• 대한간호학회지
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• 제20권1호
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• pp.16-37
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• 1990

A cost analysis for hospitalized patients was carried out based upon Patient Classification System(PCS) in order to determine an appropriate nursing fee. The data were collected from 21 nursing units of three teaching hospitals from April 1 to June 30, 1989. first, all of the 22,056 inpatients were classified into mildly ill(Class Ⅰ), moderately ill(Class Ⅱ), acutely ill(Class Ⅲ), and critically ill(Class Ⅳ) by the PCS which had been carefully developed to be suitable for the Korean nursing units. Second. PCS cost accounting was applied to the above data. The distribution of inpatients, nursing costs, and nursing productivity were as follows : 1) Patient distribution ranged from 45% to class Ⅰ, 36% to class Ⅱ, 15% to class Ⅲ, and 4% to class Ⅳ, the proportion of class Ⅳ in ‘H’ Hospital was greater than that of the other two hospitals. 2) The proportion of Class Ⅲ and Ⅳ in the medical nursing units was greater than that of surgical nursing units. 3) The number of inpatients was greatest on Tuesdays, and least on Sundays. 4) The average nursing cost per hour was W 3,164 for ‘S’ hospital, W 3,511 for ‘H’ hospital and W 4,824 for ‘K’ hospital. The average nursing cost per patient per day was W 14,126 for ‘S’ Hospital, W 15,842 for ‘H’ hospital and W 21,525 for ‘K’ hospital. 5) The average nursing cost calculated by the PCS was W 13,232 for class Ⅰ, W 18,478 for class Ⅱ, W 23,000 for class Ⅲ, and W 25,469 for class Ⅳ. 6) The average nursing cost for the medical and surgical nursing units was W 13,180 and W 13,303 respetively for class Ⅰ, W 18,248 and W 18,707 for class Ⅱ, W 22,303 and W 23,696 for class Ⅲ, and W 24,331 and W 26,606 for class Ⅳ. 7) The nursing costs were composed of 85% for wages and fringe benefits, 3% for material supplies and 12% for overhead. The proportion of wages and fringe benefits among the three Hospitals ranged from 75%, 92% and 98% for the ‘S’, ‘H’, ‘K’ hospitals respectively These findings explain why the average nursing cost of ‘K’ hospital was higher than the others. 8) According to a multi- regression analysis, wages and fringe benefits, material supplies, and overhead had an equal influence on determining the nursing cost while the nursing hours had less influence. 9) The productivity of the medical nursing units were higher than the surgical nursing units, productivity of the D(TS) - nursing units was the lowest while the K(Med) - nursing unit was the highest in 'S' hospital. In ‘H’ hospital, productivity was related to the number of inpatients rather than to the characteristics of the nursing units. The ‘K’ hospital showed the same trend as ‘S’ hospital, that the productivity of the medical nursing unit was higher than the surgical nursing unit. The productivity of ‘S’ hospital was evaluated the highest followed by ‘H’ hospital and ‘K’ hospital. Future research on nursing costs should be extended to the other special nursing areas such as pediatric and psychiatric nursing units, and to ICU or operating rooms. Further, the PCS tool should be carefully evaluated for its appropriateness to all levels of institutions(primary, secondary, tertiary). This study took account only of the quantity of nursing services when developing the PCS tool for evaluating the productivity of nursing units. Future research should also consider the quality of nursing services including the appropriateness of nursing activities.

• 중환자간호학회지
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• 제14권3호
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• pp.37-49
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• 2021

Purpose : This study aims to identify nurses' attitudes toward patients hospitalized after attempting suicide and inform directions for research and interventions to establish a therapeutic environment. Methods : For integrative review, the five stages suggested by Whittemore and Knafl were followed. Articles and theses published before February 2021 were searched using eight databases and a manual search. The search terms were suicide, self-harm, emergency department (ED), intensive care unit (ICU), nurses, and attitudes. Results : Five studies met the inclusion criteria; three of them were descriptive studies, one was a qualitative study, and one a mixed-method study. In most studies (80%), the participants were ED nurses. ED/ICU nurses showed positive or neutral attitudes toward patients. All studies suggested that suicide-related education programs are needed to increase nurses' positive attitudes such patients. Conclusion : More research is required on ICU nurses' attitudes toward patients who have attempted suicide, and efforts to identify various aspects of such attitudes are necessary. In addition, suicide education programs and support from trained psychiatric personnel should be provided to establish a therapeutic environment.

• 한국간호교육학회지
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• 제22권4호
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• pp.485-494
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• 2016

Purpose: The present research is a descriptive study aimed at understanding clinical nurses' Video display terminal (VDT) syndrome and identifying the factors that affect their VDT syndrome. Methods: Data were collected from 239 clinical nurses working in two metropolitan cities. Research tools included subject's VDT syndrome assessing musculoskeletal, ophthalmic, dermal, psychiatric, and whole body syndromes. The data were analyzed using frequency analysis, average and standard deviation, t-test, One-way ANOVA, and multiple regression analysis with the SPSS/WIN 20.0 program. Results: The subjects' VDT syndrome score was 1.34 out of 5. There were significant differences in participating subjects' VDT syndrome, hospital's size, working unit, health status, diagnosis of illness, having an Order Communication System (OCS), having an Electronic Medical Record (EMR) System, continuous VDT working for more than one hour, break time during VDT use, VDT use time, comfort of the chair, adjustability of the height of the chair, size of the VDT's desk, distance between the monitor and the user's eyes, resolution of the monitor, and frequency of eye exercise during VDT use. According to the research, influencing factors on VDT syndrome in clinical nurses included size of the VDT's desk, frequency of eye exercise during VDT use, having an EMR system, break time during VDT use, diagnosis illness, and having an OCS' system. Conclusion: The findings from this study can be used as a basis for future VDT syndrome prevention education and programs for clinical nurses.

• 한국산학기술학회논문지
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• 제16권8호
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• pp.5325-5335
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• 2015

본 연구는 임상실습 중 간호대학생이 경험하는 폭력과 폭력 경험 후 대처 행동을 파악하고자 시행된 서술적 조사연구이다. 2014년 11월 10일부터 12월 10일까지 250명의 간호대학생을 대상으로 설문지를 이용하여 자료수집 하였다. 설문지에 응답한 231명의 자료를 서술적 분석, t-test, one-way ANOVA를 이용하여 분석하였다. 연구결과, 대상자의 98.7%가 임상실습 중 폭력 경험을 했고, 폭력 발생 장소로 정신과 병동, 폭력 가해자로 환자가 가장 많았다. 폭력의 유형 중 언어폭력이 가장 많았고(97.4%), 다음으로 신체적 위협(76.2%)이었다. 폭력 경험 후 대처행동으로 '반응하지 않고 임상실습을 지속함'이 87.8%로 가장 높았고, '대처 없이 묵인하고 가해자로부터 피함'이 83.2%로 그 다음 순으로 높았다. 본 연구에서 대부분의 학생들이 임상실습 동안 폭력을 경험하였다. 이에 임상실습 중 발생할 수 있는 폭력으로부터 학생들을 보호하기 위해 교육기관과 실습기관의 대책 마련이 시급하며, 또한 폭력 예방과 대처 능력을 향상할 수 있는 다양한 프로그램이 강구되어야 한다.

• 한국간호교육학회지
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• 제6권2호
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• pp.287-302
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• 2000

The purpose of the study are to examine the perception of the importance and performance of patient education of the clinical nurse and find out the interfering factors in practicing patient education. The data were collected from convenient sample of 256 clinical nurses working in the nursing units of adult patients except the psychiatric unit, obstetric unit, dental surgical unit and intensive care unit of one University Hospital in Seoul from September 29 to October 2, 1998. Three measurement tools of self-report- questionnaires developed by researcher used. For the content validity of the questionnaires, two sessions of panel discussion and a pilot test were done and finally factor analysis was done with Varimax method. Analysis of data was done with SAS program using frequency, percentage, means, standard deviation, Pearson's Correlation Coefficients, t-test and ANOVA. The obtained results were as follows : 1. The surveyed nurses perceived the importance of patient education at higher level with mean score of 4.08 among 5 point than their perception of practice( mean score : 3.42). 2. There was positive significant correlation(r=.29, p=0.0001)between nurses' perception of the importance of patient education and it's practice 3. Among the teaching contents for patients, 'information of diagnostic procedure and operation' and 'orientation of hospitalization' were perceived most important. And 'preparation for discharge' and 'understanding of disease and health promotion' were perceived least important 4. Among the teaching contents for patients, 'orientation of hospitalization' and 'information of diagnostic procedure and operation' were perceived highly performable. And 'understanding of disease and health promotion' and 'preparation for discharge' were perceived least performable. 5. Three types of interfering factors were identified as patient-factor, situational factor, nurse-factor. The mean degree of impediment with the interfering factors was at average level(3.09 among 5). The patient and situational factors of impediments were more interfering than nurse- factor for teaching patients. 6. In older age(p<.05), married state (p<.05), higher educational status (p<.01), higher clinical experience (p<.01) and higher position(p<.01), the score of perceived importance of patients education was more high. 7. In older age(p<.01), higher clinical experience(p<.001) and surgical unit (p<.01), the score of perceived performance of patients education was more high. In conclusion, in order to activate patient education practice in the clinical setting, the continuing education for patients education should be more emphasized and the effective teaching methods and materials should be developed to help patient teaching. And an organizational support such as budgeting for patient education and reimbursement system should be administrated.

• 기본간호학회지
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• 제6권1호
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• pp.130-140
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• 1999

This study was designated to investigate communication barriers of nurses in clinical settings. This study was done in 2 phases, first content analysis on descriptions of 50 nurses in three general hospitals and 40 nursing students on communication barriers for nurses in clinical settings, and second a survey to investigate the factors related to communication barriers and the relation between the nurse's characteristics and the extent of communication barriers in clinical settings from two nurses educators, 13 nursing students who experienced clinical practice and 71 nurses in 11 general hospitals. The results are as follows : 1. Through content analysis, 11 properties of communication barriers for nurses in clinical settings were identified. These were inappropriate communication style as a nurse, lack of professionalism, in appropriate control of emotions, lack of knowledge about the clincal setting, the lack of preparation about content of communication, the problem in trust relation, differences in priorities in needs, uncontroleable situation for nurses, inappropriate nurses' perception about patients, conflict with medical team and inadequate systematic support were identified and grouped in to four categories, communicator, message, feed-back and communication context. 2. The four factors in communication barriers for nurses in the clinical setting were identified and named as ambiguity in the nurses' position, lack of confidence, difference in perspectives with patients and in-adequate nurse-patient relationship. 3. There was a significant difference(F=5.31, P=0.0022, F=3.62, P=0.0316, F=2.80, P=0.067, F=9.01, P=0.0003) among the groups according to work place in rating the extent of the communication barrier in the clinical setting and in the four factors, the nurses working in the psychiatric patient unit rated the communication barrier in the clinical setting lowest among the groups. There was a significant negative correlation between the length of the nurses's carrier and the extent of communication barrier in three factors, ambiguity in the nurses' position, lack of confidence and inadequate nurse-patient relationship.

• 대한간호학회지
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• 제23권1호
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• pp.130-141
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• 1993

This study was to find out variables influenced on the medication patterns (voluntary medication, in-voluntary medication) of antipsychotics taken by schizophrenic outpatients. Purposes of this study were to be identified that there was the significant difference between the group of voluntary medication and involuntary, and that which variables had infuence on outpsychotics medication. The sample consisted of 30 patients takeing their pills voluntary (voluntary medication group), and 15 patients involuntary(involuntary medication group) at a psychiatry hospital and a psychiatric unit of a The findings of the study are as follows : university hospital in Daegu. Data were collected from September to October, 1991 through interview using questionare about antipsychotics medication. Data were analyzed by the technique of two group discriminant function analysis using SPSS pc$^{+}$ 1) Discriminant function discriminating between voluntary medication and involuntary medication was significant at the level of 10% significance (sig.=.055, p〈.10) Hit-ratio was very high (91. 1％) 2) One of General variables, SEX, was significant of discriminating between two medication patterns at the level of 10% significance. 3) One of Family Environmental Variables, BROTH(a number of brother), were significant between two medication patterns. (p〈.10) 4) One of Therapeutic Environmental Variables, FAMHX, was significant between two medication patterns at the level of 10% significance. 5) One of Variables Related to Drug and Medication, NECESS, was significant between two medication patterns. (p〈.05) 6) Variables Related to Disease was not significant between two medication patterns.s.

• 대한간호학회지
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• 제4권2호
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• pp.1-16
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• 1974

This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

• 한국의료질향상학회지
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• 제9권2호
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.