• 임상간호연구
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• 제29권3호
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• pp.312-326
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• 2023

Purpose: This study attempted to analyze the staffing level and critical care nursing fees of intensive care units at tertiary and general hospitals and to provide a professional judgment-based recommendation on staffing level and critical care nursing fee schedules. Methods: Staffing grades and critical care nursing fee schedules for the first quarter of 2017~2020 and the fourth quarter of 2020~2022 were analyzed. A survey was conducted on nursing managers and nurses about the current and appropriate staffing levels. A total of 77 nurse managers and 708 nurses working in Intensive Care Unit(ICU)s at tertiary and general hospitals participated in the study. Results: Grade 1 staffing increased from 25.6% in 2017 to 92.1% in 2022 at tertiary hospitals and from 0.8% in 2017 to 28.4% in 2022 at general hospitals. The current staffing ratios of tertiary and general hospitals were 1:2.21 and 1:2.77, respectively. The appropriate staffing ratio according to nurse managers and nurses was 1:1.00 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in tertiary hospitals, and it was 1:1.25 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in general hospitals, respectively. Conclusion: The appropriate staffing level was suggested from 1:1.0 to 1:2.0. The new nursing fee schedules were suggested from 1:1.0 (Grade 1) to 1:3.0 (Grade 5) and recommended to be paid based on the staffing grade, minimum number of nurses, and standard annual working days. It is expected to increase staffing levels and provide a better nursing work environment.

• 여성건강간호학회지
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• 제18권3호
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• pp.200-208
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• 2012

Purpose: This study was aimed to examine the gap between predicted cesarean section rate and real cesarean section rate and it's determining factors of 44 tertiary hospitals. Method: This study is a cross-sectional analysis using the data of 25,623 deliveries in 2009 drawn from homepage of Health Insurance Review and Assessment Service. Data were analyzed with t-test, F-test, Scheff$\acute{e}$ test, and logistic regression. Result: There were statistically significant differences in the gap of cesarean section rate (more gap indicates higher quality of delivery) by grade of nurse staffing and delivery cases. Hospitals with nurse staffing grade 1 to 2 had more possibility to be classified into higher grade in quality of delivery (OR 5.67, 95% CI 1.07-30.08). Also hospitals with over 500 delivery cases had more possibility be classified into higher grade in quality of delivery (OR 4.92, 95% CI 1.14-21.23, respectively). Conclusion: The finding suggests that grade of nurse staffing may influence the real cesarean section rate because nurses do a vital role to prevent unnecessary cesarean section. Further study is required to provide evidence that nurse staffing influence on patient outcome and cost-effectiveness in order to obtain adequate number of nursing staffs.

• 임상간호연구
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• 제20권2호
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• pp.147-161
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• 2014

Purpose: This study was aimed to modify and adapt the previously developed, high-quality enteral tube feeding guidelines for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by NECA (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The modified and adapted enteral tube feeding guidelines were consisted of 11 domains and 95 recommendations. The domains and numbers of recommendations in each domain were: 4 on general issues, 2 on enteral nutrition indication and discontinue, 6 on enteral nutrition device selection, 12 on enteral tube feeding device insertions, 3 on enteral nutrition formular and choices, 16 on enteral tube feeding start and progress, 20 on enteral tube feeding maintenance and management, 15 on monitoring enteral tube feeding administration, 10 on prevention of error, 5 on medication administration, and 2 on documentation and report. There were 16.1% of the recommendations marked as A grade, 17.8% of B grade, and 66.1% of C grade. Conclusion: The adapted enteral tube feeding nursing practice guideline is to be added to the evidence-based practice guidelines for fundamentals of nursing practice. The guideline is hoped to be disseminated to nurses nationwide in order to improve the efficiency of enteral tube feeding practice.

• 임상간호연구
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• 제23권1호
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• pp.64-72
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• 2017

Purpose: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. Methods: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. Results: The staffing grade for the general wards improved during 2008-2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. Conclusion: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing.

• 임상간호연구
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• 제29권1호
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• pp.12-23
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• 2023

Purpose: This study was conducted to update the previous evidence-based nursing clinical practice guidelines for pressure injury. Methods: The guideline was revised in 22 steps based on the international standards. Results: The updated nursing practice guideline for pressure injury consisted of four domains and 494 recommendations. The numbers of recommendations in each domain was: 31 hospital policy, 64 assessment, 386 prevention and management, and 13 education. The recommended grade was 10.3% for A, 13.8% for B, and 75.9% for C. Of these, the major revision was done in 40 recommendations (8.1%). A total of 55 recommendations (11.0%) were newly added. 25 recommendations had minor revisions such as changes or additions for some words, and only one recommendation was deleted. Conclusion: The revised nursing practice guidelines for pressure injury are expected to serve as an evidence-based practice guideline for pressure injury in Korea. This guideline will provide healthcare providers, patients, and caregivers with information to help prevent and manage pressure injuries, leading to improving patient outcomes.

• 임상간호연구
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• 제24권3호
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• pp.263-272
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• 2018

Purpose: This study was done to develop an evidence-based nursing clinical practice guideline for Moisture associated skin damage (MASD) prevention and management for patients in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by the Korean Hospital Nurses Association. It consists of three main phases and 9 modules including a total of 24 steps. Results: The adapted MASD clinical practice guideline consisted of 4 sections, 8 domains and 28 recommendations. The number of recommendations in each section was: 7 on MASD assessment, 14 on MASD prevention and management, 4 on education, and 3 on organizational policy. Of the recommendations, 3.6% were marked as A grade, 28.6% as B grade, and 67.8% as C grade. Conclusion: This MASD clinical practice guideline is the first to be developed in Korea. The developed guideline will contribute to standardized and consistent MASD prevention and management. The guideline can be recommended for dissemination and utilization by nurses nationwide to improve the quality of MASD prevention and management. Regular revision is recommended.

• 여성건강간호학회지
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• 제16권2호
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• pp.137-146
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• 2010

Purpose: This study was done to examine the attitude and awareness of nurses about rooming-in for new mothers and their infants. Methods: Data were collected from 462 nurses from 40 hospitals from August 10 to September 20, 2008 using a questionnaire, and the collected data were analyzed using descriptive statistics, t-test and ANOVA. Results: The mean score for attitude and awareness of nurses about rooming-in was 3.02 (range=2.13~3.80), which indicates that the nurses had positive opinions of the system. The factors with the highest and lowest scores were awareness of a successful implementation method (mean=3.35) and awareness of the advantages and disadvantages of the system (mean=2.73), respectively. The attitude and awareness of nurses about rooming-in differed significantly with age, religion, education level, parity, type of hospital, hospital nurse staffing grade (bed-to-nurse ratio), and presence of a rooming-in system. Conclusion: This results of the study show that attitudes and awareness of nurses to rooming-in differed significantly according to personal factors (age, parity, religion, educational level) and work characteristics (hospital type, hospital nurse staffing grade, presence of rooming-in system). These findings can be used as basic data in determining optimal strategies for a system of rooming-in in the future.

• 한국간호교육학회지
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• 제19권4호
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• pp.542-548
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• 2013

Purpose: This study was conducted to explore clinical practice performance according to type of practice in students in pediatric nursing and the relationship with satisfaction of clinical practice. Methods: The subjects consisted of 531 nursing students (307 at a pediatric ward and 224 at a nursery) from 5 colleges of nursing. Data collected from March to June 2012 were analyzed using descriptive statistics, t-test, AVONA and Pearson correlation coefficients. Results: Clinical practice performance on direct nursing activity was significantly different according to the course on pediatric nursing, grade point average, and satisfaction of nursing major. Observation practice was different according to type of college, the course on pediatric nursing, grade point average, duration of practice and clinical educator in the pediatric ward. In the nursery, direct nursing activity was significantly different according to the type of college, the course on pediatric nursing, hospital type, and duration of practice. Observation practice was different according to type of college, satisfaction of a nursing major, and the clinical educator. In addition, significant correlations were found between clinical practice performance and satisfaction of clinical practice. Conclusion: Our research can assist effective pediatric nursing practice planning for nursing students.

• 임상간호연구
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• 제18권2호
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• pp.183-195
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• 2012

Purpose: This study was performed to identify the variations of nursing care cost depending on nursing care requirement and calculate nursing care cost per one day and one care requirement point. Methods: Nursing care requirement was measured by classifying 3,855 patients according to KPCS-1(Korean Patient Classification System for nurses-1). Nursing care cost was calculated from personnel expenses and nursing care requirement. Nursing cost factors were identified by multiple regression analysis. Results: Average nursing cost per patient per day was 33,588 won, Average nursing care cost per 1 patient classification score was 3,558 won. The nursing cost per 1 patient classification score was different depending on the types and levels of the hospitals. The 4th patient classification group revealed the highest nursing care cost. Nursing cost factors included the number of beds in the hospitals, seniority, number of nurses and first grade in nurse personnel accreditation ($adj-R^2$ 74.0%. p<.05). Conclusion: Nursing care requirements expressed by patient classification scores don't directly correlate with nursing care cost. Further research is needed to evaluate validity and reliability for refining KPCS-1 and to apply variable criteria to nurse personnel accreditation.

• Child Health Nursing Research
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• 제23권3호
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• pp.375-384
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• 2017

Purpose: This study was done to identify the level of adjustment to hospital life, hospitalization recognition and hospital-related fear by school-aged children, and investigate the influence of hospitalization recognition and hospital-related fear on the hospital life of these children. Methods: Participants were 112 three to six grade students who were hospitalized from 3 to 7 days at one of two children's hospital. Date were collected from September 2015 to March 2016. Data were analyzed using frequency, percentage, mean, standard deviation, multiple regression. Results: The mean score for adjustment to hospital life was $3.43{\pm}0.40$ of 5, for hospitalization recognition, $2.98{\pm}0.46$ of 4 and for hospital-related fear, $1.37{\pm}0.28$ of 3. Factors affecting adjustment to hospital life were hospital-related fear (${\beta}=-.28$, p=.002) and hospitalization recognition (${\beta}=.27$, p=.003). These factors explained 17% of the variance in adjustment to hospital life. Conclusion: Results indicate that adjustment to hospital life by school-aged children is not sufficient enough for them to cope with illnesses and hospitalization. Therefore, to improve adjustment to hospital life by school-aged children, nursing interventions that focus on increasing hospitalization recognition and decreasing hospital-related fear need to be developed.