• 디지털융복합연구
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• 제15권8호
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• pp.213-224
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• 2017

본 연구는 간호학생의 간호전문직 자아개념, 비판적 사고성향, 임상실습 만족도, 임상 수행능력, 임상실습 스트레스의 관계에 대한 구조모형을 검증하고자 시도되었다. 간호대학생 227명을 대상으로 구조화된 설문지를 이용하여 자료수집 하였다. 연구결과, 간호전문직 자아개념에 비판적 사고성향, 임상실습 만족도, 임상 수행능력, 임상실습 스트레스의 직접 효과는 유의하였으며, 수행능력과 임상실습 스트레스의 간접효과도 유의하였다. 비판적 사고성향에 수행능력과 임상실습 스트레스의 직접효과는 유의하였으며, 임상실습 만족도에 임상 수행능력과 임상실습 스트레스의 직접효과도 유의하였다. 이에 따라 간호학생의 간호전문직 자아개념의 영향 요인을 고려하여 근거중심의 비판적 사고성향과 조직적이고 체계적인 결론에 도달하는 능력을 갖추기 위해 다양한 교수법 적용과 교육환경 등 다각적인 변화와 임상 수행능력과 만족도를 향상시키고 임상실습 스트레스 줄일 수 있는 중재 프로그램 개발과 적용이 필요하다고 사료된다.

• 보건행정학회지
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• 제17권3호
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• pp.1-25
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• 2007

Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

• 한국간호교육학회지
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• 제18권1호
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• pp.53-61
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• 2012

Purpose: This study was done to identify the relationship of self-directedness, clinical competence and practice satisfaction to clinical practice for nursing students and to investigate the mediating effect of their clinical competence between self-directedness and clinical practice satisfaction. Method: The data were collected form 291 nursing students in clinical practice using self-report questionnaire on April 25 and June 20, 2011. Results: There were statistically positive relationships between self-directedness, clinical competence and practice satisfaction to clinical practice in nursing students. Clinical competence was found to completely mediate the relationship between self-directedness and clinical practice satisfaction. Conclusion: This study shows that self-directedness to clinical practice for nursing students have no direct effect on clinical practice satisfaction. It has an indirect effect by clinical competency.

• 한국간호교육학회지
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• 제13권2호
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• pp.246-256
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• 2007

Purpose: The purpose of this study was to explore the role of nurse specialist in the general hospital, and to provide basic data for the role management of nurse specialist. Method: The subjects were 38 staff nurses who worked in a medical, surgical, or other department in one general hospital. Survey tools were developed with criteria for a clinical nurse specialist by American Nurses Association(1986), Korean Nurses Association(2001), Kim(2005)'s research, and the nurse specialists' self job description. Validity of the tool was examined by 5 clinical nursing experts and nurse specialists. Data analysis was done by using SPSS Win 12.0 program. Result: The results of domains for the job of nurse specialists were 61.6% for direct clinical practice, 21.7% for education, 5.7% for consultation, 5.2% for management, 5.2% for research, and 1.1% for other domains. The results for the large classifications in nurse specialists domains were 57.6% for direct nursing practice in direct clinical practice domain, 89.1% for patient education in education domain, 57.5% for medical consultation in consultation domain, 57.5% for medical research in research domain, and 39.2% for documentation in management domain. Conclusion: This research revealed that direct clinical practice domain was higher than the other domains of research, education, and management. Discussion and development about the nurse specialist's various roles needs to be addressed on a continual basis.

• 중환자간호학회지
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• 제13권2호
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• pp.12-23
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• 2020

Purpose : This study aimed to evaluate the clinical outcomes of direct interhospital transfers (IHTs) of patients with acute aortic syndrome (AAS) led by advanced practice nurses (APNs). Methods : From September 2014 to June 2017, the study retrospectively investigated 183 patients with AAS who were transferred to a high-volume tertiary hospital. Results : One hundred forty-eight (81%) patients were admitted through direct IHTs, and 35 (19%) patients were admitted through non-direct IHTs. The direct IHT group had a significantly shorter time from symptom onset to hospital arrival than the non-direct IHT group (11.4 vs. 32.1 h, p=.043). There were no significant differences in other clinical outcomes, such as peri-transfer status, mortality, hospital length of stay, and readmission, between the two groups. In the direct IHT group, 55% of transfers were led by APNs. There was no significant difference in outcomes between APN- and physician-led transfers. Conclusions : Implementation of direct IHTs markedly shortened the time from symptom onset to hospital arrival in patients with AAS. Finally, direct IHTs can potentially improve the outcomes of patients with AAS, a condition with time-dependent mortality and morbidity. In addition, APNs can effectively lead the direct IHT of patients with AAS.

• 동서간호학연구지
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• 제11권1호
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• pp.58-64
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• 2005

The purpose of this study was to examine impact of hospital computerization on the nursing practice. The study was conducted using the repeated measured design. The subjects were 166 nurses working at surgical nursing care units in a tertiary teaching hospital. A questionnaire was developed based on the Burke's study, and reviewed by a committee for content validity. Eighty-eight nurses responded the questionnaire throughout the study. Indirect nursing care time significantly decreased(p<0.05) after the computerization. These decrease related to time saving in checking physicians' order and writing nursing records. However, the change in direct nursing care time was not clear. In conclusion, the computerization led to the decrease in indirect nursing care time but it did not link to increase in direct nursing care time. Therefore, nurse managers should take into account redesign of the nursing works after computerization.

• 전기학회논문지P
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• 제57권4호
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• pp.444-450
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• 2008

There are several ways to bond to building grounding systems for reducing GPR(ground potential rise) and EMI resulting from power system faults or lightning stroke to building. In order to verify effective bonding practice, the GPR and voltage of equipment due to the direct stroke to building are calculated with ATP-EMTP model for transformer, transmission line and MOV(Metal oxide varistor). The simulated model shows a satisfactory accuracy compared with experimental result for the $8/20{\mu}s$ simulated current pulse. It is observed that separate grounding can cause dangerous voltage to the building equipment and the performance of surge protective device can improve when it is installed to the protected equipment in distance as short as possible.

• 한국산학기술학회논문지
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• 제13권10호
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• pp.4572-4581
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• 2012

본 연구는 간호학생의 비판적사고성향, 진로정체감, 간호전문직 자아개념, 임상실습만족 및 임상수행능력의 관계에 대한 경로모형을 검증하고자 시도되었다. 간호학생 581명을 대상으로 자가보고형 설문지를 이용하여 자료수집 하였다. 자료는 SPSS 및 AMOS 프로그램을 이용하여 분석하였다. 연구결과, 간호학생의 임상수행능력에 대해 비판적사고성향, 진로정체감, 간호전문직 자아개념 및 임상실습만족이 직접효과가 있었다. 그리고 비판적사고성향과 진로정체감이 간접효과가 있었다. 간호학생의 간호전문직 자아개념과 임상실습만족에 대해 비판적사고성향과 진로정체감이 직접효과가 있었다. 이러한 결과에서 간호학생의 임상수행능력에 영향을 미치는 요인을 고려하고, 적절하고 효율적인 교육과정 및 교수학습 프로그램을 개발해야 한다.

• 수산해양교육연구
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• 제27권5호
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• pp.1221-1228
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• 2015

The purpose of this study was to describe and understand experiences of surgical ward practice in nursing students. The interview data were collected from 9 nursing students and analyzed by using descriptive phenomenology of Colazzi. The procedural steps was that described the phenomenon of interest, collected participants' descriptions of the phenomenon, extracted the meaning of significant statement, organized the meaning into them clusters, wrote exhaustive descriptions and then incorporated data into categories. The essential meanings of surgical ward practice experiences of nursing students were as following; 'Permission of direct nursing practice', 'Professionality of nursing domain', 'Serving as a stepping stone of patients' nursing', and 'Sense of achievement to participating nursing'. The results of this study would provide for basic data of surgical ward practice program and have important implication for understanding field practice in nursing. So would contribute to develop nursing practice curriculum.

• 한국보건간호학회지
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• 제13권2호
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• pp.26-44
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• 1999

The study was done to improve the job training course for Community Health Practioners (CHPs) by evaluating the level of help that the training provided to the CHPs in carrying out their work and to analyze the management activities of the CHPs in order to develop a more effective CHP training program. The methodologies used in the study were a questionnaire survey. The survey results were analyzed using SPSS Windows. The study results are as follows. 1. The total average level of help from the job training(Theory. Practice and Field Practice) for carrying out the CHP work was found to be $3.04\pm.53$ (of a possible 4), which indicates a high level of help. The average for clinical practices was $3.16\pm.60$. for theory. $3.11\pm.40$ and for field practice. $2.84\pm.60$. 2. For the theory content of the job training courses. the help level was low in the area of mother and child health management/family planning with an average of $2.65\pm.62$ and in the area of health information system development with an average of $2.62\pm.83$. The reason for these deficiencies were. in order of frequency. few opportunities to apply learning. training content that was inadequate. training methodologies which were incongruent with content. improper training items and insufficient class hours. For the practice. the clinical work in rehabilitation/orthopedics departments and in ENT/Opthalmology departments had averages of $2.96\pm.86$ and $2.97\pm.80$ respectively. This low level resulted from the lack of direct experience. lack of sincerity during the practice time. lack of practice guidance. insufficient time and lack of practice equipment. in that order. For the field practice. the delivery management averaged $2.06\pm.90$ as the lowest help level. In this case 68% of respondents replied that there were no relevant reasons for this deficiency. 21% responsed that there was a lack of direct experience, 7%, a lack of practice guidance and 4.8%, insufficient time. 3. There were significant differences for several demographic variables when comparing the help level of the clinical courses (practice and Field Practice). A higher help level was reported by older nurses as compared to younger ones, experienced nurses as compared to scholarship nurses, and married over single. Also for nurses who had finished more other programs and were qualified or licensed in several areas the level was high. Although it was not statistically significant the level was higher if the work area was in a rural county, not a city, and if one had more recently completed the job training(P<,05). 4. Of the respondents 58.6% replies stated the period of job training for the CHP was adequate, but 51.7% reported that the period for theory courses was too short while an other 48.3% responded that it was sufficient. For practice locations, 50% responsed that it was good to practice in medical institutions(primary, secondary and tertiary) at the same time. While 48.3% agreed that doing theory and practice simultaneously was good, and 56.9% agreed that field practice should be done after completing theory and practice training. Hence, the development of new field practice guidelines suitable for changing environments of health management are required in place of the existing ones which were considered low in help level to the practical work of the CHPs.