• 한국산학기술학회논문지
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• 제18권8호
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• pp.162-170
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• 2017

본 연구는 중소병원 간호인력 현황과 관련 정책을 분석하고 인력 확보에 영향을 주는 요인을 파악하여 중소병원 간호인력 확보를 위한 정책을 입안하고 결정하는 데에 근거를 제시하고자 실시되었다. 보건복지부와 건강보험심사평가원 등에서 제시한 통계자료를 2차 분석한 후 그 결과를 다양한 내 외적 보건의료환경에 대한 이해를 기반으로 조명하였다. 연구결과 우리나라의 활동 간호사 수는 면허간호사 수의 50% 미만으로 그 수는 해마다 감소하고 있었으며, 이는 간호대학 정원증가의 비용 대비 성과의 효율성을 재고할 필요가 있음을 의미한다. 또한 간호관리료 차등제 실시로 인해 신규간호사는 물론 간호사 인력부족이 심각한 중소병원의 경력간호사들이 상급종합병원으로 이동하게 되는 결과를 야기하였으며, 결국 중소병원 간호인력 부족 현상을 더욱 악화시키는 원인이 되었다. 따라서 입원환자 간호관리료 차등제가 중소병원 간호인력 확보 정책으로 실효성이 있는지에 대한 재검토가 필요하며, 면허간호사에 대한 추적 관리 시스템을 통해 간호인력 수급의 불균형을 해소할 수 있어야 한다.

• 간호행정학회지
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• 제19권5호
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• pp.565-577
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• 2013

Purpose: This study was done to propose an improvement in the Nursing Fee Differentiation Policy to alleviate polarization of nursing staffing level among hospitals and to rectify the confusion of legally mandated standards between the Korean Medical Law and National Health Insurance Act. Methods: The policy regulation was reconstructed related to nurse staffing standards and nurse-to-patients ratios. Data on nurse staffing grades were obtained from database of the Health Insurance Review & Assessment Service (HIRA) for the third quarter of 2010 for 44 tertiary hospitals, 274 general hospitals, and 1,262 hospitals. A break-even analysis was used to estimate financial burden of the revised policy improvement proposal. An industrial engineering method was used to calculate Nurse-to-Patients ratios per shift. Results: Twelve tertiary hospitals were downgraded. 74 general hospitals and 102 hospitals were upgraded after application of the regulation. Finances for total hospitalization expenditures changed from -3.55% to +3.14%. Conclusion: The results indicate that the proposed policy would decrease polarization between tertiary hospitals and small hospitals, and would not put a major strain on the finances of the Korean National Health Insurance. Therefore, it is suggested that government stake-holders and many interest groups consider this policy proposal and build a consensus.

• 대한의용생체공학회:의공학회지
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• 제37권2호
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• pp.75-83
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• 2016

Nursing staffing is of major interest in hospital management, however, no practical method has been developed. The present study proposed a mathematical model based on the patient classification system for nursing staffing optimization. A few characteristic parameters possibly determined experimentally and/or empirically were introduced followed by systematic calculation of the required number of nurses. An essential concept of the model is the unit work load defined as the amount of nursing work performed on single patient per unit time, where the work load is defined as the number of nursing staffs multiplied by the working hours. The unit work load was considered to vary with the patient classification level as well as the working time during a day, both of which were represented by corresponding parameter values. The number of patients for each class and the number of working hours were multiplied to the unit work load, and added up to obtain the total required work load. As the next step, the averaged number of hours that a nurse could provide per day was formulated considering the degree of nursing practice experience into 3 levels. Finally, the appropriate number of nursing staffs was calculated as the total work load divided by the average working hours per nurse. The present technique has a great advantage that the number of nursing staffs to fulfill the required work load is systematically calculated once the characteristic parameters are appropriately determined, leading to instant and fast evaluation. A practical PC program was also developed to apply the present model to nursing practice.

• 보건의료산업학회지
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• 제11권4호
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• pp.239-250
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• 2017

Objectives : The purpose of this study was to analyze the types of hospitals participating and the factors influencing comprehensive nursing service. Methods : Data were gathered from 231 hospitals offering the comprehensive nursing service in 2016. Collected data were analyzed using the multinomial logistic regression with the SPSS 24 version program. Results : First, factors influencing the types participating comprehensive nursing services were identified as hospital type, number of beds, medical doctor and, nurses per bed. Second, if all tertiary hospitals, general hospitals and hospitals participated in the service, approximately 122,022 ~ 166,274 nurses would be needed for the service. Conclusions : Hospitals providing the comprehensive nursing service will be expanded gradually. As such, thoughtful policy considerations are required to successfully establish services, such as improvement in hospitals, required nurse staffing level and demand and supply of nurses. Therefore, it is necessary to control the participation ratio of hospitals in consideration of the various circumstances.

• 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.

• 임상간호연구
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• 제17권2호
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• pp.138-149
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• 2011

Purpose: The objective of this research was to explore levels of patient safety and safe nursing activities depending on the level of nurse staffing, in order to provide effective management of nurse personnel. Methods: The research was conducted with 455 nurses from eight hospitals in B city. Data were collected according to the level of nurse personnel from second (nurse vs. patient ratio of 2.0-2.5) to fifth (ratio of 3.5-4.0) rank. The survey tools were, 'Questionnaire on Patient Safety, a Hospital Survey on Patient Safety Culture developed by AHRQ (2007), and 'Questionnaire on Patient Safety Nursing Act, in which the questions were selected from nursing-related items (Medication 6 & Safety Nursing Assurance Act 4) in the Safety Evaluation developed by Evaluation Institute of Medical Institution. Data were analyzed with SPSS PC 12.0 program using descriptive statistics, $x^2$ test, ANCOVA and $Scheff{\grave{e}}$. Results: The nurses' overall cognition level on patient safety and safe nursing activities showed that nurses who are in the second and third rank had higher scores than those in lower ranks. Conclusion: The results of this study indicate that hospitals need a higher ratio level for nurse personnel in order to assure patient safety and safe nursing activities.

• 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.

• 기본간호학회지
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• 제1권2호
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• pp.193-205
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• 1994

The Study was carried out for the purpose of investigating the degree of perception in nursing activities. The data of this study were collected by self-reported questionnaire composed of 5 point rating scale measure the ideal level and the performance level of nurses activity. For the analysis of the data, percentage, MANOVA and ANOVA were 231 nurses in 3 general hospitals in Taegu. Data was administrated from October 4 through 14, 1994. The results were as follow : 1. The average mean score for the ideal level was 4.19 with a maximum possible score 5points. The highest mean score was Infection Controll and the lowest mean score was nutrition The average mean score for the performance level was 3.75, the highest mean score was fluid and electrolyte, the lowest mean score was nutrition. In the desirable nursing pergormance, Education was found the highest response above charge nurse, Medication was found the highest response above General nurse, environment was found the highest response above aide. 2. In the analysis of the relationship between the ideal level and th performance level, significant defference was found in age, position, career, marital status, occupation satisfaction, Nursing unit, parent. 3. In the analysis of the relationship between the ideal level and the performance level and the general characteristics, significant difference was found in marital status in the ideal level of direct nursing care, significant difference was found in age, position, marital status, nursing unit in the ideal level of indirect nursing care, significant difference was found in age, position, career, marital status, occupation satisfaction, nursing unit in the performance level of direct nursing care. significant difference was found in age (25-29) and above 30 career(4-7 and 7), occupation satisfaction(good and moderate, good and poor) in scheffe test of the performance level of direct nursing care.

• 간호행정학회지
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• 제17권1호
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• pp.115-126
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• 2011

Purpose: This study was done to identify differences in work environment, work stress, turnover intention and burnout and investigate the relationship among these variables in nurses in Korean Neonatal Intensive Care Units. Method: Participants were 242 nurses working in 13 general hospitals. Burnout was measured by the Maslach Burnout Inventory (MBI), work stress with the instrument by Gu & Kim (1994), and turnover intention with the scale by Kim & Lee (2001). Size of the NICU, nurse to patient ratio, and communication satisfaction were included in work environment. Data were analyzed using Pearson correlation coefficients and multiple regression analysis with SPSS WIN program. Results: The mean score for work stress in NICU nurses was 3.43 points, for burnout, 2.72 points, and for turnover intention, 4.64 points. Burnout and turnover intention level of participants were moderate-high. Work stress, communication dissatisfaction with physician, and clinical career accounted for 33% of variance in burnout. Significant differences were found between size of NICU and staffing related to environmental characteristics in turnover intention and burnout. Conclusions: Results indicate that effective communication with coworkers and institutional support for appropriate staffing according to number of beds will help to prevent work stress, burnout, and ultimately, nurses' resignations.

• 대한간호학회지
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• 제22권2호
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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.