• Title/Summary/Keyword: Nurse' Performance

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의료보험 수가수준의 조정을 위한 의료보험경제지수 (Medical Insurance Economic Index: MIEI)의 개발 (The Development of the Korean Medical Insurance Economic Index(MIEI))

  • 김한중;손명세;박은철;최귀선;박웅섭;임종건;지영건
    • 보건행정학회지
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    • 제9권1호
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    • pp.156-177
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    • 1999
  • The current method of rate adjustment for inflation is based on the evaluation of the financial performance of hospitals. The method has the disadvantage such as too complicated, expensive process as well as low reliability. This study, therefore, develops the 'Korean Medical Insurance Economic Index(MIEI)' as a new model for the rate adjustment with the use of the macro economic indices. In addition, we calculate the 1992∼1998 rate adjustment with the MIEI, and examines the validity of the MIEI by comparing with the conventional method. Medical costs are classified into nine categories : physician salaries, nurse·pharmacist·medical technician salaries, assistants & others salaries, material cost(by imports), material cost(by domestics), depreciation & rent paid(by imports), depreciation & rent paid(by domestics), power utilities, other administrative costs. Then the category weight which is the ratio of category in the total cost is calculated. Macro economic indices are selected for each cost category in order to reflect the concept of the each cost category and inflation during the year of 1992∼1998. Finally MIEI which integrate all category according to the category weight and selected macro indices is calculated. The mean of hospital MIEI which weighting by amount paid by insurers was cacluated. The result from the application of empirical data to the MIEI model is very similar to that of the current method. Furthermore, this method is very simple and also easy to get social consensus. This MIEI model can be replaced the current method based on the analysis of the financial performance for the adjustment of medical fees.

환자간호실무 표준에 관한 연구 (A Study on the Patient Care Standard)

  • 윤석희;강채원;전미수;김용순;김명욱;박성애;김혜자;이병숙;정면숙;전명희
    • 대한간호
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    • 제31권1호
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    • pp.68-87
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    • 1992
  • The purpose of this study is to develop a patient care standard which is the basis of unit based quality assurance. The subjects were 570 nurses of 6 hospitals is Seoul. Patient Care Standards were developed from 3 times of clinical Nurses Association's workshop & the joint meeting of Clinical Nurses Association & the Korean Nurses Academic Socity of Nursing Administration. Respondents were instructed to rate of the 2 types of 5 - point Likert type questionnaire(one is the level of perceived importance, the other is the level of actual performance) Findings of this study were as follows 1. As a results of reliability analysis, each questionnaire ranged from $\alpha$=0.79 to 0.94

    2. The Correlations between the levels of perceived importance & actual performances were ranged from r=.40 to 0.72(P=.00) 3. There were significant differences in the level of percevied importance according to the several variables. $\circled1$ Chemotherapy unit; df=5, F=4.06, P=.000/hospital $\circled2$ Pediatric unit; df=5, F=2.8, P=.02/hospital $\circled3$ OBGY ; df=5, F=4.20, P=.00/hospital $\circled4$ ICU ; df=5, F=2.83, P=.02/hospital df=3, F=5.38, P=.00/age df=3, F=6.22, P=.00/total duration. $\circled5$ GS ; df=3, F=3.37, P=.02/total duration 4. There were significant difference in the level of actual performance according to the several variables. $\circled1$ Chemotherapy unit; df=5, F=2.89, P=.02/hospital df=3, F=3.07, P=.03/age df=3, F=3.61, P=.02/total duration $\circled2$ OBGY ; df=5, F=15.48, P=.00/hospilal df=3, F=7.83, p=.00/total duration $\circled3$ GS ; df=5, F=6.70, P=.00/hospital df=3, F=4.49, P=.01/age df=3, F=5.99, P=.00/total duration $\circled4$ ICU ; df=5, F=2.96, P=.02/hospital df=3, F=4.39, P=.0l/age df=3, F=5.20, P=.00/total duration

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  • 가정간호서비스에 대한 대상자 만족도 측정도구 개발 (The Development of Client Satisfaction Instrument in Home Care Service)

    • 박현태;박정호
      • 가정∙방문간호학회지
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      • 제8권2호
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      • pp.159-170
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      • 2001
    • Client(patient) satisfaction has been used for a variety of purposes in different settings, yet, those receiving home care services have been the focus of few satisfaction studies. Satisfaction is considered an indicator of quality of care and is also being used to assess the performance of home care providers and home health care delivery at multiple levels. The aim of this study was to develop the tool for evaluating client satisfaction in several aspects with home care service while maintaining or achieving acceptable reliability and validity. Firstly, Client Satisfaction Instrument made preliminary of 43 items composed basic 6 criteria and 7 indicators, based on a review of literature, quality improvement and client satisfaction findings in home care. Secondly, there were consisted in two expert panel groups who were made in professionals of research and practice in home care field. The tool was modified to 6 criteria and 7 indicators, 25 items after reviewing by two expert panel groups. The content validity index of the tool was above 0.8 and the results of internal consistency was more than 0.8 in all items. Finally. The Client Satisfaction Instrument in Home Care Service was made up 6 criteria such as client satisfaction of nurses's instruction of home care educational need. knowledge/technique/attitude of homecare nurses's performance. interpersonal relationship and emotional support of nurse. easiness of homecare accessibility, continuity of homecare service. overall efficacy of homecare use, 7 indicators. and 25 items. The results of evaluating client satisfaction will be able to contribute in quality improvement and service marketing in home care.

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    혈액투석실 간호사의 혈액매개감염 지식, 감염관리 수행 및 수행 장애요인 (Knowledge on Blood-borne Infections, Compliance and Barriers on Blood-borne Infection Control among Nurses in Hemodialysis Units)

    • 정선애;박경연
      • 기본간호학회지
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      • 제25권1호
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      • pp.22-32
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      • 2018
    • Purpose: The study was done to examine hemodialysis unit nurses' knowledge on blood-borne infections, compliance and barriers to control and predictors of compliance. Methods: A descriptive correlational study was conducted with 122 nurses from hemodialysis units. Data were collected using a structured questionnaire. The data collection period was May to September, 2017. Data were analysed using descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple linear regression. Results: The mean score for knowledge on blood-borne infections was $15.41{\pm}2.01$ out of 19 and the compliance with blood-borne infection control was $4.08{\pm}0.49$ out of 5. Barriers to the performance of blood-borne infections control were lack of time and personal protective devices. Knowledge on blood-borne infection did not correlate with compliance on blood-borne infection control (r=.13, p=.171). Predictors of compliance on blood-borne infections control were 1) infection control education on injuries caused by injection needles (${\beta}=.23$, p=.010), 2) infection control room (${\beta}=.24$, p=.006) and 3) blood exposure experience over the past week (${\beta}=-.24$, p=.005) and explained 22.2% of the variance (F=10.81, p<.001). Conclusion: Findings suggest that to improve the performance of blood-borne infectious disease management, customized education for nurses on blood-borne infection and systematic support related to the infection control room should be given priority.

    요양병원의 입원급여 적정성 평가 결과에 미치는 영향 요인 분석 (Factors influencing the composite quality score from the quality assessment program for long-term care hospitals)

    • 이상갑;설진주;이광수
      • 한국병원경영학회지
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      • 제25권3호
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      • pp.78-86
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      • 2020
    • Purposes: This study purposed to identify factors influencing the composite quality score from the quality assessment program for long-term care hospitals Methodology: The study variables was obtained from HIRA(Health Insurance Review and Assessment Service): the composite quality scores and hospital variables such as number of doctors, nurses, beds, medical technicians, medical equipments, administrative region, ownerships from 3rd (2010) to 7th (2018) quality assessment program. National Statistical Portal(www.kosis.go.kr) provided the number of senior citizens aged over 65 in city·county·district area. SAS 9.4 was used for the data processing and used to analyze the data. Findings: The results showed that composite quality score increased past 9 years. Hospital variables such as number of doctor, nurse, medical technicians, bed and public hospitals had significant positive relationship with the composite quality score. Administrative region(district) showed higher scores compare to that of city. Compare to the score of quality assessment year(2010), as the assessment year move to 2012, 2013, 2015, 2018, results showed higher significant positive coefficients. Practical Implication: Continuously improve the performance of long-term care hospitals, current quality assessment program are needed to update their system such as adopting indicators measuring the service process, or compensating the cost for quality assessment program. It will enable to provide more reasonable and accurate performance assessment scores.

    간호사만족이 병원성과에 미치는 영향 -환자만족과 재방문의향, 타인추천의향 중심으로- (The Effects of Nurses' Satisfaction on Hospital Performance -Focused on the Patient Satisfaction and Revisit Intention, Recommendation Intention-)

    • 한주랑;안성희
      • 디지털융복합연구
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      • 제13권9호
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      • pp.419-430
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      • 2015
    • 본 연구는 이론적 고찰을 기초로 하여 대학병원의 간호사만족도, 간호사에 대한 환자만족도, 병원에 대한 환자만족도, 환자의 병원재방문의향 및 타인추천의향 간의 가설적 구조모형을 구축하고, 모형의 적합성과 경로의 유의성을 확인하였다. 연구대상은 5개 대학병원의 간호사 2,079명과 해당 병원의 의료서비스를 받은 6,776명의 환자이다. 연구결과 가설적 모형은 전체적인 적합지수를 고려하였을 때 적합한 모형으로 판단되었으며, 간호사의 만족도가 환자의 간호사에 대한 만족도에 미치는 영향, 환자의 간호사에 대한 만족도가 환자의 병원에 대한 만족도에 미치는 영향, 환자의 병원에 대한 만족도가 병원재이용의향과 타인추천의향 미치는 영향 등의 4개 경로가 유의한 것으로 나타났다. 본 연구결과는 병원의 경영자와 관리자들이 간호사 만족도를 병원성과의 주요 요소로 포함하여 고객만족전략을 실천할 수 있는 기초자료로 활용될 수 있을 것으로 기대된다.

    근거기반 정맥주입요법 간호실무지침 실무적용 프로그램 개발 및 평가 - 중소병원을 대상으로 (Development and Effectiveness of Practice Application Program of Intravenous Infusion Evidence-Based Nursing Practice Guideline - for Small and Medium Sized Hospitals)

    • 홍인화;은영
      • 대한간호학회지
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      • 제50권6호
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      • pp.863-875
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      • 2020
    • Purpose: This study was conducted to develop and test the effects of a program for practice application of intravenous infusion evidence based nursing practice (EBP) guidelines in small and medium-sized hospitals. Methods: A mixed method research design was used, combining non-equivalent control group pre-post test design with qualitative study analysis. The subjects consisted of 55 nurses. The practice application program was developed based on the Advancing Research and Clinical practice through close Collaboration (ARCC) model. Data were collected for analysis in the following areas: nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, importance about intravenous infusion, and performance about intravenous infusion, with data assessed using valid and reliable instruments. Patient outcomes were collected from the hospital's medical records. Data were analyzed using t-test, χ2-test, and Shapiro-Wilk test, with qualitative content analysis used for interview data. Results: Following the intervention, nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, and performance of intravenous infusion and perceptions of its importance showed significant improvement in the experimental group. Phlebitis rates decreased in the experimental group compared to the control group. Conclusion: This program is effective to improve nurse's perception and practice of evidence based nursing. Therefore we recommend to use this program at same levels of hospitals.

    병원 응급실에서 여러 속성을 고려한 간호사 치료태스크 할당 규칙에 관한 연구 (A Task Assignment Rule for the Registered Nurses of the Emergency Department of Hospital Using Multiple System Attributes)

    • 김대범
      • 한국시뮬레이션학회논문지
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      • 제18권4호
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      • pp.107-116
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      • 2009
    • 병원 응급실의 환자 과밀 현상이 점점 더 심해지고 있는 상황이다. 본 연구에서는 응급실의 치료 서비스 수준 및 시스템 효율을 개선하는 방안의 일환으로 간호사에게 치료 테스크를 할당하는 규칙을 개발하고자 한다. 제시하는 규칙에서는 매 치료 테스크 할당 시에 4개 속성 즉 1)태스크의 수행시간, 2)치료 요청 후의 흐른 시간, 3)모든 치료가 다 끝날 때까지의 총 남은 시간, 4)남은 치료단계의 개수를 동시에 고려한다. 각 치료 치료태스크의 기준별 긴급도를 계산하고, 기준별 중요도를 반영한 전체긴급도 값을 계산한 후 이 값이 가장 큰 태스크에 간호사를 할당한다. 컴퓨터 시뮬레이션을 통하여 M 병원 응급실의 간략화 모형을 대상으로 기존규칙과 비교실험을 수행하였다. 환자가 응급실에 머문 평균시간 및 단위시간 동안 처리한 환자 수를 평가기준으로 실험한 결과 제시한 규칙이 두 기준 모두에서 우수한 성능을 보였다.

    임상 간호사의 교대근무 기간이 circadian rhythm 변화에 미치는 영향 (Effect of Shift Interval for the Clinical Nurse on the Circadian Rhythm)

    • 황애란;정현숙;임영신;이혜원;김조자
      • 대한간호학회지
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      • 제21권2호
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      • pp.129-149
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      • 1991
    • Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entrainment of the pacemaker timing the human circadian sleep - wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. This study was a quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to a weekly shift group and another ten to a biweekly shift group engaged in a semi -continuous shift schedule(sunday off) with a backward direction, that is, morning -evening - night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking tim, sleep - wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep- wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep -wake cycle for subjects on the morning, evening, and night shift in both of the shift groups(weekly shift group : λ=0.121, p<0.01, λ=0.112, p<0.01, biweekly shift group : λ=0.116, p<0.01, λ=0.084, p<0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group. In the weekly shift group, physical fatigue was significantly different for the first day and the sixth day of the night shift(t=-2.28, p<0.05). Physical fatigue and total fatigue on the first day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=5.79, p<0.01, F=4.56, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05), Physical fatigue, neurosensory fatigue and total fatigue on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=12.65, p<0.01, F=7.77, p<0.01, F=9.68, p<0.01). There was a significant difference between the shift groups and the control group(p<0.05). 4. No difference in mental performance was seen between the first day and the last day of work in each case. An arithmatic test on the first day of the night shift revealed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.79, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05) . The digital symbol substitution test and the arithmetic test on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.68, p<0.05, F=5.55, p<0.01), and both showed a significant difference between the shift groups and the control group(p<0.05). Accordingly, this study showed that during night duty, the waking time, sleep- wake cycle, and fatigue increased and mental performance decreased compared with morning and evening duty. It was also found that the weekly shift group had a higher fatigue score on the sixth day of night duty as compared to the -first day, but the waking time, sleep- wake cycle, and mental performance revealed no difference for the duration of the night duty or between shift groups, and complete adaptation of temperature rhythm was achieved between the sixth and ninth day of night duty. It is possible to conclude from these results that for intermediate circadian type in a healthy young woman, a biweekly shift system is more compatible with the circadian timing system than weekly shift system.

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    간호대학생의 자기효능감, 의사소통능력, 비판적 사고성향 및 임상수행능력에 관한 연구 (Study on Self-efficacy, Communication competency, Critical thinking disposition and Clinical performance ability of nursing students)

    • 김미옥
      • 한국산학기술학회논문지
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      • 제17권6호
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      • pp.609-617
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      • 2016
    • 본 연구는 간호대학생의 자기효능감, 의사소통능력, 비판적 사고성향과 임상수행능력의 관계를 확인하고 각 요인들이 임상수행능력에 미치는 영향을 파악하여 학생들의 임상수행능력 향상을 위한 교육과정 개발 및 교수학습방법 개발을 위한 기초자료를 얻기위해 시도되었다. 본 연구의 목적을 이해하고 동의한 간호대학 3, 4학년에 재학중인 학생 274명을 대상으로 구조화된 설문지를 이용하여 2015년 9월 1일부터 9월 20일까지 자료수집하였고, 수집된 자료는 SPSS WIN 21을 이용하여 빈도와 백분율, t-test, ANOVA, Pearson 상관계수, 다중회귀분석을 시행하였다. 연구결과, 간호대학생의 자기효능감, 의사소통능력, 비판적 사고성향은 보통이상으로 나타났고 변수들간의 관계는 자기효능감(r=.533, p<.001), 의사소통능력(r=.497, p<.001), 비판적 사고성향(r=.439, p<.001) 모두 임상수행능력과 높은 정적 상관관계를 보였다. 그리고, 자기효능감, 의사소통능력, 비판적 사고성향의 순으로 임상수행능력에 영향을 미치는 것으로 나타났으며, 설명력은 40.8%였다. 따라서, 간호대학생의 임상수행능력을 향상시키기위해서는 학생 개개인이 가지고 있는 자기효능감, 의사소통능력과 비판적 사고성향에 대한 고려가 우선적으로 이루어져야 하고 나아가서 이러한 요인들을 증진시킬 수 있는 교과 및 비교과 교육과정의 개발과 효율적인 교수학습방법에 대한 연구가 필요하다.