• Journal of Korean Critical Care Nursing
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• v.14 no.2
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• pp.42-56
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• 2021

Purpose : The purpose of this study was to understand and describe the experiences of the advanced nurse practitioner (APN) system used by healthcare providers including APNs, doctors who worked with APNs, and APN master's course professors at a graduate school. Methods : Qualitative data were collected via snowball sampling. The participants were nine APNs, six doctors, and three professors. They were divided into three focus groups, each of which consisted of all three types of healthcare providers. Data were collected via interviews with the three focus groups conducted from September to October 2019. All interviews were audiotaped and transcribed verbatim. The transcribed data then underwent qualitative content analysis. Results : Based on the data, we extracted four themes and 14 categories. The themes were "Role and system of APNs started according to healthcare environment changes", "Optimal healthcare provider to ensure quality of care", "Confused role and system of APNs due to incomplete medical law", and "Tasks for the stable operation of the APN system." Conclusion : For quality treatment and safety of patients, a legal basis must be established for the APN system. For its stable operation, social consensus regarding legislation about APNs' scope of practice is required. Finally, a discussion is necessary about the integration of APNs' 13 fields.

• Journal of Korean Academy of Nursing
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• v.32 no.6
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• pp.917-928
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• 2002

The traditional nursing roles have become increasingly blurred. Nurses are now working in different ways and at higher levels of practice that enable nurses to adapt their roles and take on new responsibilities. The advanced role of nurses requires a different kind of master-level prepared education. Method & Result: This article describes an curriculum development process in preparing registered nurses for their advanced nurese' roles in the area of acute adult health nursing, geriatric nursing, pediatric nursing, neonatal intensive care nursing and oncology nursing. Several important issues to be solved regarding introduction of APN were also discussed. Conclusion: The curriculum that was proposed in the study will equip nurses to meet the challenges of future healthcare provision and will be a model to other areas of nursing practice and curriculum development.

• Journal of Korean Academy of Nursing
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• v.37 no.4
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• pp.586-593
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• 2007

Purpose: The purpose of this study was to describe patients' anxiety in the ICU and to investigate related factors on the anxiety level. Methods: An exploratory cross-sectional survey design was used. Forty-eight patients participated in the study. Questionnaires were asked to patients who had been cared in the ICUs. Results: Related to the anxiety level, the mean of the total anxiety score was 5.47, and 60% of the patients had moderate or severe level of anxiety. Patients from the coronary care unit had a significantly higher level of anxiety than those from surgical intensive care unit or pulmonary surgery care unit. Moreover, significantly different levels of anxiety were found among patients who had been stayed for 2, 3, or 4 days. Conclusion: Patients who were from the coronary care unit or had been stayed longer (up to 4 days) in the ICU were significantly associated with higher anxiety level.

• Journal of Korean Academy of Rural Health Nursing
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• v.4 no.1
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• pp.31-40
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• 2009

Purpose: This research was done do identify and analyze the beginnings of the community health practitioner system in the Republic of Korea (ROK) around 1980. Method: Primary sources were collected and analyzed, mainly newspapers around 1980, the act for health service for rural areas, and other relative publications. Results: The government of the ROK was trying to solve the problem of doctorless villages and regarded the introduction of primary health care (PHC) services using registered nurses (RNs) to be an economic solution to this problem. The Korean Nurses' Association presented 'a plan for community health service' to the government party and medical association in 1976. In this plan, RNs would provide primary care at the sub-county (myun) level, and hospital would provide secondary care. The Korean Public Health Development Research Center was awarded the project 'RNs and nurse aids as CHP for primary care service and their training'. In 1977, 25 RNs began to work as PHC in 3 areas, and interim findings showed that RNs were very capable of doing PHC. The Ministry of Health and Welfare announced long term plans for health and welfare administration including a tertiary health care delivery system. RNs after training were posted to rural areas with no medical services to do medical treatment for mild cases. The Act for health services for rural areas was enacted on December 31, 1980. Enforcement Ordinance and Enforcement Regulations were enacted in 1981. In 1981, 257 CHP were selected, trained, and deployed. In 1983, the president of the ROK announced continuation of the CHP system for residents of medically vulnerable areas. The number of CHP increased from 257 in 1981 to 2038 in 1989.

• The Journal of Korean Medicine
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• v.29 no.3
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• pp.100-112
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• 2008

Objectives: The purpose of this survey is to monitor the changes that have occurred in the business environment surrounding Oriental medicine clinics, with the focus on their facilities, staff, patients, and service fee revenue. Method adopted: A questionnaire was sent in December 2006 to 1,000 Oriental medicine clinics nationwide, of which 122 (or 12 percent of them) replied. Previous questionnaires similar to this one in nature were checked for comparison. Results: As a result of analyzing the aforesaid replies, the average Oriental medicine clinic appears to have a floor size of 156 square meters (= 47.2 pyeong) and is equipped with 6.6 beds. The number of helpers and nurse's aids at each Oriental medicine clinics comes to 3.2 and 1.58, respectively. The number of patients coming to see a practitioner of Oriental medicine stands at 36.3 persons per day, of whom 32.06 come for acupuncture treatment. 50.2 percent of the Oriental medicine clinics' service fee revenue is paid from the health insurance. Each clinic spends on average 2.42 million won per month on the purchase of medicinal substances and so forth. The foregoing indicates a 27 percent increase from 1999 in terms of floor size, a 30 percent increase in the number of beds, a 47 percent increase in the number of helpers, a 45 percent increase in the number of nurse's aides, and an 11 percent increase in the number of patients who visit a practitioner of oriental medicine. As for the latter figure, there was an increase of 3.64 over a seven-year period. The number of patients coming for acupuncture treatment increased by 7.06 in the same period, whereas the number of those coming for medication treatment decreased by 4.28 percent. Health insurance payments as a proportion of Oriental medicine clinics' service fee revenues increased by 23.9 percentage points from 26.29 percent in 1997 to 50.2 percent in 2006. The amount that a clinic spends on the purchase of medicinal substances, etc, decreased by 250,000 won or by 9.3 percent from 1999. The estimated value of the domestic Oriental medical service market for 2006 stood at 2,422.2 billion won in total. Conclusion: Oriental medicine clinics in Korea appear to be getting larger, with an increase in the number of beds and helpers. Health insurance payments now account for a greater proportion of Oriental medicine clinics' service fee revenues, and management conditions at the clinics are deteriorating.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• Asian Oncology Nursing
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• v.11 no.2
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• pp.155-162
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• 2011

Purpose: The purpose of this study was to examine the actual care costs paid to Korean Oncology Advanced Practice Nurses (KOAPN). Methods: We collected data using a group discussion and questionnaire identified 115 tasks from job descriptions developed by the Korean Accreditation Board of Nursing. Forty-two KOAPN working at three university hospitals in Seoul were asked to evaluate each task as to type and whether the cost is paid or not. They were also asked to indicate the tasks in urgent need of development of a care cost with high priority. Results: Only five tasks (4.3%) related to treatment and complication related interventions or education were paid, and they were paid only once during the entire treatment period and were not covered by national health insurance. It was approved as a medical fee by health insurance review & assessment service. Furthermore, the names of the authority (doctor) and the actual provider (nurse) of the prescriptions were different for three of those tasks. Most of the suggested tasks needing development of care costs were actions specifically performed by nurses (physical-psychosocial-spiritual assessment, independent nursing interventions). Conclusion: KOAPN are currently paid for few tasks. To maximize the utilization of KOAPN, the establishment of a clear rational payment system directly related to their actual activities is needed.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.236-247
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• 2017

Purpose: This study was to present improvement strategy and the problems of the nursing fee in national health insurance system. Methods: A total of 23 nursing activities performed by nurses were selected. Data were collected the relative value score and criteria of the Health Insurance Review & Assessment Agency. Sixty clinical nursing experts panels were composed and nursing time surveyed self-reported method. The actual fee was calculated through the nursing time, relative value score and actual labor costs. Nextly, the labor costs analyzed was compared with that in the national health insurance. Results: Although the practices were mainly performed by the nurse, other occupations have been recorded as main practitioners and the time of the nursing activity is partially improperly reflected. Additionally, although the nurse practiced mainly in glucose (semi-quantitative) test, it was confirmed that the principal practitioner was described as a clinical pathologist. The the labor cost gap was estimated that is 9.3 times (median) and 11.9 times (average) in this analysis. Conclusion: This study suggests that it is necessary to legislate a policy that can improve the quality of clinical nursing by reinforcing the appropriateness and improving nursing fee through reflection of the actual time spent for nursing care.

• Korean Journal of Adult Nursing
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• v.13 no.1
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• pp.53-69
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• 2001

As a nursing practice involves nurses'actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives. Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal); excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, accountability and commitment(4 theories of nursing ethics); human respect, partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences, positive perspectives(4 theories of nurse), role of intervention, rewarding, peer relationship(3 theories of situations). The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore, it is recommended to review the theories-in-use in order to find any discrepancies between the espoused theories and the reality of nursing actions.

• The Korean Journal of Rehabilitation Nursing
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• v.12 no.1
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• pp.30-38
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• 2009

Purpose: The purpose of this study was to compare the rehabilitation nursing services what nurses recognize to be important and what they do in practice of the industrial workers. Method: The subjects were 150 nurses who were working at the industrial hospital. The questionnaire was made up with 43 items about the perception on importance and performance of rehabilitation services. Result: The highest services in the perception on importance and performance subscale were physical and therapeutic services. The highest difference between perception on importance and performance was the social and occupational services. The perception on importance of rehabilitation services had positive correlation with performance. The group take care of general patients had a higher level of perception on importance than the other group, and level of performance had significant difference with age and position. Conclusion: We need to develop the strategy for promoting the performance of services that recognize it will be important services, but not to do. Further study on system for promoting the nurse practitioner who responsible for rehabilitation nursing.