• Journal of Home Health Care Nursing
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• v.11 no.1
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• pp.57-70
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• 2004

Purpose: This study was to develop a cost-effective and efficient curriculum for advanced practice nurse (APN) programs in home health care and hospice. Method: The process was to: (1) compare and analyze the present curriculum in home health care and hospice programs, (2) identify the needs of 7 expert nurses in home health care and hospice, and (3) develop a common curriculum structure and contents between home health care and hospice specialty courses. Result: Out of the 10 credits constituting the home health care and hospice specialty courses respectively, 6 credits were identified the common courses, Common content areas included introduction to hospice, communication skills, pain control. symptom control. teaching methods, and agency management. Conclusion: These results can be utilized in the development of APN programs for home health care and hospice in terms of qualified and cost-effective aspects of education.

• Perspectives in Nursing Science
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• v.14 no.1
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• pp.37-44
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• 2017

Purpose: This study aimed to provide information on the developmental process and current status of Advanced Practice Nurses (APN) and to suggest ways for activating APN roles in Korea. Methods: We reviewed literatures to explore domestic and international trends related to the roles, practice settings, scope of practice, regulatory policies, and political environment of APN. Results: Interest in the APN role has been gaining ground worldwide. While the roles of APN in the USA, Taiwan and Japan have been changed in terms of legislation and institutional regulations, the role of APN in 12 fields except for APN in home care has not been legislated since qualification was specified in Korean Medical Law. Many problems were found in vitalizing APN roles: absence of legal regulations on the scope of practice or health insurance coverage for APN, increase the number of medical support staffs who are not qualified, and a disagreement regarding the qualification field and practical field. Conclusion: This study presents snapshots and vitalizing strategies of practice, and regulation for APN to develop their unique roles in Korea. The tasks and duties of APN should be identified specifically to fulfill their roles. In terms of national health insurance policy APN's Nursing care should be reimbursed just as nursing care of APN in home care.

• Journal of Korean Critical Care Nursing
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• v.5 no.2
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• pp.37-48
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• 2012

Purpose: The purpose of the study was to evaluate how advanced practice nurses (APNs) recognized their work by analyzing nursing outcomes. The ultimate goal was to examine the utility of APNs by connecting their work to the outcomes. Methods: Cross-sectional survey was conducted to collect the data from 59 APNs in a tertiary hospital lovated in Seoul, Korea. The questionnaire with 84 outcome indicators for advanced practice nurses was used. Descriptive statistics were used to analyze the data. Results: Among 84 outcome indicators, 11 indicators were associated with the work of APNs. Majority of these findings were included in the categories of clinical results and satisfaction. Items identified to be associated with the work of APNs were different among oncology nursing area, surgical speciality area, emergency care area, and critical care area. Conclusion: The results of the study indicated that the works of APNs were relevant to education/counseling/training and interpersonal relationship with other health professionals. The results of the study could be helpful to delineate the work characteristics of APNs and increase the utility of APNs in Korea where roles of APNs are not yet clearly delineated in most clinical settings.

• Women's Health Nursing
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• v.12 no.2
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• pp.87-96
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• 2006

Purpose: This study was conducted to provide fundamental information for a system establishment of advanced practice nursing for gynecological cancer patients (APN-GCP). Method: Data was collected by focus group and individual interviews and analyzed in the framework of the Grounded theory method mapped by Strauss and Corbin (1990). There were 13 subjects in this study (nurses, doctors, patient and her family). Result: We identified 87 concepts, 22 sub-categories, and 10 categories. Categories for role expectation were arrangement of diagnosis and treatment process, giving information of treatment course, support of treatment process, patients' right toward making a decision of treatment, counseling and teaching after discharge from hospital, medical insurance and financial problems, counseling about sexual problems and use of family and community resources. All subjects perceived the necessity of an APN-GCP. An APN-GCP requires over 2$\sim$7 years clinical experience and a master's degree. Services would be performed from initial registration to termination of treatment or death, and accomplished on an outpatient clinic basis. Conclusion: The nursing delivery system and curriculum should be developed for a women's health nurse practitioner including APN-GCP. As a further step, cost-effectiveness and projected estimation of manpower of APN-GCP should be studied in the future.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.131-141
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• 2017

Purpose: This study was to investigate the nationwide operational status of the professional medical support staffs (PMSS) who practice the expanded roles in the hospital setting. Methods: The data were obtained through survey from 36 hospitals with over 500 beds from 25th May to 12th July 2016. Data from 1,666 PMSS were analyzed. Results: Since the job titles varied, we classified them into 5 groups according to their roles; advanced practice nurse, clinical nurse expert, PA (physician assistant), coordinator, and others. There were differences in the operation status of PMSSs depending on the region, nurse staffing grade and number of hospital beds. Qualification criteria varied from hospital to hospital, and almost half of the hospitals didn't have any qualification standards for them. There were differences in age, educational level, clinical careers, rewards, and job satisfaction in 5 groups. Especially PA group had low salary, poorer working conditions, more difficulties in performing their work, and lower job satisfaction than other groups. Most PMSS (99.5%) were using a delegated prescription authority, however only 68.3% had job description and 19.9% had documented delegated role. Conclusion: Adequate training curriculum, documented delegated roles, and the protocols for legal protection and efficient medical services are needed.

• Journal of Korean Critical Care Nursing
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• v.11 no.1
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• pp.15-27
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• 2018

Purpose : This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS). Method : The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others. Results : Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics. Conclusion : To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.

• Journal of Korean Clinical Nursing Research
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• v.26 no.2
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• pp.217-231
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• 2020

Purpose: To identify the clinical role of Advanced Practice Nurses (APN), and evaluate how other medical personnel perceive their work(difficulty, importance). Methods: A questionnaire survey was performed with 277 health care providers (APN 52, nurses 88, and medical doctors 137 [professors 51, fellows 44, & residents 42]) in a single, tertiary hospital. The questionnaire was categorized into 6 domains (total 40 tasks): 6 tasks on identifying health issues (A); 3 tasks on prescribing and conducting diagnostic tests (D); 18 tasks on disease treatment (T); 4 tasks regarding prescribing medicine (M); 3 tasks regarding medical collaboration (C); 6 tasks regarding patient education (E). The survey measured the frequency, difficulty, and importance of APN's clinical tasks, and evaluated the willingness of authorizing clinical tasks to APN. Results: The most frequent tasks for APN were A domain, lowest were T domain. The scores for perceived job difficulty were lower than those for job importance in all groups. The proportion of willingness to legally delegate clinical practices to APN was higher in A and E domains, but lower in D and T domains. However, professors, who spent the most time with APN, showed a higher willingness to legally delegate clinical practice. The participants favored medical doctors as substitutes for tasks which were not legislated for delegated job performance. Conclusion: In this study identified clinical roles that medical doctors considered possible for legal delegation to APN were identified. The results can be used as evidence for the legalization of the practice of APN.

• Journal of Korean Academy of Nursing
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• v.53 no.1
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• pp.39-54
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• 2023

Purpose: This study aimed to investigate the nationwide intention to delegate clinical practice of medical specialists in accordance with the enactment of the scope of practice for advanced practice nurses (APNs). Methods: Data were collected from October to December 2021 using Google Surveys. In total, 147 medical specialists from 12 provinces responded to the survey. The survey questionnaire was categorized into four legislative draft duties, according to the scope of practice (a total of 41 tasks): Twenty-nine tasks on treatments, injects, etc., performed under the guidance of a physician and other activities necessary for medical treatment (treatment domain); two tasks on collaboration and coordination; six tasks on education, counseling, and quality improvement; four regarding other necessary tasks. Participants were asked whether they were willing to delegate the tasks to APN. Results: The intention to delegate tasks to APN was higher for non-invasive tasks such as blood sampling (97.3%) or simple dressing (96.6%). Invasive tasks such as endotracheal tube insertion (10.2%), sampling: bone marrow biopsy & aspiration (23.8%) showed low intention to delegate in the treatment domain. Participants who were older, male, and had more work careers with APN, showed a higher intention to delegate tasks. Conclusion: To prevent confusion in the clinical setting, a clear agreement on the scope of APN practice as APN delegated by physicians should be established. Based on this study, legal practices that APN can perform legally should be established.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.5
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• pp.613-621
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• 2013

Purpose: To identify the extents of nursing professionalism, clinical decision making abilities and job performance of advanced practice nurses and investigate the relationship among the variables Methods: Participants, selected by a convenience sampling method, were 135 advanced practice nurses working in 4 tertiary care general hospitals in 'B' Metropolitan City and in 1 tertiary care general hospital in 'J' city. Data collection was done from January 15 to February 28, 2013 using self-reporting questionnaires. Results: The average score for nursing professionalism of study participants was $81.19{\pm}7.56$. for clinical decision making abilities, $140.42{\pm}9.62$ and for job performance, $102.54{\pm}10.30$. These averages are relatively high. The relationship between the extent of nursing professionalism and the extent of clinical decision making abilities showed an intermediate level positive correlation (r=.45, p<.001). The relationship between the extent of nursing professionalism and the extent of job performance was also an intermediate level positive correlation (r=.42, p<.001). The extent of clinical decision making abilities and the extent of job performance was an intermediate level positive correlation (r=.41, p<.001). Conclusion: Developing a program, which can improve nursing professionalism and clinical decision making abilities of nurse, is required to enhance their job performance.

• Journal of muscle and joint health
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• v.26 no.3
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• pp.290-306
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• 2019

Purpose: This study aimed to describe the experiences of health-care providers about advanced practice nurses (APNs) focusing on the perspectives of physicians and APNs in Korea. Methods: Qualitative data were collected with snowball sampling. Six physicians and 13 APNs participated in this study through in-depth interviews or a focus-group interview. Qualitative content analysis was employed. Results: Three themes and seven categories were emerged. Three themes were 1) challenging start and attempts to settle down on unfamiliar system, 2) being positioned as an APN at clinical settings, 3) long journey for social recognition and legal institutionalization of APNs' role. Seven categories were 1) challenges to new area, 2) introduction and conflict of APN system, 3) driving force for stepping toward becoming APNs, 4) dedication and commitment to role development, 5) efforts to prove APNs' competency, 6) approaches to guarantee legal APNs' activities, and 7) filling the gap in health-care service. Conclusion: The findings suggest that health-care providers who have collaborated with APNs are aware of the needs to operate APN system more stably through the legislation of APNs' scope of practices. Further research is needed to provide the evidences of APNs' practice outcomes such as health care quality, patient safety, reduction of medical expenses, etc.