• Journal of Korean Academy of Nursing
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• v.22 no.2
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• pp.185-206
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• 1992

In this study nursing activities were examined to determine the nursing cost. A professional nursing group developed a tool for the investigation. 128 nursing activities were identified by the tool in 16 nursing care areas as referenced in the literature. Each activity was examined for four essential factors to define nursing cost ; time consumed for the care, level of professional skill, degree of independency and performer of the care. The activity was rated by a five point Likert scale. This investigation was conducted with the nursing staffing working in the 21 university hospitals in Korea and having more than four years experience especially in medical or surgical wards. The participating nursing staff were screened on the basic of the recommendation of the nursing director. The data were gathered from June 12th to August 12th, 1989. All the data were analyzed for mean, standard deviation, percent, and correlation coefficients between items. The results are summarized as follows : 1. Direct nursing care was classified into 16 large areas and 128 small activities. 2. No significant correlation was found between the study items of each activity. 3. Among 128 nursing activities, Those performed less than 50% of the time by a nurse were excluded from the nursing cost. Also excluded activities which were given less than 9 marks in all three items, time consumed, level of professional skill, and degree of independency. As a result, 83 activities in 14 nursing care areas were selected for the proposal to estimate nursing cost.

• 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.

• Korean Journal of Occupational Health Nursing
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• v.22 no.1
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• pp.24-34
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• 2013

Purpose: We investigated the relationship between patient safety culture and safety care activity, and identified factors for safety care activity of entry-level nurses. Methods: The subjects of the study were 204 entry-level nurses working at five general and advanced hospitals with over 500 beds located in C and D City. The data were analyzed using descriptive analysis, t-test, ANOVA, Pearson's correlation and hierarchical multiple regression with SPSS/WIN 18.0 program. Results: Perception of patient safety culture had significant correlations with safety care activity. Multiple regression analysis showed that demographic variables of quality of nursing on patient safety and health state of entry-level nurses affected safety care activity. In addition, patient safety culture in ward and communication affected safety care activity. These factors explained 38% of variance. Conclusion: Based on the results of the study, patient safety culture promotion strategies to facilitate supportive work environment and effective communication are needed.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.11 no.1
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• pp.23-32
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• 2004

Purpose: The purpose of this research is to give basic data about a way of connection to individual centers and vitalization of visiting nursing program on Busan. Method: The research is done with survey for eight hospitals. sixteen public heath centers, forty-six social welfare centers to be practised visiting nursing program on Busan for actual condition of that. Results: 1. The average nursing career is below 5-10 years. But visiting nursing career is below 3 years(70%) in hospital. public, public heath center, and heath center. 2. Hospitals coverage of visiting nursing service is city as a whole. Whereas public heath center and social welfare center covered some local area. 3. Client of visiting nursing service possess in order of alone lived elderly, person in uncomplete movement, a disabled person, and a chronic disease person. 4. The main service in visiting is patient assessment, basic nursing activity, and treatment nursing activity with medication care, B.P check, dressing, bedsore care, catheter care and exchange, fluid therapy. Particularly, the hospital runs parallel to basic care and treat care in 100%. The social service center has 65.0% in a patient assessment and basic nursing activity. 5. The concern about services connecting with other center is very high. Conclusion: Actual conditions of visiting nursing program on Busan, which is presented in this study. The results of this study will become the pillar of visiting nursing program planning and application.

• 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 Academy of Nursing Administration
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• v.4 no.1
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• pp.73-88
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• 1998

The management of nursing resource is very important. that is because nursing staff accounts for 30-40% of total staff in a hospital and nurses provide patoents with attentive service for hours daily. The continuous turnover of nursing staff. however, impedes the quality-oriented nursing care, which will consequently leads to the loss of human and material resource in competitive society. This study aimed to calculate nurse's activity and compare the activity amount based on career experience. Futhermore it aimed to find factors which would influence 'quality weighed direct nursing activity amount'. Questionnaires and check lists for this study were distributed to nurses in a suburban hospital outside of Seoul from October 20 to November 14. 1997. The nursing activities were calculated according to professionality. independency and working hour. And then it were accumulated by quality score. The collected data was analyzed by statistical methods as t-test, ANOVA, correlation, multiple regression. The results of this study were as follows ; Firstly, carrel' experience had no influence on the quality weighed nursing activity amount. But the quality level of service of skilled nurses was higher than that of new nurses. Secondly, career was a variable affecting the quality in nursing service. So career was positively related to the quality of nursing care. Patient's disease severity and number of patient were positively correlated with weighed nursing activity amount. But job satisfaction was negatively correlated v:ith the amount. Thirdly, the independent variables which had significant influence on the weighed nursing activity amount were disease severity and the number of patients, The severity score and number of patient were directly proportional to the weighed nursing activity amount. This results indicated· that weighed nursing activity amount was influenced by the number of patient and patient's disease severity. The quality score of nursing services for experienced members is higher than that of new staff. But both new and skilled staff showed no difference in the quality weighed nursing activity amount. Internal and. external environment influences nursing activities. The quality of nursing services is very important factor in nursing activity. Therefore nursing managers should make an effort to improve nursing care quality through continuous research. Also they should try to maintain experience nurses and assign nursing staff appropriately with patient's severity and other relevant factors being considered. The quality-improved nursing care in the hospital will strengthen hospital's competitiveness.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.7 no.1
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• pp.26-38
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• 2000

The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

• Quality Improvement in Health Care
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• v.19 no.2
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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.

• Journal of Korean Academy of Nursing
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• v.29 no.5
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• pp.1103-1112
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• 1999

In the last few years, psychiatric nurse practitioners have shown a growing an interest in community psychosocial rehabilitation, caring for chronic psychiatric patients as case manager in South Korea. The purpose of this study was to evaluate the effectiveness of a community psychiatric rehabilitation nursing program on self-care activity and quality of life and to suggest this program as an effective nursing intervention in a group of chronic home-based psychiatric patients in a poor town. A nonequivalent control group, pretest-posttest design was used. Of the twenty women that started the program, sixteen finished it. The data were analyzed by the Wilcoxon Rank Sum Test. The program included the process of case management which consisted of four phases: the first was an active case finding and pre-test, the second was home visiting and contacted by phone. the third was group activity therapy of 12 sessions, and the fourth phase was terminal and post-test. The effects of the program were assessed by quality of life and self-care activity. The quality of life and the self-care activity, especially, area of nutrition. elimination, dressing. leisure activity, and follow-up clinic visiting showed greater improvement than those of the control group. The results of this study suggest that this program was effective in improving the quality of life of chronic home-based psychiatric patients.

• Korean Journal of Adult Nursing
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• v.13 no.1
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• pp.40-52
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• 2001

The ratio of the elderly population is rapidly growing due to socio-economic development and better medical services. As the average life-span of the Korean elderly becomes longer, the proportion of the elderly is increasing. Therefore, the elderly need to sustain a high quality of life. However, all these factors, such as sensory loss, decreased endurance, mobility limitation, and a loss of independence, act to diminish the quality of life among the elderly. It is necessary for elders to adapt themselves to aging, to maintain their physical functions and especially, it is important to keep their independence in activity of daily living and self care. Therefore, this study was designed to identify the degree of activity in daily living and exercise of a self-care agency and to investigate the relationship between activity of daily living and self-care agency. Also, this research aimed to contribute to nursing interventions that maintain and promote quality of life of the elderly and to enable themselves to live independently. The subject of this study were 160 elders, over age 65, who were sampled in C city. Data were collected by observation and questionnaires from May,1999 to December, 1999. The measurement tools were Barthel Index(1979), Lawton & Brody(1969) for activity of daily living and Kearney & Fleischer(1979) for self-care agency. Data were analyzed by SAS PC+ package and included descriptive analysis, t-test, ANOVA, Pearson correlation coefficient, and Cronbach's alpha. The conclusions of this study are summarized as follows; 1. The mean of ADL and IADL was 96.09 and 16.38, respectively. The score described activity of daily living among the elders in C province as moderate. Particularly, in the items of IADL, the item of medication was the highest score. 2. The mean for exercise of self-care agency was 76.48, a moderate degree. 3. The degree of ADL and IADL according to demographic characteristics was significantly different statistically in pocket money, the presence of disease, perceived health status and in occupation, pocket money, family type, the presence of disease, and perceived health status, respectively. 4. The dagree of selt-care agency according to demographic characteristics was significantly different statistically in gender, education level, economic status, and pocket money. 5. There was a significant positive correlation between activity in daily living and self-care agency. Based on these results, further research is suggested to discover the variables influencing the activity of daily living and self-care agency to develop nursing strategies for improving self-care and activity of daily living among the elderly.