Purpose: The purpose of this study is to identify the factors influencing the intention to report child abuse of emergency room nurses based on the health belief model. Methods: This was a descriptive study that used a cross-sectional design. A total of 188 emergency room nurses working at general hospitals with more than 300 beds in Seoul participated in the study. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple regression analysis with the SPSS 25.0 program. Results: Correlations and regression analyses showed that the perceived severity (β=.14, p=.024), perceived barrier (β=-.25, p<.001), and self-efficacy (β=.31, p<.001) were factors influencing emergency room nurses' intention to report child abuse, and the explanatory power of the model was 33.0%. Conclusion: The results of this study related to the health belief model, being a valid theoretical basis for child abuse reporting intention research, significantly suggest new research directions in the future. In addition, to increase the nurses' intention to report child abuse in the emergency room, the influencing factors identified in this study can be utilized and develop specific interventions using the health belief model.
The purpose of the study is to find out how laws related to the nursing profession can be improved by analyzing the rules and regulations concerning nursing. Furthermore, to help settle legal matters in the process of doing nursing work. The data used for the study are the Health and Medical Act, the Maternal and Child Health Act, the School Health Act, the Special Act for Health and Medical Service in Rural Areas, the Industrial Health & Safety Act and the Notice on Nursing Professional Courses analyzed by age and content. The results of the study are as follows : First, basic nursing practice includes 'nursing care for recuperation and assistance in medical treatment and in special areas including the pre-vention of disease, maintenance of health, control of environment, and other therapeutic activities. It is suggested that the phrase 'assistance in medical treatment' should be eliminated as it limits the basic nursing practice to the assistance of the medical treatment. Second, Article 56 of the Health & Medical Act prescribes a special nurse but it does not prescribe a specific job. Accordingly, the new provison concerning the specific jobs of a special nurse should be added or a job guide should be inseated. Third, it is prescribed that those who have completed the training course after obtaining a license are qualified to be a midwife, a special nurse and a nurse practitioner working in special areas. However, school nurses, occupational health nurses and maternal and health workers are required to obtain a nurse license, but not to take an additional training course. Nurses working in special areas should be legally recognized as nurse specialists. The regulations to control various qualification standards consistently should be established. Fourth, the qualifications and types of nurses by area prescribed by Article 54 of the Health and Medical Act are not consistent with those of special nurses as recognized by affiliated organizations of the Korean Nurse Association and some hospitals. Accordingly, the qualifications and types of special nurses should be adjusted in consideration of special nurses. Fifth, as Article 16, Paragraph 2 of the Health and Medical Act does not prescribe the type and scope of first - aid treatment that nurses can provide, the first-aid treatment of nurses might be considered as an unlicensed practice. The specific regulations regarding these matters should be established. Sixth, the contents of the nursing record, which are prescribed by Article 21 of the Health and Medical Act as a duty, include 1) matters concerning body temperature, pulse, breath and blood pressure 2) matters concerning drug prescription 3) matters concerning input and output 4) matters concerning the treatment and nursing care (Article 17 of the Enforcement Regulations, Health and Medical Act). However, these matters are limited to basic nursing care and assistance in medical treatment. The new recording methods on nursing process are suggested to be adopted legally. Seventh, the prescription right entrusted to nurses which are prescribed by the School Health Act, the Special Act on Health and Medical Service for Rural Areas, and the Industrial Health and Safety Act are not consistent with the rights of nurses as prescribed by the Health and Medical Act. New regulations prescribing the partial right for medical treatment entrusted to nurses in consideration of the restraint of time and place in emergency situations should be established.
Objectives : In this paper, we proposed a method to comprehensively examine the roles of medical insurance review nurses' by analyses of task importance and task performance. Methods : For the analyses, we used the responsesof 268 nurses who completed a questionnaire for members of the Medical Insurance Review Nurses Association in 2015, and analyzed task importance and task performance using the IPA method and the standard task guide. Results : There were significant differences in task importance and task performance according to task position. In the category of 'Keep up the good work,' 'Calculate benefit standard' was indicated only in administrative positions, and in the category of 'Concentrate here,' 'Manage hospital resources' and 'Process after appeal results' was demonstrated only in general positions. There were differences in the 'Low priority' and 'Possible overkill' categories by task performance according to task position. Conclusions : Our results indicate the necessity of a new education system and task reassignment according to task importance and task performance as perceived by medical insurance review nurses.
The condition of nutrition during infancy will greatly affect infants' physical, emotional growth, especially breast feeding is important in their growth and development, and emotional stability, too. Despite such advantages of breast-feeding, its rate has continued to fall year after year in Korea : the 95% rate in 1960's has fallen to 25.4% in 1990. It is known that such a downfall of breast-feeding rate is associated with various factors. The purpose of the study is to examine mother's and nurses' in nursery perception of the impediment factors of breast-feeding : to compare those between of breast-feeding : to compare those between two groups : to provide fundamental data for developing strategies for increasing breast-feeding. The subjects were 45 new mothers from one hospital and the same number of nurses sampled from 3 university hospitals, in Seoul. The data were collected for 11 days from April 12 to April 23, 1994 and a questionnaire was developed based on the interview with 14 nurses and 10 mothers and the literature reviews. Liker's Five-Point Scale was used as measurement. The Data were analyzed using SPSS / PC and descriptive statistics, t-test, ANOVA. The results of study are as follows : 1) Most new mothers get the information about breast-feeding from their mothers, books or newspaper, and relatives in rank than professionals(nurses or doctors). 2) The impediment factors the breast-feeding are categorized as mothers, hospital system, medical personnels and social factors. The most frequently mentioned impediment factors from mothers are 'Difficulty by operational wounds'(3.13), 'Lack of will for breast-feeding'(3.47), 'Insufficient rest and sleep'(3.52) and 'Opposition from husband or his family members'(4.77)in rank. On the other hand those factors from nurses are 'Inadequate nipple condition'(2.37), 'Decreasing milk secretion given medicine after operation'(2.63), 'Mothers knowledge deficit by poorly prepared education'(2.79) and 'Mothers abhorance of breast-feeing'(3.87) in rank. 3) As for the hospital system, the highly perceived impediment factors by mothers are 'Seperation of baby from mother after birth'(2.78), 'Lack of space for breast-feeding in the hospital'(2.93), 'Lack of facility for informing the time for breast-feeding'(3.18) and 'Because of babys' preference artificial nipple by being accustomed to it in hospital(3.97), in rank. Meanwhile, those from nurses are "Seperation of baby from mother after birth",(1.92), "Inconsistency between hospital's nursing time and mother's breast secretion time" scretion time(2.97), "Lack of space for breast-feeding in the hospital"(3.39), and "Lack of facility for informing the time for breast-feeding"(3.74) 4) As for the medical personnels, the highestly perceived Impediment factor from mothers in "Lack of professional nurses for breast-feeding"(2.96), and the lowestly perceived one is "Doctors' reluctance"(4.75). Nurses perceived same as mothers, too. 5) As for the social factors, the highestly perceived impediment factor by mothers and nurses is "Inconvience of social activities"(2.83) and the lowestly ones are "The sense of self-sacrifice"(4.22) by mothers, and "The sense of old fashioned"(4.13) by nurses. 6) The difference of the perception of impediment factors between mothers and nurses is statistically significant only in mother factor.
Purpose: This study aimed to estimate the pooled prevalence of workplace bullying among nurses and examine the effect of moderate factors. Methods: Studies that assessed nursing workplace bullying using the negative act questionnaire developed by Einarsen et al. were searched for in 8 databases. The pooled prevalence was calculated with overall event rate and meta-ANOVA was performed for subgroup analysis. A funnel plot and Egger's linear regression asymmetry test were performed to confirm the publication bias of meta-analyzed studies. Results: A total of 23 studies (N=11,748) were included in the systematic review, and 14 studies (N=4,585) that reported prevalence using operational criteria of victim were selected for meta-analysis. The pooled prevalence of workplace bullying was 22.2% (95% CI: 19.0~25.7). Domestic studies reported lower prevalence than international studies (18.6% vs. 27.0%, Q=8.75, p=.003). The prevalences were different according to publication year (30.6% in 2008~2010, 19.5% in 2011~2014, 21.8% in 2015, Q=11.89, p=.003). Studies that recruited only new nurses reported higher prevalence than others (28.4% vs. 20.6%, Q=3.92, p=.048). Publication bias was not found. Conclusions: Workplace bullying is prevalent in the nursing profession, and is more serious for new graduate nurses. Individual and organizational measures for preventing workplace bullying among nurses need to be sought.
Purpose: The purpose of this study is to identify the effects of a standardized educational program to improve nursing competency on newly graduated nurses in a children's hospital after developing and applying a pediatric nurse education program. The effectiveness of the program was confirmed by evaluating the clinical competency and field adaptation. Methods: In the first step, an education program was developed using the analysis, design, development, implementation and evaluation (ADDIE) model. As a second step, a similar experimental study of a single group repeat measures design was conducted to evaluate the clinical competency and field adaptation over time after application of the program. Additionally, a focus group interviews were conducted to collect subjective data on the effects and improvement points of the program. Results: As a result of applying the program, there was a significant change in the clinical competence and the field adaptation of newly graduated nurses in a children's hospital. The categories derived from the focus group interviews were "getting special guidance," "better care," "becoming a nurse at a children's hospital" and "winning together." Conclusion: It was confirmed that the education program enhances the clinical competency of new nurses in children's hospitals. In addition, it provided the necessary data to understand the experiences of new nurses, help them adapt effectively, and establish appropriate interventions.
Purpose: This study investigates the participation status in clinical nursing education and nurses' continuing education needs to develop educational programs. Methods: Participants were 227 nurses working in medical institutions where nursing students practiced, and the selection criteria were nurses with more than two years of clinical education experience; data were collected using structured questionnaires. Results: More than half of the clinical nurses had completed a preceptor training program for clinical nursing education, and the subjects mainly educated by nurses were new graduate nurses and nursing students. The obstacles to clinical nursing education were lack of compensation, lack of manpower, lack of patient nursing time, excessive workload, and lack of knowledge as educators. The educational methods preferred in continuing education were small-group workshops and online education. The desired educational topics in continuing education were current nursing practice standards, simulation nursing education, and the role of clinical nursing educators. Conclusion: Based on our results, it is necessary to understand the importance of clinical nursing education, which is essential for clinical nurses, to prepare a specific system for them and to develop and operate a systematic education program according to medical institutions' characteristics.
Purpose: This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. Methods: Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression. Results: An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870). Conclusion: To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future.
Purpose: The purpose of this study was to examine the perception of the healthcare accreditation and the level of job stress and also to identify the factors affecting turnover intention in general hospital nurses. Methods: This cross-sectional study was performed using questionnaires. Data were collected from 230 nurses who worked at one general hospital from February 20 to April 10, 2014. Data were analyzed with independent t test, ANOVA, Pearson correlation coefficient, and regression using SPSS/WIN v 21.0. Results: The scores of perception of the healthcare accreditation, job stress, and turnover intention were 3.05 out of 5, 4.30 out of 5, and 3.18 out of 5. A positive correlation was observed between turnover intention and job stress. Turnover intention was negatively correlated with perception. The factors affecting turnover intention were the perception of healthcare accreditation (35.3%), total clinical experience (12.3%) and job stress (7.4%). The total explanatory power was 55.3%. Conclusion: The perception of the Healthcare Accreditation was confirmed as a new factor affecting turnover intention in nurses. These findings can be utilized to the development of strategies for reducing job stress, and enhancing perception and resulting in both the quantitative and qualitative development of the healthcare system.
Korean labor market has showed remarkable change of the increase in the amount of unemployment and contingent employment since IMF bailout agreement. There is a theoretical position to explain this increase in contingent employment at hospitals with the notion of flexibility. The high flexibility of employment due to the increase of contingent employees is becoming very important part in new business strategy of hospitals. The types of contingent employment of the nurse are part-time employment temporary employment, fixed-term employment, and internship which was introduced in early 1999. Recently, Korean health care industry managers have paid attention to the customer oriented service, rationalization of business administration, service quality control so that they can adjust their business to outer environment. Especially their efforts concentrate on the wage reduction through efficient and scientific control of man power because wage shares about 40% of total cost. This dissertation aims at verifying the phenomena of the contingent employment of the nurse and analyzing the related factors and problems. To rephrase these aims in ordinal: First, verifying the phenomena of contingent employment of the nurse. Second, verifying the problems of that phenomena. Third, analyzing the related factors of the contingent employment of the nurse. To accomplish these research goals, a statistical survey was executed. in which 384 questionnaires-66 for manager nurses, 318 for contingent nurses - were given to nurses working at 66 hospitals-which have at least 100 beds-in Seoul. Among them, 187 questionnaires-38 from manager nurses, 149 from contingent nurses'- 'were returned. Then, the data coded and submitted to T-test, $X^2$ -test, variance analysis(ANOVA), correlation analysis, multiple regression analysis, Logistic Regression with SAS program. The research results of the contingent nurses are followings: 1. The average career term at the present hospital 8.4 months: duty-on days per month are 24.2 days: working time per day is 7.9 hours. These results showed little difference from regular nurses. 2. Their wage level is about 70% of regular nurses except for internship nurses whose wage level is 41% of regular nurses. To break down the wage composition, part-time nurses and internship nurses get few allowance and bonus. And contingent nurses get very low level of additional pay except for fixed-term nurses who are under similar condition of employment to regular nurses. These results show that hospital managers are trying to reduce the labor cost not only through the direct way of wage reduction but through differential treatment of bonus, retirement allowance, and other additional pay. 3. The problem of contingent employment: low level of pay; high level of turn-over rate: weakening of union; low level of working condition: heavy burden of work; inhuman treatment. The contingent nurses consider these problems more seriously than manager nurses do. What manager nurses regard problematic is the absence of feeling-belonged and responsibility of the contingent nurses. 4. The factors strongly related with the rate of the number of contingent nurses for the number of regular nurses; gross turn-over nurses; average in-patients per day; staring wage of graduate from professional college: the type of hospital ownership; the number of beds; the gap between gross newcomer nurses and gross turn-over nurses. The factors related with their gross wage per month; the number of beds; applying of health insurance; applying of industrial casualty insurance; applying of yearly-paid leave; the type of hospital ownership; average out-patients per day; gross turn-over nurses. The meaningful factors which make difference by employment type: monthly-paid leave; physiological leave. The logistic regression analysis using these two factors shows that monthly-paid leave is related with the type of hospital ownership; the number of beds; average out-patient per day, and physiological leave is related with the gross newcomer nurses; gross turn-over nurses; the number of beds.
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