The purpose of this research was fourfold: (a) to identify the use rate of the indirect care interventions performed by nurses, (b) to estimate the time to perform each intervention, (c) to identify the indirect care interventions to be delegated to others, and (d) to determine the level of provider preparation needed to delegate indirect care interventions. The sample consisted of 199 nurses working in three hospitals. The Indirect Care Survey developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean and validated by nurse experts. Each of the 26 indirect care interventions were used several times a day. Four interventions (i.e.. Documentation, Shift Report, Specimen Management, and Transport) were performed several times a day by 50% or more of the nurses. The most frequently used intervention was Documentation, followed by the interventions Shift report. Environmental Management, Transport, and Examination Assistance. The least used intervention was Quality Monitoring, followed by the interventions Order Transcription, Referral, Health Care Information Exchange, Multidisciplinary Care Conference, and Product Evaluation. The intervention taking the most time to per-form was Technology Management (155.3 minutes), followed by the interventions Documentation, (122.2 minutes), Delegation (84.4 minutes), Supply management (83.4 minutes), and Preceptor: Student (79.9 minutes), Overall, the nurses reported that they would not delegate to others the majority of the interventions. More than 50% of the nurses would not delegate 21 interventions. Shift Report would not be delegated by 95% of the nurses and Documentation would not be delegated by 92% of the nurses. Caregiver Support would be delegated by 68% of the nurses to family. Three interventions (i.e.. Environmental Management, Examination Assistance, and Transport) would be delegated by more than 50% of the nurses to Nursing Assistant. This study will contributes to determining costs of nursing services and enhancing quality of nursing care. Replication study will be needed with large sample.
Purpose: This study was done to assess development and postnatal care interventions in postnatal care intervention records for maternity ward nurses in tertiary hospitals and women's hospitals in South Korea. Methods: This mixed-method research was a Time-Motion (TM) study. Data were collected through external observation of 12 nurses in 4 wards over 24 hours. Mann-Whitney U test and independent t-test were employed for the analysis of frequency and provision time of direct/indirect care activity. $x^2$ (Fisher's exact test) was utilized to determine the difference in frequency between two groups. IBM SPSS 22.0 statistical program was employed for calculation. All statistical significance levels were at ${\alpha}=.05$. Results: According to the KPCS-1 (Korean Patient Classification System-1), women's hospitals are group 3 and tertiary hospitals, group 4. With respect to time difference in direct care, tertiary hospitals showed 791 minutes and women's hospitals, 399 a difference of 392 minutes. For time difference in indirect care, women's hospitals had 2,415 minutes while tertiary hospitals, 2,080, a difference of 335 minutes for women's hospitals. No difference was found in the average total care workload between the two institutions. Individual time also showed no difference (p>.05). Conclusion: High-risk maternal care strength in tertiary hospitals and breast-feeding strength in women's hospitals need to be benchmarked with each other.
This study was done to determine direct and in-direct nursing time in nursing units in hospital to ap-plied computer system and expect that those results contribute to measure efficiency of nursing practice and planning of nursing manpower. The design for study was a descriptive study. The study results are as follows. 1. Patients admitted to the Internal Medicine and General Surgery units were grouped into four. Group Ⅰ, 32.9% of the total patients, consisted patients whose condition was considered minor Group Ⅱ, 26.1%, was of those whose condition was considered moderate, Group Ⅲ, 41. 8%, moderate severe and Group Ⅳ, 29.2% the most severe. 2. Nursing intervention times by care type were as follows four minutes spent for suction eight minutes, for simple position change, ten minutes, for sheet change, seven minutes for a hot or cool compress, six minutes for dressing change, four minutes for Ⅰ.M. injection, six minutes for patient health education and five minutes for body temperature check. 3. Direct care time by patient group revealed the following : Group Ⅰ rquired 191.4 minutes, Group Ⅱ required 331.1 minutes, Group Ⅲ rquired 499.4 minutes, and Group Ⅳ rquired 1328.0 minutes. 4. The ratio of time for adequate nursing care and direct care time in the Internal Medicine and Goneral Surgery units was 67.4%-83.4% and 94.7%-99.3% in the Intensie Care Unit. 5. Average daily direct care time per patient was 5.5 hours in the Internal Medicine unit and 11.5 hours in the Intensive Care Unit. 6. Time spent in indirect care was 48.3 minutes for computer recording,34.8 minutes for giving and receiving patient information for shift duty, 28.0 minutes for eating and resting time, 26.6 minutes for transfering and identifying patients, 25.6 minutes for identifying Doctor's order, 23.9 minutes for recording vital signs. 7. Time spent in indirect care was 282.2 minutes by head nurses (charge nurses), 258.7 minutes by nurses and 261.6 minutes by nurse aids. 8. The average nurse's workload was 9.3 hours and daily indirect nursing time required 46.3%-50. 5% of above mentioned workload time. .9. The average daily indirect care time per patient was expected to be 57.7 minutes in the Internal Medicine unit and 3.3 hours in the Intensive Care Unit.
Nursing Intervention Classification(NIC) includes the 433 intervention lists to standardize the nursing language. Efforts to standardize and classify nursing care are important because they make explicit what has previously been implicit, assumed and unknown. NIC is a standardized language of both nurse-initiated and physician-initiated nursing treatments. Each of the 433 interventions has a label, definition and set of activities that a nurse does to carry it out. It defines the interventions performed by all nurses no matter what their setting or specialty. Principles of label, definition and activity construction were established so there is consistency across the classification. NIC was developed for following reasons; 1. Standandization of the nomen clature of nursing treatments. 2. Expansion of nursing knowledge about the links between diagnoses, treatments and outcomes. 3. Devlopment of nursing and health care information systems. 4. Teaching decision making to nursing students. 5. Determination of the costs of service provided by nurses. 6. Planning for resources needed in nursing practice settings. 7. Language to communicate the unigue function of nursing. 8. Articulation with the classification systems of other health care providers. The process of NIC development ; 1. Develop implement and evaluate an expert review process to evaluate feedback on specific interventions in NIC and to refine the interventions and classification as feedback indicates. 2. Define and validate indirect care interventions. 3. Refine, validate and publish the taxonomic grouping for the interventions. 4. Translate the classification into a coding system that can be used for computerization for articulation with other classifications and for reimbursement. 5. Construct an electronic version of NIC to help agencies in corporate the classifiaction into nursing information systems. 6. Implement and evaluate the use of the classification in a nursing information system in five different agencies. 7. Establish mechanisms to build nursing knowledge through the analysis of electronically retrievable clinical data. 8. Publish a second edition of the nursing interventions classification with taxonomic groupings and results of field testing. It is suggested that the following researches are needed to develp NIC in Korea. 1. To idenilfy the intervention lists in Korea. 2. Nursing resources to perform the nursing interventions. 3. Comparative study between Korea and U.S.A. on NIC. 4. Linkage among nursing diagnosis, nursing interventions and nursing outcomes. 5. Linkage between NIC and other health care information systems. 6. determine nursing costs on NIC.
Purpose : This study aimed to examine the relationships of burnout and compassion competency with job satisfaction among nurses working in the intensive care units and emergency rooms. Methods : A correlational survey was conducted from August 1 to August 14, 2018 and involved in 102 nurses working at four university hospitals for more than 1 year. A structured questionnaire was used to measure burnout, compassion competency, and job satisfaction, and data were analyzed using hierarchical multiple regression and mediation effect analysis. Results : The mean scores of burnout, compassion competency, and job satisfaction were 2.58, 4.35, and 2.95, respectively. Burnout and compassion competency along with working night shifts and a wish to transfer explained 35.3% of variance in job satisfaction. Compassion competency showed a small but significant mediating effect in the relationship between burnout and job satisfaction (indirect effect -.0446, 95% CI -.1133, -.0075). Conclusion : Burnout and compassion competency were the significant influencing factors of job satisfaction among nurses working in intensive care units and emergency rooms. Since compassion competency showed a significant mediating effect, further studies should focus on intervention strategies for compassion competency to improve job satisfaction in this population.
The need of oriental nursing role is recently increasing. The implication of this trend is enormous not only for the need of independent of independent oriental nursing intervention. Hence, this study was designed to describe the characteristics of oriental nursing activity and identify the meaning of nursing activity in oriental hospital. A total of 24 nurses were selected by convenience sampling from eight units at one oriental hospital. A total of 168 data were collected using minute-by-minute recording during nurse s work shift. The data were analyzed using nova and scheffe method as post-hoc test The results of this study are as follows; 1. the category of nursing activity in oriental hospital 74.4% of nursing activity was the patient-oriented nursing care. The nursing activity included others (18.28%), the function-oriented nursing care (7.07%), and staff-oriented care (0.2%). 29.1 % of the patient-oriented nursing care was the direct care, and 24. 5 % of the patient-oriented nursing care was the indirect care. There was a lack of patient education and the communication patient. 2. Nursing activity in oriental hospital by characteristics 1) Nursing activity by unit For patient-oriented nursing care, there was a statistically significant difference among 8 units. In the critical care unit, the patient-oriented nursing care was mostly performed. For function-oriented nursing care, there was statistically significant difference among 8 units. In the physical therapy unit, the function-oriented nursing care was mostly performed. 2) Nursing activity in oriental hospital For all kinds of nursing activity, there was a statistically significant difference between shifts. In night shift patient-oriented nursing care, function-oriented nursing care, and other kinds of nursing care was mostly performed. Patient-oriented nursing care included indirect care, treatment set management, and the breaktime. In day shift, staff-oriented nursing care was performed. 3) Nursing activity in oriental hospital For all kinds of nursing activity, there was not a statistically significant difference by day. The day has not impact on nursing activity. 3. the meaning of activity in oriental hospital The results of this study show that the patient-oriented care was vital check, input! output check, medication, bedsore prevention, nasogastric feeding, oral care, catheterization care, perinatal care, nursing care associated with acupuncture and moxacautery, observation (fever, sweating), heat and cold application communication with patent and family, and patient room management In conclusion, two issues associated with the findings of the research appeated to be involved in the difficulty of nursing activity in hospital. The first issue was the nursing care in oriental hospital provided by nurses who have a limited understading of the principles of oriental medicine. The second issue was the deficiency of systematic guideling for oriental nursing activity. The findings suggest the need to develop the systematic guideline for oriental nursing activity. The need of continuing education for nurses who work in the oriental hospital, and the need of nursing education including oriental nursing are critical.
Objective: The purpose of this study was to examine the direct and indirect effects of mothers' and children's emotional instability and maternal affectionate-rational parenting on children's attributional style. Methods: The participants of this study were 253 4th, 5th and 6th grade elementary school students and their mothers in Seoul and Incheon. Data were analyzed by path analysis using AMOS 21.0. Results: The results were as follows: First, children's attributional style for negative and positive events was significantly related to children's emotional instability and maternal affectionate-rational parenting. Also, mothers' and children's emotional instability was significantly associated with affectionate-rational parenting. Second, mothers' emotional instability had indirect effects on children's attributional style for negative and positive events through maternal affectionate-rational parenting. Finally, children's emotional instability had not only significant effects on children's attributional style for positive achievement events, but also indirect effects on children's attributional style for negative and positive events through maternal affectionate-rational parenting. Conclusion/Implications: The results of this study suggest that both environmental and individual factors, including mothers'and children's emotional instability and maternal affectionate-rational parenting, need to be considered to explain children's attributional style. Also, these findings have implications for developing intervention programs for children's attributional style and parental education.
Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen's medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion: The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.
This study is an empiriacl analysis of effects of government intervention on the health care delivery system in Korea. The purposes of this study are to find out the effects of government intervention on the per capita national health expenditure(per capita NHE), crude mortality rate(CMR), and institutional efficiency. Here, the institutional efficiency is defined as a formula shown below: log$\frac{100-curde mortality rate }{per capita NHE}$$\times$100. The formula indicates that the instiutional efficiency increases if the CMR and/or per capita NHE goes down. In the meantime the government intervention is measured by six independent variables: I) the degree of social developments, ii) the numberr of physicians per 100, 000 population, iii) the proportion of specialists among the total physicians, iv) the proportion of public expenditure among the NHE, v) the proportion of public beds to the total number of beds, vi) the proportion of physicians working at the public sector to the total number of physicians. In the above six independent variables iv), v) and vi) are the ones that reflect the degree of government intervention. In actual calculation, the two independent variables v) and vi) are integrated into a new variable based on one to one correspondence. The materials used are the time-series data from 1970 through 1990 in Korea. A path analysis and the time-series regression analysis were adopted to estimate and examine the causal relationship between variables involved. And decomposition of the effect of causal relationship is made to find net effect, direct and indirect effect. The major findings are as follows; 1. The effect of public expenditure, number of physicians per 100, 000 population, the proportion of specialists among the total physicians and social development shows a positive relationship with per capita NHE. Only if the government intervention would be counted, the effects of the number of physicians and the proportion of specialists succeed in containing per capita NHE. 2. In additionn to the above four variables, one additional variable, per capita NHE, was also responsible for the reduction of CMR. The factor of social development found to be the most potent predictor of the CMR reduction. However, the CMR reduction due to government intervention was negligible. 3. Meanwhile, the above four variables were found to was have negative effects on the institutional efficiency. The reverse is true when the government intervention is counted. For example, the number of physicians and the proportion of specialists have played a positive role in raising institutional efficiency via goverment intervention. This comes from the factual effect that the increment of institutional efficiency via the reduction of per capita NHE is bigger than via the reduction of CMR.
This study examined the effects of marital relationships, mother's parenting stress and positive parenting behavior on the behavioral problems of preschoolers. For this purpose, we created a structural equation model and examined the goodness of fit of the model using the RMSEA, SRMR, TLI, and CFI. The participants were 986 4-year-old preschoolers and their mothers taken from the 5th year of the Korea Children's Panel. The results of this study were as follows: First, a negative marital relationship had a significant negative effect on behavioral problems of preschoolers directly. And a negative marital relationship had a significant indirect effect on behavioral problems of preschoolers through the parenting behavior. Second, parenting stress had a significant negative effect on behavioral problems of preschoolers directly. And parenting stress had a significant indirect effect on behavioral problems of preschoolers through the parenting behavior. These findings imply that both improving marital relationships and regulating mothers' parenting stress and parenting behavior need to be emphasized when designing prevention and intervention programs aimed at improving the behavioral problems of preschoolers.
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