Purpose: This study was to find out hospice nurses and other health professionals' perception on the system of hospice and palliative nurse specialist. Methods: Using questionnaire, 63 nurses and 22 other health professionals answered about the benefit required qualification, workforce standard, and the extent of autonomy needed for hospice and palliative nurse specialist. Data was collected from August, 2002 to November, 2002. and analyzed by using SPSS 10 program. Results: 1) 96.4% of the subjects perceived that hospice nurse specialist will improve the quality of care and patient satisfaction. 2) The most frequent response for the type of education required for hospice nurse specialist was one year post RN program. 3) The most frequent response for the required clinical experience of hospice nurse specialists was minimum of four to five years. 4) The most important qualification for the hospice nurse specialists was an "good relationship with others", and "clinical experience". 5) One to two hospice nurse specialist per hospice facility was viewed as a sufficient number. 6. Autonomy was viewed as the most important characteristic which should be granted to hospice nurse specialist. Conclusion: The results of this study can be used as a basic information in establishing hospice nurse specialist program.
The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.
Various accidents and injuries are currently occurring in Korea at increasingly high rates. Good quality emergency care service is urgently needed to cope with these various forms of accidents and injuries. In order to develop a sound emergency care system, there need to be a plan to educate and train professionals specifically in emergency care. One solution for the on going problem would be to educate and train emergency clinical nurse specialists. This study on a strategy for curriculum development for emergency clinical nurse specialist was based on the following five content areas, developed from literature related to the curriculum of emergency nursing and emergency care situation : 1. Nurses working in the emergency rooms of three university hospitals were analyzed for six days to identify categories of nursing activities. 2. Two hundreds and eleven nurses working in the emergency rooms of 12 university hospitals were surveyed to identify needs for educational content that should be included in a curriculum for the clinical nurse specialist. 3. Examination of the environment in which emergency management was provided. 4. Identification of characteristics of patients in the emergency room. 5. The role of emergency clinical nurse specialist was identified through literature, recent data, and research materials. The following curriculum was formulated using the above mentioned process. 1. The philosophy of education for emergency clinical nurse specialist was established through a realistic philosophical framework. In this frame, client, environment, health, nursing, and learning have been defined. 2. The purpose of education is framed on individual development, social structure, nursing process and responsibility along with the role and function of the emergency clinical nurse specialist. 3. The central theme was based on human, environment, health and nursing. 4. The elements of structure in the curriculum content were divided to include two major threads, I, e., vertical and horizontal : The vertical thread to consist of the client, life cycle, education, research, leadership and consultation, and the horizontal thread to consist of level of nursing (prevention to rehabilitation), and health to illness based on the health care system developed by Betty Neuman system model. 5. Behavioral objectives for education were structured according to the emergency clinical nurse specialist role and function as a master degree prepared in various emergency settings. 6. The content of the curriculum consisted of three core courses(9 credits), five major courses(15 credits), six elective courses(12 credits) and six prerequisite courses (12 credits). Thus 48 credits are required. Recommendations : 1. To promote tile quality of the emergency care system, the number of emergency professionals, has to be expanded. Further the role and function of the emergency clinical nurse specialist needs to be specified in both the medical law and the Nursing Practice Act. 2. In order to upgrade the qualification of emergency clinical nurse specialists, the course should be given as part of the graduate Program. 3. Certification should be issued through the Korean Nurses Association.
Purpose: Ongoing treatment and care, as well as initial stabilization, are required for trauma patients. With increasing number of sickest trauma patients and shortage of surgeons, the need for advanced practice nurse to provide and coordinate trauma care has been greater. The purpose of this study is to analyze the effect of hiring a trauma clinical nurse specialist and its influence on the treatment of trauma patients. Methods: Based on the employment of the clinical nurse specialist in December 2010, the patients were divided into two groups: patients admitted from January 1, 2010 to November 30, 2010 and patients admitted from December 1, 2010 to December 31, 2011. Retrospectively, data were collected using electronic medical records. The general characteristics, clinical courses, and ICU re-admission rates, collaboration (transfers to other departments and collaborative surgery) were compared. Results: To have a clinical nurse specialist on the trauma team resulted in a statistically significant reductions in the length of general ward hospital stay (p<0.05), the ICU re-admission rate, (p<0.03), the lead-time before transfer to other departments (p<0.05). Conclusion: The clinical nurse specialist, as a professional practitioner, improved the quality of treatment through early detection and management of problems. In addition, as a coordinator, the clinical nurse specialist maintained a cooperative relationship with multi-disciplinary medical personnel. The trauma clinical nurse specialist contributed to the treatment of trauma patients positively through a decrease in ICU re-admission rate and length of hospital stay.
One-hundred eighty four medical doctors and 349 nurses out of 6 university hospitals and 1 general hospital were surveyed from Mar. 3, to Mar. 31, 1995, in order to appreciate the extent of their understandings on the clinical nurse specialist system. The difference was analyzed by the subjects' age, their position and department, the expected benefits of the system. the assigned department, the position and qualification, the required special educational organization and program, and the extent of autonomy of the function of clinical nurse specialists and the special nursing field. The results were as follows ; 1. The perception about the expected benefits of the introduction of clinical nurse specialist system was significantly different among the age groups of medical doctors, and the age group of 40s among them showed the most positive perception. 2. The extent of acquaintance with clinical nurse specialist was the higher in the older age groups of respondent nurses. Meanwhile, the experience of participation with clinical nurse specialists was the more in the older age group of medical doctors. 3. The opinion about the required position of clinical nurse specialists was significantly different by the age and position of the respondent nurses. The rank of head nurse was suggested by the respondent nurses of older age and higher positon, while the level of in-charge nurse was suggested by the staff nurses. Also, the duration of clinical experience required of clinical nurse specialists was the most frequently responded as 6 to 10 years by nurses, as 2 to 5 years by medical doctors. 4. The degree of educational background required of clinical nurse specialists was differently responded by the various position of medical doctors and nurses. Of the medical doctors, professors frequently responded bachelor degree and medical residents frequently responded master degree as the required educational background. Of the nurses, nursing administrators more frequently responded that master degree was required of clinical nurse specialists than staff nurses and clinical nurse specialists did. 5. The extent of acquaintance with clinical nurse specialist system was different among the various department of medical doctors, which was the highest in the doctors of psychiatry, internal medicine and pediatrics, respectively. The doctors of surgery were the least acquainted of clinical nurse specialist. 6. The nurses of special parts, of surgery and of obstetrics & pediatrics responded more frequently that clinical nurse specialists should belong to the nursing department than the nurses of internal medicine and of others did. 7. The Special parts that necessitate clinical nurse specialists were responded to be the more important by nurses than by medical doctors. Clinical nurse specialists were responded to be the more necessary in the parts of diabetics, oncology, pyschiatry, dialysis, organ transplantation, intensive care, and in cardiovascular part. They were responded to be the less important in the parts of intravenous therapy, computer informatics, nursing administration, the improvement of nursing quality.
Purpose: The purpose of this study was to identify related factors in the organizational socialization of new nurses, focusing on the reality shock of new nurses and social support by education specialist nurses. Methods: Participants were 122 new nurses with clinical experience of 1 year or less as nurses working in a general hospital that is carrying out a pilot project for a new nurse training system. Data were collected using self-report questionnaires which included identification of participants' characteristics, social support of education specialist nurse, reality shock and organizational socialization. Results: The organizational socialization score was 3.07±0.45 points. The results of the stepwise multiple regression showed that factors affecting organizational socialization of new nurses were social support by gender, education specialist nurse and reality shock. These three variables accounted for 72.0% of organizational socialization. Conclusion: These findings suggest that the social support of education specialist nurses be enhanced to increase the organizational socialization of new nurses. There is also a need for a program to decreased the reality shock of new nurses.
Purpose: The purpose of this study was to explore the role of nurse specialist in the general hospital, and to provide basic data for the role management of nurse specialist. Method: The subjects were 38 staff nurses who worked in a medical, surgical, or other department in one general hospital. Survey tools were developed with criteria for a clinical nurse specialist by American Nurses Association(1986), Korean Nurses Association(2001), Kim(2005)'s research, and the nurse specialists' self job description. Validity of the tool was examined by 5 clinical nursing experts and nurse specialists. Data analysis was done by using SPSS Win 12.0 program. Result: The results of domains for the job of nurse specialists were 61.6% for direct clinical practice, 21.7% for education, 5.7% for consultation, 5.2% for management, 5.2% for research, and 1.1% for other domains. The results for the large classifications in nurse specialists domains were 57.6% for direct nursing practice in direct clinical practice domain, 89.1% for patient education in education domain, 57.5% for medical consultation in consultation domain, 57.5% for medical research in research domain, and 39.2% for documentation in management domain. Conclusion: This research revealed that direct clinical practice domain was higher than the other domains of research, education, and management. Discussion and development about the nurse specialist's various roles needs to be addressed on a continual basis.
Purpose: To make a contribution to raising the quality of nursing and home healthcare services through reviewing the present state of home healthcare nurse specialist training institutions and education programs and creating concrete measures to establish high-quality education courses. Method: International comparative study of accreditation criteria and curriculum in home healthcare nurse specialist program. Result: The Authorization Standards of home healthcare nurse training institutions consists of 8 items, 23 evaluation criteria and 72 evaluation indexes. Proposal to develop a specialist training program: Curriculum. Modify and complement a present homecare nurse education program. Curriculum I. Designate two forms of certification. The first certification has been granted the authority to serve as a manager and open a home healthcare agency to nurses having masters degrees and clinical experience for five years. The second certification is allowed to perform general home healthcare after having completed a short term training course. Currculum 2. To meet increasing demands, granting a certification to perform home healthcare to registered nurses having clinical experience of more than three years. Conclusion: These results can be utilized in the home healthcare educational program for raising the quality of nurses and home healthcare services.
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