took 13.6 minutes, and duration of a flight from scene to hospital was 14.5 minutes. Nursing activities were categorized into 12 direct nursing activities and 5 nursing management activities, and a total number of 7806 nursing activities were occurred in HEMS. The most frequently performed nursing activity was measurement and monitoring (27.9%) followed by medication (11.5%) and respiratory management (8.7%). The most frequent nursing management were information management (11.0%). Nursing activities performed were significantly different depending on the patient's level of consciousness, cause of illness, crew configuration, and type of transportation. Conclusion: This study described HEMS nursing activities performed by flight nurses. Difference in nursing activities according to patient characteristics, crew configuration and type of transportation requires flight nurses to be prepared through educational programs to improve nursing activities and nursing management during air transportation.

• 지역사회간호학회지
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• 제10권2호
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• pp.291-306
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• 1999

Health promotion has come to the fore through new concept approach in consequence of the increase of chronic diseases. increase of medical cost and social trend of putting more emphasis on the individual responsibility for health. Studies of health promotion can be classified into two types: one is micro intervention method which is mainly focused on modifying individual life style and the other. macro intervention method in which they put another emphasis on the environment the individual is surrounded. in addition to modifying individual life style. This study belongs to the later. This study aims to develop nursing activities and program it for the purpose of community health promotion. The process of the study can be briefed as follows: to draw out nursing contents to intervene for community health promotion: to promote community health to develop nursing action indicators; to develop nursing action indicators for the development of main nursing activities. And those developed nursing activities are programmed systematically. The community health promotion program is composed of a hierarchical structure with nursing process that the nurses are supposed to apply to perform professional nursing. the level of nursing perform. the main items of nursing process. health promotion nursing indicators. health promotion nursing activities. The conclusion of this study according to objectives are as follows. First. community health promotion contents at individual and community level are remained revised and complemented and those at organizational level are developed. The developed main contents of community health promotion nursing are as follows. 1) Revised individual level nursing contents: 35 items. 2) Developed organizational level nursing contents: 24 items. 3) Revised community level nursing contents: 36 items. Second. for the development of the health promotion nursing action indicators. principles were set up and applied as follows. 1. Developed indicators should be provided with such qualities as comprehensiveness. diversity. developability, availability. practicability. 2. Developed indicators should be provided with functional abilities to measure the conditions and changes in any phenomena or state. inspect the development of the states. control the implementing program. evaluate the result of program and grasp what nurses should do. 3. Developed indicators should be provided with relevance and sequence. 4. Developed indicators should be undergo inspections from the expert. The developed community health promotion action indicators developed in this study. observing above mentioned principles. are total 330 indicators of 95 items. Third. when the main nursing activities were developed for each nursing action indicator. five priciples were set up in accordance with each nursing action indicators to decide main nursing activities. Main nursing activities developed observing those principles. are total 1273. Forth. for the programming of the developed nursing activities. three principles were set up. 1. The nursing activities are systematized in line with (nursing process) (nursing client) (key items of nursing process) (nursing action indicators for health promotion) (nursing activities). 2. The program is constructed in downward and hierarchical order. 3. The program is constructed not in relation to same level activities but in relation to high and low level activities. The process step of programming of developed main health promotion nursing activities are; Step 1. The Developed nursing action indicators are classified into nursing process. Step 2. The main nursing activities are allocated per each nursing action indicators. Step 3. The statement of main nursing activities are inspected. Step 4. The items of main nursing activities allocated by a certain nursing action indicators are sequenced. taking into consideration the elaborateness of activity. the sequency of activity. familiarity of activity. the difficulty of activity. the interest of activity. the frequency of activity. Step 5. The whole developed program should undergo comprehensive and critical inspections.

• 대한간호학회지
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• 제30권6호
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• pp.1580-1591
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• 2000

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.