Purpose: Korean health insurance extended application of the Diagnosis Related Groups (DRG) payment system to tertiary and general hospitals from July, 2013. This study was done to develop a DRG fee adjustment mechanism applied to levels of nurse staffing to assure quality nursing service. Methods: Nurse stafffing grades among hospitals in Korea were analyzed. Differences and ratio of inpatient costs by nurse staffing grades in DRG fees and differences of DRG fee between tertiary and general hospitals were compared. Results: In 2013, nurse staffing grades in tertiary and general hospitals had improved, but other hospital nurse staffing grades remained at the 2001 level. Gaps of inpatient costs between first and seventh nurse staffing grades were over 10% in 4 out of 7 DRG diagnosis; However differences of DRG fee between tertiary and general hospitals were only 4.51% and 4.72% respectively. A DRG fee adjustment mechanism was developed that included nurse staffing grades and hospitalization days as factors of the formula. Conclusion: Current DRG fees motivate hospitals to decrease nurse staffing grades because cost reduction is bigger than compensation. This DRG fee adjustment mechanism reflects nurse staffing supply to motivate hospitals to hire more nurses as a reasonable compensation system.
The purpose of this study was to investigate the image of nurse perceived by students of elementary. middle and high schools in Taegu. Korea. Also the details for establishing the image were analyzed. The subjects of this study were 1.119 students from elementary. middle and high schools in Taegu. Data were collected from July 1. to July 16. 1998 and analyzed with Frequency. X 2-test. t-test. ANOVA. and Stepwise Multiple Regression in SPSS 7.5. The results of this study were as follows; (1) There was a significant difference in the nurse's image among the three groups(F= 168.42. p= .000). and the elementary students had the most positive image among the groups. (2) There was a significant difference in the nurse's image between male andfemale students. and the male students had more positive image(t=3.20. p = .001) than female students. (3) The experiences of hospitalization. books. and mass media affected on establishing the image of nurse, and experienced students had more positive image than those who was not. (4) 22.3% of the nurse's image was explained by the educational years. (5) The students who could distinguish between nurses and nurse aids, who had a nurse in their family, and who had experiences of nurse by TV had more positive image than those who had not. The students who had experiences of family member's hospitalization had more negative image than those who had not.
Purpose: This study aimed to explore the discourses and the patterns of problem solving behaviors among the nurse managers. The focus of the study was the difficult situations in caring with patients and their families. Methods: Field study was performed at a for-profit hospital from March, 2004 to March, 2007. The participants of the study were 5 head nurses and 2 nurses in charge. The data were collected with iterative interviews and participant-observations. For the analysis of the data, taxonomy and critical discourse analyzing were applied. Results: The nurse mangers who showed wholistic patterns of behavior took the role of a broker among the client system, professional nursing system, medical system, and other allied health system. The nurse managers whose approach was profession-centered took the role of protector of nursing system. The nurse manager who practiced nurse-oriented pattern of behavior tried not to have harm against other members of health system. The experiences of nurse managers were effected from the discourses of patriarchal and market mechanism. Conclusion: The situation that provoke conflict between clients and nurses become more common with the changes to the health care system and to society. Nurse managers take the role of these conflict problems. The successful solving of conflict in a nursing care setting promotes the quality of care and satisfaction of clients. Programs for enhancing nurse's problem solving competency should anchored be in their practices.
Purpose: The purpose of this study was to analyze the trends of research on Community Nurse Practitioners in Korea in order to suggest future directions for research on Community Nurse Practitioners. Method: A total of 109 studies published from 1980 to 2006 were analyzed according to the year of publication, research design, journal type, subject type, and major study concepts. Results: 1) The number of studies related to Community Nurse Practitioners increased by 28.4% from 1985 to 1989, and also by 28.4% from 2000 to 2004. 2) The most frequently used research design in the studies was a descriptive study design (90.8%). 3) There were 43 master's theses on Community Nurse Practitioners, and 16 studies in the Journal of Korean Community Nursing. 4) The most frequent participants were Community Nurse Practitioners (68.9%). 5) The most frequent major study concept was job analysis of Community Nurse Practitioner programs (27.5%). Conclusion: It is suggested that there should be more studies on Community Nurse Practitioner programs in the future and, particularly, experimental studies to exam the effects of interventions on health promotion by Community Nurse Practitioners are considered necessary.
Purpose: The aim of this study is to review the nurse demand forecasting methods in empirical studies published during 1991~2014 and suggest ideas to improve the validity in nurse demand forecasting. Methods: Previous studies on nurse demand forecasting methodology were categorized into four groups: time series analysis, top-down approach of workforce requirement, bottom-up approach of workforce requirement, and labor market analysis. Major methodological properties of each group were summarized and compared. Results: Time series analysis and top-down approach were the most frequently used forecasting methodologies. Conclusion: To improve decision-making in nursing workforce planning, stakeholders should consider a variety of demand forecasting methods and appraise the validity of forecasting nurse demand.
Background: Adolescent mothers may find the transition to motherhood to be Aim: The aim of this study was to investigate the viewpoints of nurse managers and directors of nursing services in community hospitals regarding the essential competencies of head nurses. Methods: A qualitative descriptive design was used to investigate the perspective of nurse managers and directors of nursing services about essential competencies of nurse managers in community hospitals. A total of ten participants (four directors of nursing services and six nurse managers) were interviewed. Findings: Nurse managers and directors of nursing services identified leadership, management, communication, professional ethics, and policy and healthcare environment as the essential competencies for their positions in community hospitals. Conclusions: These findings can be used by executives of community hospitals and nursing institutes to plan for competency development for nurse managers. They should be included in nursing administration programs.
The purpose of this study is to provide the necessary data for the effective performance of school nurse's work by comparing with the recognition and expectation on school nurse's work by the students and their teachers in school settings. The sample of this study was consisted of the 441 students and 535 teachers in Suwon. The data were collected by means of a structured questionnaire from 24th, Sept, to 29th, Sept. 1990. The collected data were analyzed utilizing SAS/PC program for percentage, frequency, mean, standard deviation and chisquare test. The major findings of this study were as follows: 1. The result of analysis in recognition on school nurse's work. There is no statistically significant difference 'depending on teachers' school level, sex, age and career with school nurse(P>0.05). The students show significant difference on their school level and sex(P>0.05). Also, in the areas of school nurse's work, school clinic management has the highest recognition and school environment management has the lowest recognition. 2. The result of analysis in expectation on school nurse's work. There is statistically significant difference depending on teachers' and students' school level: the order of expectation is elementary, middle, and high school(P<0.05). In the result of comparison with students' and teachers' expectation in the same school level, there is significant difference only in elementary school(P<0.05). However, there is no statistically significant difference depending on teachers' sex, age, career with school nurse and students' sex(P>0.05). Also, in the areas of school nurse's work, school clinic management has the highest expectation and school environment management has the lowest expectation. Synthesizing the result of the study, we can have the conclusion like following. First, students' recognition on school nurse's work is lower than teachers' because most of school nurse's work is performed through their homeroom teachers or other teachers. That can be the limitation for students to recognize school nurse's work. So, there must be a chance of regular meeting between school nurse and students to perform school nurse's work effectively. For this. we must change our educational system and make school nurse charge regular lesson. Second, in each area of school nurse's work, both students' and teachers' recognition and expectation about the area of school environment management has much lower score than the other areas. This indirectly shows the school nurse don't do the work of the area actively. So, school nurses must make an effort to do the work of the area actively. And we must enforce the education of this area in education for new school nurses or re-education for school nurses.
Journal of Korean Academy of Nursing Administration
The health care environment becomes more competitive every day. It has fallen to nurse managers - from vice presidents of patient care to nurse managers and their assistants - to recruit and develop a workforce that successfully meets the needs of both patients and the organization. This means employees who demonstrate advanced critical thinking skills, creative problem solving, and sound decision making skills combined with clinical skills and patient advocacy. The environment which nurse managers create and the way they relate to their workforce, are pivotal to organizational viability. Especially leadership of first -line nurse managers contributes to the success of their organizations. First-line nurse managers are deserved to be one of the most administrative supervisors through the middle stratum in a hospital organization as being a manager in the field service if assessed from the overall aspects of hospital, as being an interim managers in the nursing department as well as being a supreme supervisor in a unit in terms of an organizational structure in the hospital. Similarly, as a compete leader, the first-line nurse managers have not only a professional which is qualified to perform a role of appropriate coordination with medical staff and key personnel but also hold an important key position a being responsible for performing his or her given role. The first-line nurse manager is expected to manage human and fiscal resources in ways not required before. While an identified need for well-prepared first-line nurse manager continues to plague the profession, first-line nurse managers often have difficulty providing the leadership required. The need leadership training to function effectively in their positions. But we hardly find a useful leadership training program for first-line nurse managers, therefore the purpose of this study was to developed the leadership training program for them. The steps of leadership program development were below: 1st step, 2 studies were done before develop a leadership program. One was done to ask to first-line nurse managers what they want to learn through leadership training, the other one was to ask the staff nurses what their opinions are for their first-line nurse managers leadership. 2nd step was searching other leadership programs contents. The results of this study were below: The total amount of hours is 24. Leadership training program contents are : Future of nursing profession (210min), understanding basic factor's of leadership and leadership theories(310 min), self understanding as first- line nurse managers(320 min), basic principle and practice of interpersonal relationship(210 min), assertiveness training, conflict management (180min), and group study(210min). This is challenging time to be a leader, especially in nursing. As nurse managers look toward the new millennium, it seems as through the same struggles are ahead that are behind. So nurse managers need to embrace change with a positive attitude. They need to demonstrate risk taking and support it in their staffs. All these things are possible that after they participate the leadership training program.
Park, Suin;Park, Sohee;Lee, Young Joo;Park, Choon-Seon;Jung, Young-Chul;Kim, Sunah
Journal of Korean Academy of Nursing
Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.
The Journal of the Convergence on Culture Technology
The purpose of this study is to analyze the difference between female nurse and male nurse in female nurse by applying the phenomenological method of Colaizzi which is one of the qualitative research methodology and to analyze the difference between female nurse and male nurse. What is the difference between a male nurse and a female nurse perceived by a female nurse? This study investigated the differences between female nurses and male nurses with research problems. The participants in this study were 13 female nurses who agreed to participate in the study after explaining and understanding the purpose of the study. The recruitment of the subjects was applied by the snowball method. As a result of this study, five categories were found. The categories were different in clinical tasks, the burden of family economic life, differences in interpersonal relationships, differences in nursing organization, and differences in unknown areas. The results of this study can be used as teaching materials and research data to expand the understanding of difference between male nurse and female nurse.
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