• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.279-294
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• 1996

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

• 간호행정학회지
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• 제6권1호
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• pp.55-81
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• 2000

This study examined nursing care in a Newborn Intensive Care Unit (NICU) by reviewing nursing activities for the newborns. Through direct observation, time used for nursing care according to the nursing activity, shift, day of the week, and position of the nurses was measured. This study was done on November 15, 21, 24, 1999 at a university medical center hospital and included eight nurses and 179 newborns as the study subjects. The data were collected from the medical records, and by using a nursing activity record for the NICU, and a nursing activity time record for the NICU. The first step in the data collection process was to develop a list of nursing activities which was done through a literature review, examination of medical affairs and duty records. Content validity was measured by a panel of three professors who were experienced clinicians. In the second step two pre-training sessions were held with three sophomore student nurses who then measured the time for each nursing activity using a stopwatch. The data were analyzed using frequencies for nursing activities, averages, percentages and ANOVA for differences between shift and between days of the week, and percentages and t-test for differences according to position of the nurse. The results are as follows: 1) The total number of activities was 156, direct or indirect nursing activities. Direct nursing activity classified according to physical, educational, emotional/social/economic/spiritual needs. There were 109 direct nursing activities in 16 fields. 2) The order of nursing activities, according to time required, was record keeping, nutritional care, measurement/observation, medication, hygiene care, examination and specimen collection, and checking supplies, and according to frequency, measurement/ examination, record keeping, nutrition care, hygiene care, elimination care and medication. 3) According to shift, direct care during the night shift at 313.4 minutes was the longest time and indirect nursing care during the night shift at 252.2 minutes was the highest time. 4) For days of the week, Monday had the highest time for direct care 275.8 minutes (34.6%) and Wednessday had the highest time for indirect nursing care 269.6 minutes (36.1%). 5) For nursing time according to position of nurse, general nurses had the highest for direct care (330.7 minutes), nurse managers for indirect nursing activities (239.0 minutes) and general nurses for individual private time (63.9 minutes). The results of this study show that the major nursing time consuming activities included record keeping, nutrition care and measurement/examination. For newborns, time needs to be allowed for care to be sensitive, sophisticated and specialized rather than concentrated on indirect nursing tasks such as record keeping. Therefore, it is imperative to develop computerized systems that support a systematic approach to record keeping which is more efficient. Moreover, nursing needs according to shift, day or position of nurse can be utilized in assessing nursing resources through a computerized process.

• 기본간호학회지
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• 제13권3호
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• pp.368-375
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• 2006

Purpose: The purpose of this study was to investigate the risk factors of exposure to blood and body fluid by clinical nurses. Method: The participants in this descriptive study were 276 clinical nurses involved in nursing care in a general hospital located in Seoul. The collected data were analyzed using a logistic regression model. Results: The annual exposure rate to blood and body fluid by clinical nurses was 66.3%, and the ratio was higher in the exposed group than in the non-exposed group for nurses under the age of 25, nurses who were unmarried, nurses with low clinical experience, and nurses who work night shifts more than six days a week. Clinical nurses who were unmarried were 1.9 times more likely to have been exposed compared to married nurses. Nurses whose work experience was less than 18 months were 2.7 times more at risk than nurses with more than 18 months of experience. Also, nurses whose fatigue scores were high had an increased chance of exposure (1.9 times). Conclusion: It is necessary to provide intensive training programs for clinical nurses who are in the early months of their career and are likely to be young and unmarried, in order to prevent exposure to blood and body fluid. Administrative supports to self-control and hospital ward operation measures to relieve nurses' fatigue should be provided.

• 중환자간호학회지
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• 제5권2호
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• pp.37-48
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• 2012

Purpose: The purpose of the study was to evaluate how advanced practice nurses (APNs) recognized their work by analyzing nursing outcomes. The ultimate goal was to examine the utility of APNs by connecting their work to the outcomes. Methods: Cross-sectional survey was conducted to collect the data from 59 APNs in a tertiary hospital lovated in Seoul, Korea. The questionnaire with 84 outcome indicators for advanced practice nurses was used. Descriptive statistics were used to analyze the data. Results: Among 84 outcome indicators, 11 indicators were associated with the work of APNs. Majority of these findings were included in the categories of clinical results and satisfaction. Items identified to be associated with the work of APNs were different among oncology nursing area, surgical speciality area, emergency care area, and critical care area. Conclusion: The results of the study indicated that the works of APNs were relevant to education/counseling/training and interpersonal relationship with other health professionals. The results of the study could be helpful to delineate the work characteristics of APNs and increase the utility of APNs in Korea where roles of APNs are not yet clearly delineated in most clinical settings.

• 대한간호학회지
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• 제40권4호
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• pp.561-570
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• 2010

Purpose: This was a cross sectional descriptive study to introduce the Infants Coma Scale (ICS), describe mental status of high risk infants using ICS and explore the relationships between ICS and clinical variables in infants hospitalized in a neonatal intensive care unit of a university hospital in Korea. Methods: After ICS was developed and tested by the authors, a research nurse evaluated the mental status of the infants using the English version of ICS and obtained clinical information on the infants from their medical records. Results: Data from 88 infants were analyzed. About 60% were male, 90% were preterm births, and 40% had pathologic abnormalities. Their mean gestational age was 32.4 (${\pm}3.50$) weeks and the mean birth weight was 1,842 (${\pm}728.6$) grams. The Cronbach's alpha for the ICS was .78. There was a statistically significant positive correlation between ICS total score and five clinical variables including gestational age, birth weight, 1 and 5 min Apgar scores and respiration status. Conclusion: Mental status is an important parameter in nursing assessment. ICS is a valid and reliable instrument, which clinicians can easily use to evaluate the mental status of high risk infants.

• 한국병원경영학회지
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• 제spc호
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• pp.1-13
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• 2016

In a situation where competition becomes intense, health care organizations constantly strive to provide more services with given personnel and time. While not only the 'quantity' of the services but also the 'quality' becomes increasingly important, various problems that can occur during the 'process' of service provision can be effectively managed by applying the methods of management science. In this study, we introduce the cases where the methods of management science can be applied for the management of health care organizations in Korea and abroad. There are many cases where various scenarios for improving the patients' accessibility to the services and for maximizing the efficient use of limited resources are established, and simulation or basic statistical analysis methods are used to solve the problems more systematically or to develop improvement plans. In this study, several exemplary cases, such as no-show of patients, crowding in the emergency room, prediction of the number of available beds in the intensive care units, nurse scheduling, delay of arrival of patients, and ordering of the proper amount of therapeutic materials, are introduced and discussed. From the perspective of administrators or clinicians, however, it may not be easy to master the methodology that requires considerable mathematical background or apply the theories to practice directly. Therefore, it is suggested that more practical and relatively simple analytical methods should be applied. Also, having a more positive attitude toward improving the current performance (e.g., a belief that 'we can always be better than now'), and paying attention to improving the job satisfaction by addressing problems, with experimental spirit and data-driven decision management.

• 한국임상약학회지
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• 제25권4호
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• pp.264-272
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• 2015

Background: The over-prescription of acid-suppressive therapy for the provision of stress ulcer prophylaxis (SUP) in hospitalized patients has been identified in a proceeding study. Objective: This study was conducted to evaluate clinicians' beliefs, knowledge and other factors that influence the over-prescribing of SUP in low-risk, non-intensive care unit (non-ICU) patients. Method: A cross-sectional survey consisting of multiple-choice queries and close-ended questions was distributed to healthcare personnel at a major teaching hospital in Korea. Results: More than half of total respondents reported that they would continue SUP following patients discharge from the ICU (77.8%, 43.5%, and 39.7% in the physician, pharmacist, and nurse groups, respectively). Over 55% of physicians would also initiate non-ICU patients on SUP upon hospital admission, and 42.6% of physicians would even continue prophylaxis post hospital discharge. The mean knowledge score regarding SUP indications and side effects was higher in pharmacists compared to physicians and nurses (12.44, 7.40, and 7.28, respectively; p<0.001). High-prescribing behavior was associated with a prescriber's belief that SUP is effective for preventing bleeding (odds ratio 7.40; 95% confidence interval 1.57 to 31.94; p=0.012). Low knowledge score and computerized order set also showed statistically significant association with the overutilization of SUP.

• 기본간호학회지
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• 제7권1호
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• pp.16-29
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• 2000

The purpose of this study was to examine the effects of a warmed blanket on relieving the cold discomfort after Cesarean Section delivery. A nonequivalent control group pre-test/post-test design was used for this quasi-experimental study. Sixty women were recruited for this study and divided by two groups: experimental and control groups. Blankets warmed to $40^{\circ}C$ were applied to the women in the experimental group for one hour and unwarmed blankets were applied to the control group. Using Abbey's shivering scales, subjective thermal sensation score, and Celsius mercury thermometer, cold discomfort was measured at four time points: 1) baseline measure (at the point the blanket was applied) 2) 15 min. later, 3) 30 min. later, and 4) 45 min. after application. Data were analyzed using SPSS/WIN and t-test and MANOVA were used to examine the effects of the warmed blanket for relieving cold discomfort. The results of the study are as follows. The experimental group had less cold discomfort than the control group(Wilts's value =0.580, p=0.000) at the 45 minute point after blanket application. the Experimental group reported less shivering and subjective thermal sensation than the control group. Shivering scores showed significant differences between the two groups at each of the four time points (baseline, 15 min., 30 min., and 45 min.) and subjective thermal sensation score showed significant differences between two groups at 45 minutes. after blanket application. In conclusion, the application of a warmed blanket was more effective on shivering and subjective thermal sensation than body temperature measured by objective means. Because women in this study were in the normal range of body temperature, differences in the objective body temperature between the two groups may not be sensitive enough to be detected. Even though differences in objective body temperature were not found, reduced subjective discomfort for low body temperature may be a sufficient significant finding in for nurse clinicians to utilize this method on their practice. Further studies in this area are needed to support these findings.

• 여성건강간호학회지
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• 제17권1호
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• pp.1-9
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• 2011

Purpose: The purpose of this study was to compare knowledge level of those clinical nurses who received HPV vaccine and those who did not and their perception of the relatedness of HPV vaccine to causes of cervical cancer. Methods: A total of 249 clinical nurses were surveyed from June to July, 2009. The questionnaire originally developed by Kim & Ahn (2007) examined HPV-related knowledge originally and the tool for perception of the causes of cervical cancer was originally developed by Kim (1993). The total number of subjects equaled to: vaccination group of 52 (20.9%) and non-vaccination group of 197 (79.1%). Results: Vaccination group showed significantly higher score of both knowledge of HPV vaccination and the perception of the cause of cervical cancer in comparison to the nonvaccination group at (p<.05). Among 4 subscales of the perception of causes of cervical cancer, destiny and constitution subscale scores were significantly different between the two groups at (p<.05). Conclusion: Clinical nurses need to constantly update with current knowledge of HPV and be prepared with currently changing cancer prevention strategies, especially in cervical cancer.

• 대한간호학회지
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• 제26권1호
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• pp.94-106
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• 1996

Nursing literature suggests that the self-concept of nurses gives an important implications to educators and administrators as well as clinicians for their professional development. With a view to exploring how nurses view themselves, the Professional Self-Concept of Nurses Instrument (PSCNI) using 27 Likert items was developed by Arthur in Australia in 1990. This study is an extension of the PSCNI using Korean samples with some modifications. A convenience sample was drawn from 800 nurses working in three university hospitals in Seoul ; three university hospitals in Kyonggi-do and a university hospital and a psychiatric hospital in Kangwon-do. Seven hundred questionnaires were analyzed using the statistical analysis system(SAS). The reliability of the scale was tested by test-retest and Cronbach's alpha. Differences in the PSCNI, which are closely related to demographic variables, were examined by t-test, ANOVA and the Duncan's multiple range test. Factor analysis was employed so as to examine component factors. The results are summarized as follows : 1. The test-retest reliability of the PSCNI was .79 and Cronbach's alpha was .85. Item correlations with total revealed consistent correlations and subscale reliability varied from .49 to .85. 2. The average score of PSCNI was 75.21 and average item score was 2.79. 3. Twenty four items were derived from the PSCNI 27 items and these items clustered in three component factors. The cumulative percent of variance was 38.12％ and for factor 1 was 22.81％, for factor 2, 9.79％ and for factor 3, 5.51％ respectively 4. A comparison of the scores for the dimensions of the PSCNI shows a relative difference in terms of mean item scores and in descending order, professional practice（m=2.83）, communication （m=2.82） and satisfaction（m=2.70）. 5. Professional self-concept of nurses was found to vary significantly according to age（P=.0001）, religion（P=.0001）, academic background（P= .0109）, marital status（P=.0001）, career（P= .0001） and position（P=.0001）. In conclusion, there was a correlation between professional self-concept of nurses, and life and work variables. This study provides an important message for administrators and nurse educators by highlighting factors which can be addressed by education programs, staff development and appraisal. While the test results largely confirm the Australian and Canadian tests, further research is necessary to improve the cumulative percent of variance instead of applying Arthur's PSCNI directly to Korean nurses.