• Perspectives in Nursing Science
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• v.4 no.1
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• pp.19-25
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• 2007

Systems and processes to provide clinical education to students of nursing have been established between universities and health facilities in all countries where nurse education is tertiary based. However, systems and processes to link nurse researchers based in universities to their clinical colleagues are less well developed. When collaborations are established they are frequently based on personal networks, and while the rhetoric of the organizations encourages these collaborations, they are largely unrecognised by senior administrators in health facilities. The research is frequently "invisible" and the clinician researchers usually do not have access to appropriate infrastructure and other resources that are required to support large projects that have the potential to change practice across organisations. This situation influences the focus and scope of nursing research and limits opportunities for clinicians to be engaged in the generation of professional knowledge. The University of Western Sydney (UWS) has taken a strategic approach to the development of collaborations for research and has linked with health services in Western Sydney to establish and maintain research centres and adjunct appointments. The partner organisations jointly fund the infrastructure of the centres which include a Professor, research assistant position(s) and administrative staff. Five Professors of Nursing have been appointed to positions in one of three nursing research centres. This paper describes the approach established by the School of Nursing at UWS to build collaborations with clinical areas to promote research. This approach could be adopted or adapted by other facilities.

• Journal of Korean Public Health Nursing
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• v.19 no.2
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• pp.217-228
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• 2005

Purpose: The purpose of this study is to understand nursing students' experiences during clinical practice at a public health center. Method: This research used narrative inquiry far data collection. From April 2005 to June 2006, data collection was conducted by open-ended interview, questionnaire and close observation. The participants, who were student nurses, were willing to take part in this study. Results: On the basis of these data, the experiences of clinical practice at public health center were: 1) when the student nurses begin clinical practice at public health centers for the first time, most of the students feel fearful, nervous and stressed. They also mentioned having a hard time being polite to clients and the staff. 2) The students had new experiences at the health public center compared with clinical practice. Especially, the student nurses who were determined to be good nurses were doing home visiting care service. Not only did they have the opportunity to confirm their identity as nurses, but also the students change their career course from clinical nursing to public health nursing. 4) They reflected on themselves after home visiting care service. Conclusion: On the basis of these findings, the following recommendations are made. 1) Data collection and analysis are needed, net only through the narrative method, but also through other various qualitative methods. 2) Comparative study is necessary to enhance clinical experiences through the analysis of the interfering factors and the original experiences.

• Research in Community and Public Health Nursing
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• v.5 no.2
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• pp.130-146
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• 1994

Our medical care system is trying to diversify in order to meet the client's needs, and to adjust to a medical environment which is changing very rapidly. Because current nursing theory and practice focus on holistic care, health care management, education, and research, contrary to the traditional emphasis on only assisting a physician, more autonomy and specialization for the implementation of nursing are required. Considering these trends and actual needs, the category of clinical nurse specialist should be established as soon as possible. In order to develop strategies for implementing this new professional specialty, the authors conducted a field survey and literature review of the current system in Korea. As a result, various obstacles and constraints were discovered as follows : 1) There are few accredited educational programs for the training of CNS's. 2) Several hospitals already have staff designated as clinical nurse specialist (CNS) even though the term CNS is not yet standardized or adopted in nationwide. 3) The role of the CNS is not clearly understood by the medical societies, or even nursing societies. A nurse who works in specific nursing areas such as central supply, kidney dialysis, intensive care, coronary care, etc. for a long time, considers herself /himself a CNS. Based upon the above findings, the following alternatives are recommended. 1) The role of the CNS should be defined according to specified functions and authority : professional autonomy ; counselling and educating patients and their familes, nurses, and even other medical personnel ; research on improvement of nursing ; and management of the nursing environment including medical resources, information, and cases. 2) the qualification of CNS should be attained only by a nurse who has an RN license and clinical experience of more than 3 years in a specific nursing field: passes a qualifying examination; and contributes to the professional development of peers, colleagues, and others. A master's degree should only be optional, because of the insufficient of graduate programs which are well designed for the CNS. 3) The CNS should initially be a head nurse rather than line staff in order to deal with as wide an experience base as possible. 4) The nursing specialty could be divided into two areas such as a clinical field and a community field. The clinical field could then be categorized by the Styles' classification such as diseases and pathogenics, systems, ages, acuity, skills/techniques, and function/role ; the community field could be classified according to work site.

• Korean Journal of Adult Nursing
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• v.25 no.6
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• pp.701-711
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• 2013

Purpose: The plan proposed by the Ministry of Health and Welfare in 2012 did not reflect the position of nurses and focused only on how to increase the number of nurses. There is a need for coming up with a specific and viable alternative plan considering the qualitative aspect of nursing, delegation of nursing tasks, the in-death analysis of the reasons for leaving the nursing profession, and the legal standards based on varying nursing tasks. Methods: Drawing on a review of existing literature, this report was written to examine policy directions and the factors that influence the institutional environment that regulates the supply and demand of the nursing workforce in Korea. Results: Implementing the government's plan for introducing a new type of nurse, the registered practical nurse, which generally requires a two-year associate's degree, must be reconsidered. Also, a concrete plan to make use of unemployed nurses and to close the salary gap between nurses working at hospitals in cities and those working at hospitals in rural areas must be prepared. Furthermore, there is a need for introducing a new rating system aimed at boosting the quality of nursing care in small-and medium-sized hospitals, thereby increasing the number of nursing professionals who provide high quality care. Conclusion: In preparation for expected poor quality of care and looming unemployment crisis due to the increase in the number of nursing professionals, a practical and concrete plan for the supply and demand of the nursing workforce should be made. The Korean Nurses Association should mount a profession-wide campaign to make the government formulate a new and viable policy on the supply and demand of the nursing workforce.

• Journal of Korean Critical Care Nursing
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• v.6 no.2
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• pp.65-77
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• 2013

Purpose: The purpose of the study was to analyze the nursing activities related to continuous renal replacement therapy (CRRT) in the intensive care units (ICU). Methods: We developed a list of 31 CRRT related nursing activities based on literature review and reviewed by expert group. A total of 109 direct time measurement records by 43 ICU nurses were collected and analyzed in terms of total time per shift, frequency, standard time, difficulty and performance levels of each CRRT nursing activity. Results: The mean time for CRRT nursing activity was 85.60 minutes per 8 hour shift. Nurses have spent average $9.46{\pm}6.98$ minutes in a shift for "waste fluid bag change" activity. In addition, "check catheter location" was the most time consuming single activity. The most difficult activity was "counseling-answer" and the most competent one was "dialysis solutions change". Conclusion: The CRRT nursing activities accounted for a significant portion of total nursing workload. Practical allocation of nursing staff for CRRT patient along with development of a new nursing cost system need to be considered. Continuous nursing educational and training programs on CRRT should be developed.

• Journal of Korean Academy of Nursing
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• v.44 no.1
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• pp.21-30
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• 2014

Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.2
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• pp.123-136
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• 1997

The purpose of this study was to confirm the classification of nursing activity and to analyze the time of nursing workload in a new open hospital. The data were collected from 20 nurses working in 6 general nursing units by 4 trained observers. The tools used for this study were an observation recording sheet and a classification sheet of nursing activity. The classification sheet was constructed to be adaptable to each hospital system based on the instrument described in the literature. The results of the study are as follows : The direct nursing activities consisted of 6 sections, 33 subsections and the indirect nursing activities consisted of 14 sections, 53 subsections. The direct nursing activities included medication, measuring and observation, care of therapies, care of physical comfort, laboratory and treatment. The indirect nursing activities included preparation of medical utensils, collection of information and assessment, recording, phone communication, professional interaction related to patients, personal time, assigning work to staff, patient eaucation and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. Nurses spent 127.6min for direct nursing activity during day duty. It was 24.5% of total nursing activity. Within that activity medication had the highest percentage of time(40.09%), followed by communication and education with patient(24.76%), measuring and observation (16.93%), laboratory and treatment (12.85%), care of therapies(3.21%) and care of physical comfort (2.16%). The time breakdown for indirect nursing activities is as follows ; the preparation of medical utensils 22.3%, collection of information and assessment 20.29%, recording 20.27%, phone communication 8.14%, professional interaction related to patients 7.33%, personal time 7.24%, with the remaining timeshared by staffing, patient education and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. In the analysis of the relationships between the working time and the work allocation characters of the nurses(including nurse's experiences. nurse-patients ratio, nurse-rooms ratio, and character of nursing unit) ; There were no significant differences in direct-indirect nursing times between nurse's career years. There was significant difference in direct nursing time between assigned patient numbers. The nurses assigned larger number of patients spent significantly more time in direct nursing care than that of the smaller. On the other hand, there was no significant difference in indirect nursing workload between the assigned patient numbers. There were no significant differences in direct-indirect nursing time between an allocated patient's room numbers. There was significant difference in working time between working places. The nurse in the medical unit spent more time in direct nursing care than her counterpart in the surgical unit. However there was no difference in direct nursing time between two groups. The study results indicate that nurses spent less time in the direct nursing care than in the previous studies even though the hospital system has been modernized. On the other hand they spent much more time for the coordinating role within the interdisciplinary team and for the overlapping paperwork. Therefore it is recommended that patient oriented job description and more efficient usage of modernized utilities be made.

• Journal of Korean Academy of Nursing
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• v.35 no.8
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• pp.1493-1499
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• 2005

Background. Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. Purpose. To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. Methods. A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. Results. None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. Conclusions. The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.

• The Korean Nurse
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• v.37 no.4
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• pp.58-71
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• 1998

The purpose of this study was to contribute the improvement of nursing staff development by implementing of effective and organized orientation program using the measure of effectiveness in the application of preceptor program with the reduction of the time of New entry nurse orientation. The subjects were comprised of 116 new entry nurses(59 new entry nurses were employed at June, 1996 and 57 at May & July, 1997) and 79 preceptors, who were in charge of new entry nurse orientation at 1997. These date were collected from June 18, 1996 to August 29, 1997. The characteristics of questionairs applied in this study were general characteristics(7 questions), knowledge of nursing care(138 questions); attitude toward her profession(40 questions) and the degree of satisfaction for the program(5 questions). The questionnairs were developed by the researchers of Asan Medical Center. The Check-list for basic nursing skill were used for the measurement of nursing skill which was developed by nursing department of AMC. The data were analyzed for the mean, standard deviation, difference of mean, ANOV A & t-test. The results of this study are as follows : 1) The changes in knowledge of nursing care : After three months of training the difference of mean between before and after the orientation was higher than the result of two month period training. However, the result was insignificant(p= .469). 2) Performance in nursing practice : Two month period orientation was more effective than three-month training period, however, the statistical significance can not be reached than 3 month period, which resulted in insignificant difference(p=.150). 3) The change in attitude toward her profession : After three-month of orientation, the difference of mean between before and after the orientation was higher than 2 month period orientation, which resulted in significant difference (p=.000). 4) The degree of satisfaction for the program with the time of new entry nurse orientation : After two-month of orientation, the mean of points was 2.57 where the score is higher than 3 month period with mean of 2.30. It resulted in significant difference(p=.000).

• Journal of Korean Academy of Nursing
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• v.38 no.1
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• pp.45-54
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• 2008

Purpose: The purpose of this study was to develop a balanced scorecard (BSC) for performance measurement of a Korean hospital nursing organization and to evaluate the validity and reliability of performance measurement indicators. Method: Two hundred fifty-nine nurses in a Korean hospital participated in a survey questionnaire that included 29-item performance evaluation indicators developed by investigators of this study based on the Kaplan and Norton's BSC (1992). Cronbach's alpha was used to test the reliability of the BSC. Exploratory and confirmatory factor analysis with a structure equation model (SEM) was applied to assess the construct validity of the BSC. Result: Cronbach's alpha of 29 items was .948. Factor analysis of the BSC showed 5 principal components (eigen value>1.0) which explained 62.7% of the total variance, and it included a new one, community service. The SEM analysis results showed that 5 components were significant for the hospital BSC tool. Conclusion: High degree of reliability and validity of this BSC suggests that it may be used for performance measurements of a Korean hospital nursing organization. Future studies may consider including a balanced number of nurse managers and staff nurses in the study. Further data analysis on the relationships among factors is recommended.