• Title/Summary/Keyword: Nursing grade of hospital

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Nursing Delivery System Improvement Plan in A Hospital (간호전달 체계 개선 방안 - 일 병동을 중심으로 -)

  • Lee, Jin-Hi;Lee, Sung-Ae;Ham, Yong-Hee;Yang, Myong-Ju;Kim, Ok-Sohn
    • Quality Improvement in Health Care
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    • v.3 no.2
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    • pp.52-59
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    • 1997
  • Background : In many Nursing Delivery System, Nursing Department at D Hospital had used to traditional nursing practice model what is called functional activities based system. It has a lot of merit that carried out specialized and rapid works but tend to ignore indivisual professional responsibility and task-based work assignments. In addition this system showed high turnover rates due to heavy workload, timesum of handing over duties, lack of support from peers and interstaff communication. So we performed conversion of Nursing Delivery System to My Patients Nursing Care System for providing comprehensive nursing to patient and reducing turnover rates and increasing job satisfaction to nurse. Method : 1. 1st step(96.4.9): Detected the problem of Nursing delivery System and estabilished improving planning 2. 2nd step(96.4.26): Visited other hospital on job training 3. 3th step(96.4.29): Discussed to premonitoring problem after conversion Nursing Delivery System and prepared structure 4. 4th step(96.5.6): My Patients Nursing Care System practical application 5. 5th step(96.7.20): Held complementary meeting 6. 6th step(96. 7): The other ward application 7. 7th step(96. 10): Extended application to whole wards Results: 1. Workload: (1) reduction(55.6%) (2) addition(44.4%) 2. Strong points after conversion: (1) decreased timesum of handing overduties (35.2%) (2) increased responsibility(33%) (3) broaden nurse's outlook to duties(14.8%) 3. Shortcoming after conversion: (1) understanding difficulties except my patient(57.8%) (2) weak teamwork(23.3%) (3) intensive stress to low grade nurse(12.2%) 4. Effective complemental way: (1) manpower(76.7%) (2) conversion of though (8.9%) (3) education(14.4%) 5. Patient's satisfaction: (1) satisfaction(64%) (2) no effect(36%) 6. Physician and peer's satisfaction: (1) satisfaction(12.5%) (2) dissatisfaction(21.6%) (3) no interest(44.3%) 7. Nurse's satisfaction: (1) satisfaction(74.7%) (2) dissatisfaction(5.5%) (3) unknown(20.5%) 8. Want to continued: (1) want(76.4%) (2) try to any other system(18%) Conclusion : Even though Nursing Delivery System conversion still has many problem, we gained more merits than traditional nursing delivery system. So we suggest that My Patients Nursing Care System should be encouraged for comprehensive nursing care and satisfaction to nurses.

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Updates of Nursing Practice Guideline for Enteral Nutrition (경장영양 간호실무지침 개정)

  • Cho, Yong Ae;Gu, Mee Ok;Eun, Young;Yu, Mi;Kim, Jung Yeon;Lee, Hyun Hee;Min, Ja Kyung;Song, Jung Mi
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.1
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    • pp.10-25
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    • 2020
  • Purpose: The purpose of this study was to update the previously developed nursing practice guideline for enteral nutrition (EN). Methods: The guideline update was done in 22 steps using standardized methodology for nursing practice guidelines. Results: The updated EN guideline consisted of 16 domains and 228 recommendations. The domains and number of recommendations in each domain were for IDSA (Infectious Diseases Society of America): 8 on general instruction, 9 on general instruction for special nutrition, 9 on general instruction for EN, 3 on assessment of EN, 10 on access to EN, 18 on EN device insertion, 16 on selection and preparation of nutritional supplements, 46 on administration and stopping EN, 22 on maintenance and management of EN, 9 on monitoring EN, 16 on prevention and management of complications of EN, 18 on medication administration, 20 on EN in various situations, 20 on prevention of errors, 1 on nursing education, and 3 on nursing documentation. For the levels of evidence, there were 9.7% for level I, 13.1% for level II, 62.5% for level III and 1.1% for GRADE (Grading of Recommendations Assessment, Development and Evaluation): 3.3% for low, 0.8% for moderate, 9.3% for very low. A total of 133 recommendations were newly developed and 10 previous recommendations were modified. Conclusion: This updated EN nursing practice guideline can be used to enhance evidence-based practice in fundamentals of nursing practice and it should be disseminated to nurses nationwide in order to improve the efficiency of EN practice.

Development of Korean Patient Classification System for Neonatal Care Nurses (한국형 신생아중환자간호 분류도구 개발)

  • Yu, Mi;Kim, Dong Yeon;Yoo, Cheong Suk
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.2
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    • pp.205-216
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    • 2016
  • Purpose: This study was performed to develop a valid and reliable Korean Patient Classification System for Neonatal care nurses (KPCSN). Methods: The study was conducted in tertiary and general hospitals with 1~2 grade according to nursing fee differentiation policy for NICU (neonatal intensive care unit) nurse staffing. The reliability was evaluated for the classification of 218 patients by 10 nurse managers and 56 staff nurses working in NICUs from 10 hospitals. To verify construct validity, 208 patients were classified and compared for the type of stay, gestational age, birth weight, and current body weight. Nursing time was measured by nurses, nurse managers, and nurse aids. For the calculation of conversion index (total nursing time divided by the KPCSN score), 426 patients were classified using the KPCSN. Data were collected from September 5 to October 28, 2015, and analyzed using t-test, ANOVA, intraclass correlation coefficient, and non-hierarchial cluster analysis. Results: The final KPCSN consisted of 11 nursing categories, 71 nursing activities and 111 criteria. The reliability of the KPCSN was r=.83 (p<.001). The construct validity was established. The KPCSN score was classified into four groups; group $1:{\leq}57points$, group 2: 58~80 points, group 3: 81~108 points, and group $4:{\geq}109points$ in the KPSCN score. The conversion index was calculated as 7.45 minutes/classification score. Conclusion: The KPCSN can be utilized to measure specific and complex nursing demands for infants receiving care in the NICUs.

The Effects of Reeducation on Core Basic Nursing skills on Nursing Students' Competence, Confidence and Anxiety (핵심기본간호술 재교육이 간호대학생의 간호수행능력과 수행자신감 및 불안에 미치는 효과)

  • Yoon, Eun-Joo;Park, Young-Mi
    • Journal of Convergence for Information Technology
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    • v.7 no.5
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    • pp.39-45
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    • 2017
  • This study examined the effects of reeducation of core basic nursing skills on competence, confidence and anxiety in nursing students. We collected the data from 176 2nd grade nursing students. Reeducation of core basic nursing skills was conducted from December 20th to 23rd, 2016. Data were analyzed by SPSS 21.0 program. As the result of reeducation, significant improvement was found in competence(t=-11.57, p<.001), confidence(t=-10.21, p<.001) and considerable decrease was recognized in anxiety(t=-4.76, p<.001). In conclusion, reeducation of core basic nursing skills can help students to improve their overall competence and confidence, and also to reduce their anxieties as they start their first clinical practice. Therefore we suggest that more systematic and continual reeducation of core basic nursing skills should be applied to each grade of nursing students who are facing their clinical practice in hospital

Impact of Increased Supply of Newly Licensed Nurses on Hospital Nurse Staffing and Policy Implications (신규면허간호사 공급량 증가가 의료기관 간호사 확보수준에 미친 영향과 정책적 함의)

  • Kim, Yunmi;You, Sunju;Kim, Jinhyun
    • Journal of Korean Academy of Nursing
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    • v.47 no.6
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    • pp.828-841
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    • 2017
  • Purpose: This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. Methods: Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression. Results: An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870). Conclusion: To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future.

Stress, Anxiety and Fatigue of Nursing Students in Clinical Practice (일 간호학생의 임상실습 스트레스, 불안 및 피로조사)

  • Kim, Chang-Sook;Kim, Ran;Kim, Young-Jae;Park, Myung-Hee;Park, In-Soon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.11 no.2
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    • pp.151-160
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    • 2005
  • Purpose: The purpose of this study was to identify the levels of stress, anxiety and fatigue of nursing students in clinical practice, and the relationship among these variables. Method: Data was collected by structured questionnaires from 223 nursing students who have practiced at the hospital in Gwangju. Data was analyzed by using descriptive statistics, ANOVA, t-test and Pearson's correlation coefficient. Result: The mean score for stress was 3.87. The mean score for anxiety was 44.88. The mean score for fatigue was 30.79. There was a significant difference of stress according to student grade, practice unit, practice time, satisfaction of clinical practice. There was a significant difference of anxiety according to religion, health status, satisfaction of clinical practice, satisfaction on nursing. There was a significant difference of fatigue according to religion, health status, practice time, satisfaction of clinical practice, selective motivation on nursing, satisfaction on nursing. Conclusion: This study revealed that there was a significant correlation among stress, anxiety and fatigue of nursing students in clinical practice.

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Relationship between Positive Affectivity, Self-Leadership, and Satisfaction of Clinical Practice among Nursing Students (간호 대학생의 긍정적 정서, 셀프리더십 및 임상실습 만족도간의 관계)

  • Lee, Soon Neum;Kim, Jung A
    • The Journal of Korean Academic Society of Nursing Education
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    • v.22 no.2
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    • pp.125-136
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    • 2016
  • Purpose: This study aimed to identify the relationship between positive affectivity, self-leadership, and satisfaction of clinical practice among nursing students. Methods: This study was a descriptive correlational study. A total of 205 participants were obtained by convenience sampling from third- and fourth-year nursing students in three nursing schools. The data were collected by using a self-reporting questionnaire. Collected data were analyzed with SPSS Win 18.0. Results: Mean scores were 3.40 (5-point scale) for positive affectivity, 3.68 (5-point scale) for self-leadership, and 3.30 (5-point scale) for satisfaction of nursing clinical practice. There was a significant positive correlation of nursing students among positive affectivity (r=.43, p<.001), self-leadership (r=.41, p<.001), and satisfaction of clinical practice. The predictors were levels of satisfaction about nursing major, grade, positive affectivity, and rehearsal, which accounted for 34% of the variance in satisfaction with clinical practice nursing students. Conclusion: It is necessary to enhance the levels of satisfaction about nursing major, the level of positive affectivity, and self-leadership in nursing students. The results of this study delineate the need for the development and application of diverse educational programs that can increase positive affectivity and self-leadership for clinical practice.

Effect of palliative care practical training on nursing students' attitudes toward death, end-of-life care nursing attitude, and spiritual nursing competency (말기 환자간호 실습교육이 간호대학생의 죽음에 대한 태도, 임종간호 태도, 영적간호역량에 미치는 효과)

  • Kim, Kyung Ah
    • Journal of Home Health Care Nursing
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    • v.30 no.3
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    • pp.276-286
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    • 2023
  • Purpose: This study aimed to assess the effect of palliative care practical training for nursing students. Methods: This quasi-experimental study included 38 third-grade nursing students form one university. Practical training, develooed by experts, was provided for 2 weeks (90 h) in a palliative care hospital. Participants received education on palliative care but no clinical practical experience. Collected data were analyzed using independent t-test, χ2 test and paired t-test using the WIN SPSS 23.0 program. Results: Students showed significant pretest-posttest differences in attitude toward death (t=-2.43, p=.021), end-of-life nursing attitude (t=3.90, p=<.001) and spiritual nursing competency (t=3.82, p=.001). Conclusion: The study results revealed that palliative care practical training was an effective learning method to improve nursing attitude, toward death, end-of-life nursing attitude and spiritual nursing competency. Further studied are needed to assess the effects of various education programs of palliative care.

Study on Cancer Patients Who Visited an Emergency Department with the Side Effects of Chemotherapy (응급실 내원 암환자의 항암화학요법 부작용에 대한 후향적 조사연구)

  • Lim, Soo Jung;Yi, Myungsun
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.1
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    • pp.75-89
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    • 2014
  • Purpose: This study was done to identify conditions of cancer patients who visited an emergency department (ED) with the side effects of chemotherapy. Methods: Data were collected retrospectively from medical records of 294 cancer patients who visited a tertiary hospital in 2009 for treatment of side effects of chemotherapy. Records were reviewed for characteristics of participants and side effects of chemotherapy. Data were analyzed using SPSS software. Results: ED Triage grade 3 was 81.6%. The hospitalization ratio was 72.8%, and 6.5% died during the admission. Most frequent side effects were thrombocytopenia (80.6%), anemia (74.5%), pain (52.0%), neutropenia (50.7%), and leucopenia (46.3%). The hospitalization group showed more severe leucopenia than the discharge group (p=.020). Patients in the group who died had higher scores for dyspnea compared to patients discharged or hospitalized (p<.05). Conclusion: Results of the study suggest that there is a special need to develop a system to manage side effects of chemotherapy. Also it is necessary to provide appropriate care and treatment with prompt initial evaluation when cancer patients with side effects of chemotherapy present in the ED. More effective educational discharge programs should also be developed to help these patients cope with various side effects of chemotherapy.

Relations between Satisfaction in Major, Career Decision-making Self-efficacy and Career Identity of Nursing Students (간호대학생의 전공만족도, 진로결정 자기효능감과 진로정체감 관계)

  • Jung, Jeom Suk;Jeong, Mi Jo;Yoo, Il Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.20 no.1
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    • pp.27-36
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    • 2014
  • Purpose: The purpose of this study was to investigate the relation between satisfaction in major, career decision-making self-efficacy and career identity of nursing students. Methods: Data were collected from 543 students by means of self reported questionnaires about satisfaction in major, career decision-making self-efficacy and career identity from November 26 to 30, 2012. Results: The average score of satisfaction in major, career decision-making self-efficacy and career identity of nursing students was 3.56 on a 5 point-scale, 3.28 on a 5 point-scale, and 2.65 on a 4 point-scale respectively. There were significant correlation between satisfaction in major, career decision-making self-efficacy and career identity of nursing students. Career identity could be explained 26.2% by satisfaction in major, career decision-making self-efficacy, admission motivation, and school grade. Conclusion: Career identity was correlated with satisfaction in major and career decision-making self-efficacy in nursing students. Therefore, it is necessary to develop an effective intervention program to improve nursing students's satisfaction in major, career decision-making self-efficacy and career identity.