• 대한간호학회지
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• 제43권1호
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• pp.39-49
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• 2013

Purpose: To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing. Methods: Secondary data were obtained from Statistics Korea, Education Statistics, and Health Insurance Review & Assessment Service and Patient Survey. Intensity of monopsony in the nurse labor market was measured by Herfindahl Hirshman Index (HHI). Hospital nurse staffing level was divided into high and low. While controlling for confounding factors such as inpatient days and severity mix of patients, effects of characteristics of nurse labor markets on nurse staffing levels were examined using multi-level logistic regressions. Results: For characteristics of nurse labor markets, metropolitan areas had high intensity of monopsony, while the capital area had competitive labor market and the unemployed nurse rate was higher than other areas. Among hospital characteristics, bed occupancy rate was significantly associated with nurse staffing levels. Among characteristics of nurse labor markets, the effect of HHI was indeterminable. Conclusion: The Korean nurse labor market has different structure between the capital and other metropolitan areas. But the effect of the structure of nurse labor market on nurse staffing levels is indeterminable. Characteristics such as occupancy rate and number of beds are significantly associated with nurse staffing levels. Further study in support of the effect of nurse labor market is needed.

• 간호행정학회지
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• 제21권2호
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• pp.174-183
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• 2015

Purpose: This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs). Methods: Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients. Results: Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level. Conclusion: In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.

• 대한간호학회지
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• 제44권1호
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• pp.21-30
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• 2014

Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

• 간호행정학회지
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• 제14권4호
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• pp.413-420
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• 2008

Purpose: To examine the relationship between nurse staffing level and nurse perception of nursing performance. Method: The subjects of this study were 724 nurses from 70 medical or surgical wards in 23 hospitals from February to March 2006. A self-reporting questionnaire, which was developed by the researcher through a preceding study, was used. In data analysis, SAS program was utilized for descriptive statistics, t-test, ANOVA, and Tukey test. Results: The mean score of the nursing performance was 53.3. The mean of bed-to nurse ratio was 3.39:1. The study revealed a negative correlation between bed-to nurse ratio and the nurses' perception of nursing performance. There was a significant relationship between above 3.5:1 and below 2.5:1(F=4.59, p=0.010). Conclusion: We found that the higher the nurse staffing, the better the nursing performance. It is recommended that future research measures nurses' performance and nursing organizational performance using objective measurement tools including clinical indicators.

• 간호행정학회지
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• 제17권3호
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• pp.327-335
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• 2011

Purpose: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. Methods: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. Conclusion: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients.

• 한국문헌정보학회지
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• 제51권4호
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• pp.183-201
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• 2017

현행 공공도서관 사서 배치기준에 대해 공공도서관 현장의 실정과 그간의 광범위한 사회발전을 제대로 반영하지 못하고 있다는 비판이 있다. 이에 본 연구에서는 먼저 (1) 현행 법정 공공도서관 사서배치기준 대비 사서배치 현황을 국가도서관통계를 토대로 분석했고, (2) 현행법상 사서배치기준의 핵심 요소들의 도출 근거를 국내외 관련 문헌을 검토하면서 그 타당성을 분석하였으며, (3) 공공도서관 인력배치 현황데이터를 토대로 주요 배치기준별로 사서충원율을 산출하는 시뮬레이션 분석을 수행하여 그 결과를 비교분석하였다. 분석 결과, 2016년말 현재 전국 989개 공립 공공도서관의 1관당 평균 사서수는 4.3명이며, 법정 충원율은 18.2%에 불과했다. 법정 최소 기본 배치인력 3명에 미달하는 도서관이 40%를 넘었다. 연면적과 장서수로 사서수를 산출하는 현행 법적 기준은 봉사구간에 제시된 최소 연면적을 초과할 경우 과도한 수의 필요인력을 산출하여 고질적인 법적 기준 미달의 원인이 되고 있었다. 현행 법적 기준을 국제도서관연맹(IFLA) 및 한국도서관협회의 권장기준과 비교한 결과, 가장 낮은 사서충원율을 기록했다. 향후 사서배치기준은 필요이상의 복잡한 배치기준 대신, 해외에서 보편적으로 사용하는 봉사대상인구로 개정하고, 기본 인력 3인을 배치한 후, 증원기준으로 개별 도서관과 지자체의 상황을 반영해 2-3단계의 서비스 목표 수준별로 등급화하여 사서수를 배치하는 방안을 제안하였다.

• 성인간호학회지
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• 제28권3호
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• pp.256-265
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• 2016

Purpose: This study examined differences in nursing care activity, work performance outcomes, and job satisfaction associated with upgrading nurse staffing of a nurse-to-patients ratio. Methods: Descriptive design was used in this study. In total, 148 medical and surgical nurses were recruited from one university hospital. Three instruments were used for data collection: Scale of Nursing Care Activity, Nurses' Work Performance Outcome Measurement Scale and Nurses' Job Satisfaction Scale. Data were analyzed by using descriptive statistics, t-test, ANOVA, and paired t-test. Results: There were significant differences in nursing care activity (t=-5.06, p<.001), in work performance outcomes (t=-5.46, p<.001) and in job satisfaction (t=4.61, p<.001) when the grading for the nursing staff was changed from three to two indicating increasing number of nurses. Conclusion: The findings from this study showed that there were more nursing care activities, better work performance outcomes, and higher job satisfaction when numbers of nurses were increased. The changes in the scale to evaluate nursing staff influence nursing activities, work performance and job satisfaction.

• 간호행정학회지
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• 제9권4호
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• pp.559-569
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• 2003

Purpose: The purpose was to investigate nurse staffing levels and patient outcomes(nosocomial infection, patient fall, pressure ulcer). Method: The subjects of this study were 305 nurses from 20 general hospitals who worked at 39 medical and surgical wards. Self-reporting questionnaire which was developed by the writer through preceding study was used. In data analysis, SPSS WIN 10.0. program was utilized for descriptive statistics, ANOVA. Result: The mean of patient-to-nurse ration was 5.2:1. 65% among 20 hospitals was over 300 beds, 90 was located in urban area and 55 was private hospitals. Patient-to-nurse ration of hospitals in under 300 beds or rural area or private ownership was lower than hospitals in 300 beds or urban area or public ownership. 89.9 among 39 wards was medical or surgical wards. The mean of length of stay, 8-14 days got a majority and showed higher patient-to-nurse ration. Of the general characteristics, rural was significantly hight to patient fall(F=3.205, p<.05), medical unit was significantly high to patient fall, pressure ulcer(patient fall: F=8.890, p<.001, pressure ulcer: F=3.399, p<.05) and over 15 days was significantly higher than under 14 days of the mean of length of stay. And there was significant relationship between over 6.0:1 and over 4.0:1 to less than 5.0:1(F=4.817,p<.01). Conclusion: This study has shown a relationship between patient-to-nurse ration and patient fall using not objective research tool but self-reporting questionnaire. Therefore further research is needed to study using objective research tool. Based on this study, the effect of nurse staffing levels on patient outcome also has to be studied.

• 중환자간호학회지
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• 제10권1호
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• pp.1-12
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• 2017

Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.

• 응용통계연구
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• 제31권1호
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• pp.109-122
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• 2018

임계값을 기준으로 그 보다 작은 값은 로그정규분포(lognormal distribution; LN)를, 큰 값은 일반화파레토분포(generalized Pareto distribution; GPD)를 따르는 합성 분포를 LN-GPD 합성분포라 한다. Scollnik (2007)은 LN-GPD 합성분포가 로그정규분포와 GPD를 합성 시킴으로써 자료의 손실 없이 꼬리가 두꺼운 분포에서 좋은 적합력을 가진다고 밝혔다. 본 논문에서는 시간에 따라 변하는 LN-GPD 평균모형을 다루었으며 방법론으로는 국소 다항최대우도법을 기반으로 추정하는 방법에 대해서 연구하였다. 시간에 따라 변하는 분포를 추정함으로써 자료에 대한 훨씬 자세한 이해가 가능하며 이는 곧 상담원 배치나 자원배분과 같은 운영관리에 큰 도움을 줄 수 있다. 본 연구는 GPD 분포만을 고려한 Beirlant와 Goegebeur (2004)를 확장하여 절삭한 로그정규분포를 추가하여 자료의 손실 없이 자료의 특징을 살펴볼 수 있다는데도 의의가 있다. 모의실험을 통해 제안한 방법론의 적절함을 살펴 보았고 실증 자료 분석으로 이스라엘 은행의 콜센터 서비스 시간에 대해 분석하여 상담원 배치와 관련된 흥미로운 결과를 찾을 수 있었다.