• Journal of Korean Academy of Nursing
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• v.3 no.1
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• pp.13-40
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• 1972

Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.2
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• pp.228-233
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• 2012

Two years ago, a 75-year-old female was diagnosed left renal cancer and went on radical nephrectomy. Recently, metastatized lesions on lumbar spine and various lymph nodes including paraaortic lymph node of which diameter was about 5.5 cm was identified. She suffered from extreme low back pain despite using opioid agents of fentanyl patch and oral oxycodone. During about one month, Korean medicine therpies including herbal medicine(Yang-He tang), acupuncture with her conventional medications were co-administered. However her pain didn't improved and gradual cough and dyspnea developed. So she transferred to the hemato-oncology part for 2 weeks under the diagnosis of everolimus-induced noninfectious pneumonitis. After quitting everolimus her pneumonitis was improved and she came back our ward and started another herbal medicine, Ai-Tong-Ning tang for about 2 months. During this period, her pain was well managed without oral opioid agents and her paraaortic lymph node was regressed to about 2.2cm in diameter.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1467-1478
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• 2000

The purpose of this study was to develop a curriculum for the oriental clinical nurse specialist program based on the understanding of Korean human beings so as to develop nursing as a profession and promote the client's health. The design of this study was based on literature review and nominal group study. The research was managed by East-West Nursing Research Institute of nursing science college at Kyung Hee University. The research team was composed of 17 professors of nursing departments of oriental medical colleges. We obtained opinions from Oriental Nurses Association, Oriental Nursing Research Association, and professors in oriental medical college. We reviewed articles, curriculums of other clinical nurse specialist programs, medical laws and the curriculum development plan for the oriental clinical nurse specialist program from Korean Nurses Association. We discussed a curriculum thoroughly in numerous meetings. We developed a following curriculum: 1. Educational philosophy was founded on the oriental human view which was based on Chun-In union theory. It was founded on the oriental health view which recognized health being in harmony with nature and the balance of body function with the harmony of Yin-Yang in the five elements. In addition, it was founded on oriental nursing view to promote these health states. 2. Educational goals were to train oriental clinical nurse specialists, oriental nursing educators and oriental nursing researchers who developed knowledge of oriental nursing theory, nursing practice and created a leadership. 3. Curriculum consisted of 48 credits, of which 36 credits are based on lectures and laboratory classes and 12 credits are based on clinical practice. 36 credits consisted of 5 general subject credits and 31 core subject credits. General subjects consisted of nursing theory, nursing research, law and ethics. Students who had earned master's degrees are not required to take the general subjects. Core subjects consisted of 11 subjects such as advanced physical examination and laboratory, oriental nursing theory, original text of oriental nursing, oriental medical nursing, oriental pediatric nursing, oriental gynecologic nursing, oriental gerontologic nursing, oriental pharmacology, oriental constitutional nursing, advanced nursing of channels and acupuncture points and laboratory and oriental rehabilitation nursing and laboratory. In addition, clinical practice in a hospital ward, out patient department, herb prepation room, department of physical therapy and health promotion center in oriental medical hospitals for 12 weeks. To admit this program, students should complete prerequisites of introduction to oriental nursing and nursing of channels and acupuncture points. 4. Course contents of each subjects were developed to include the course's goal and objectives and specific items. 5. Evaluation involved lecture, laboratory and in field practice. We applied various evaluation systems and methods that were based on both knowledge and skills of the students to ensure full credibility and validity.

• The Journal of Internal Korean Medicine
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• v.30 no.2
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• pp.422-430
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• 2009

Background : Stroke is the second leading cause of death in Korea, following cancer. Stroke consists of ischemic and hemorrhagic stroke, and ischemic stroke can be largely classified as atherothrombotic stroke or embolic stroke. Carotid intima-media thickness (IMT) is an indicator of atherosclerosis used commonly as a screening test for abnormalities of the coronary artery. 24-hour ambulatory ECG is widely used to screen for underlying diseases that causes syncope, palpitation, arrhythmia, etc. Objectives : Since both carotid IMT and 24-hour ambulatory ECG are used to screen for cardiac problems, we endeavored to explore the correlation between carotid IMT and 24-hour ambulatory ECG of stroke patients. Methods : The records of ischemic stroke patients who were admitted to Kyunghee Medical Center Oriental Hospital ward from March 2006 to May 2009 were reviewed. 28 patients who had both carotid Doppler US and 24-hour ambulatory ECG test undertaken during their admission were analyzed. The relationship of abnormal ambulatory results and common carotid artery(CCA) IMT were statistically analyzed using Fisher's exact test and t-test. Results : The mean age of the abnormal ambulatory group was older than the normal group (74${\pm}$ 8.0 vs. 61${\pm}$12.1, p=0.0098). Although insignificant, the abnormal ambulatory group showed much thicker CCA-IMT than normal ambulatory group (2.l7${\pm}$ 1.16 vs. 1.51${\pm}$0.97. p=0.l389). Conclusion: No significant correlation was observed between abnormal ambulatory results and CCA-IMT. However, the difference in CCA-IMT between the two groups was too big to be ignored and further investigation with larger and better controlled trials are warranted.

• The Korean Nurse
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• v.31 no.4
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• pp.62-76
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• 1992

The intent of chis descriptive study is to investigale lhe patients perceived effect and expectance of activity therapy. The subjects for this study were 56 patients from the psychiatric ward in Severance Hospital. The data were collected during Lhe period from June 1, 1991 to January 18, 1992. The effect and expectance of the activity therapy was measured using a questionnaire developed by this study's investigators. The date were analyzed by descriptive statistics, t-test ancl one-way ANOVA, using the SPSS program. The results of this study can ue summarized as following ; 1. For motivatiorc for the accivity therapy, the response range was from 64.;] % to 89.3 %, that is, it showed a relatively positive response. 2. For the degree of improvement according to the nurse's method in the activity therapy, it was shown that the nurses need professional skill and meeting after activity therapy. 3. For the relevance of the nurse in the activity therapy, 90 % of the subjects had a positive answer for all of the activity therapy except the painting therapy. 4. For the perceived effect of the activity therapy, the following results were obtained. 1) 92% of the subjects had a positive response to the dance therapy, that is-I am vigorous physically. 2) 90 % of the subjects had a positive response to the reading therapy, that is-I acquire good ideas and instruction. 3) 98.1 % of the subjects had a positive response to the recreation therapy, that is-I am joyful. 4) 88.9% of the subjects had a posilive response to the writing therapy, that is-I am interested and become acquainted with other patients. 5) 86.8 % of tbe subjects had a positive response to the occupation therapy, that is-I am happy when I work. 6) 92.6 % of the subjeccs had a positive response to lhe painting therapy, that is-I can express myself in painting. 7) 87.3% of the subjects had a positive response to the musie therapy, that is-I am comforted. 5. For the expectance related to the activity therapy, 97.1 % the subjects had the most postive response to the music therapy which is a pleasant comfortable time. From the above-mentioned findings, it is suggested that psychiatric nurses need to development systematic and professional group activity therapy, and know the patient premorbid hobbies, interests and occupations.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.160-168
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• 2017

This study examined the awareness of the healthcare accreditation system, job stress, organizational commitment, and the turnover intention to determine the effects of these factors on the turnover intention of small and medium sized hospitals. A total of 202 nurses who worked in hospitals with less than 500 beds located in Gyeonggi-do, participated in this study. Questionnaires were given to the nurses who experienced healthcare accreditation, and data were collected between 1 December 2015 and 30 March 2016. As a result, the factors and general characteristics, influencing the turnover intention were found to be age (F=4.68, p<.001), marital condition (F=3.92, p<.001), and department of work (F=3.23, p<.008). The turnover intention was negatively correlated with the awareness of the healthcare accreditation system (r=-.46, p<.001) and nursing organizational commitment(r=-.35, p<.001), but positively correlated with the job stress (r=.21, p=.002). Regression analysis showed that the turnover intention of nurses from small and medium sized hospitals had 22.0% on the organizational commitment, department type, and job stress. Therefore, to decrease the nurses' the turnover intention, managers of small and medium sized hospitals need to draw up measures to support job involvement and policy improvement. The results also showed the difference in turnover intention according to the department type. Accordingly, there is a need for a differentiated approach according to the department of work, such as a special unit, ward, and outpatient department.

• Journal of Digital Convergence
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• v.12 no.6
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• pp.365-373
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• 2014

The basic data will be provided for increasing the coping efforts and for decreasing the improvement of nursing services and stress in mothers of hospitalized child by examining the effects of the nurse's communication styles on the stress and coping efforts in mothers of hospitalized child. This study is the correlation research, and the data collection was conducted from September 2013 until December, and it was based on 196 mothers of hospitalized child in the pediatrics ward of E hospital in D city 196. The data collected was analyzed by the frequency, percentage average, standard deviation, Pearson correlation coefficient, regression analysis method. As the result of the study, about the effects of the nurse's perceived communication styles on the stress and coping efforts in mothers of hospitalized child, the nurse's non-authoritative communication style had the biggest effects on the stress, and the explanation power of those variables was 30.1%. In conclusion, in order to decrease the stress in mothers of hospitalized child and to enhance coping efforts, the nurses should sublate the authoritarian attitude and they should show the communication skills of friendly attitude and communication skills of the informative attitude. These communication skills are needed to be maintained and enhanced continually through the systematic communication enhancement program.

• Journal of Digital Convergence
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• v.18 no.11
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• pp.319-328
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• 2020

This study aimed to investigate the relationships between basic pychological needs, positive psychological capital, authentic leadership and psychological burnout of clinical nurses, and to identify the mediation effect of positive psychological capital and moderated mediation effect of authentic leadership. The participants were 182 clinical nurses at 5 general hospital located in M city from April 2020 to June 2020 by questionnaire survey. Data analysis was done by using SPSS WIN 23.0 program and SPSS PROCESS MACRO program(model 4 and model 7). This study shows that the basic psychological need had an negative effect on psychological burnout, and the mediating effect of positive psychological capital and the moderated mediating effect of authentic leadership were confirmed in the relationship between basic psychological need and psychological burnout. Therefore, in order to reduce psychological burnout of general ward nurses, it is necessary to develop strategy to improve basic psychological needs and positive psychological capital of nurses, and leadership program for authentic leadership of nurse managers.

• Korean Journal of Clinical Pharmacy
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• v.26 no.4
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• pp.318-323
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• 2016

Background: Multidisciplinary team care (MTC) is a collaborative approach to treatment plan and ongoing care. We aimed to evaluate the clinical effect of MTC on the regulation of chronic kidney disease-mineral and bone disorder (CKD-MBD) complications in dialysis patients. Methods: This retrospective observational study was approved by the institutional review board. Among patients who have undergone dialysis at admission, the patients admitted to the nephrology ward were allocated to MTC group, and the others to usual care (UC) group. The MTC group had collaborative care by nephrologists, nurses, pharmacists, and nutritionists. The endpoints were the regulation of corrected calcium (cCa) and phosphate (P), the percent of patients in target level of cCa-P product ($cCa{\times}P$), and the prescription rate of non-calcium based P-binders. Results: A total of 163 patients were included from January to December 2009. A significant difference was shown in the percentage of patients in target $cCa{\times}P$ level at admission (MTC vs. UC, 81.40% vs. 91.67%; P = 0.038), but there was no significant difference at discharge. During admission, the cCa and P levels of patients in only UC group were significantly changed. In addition, compared with UC group, patients in MTC group were more likely prescribed appropriate P-binders, when they had higher $cCa{\times}P$ levels than $55mg^2/dL^2$ (P <0.001). Conclusion: It was found that MTC had beneficial effect on improving the regulation of CKD-MBD and the appropriate phosphate binder uses. Therefore, application of the MTC is anticipated to enhance quality of clinical care in chronic diseases.

• Biomedical Science Letters
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• v.12 no.3
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• pp.289-301
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• 2006

Cardiopulmonary bypass (CPB) for cardiac surgery triggers the production and release of numerous chemotactic substances and cytokines, ensuing systemic inflammatory response that leads to postoperative major organ dysfunction. Traditionally, corticosteroids (steroid) have been administered to patients undergoing cardiac surgery to ward off these detrimental physiologic alterations. However, the majority of the studies have been performed on adult patients with high-dose steroid. We carried out a randomized, prospective, double-blind study to compare the efficacy of low-dose steroid with that of high-dose steroid and to determine the adequate dose of pretreated-steroid for prophylactic effects in pediatric cardiac surgery. Thirty pediatric patients scheduled for elective cardiac surgery were randomly assigned to two groups; fifteen patients received low-dose methylprednisolone (10mg/kg intravenously, n=15, low-dose group) and the others received high-dose methylprednisolone (30mg/kg intravenously, n=15, high-dose group) 1 hour prior to CPB. Arterial blood samples were taken before CPB (Pre-CPB), 10 minutes after start of CPB (CPB-10), and immediately after CPB-end (CPB-OFF) for measuring total leukocyte counts (T-WBC) and diff-counts, platelet counts, interleukin-6 (IL-6), myeloperoxidase (MPO), total antioxidant (TAO), neuron-specific enolase (NSE), troponin I (TNI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and blood urea nitrogen (BUN) levels. Other parameters such as volumes of urine output, pulmonary index $(PI,\;PaO_2/FiO_2)$, mechanical ventilating period, intensive care unit (ICU)-staying period, postoperative complications (fever, wound problem), postoperative 24 hrs and total volumes in blood loss, and hospitalized days were also assessed. All parameters were compared between two groups. There were no significant differences in T-WBC counts, monocyte fraction, platelet counts, TA levels, NSE levels, creatinine levels, BUN levels, the volumes of total urine output, PI, the incidences of fever and wound problem, postoperative 24hrs- and total-blood loss volumes and ICU-staying period between two groups (P>0.05). At CPB-OFF, neutrophil fraction, MPO level, TNI level, and AST level were higher in the high-dose group than in the low-dose group (P<0.05). IL-6 level at CPB-10 was higher in the high dose-group than in the low-dose group (P<0.05). Furthermore, mechanical ventilating periods and hospitalized days of the high-dose group were significantly longer than those of low-dose group (P<0.05). The high-dose group had significantly low lymphocyte fi-action at CPB-OFF compared with the low-dose group (P<0.001). These findings suggest that pretreatment of high-dose steroid is not superior to that of low-dose steroid regrading its potential benefits in pediatric cardiac surgery. Therefore, the conventional strategy of steroid treatment, high-dose pretreatment, should be modified in the cardiac surgery with CPB. However, further studies must be performed on the larger number of patients in as much as small number of patients in this study.