• 의료법학
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• 제15권2호
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• pp.285-316
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• 2014

As the number of medical disputes regarding nurses has increased after medical disputes have increase, there is a need for a study on it. However, the legal relationship between nurses and patients has not yet been analyzed. Recently, the role and function of nurses are expanded according to the development of the science of nursing; moreover their activity and limitation of responsibility are also expanded. For this reason, the medical disputes regarding nurses have been increasing. However, the majority of these kind of dispute are just passed over because their practice is usually considered to be a mere action to assist doctor's role. In addition, nurse practice is not a secondary action of doctor's role, but forms part of a medical treatment. Of course, nurses handle many secondary tasks after doctors finish their medical treatment. But this is only part of the whole tasks of nurses. Furthermore, the general details of their medical treatment are not different from those of doctors because they also belong to the medical service personnel. Considering these features of nurse and the medical condition in South Korea, their task is becoming increasingly developed and specialized and they are also establishing their own field. With this stream of times, there is a growing interest in enacting a Nursing Practice Act, in other words, the independent law on nurse for the sake of patient safety and national health promotion. Then, their responsibility will distinctly be expanded as much more. That is, the time that nurses practice their medical care by following doctors' order and also pass over their responsibility to doctors is closed. Thus, this study examines the features and responsibilities of nursing practice, and discusses an institutional framework to efficiently cope with the legal disputes between nurses and patients. It aims to throw light on the decision making on nurse-patient disputes in future.

• 임상간호연구
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• 제19권1호
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• pp.81-95
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• 2013

Purpose: The purpose of this study was to identify the frequency and severity of role conflict experienced by nurses in the hospital. Methods: For this survey a self-report questionnaire on nurses' role conflict was used for data collection. Participants were 472 nurses in hospitals with over 500 beds. The questionnaire had 82 items classified into five categories (role activity, relationships between: nurse-nurse, nurse-patient/caregiver, nurse-doctor, and nurse-other department staff). The questionnaire was developed through focus group interviews with nurses according on their work experiences and literature reviews that were validated by the researchers. Data were analyzed using descriptive statistics for frequency and severity of nurses' role conflict. Cronbach's ${\alpha}$ for the questionnaire was .95 (frequency), .97 (severity). Results: Mean score for nurses' role conflict was 1.64. The highest frequency for nurses' role conflict was in the category, relationship between nurse and patients or their families ($2.00{\pm}0.46$). The highest severity for nurses' role conflict was in the category; relationship between nurses and doctors ($1.96{\pm}0.56$). Conflict about nurses' role activity showed both high frequency ($1.99{\pm}0.39$) and severity ($1.95{\pm}0.43$). Conclusion: Results indicate a need to develop programs to improve interpersonal relationship so as to reduce role conflict and encourage nurses' professional satisfaction and achievement.

• 한국콘텐츠학회논문지
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• 제15권10호
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• pp.292-304
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• 2015

본 연구는 건강관리조직에서 간호서비스의 생산성과 효율성을 높이고자 간호조직문화의 중요성이 강조되고 있는 현실에서 간호사를 대상으로 그들이 인지하는 조직문화유형과 언어폭력, 직무스트레스와의 관련성에 대해 살펴보고자 하였다. 이를 위해 서울시, 경기도, 충청도에 소재하는 4개 종합병원에서 근무하고 있는 간호사를 대상으로 설문지를 배포하였고 총 235부를 분석하였다. 수집된 자료는 SPSS 22.0으로 분석하였다. 연구 결과 병원별로 조직문화유형 간에 차이를 보였으며 이중 관계지향문화는 의사에 의한 언어폭력, 간호사에 의한 언어폭력과 정적상관관계가 있는 것으로 나타났으며, 혁신지향문화는 의사에 의한 언어폭력과 정적 상관관계가 있는 것으로 나타났다. 또한 직무스트레스는 조직문화 유형 중 위계지향적 조직문화를 제외하고 모두 유의한 정적 상관관계가 있는 것으로 나타났다. 직무스트레스에 영향을 미치는 주요변인은 관계지향적 조직문화, 간호사에 의한 언어폭력으로 나타났으며 이 변수들은 간호사들의 직무스트레스에 대해 14.9%의 설명력을 보이는 것으로 나타났다. 따라서 간호사들이 소속된 병원 또는 조직별 문화에 대한 다차원적인 연구와 문화유형 별 직무스트레스를 줄여주기 위한 프로그램 개발이 필요하다.

• 대한간호학회지
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• 제3권1호
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• pp.97-104
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• 1972

This study was designed to investigate differences in some aspects of value conceptions in fundamentals of nursing functions between nursing service personnel and nurse-educators. The purpose of the study was to identify the difference of value conceptions between the hospital nurses and school instructors, to contribute as a reference in strengthening the educational program in establishing nay hinder professional growth. The questionaries of this study were focused in the following aspects: 1) establishment of nursing service management system, 2) strengthening of the professionalization of nursing service, 3) hindrance in accomplishment of independent nursing functions, 4) communication skills in nurse-patient relationship, 5) activities directly related to nursing care planning, 6) communication skills in nurse-doctor relationship, 7) attitude towards taking responsibilities for patient- centered nursing approach, and 8) nursing educational approach towards preparation of professional competence in practicing independent nursing functions. 265 graduate nurses from 14 general hospitals and 88 nursing instructors from 18 schools, collegiate and diploma, were sampled. The main findings of the study were as follows; 1. Both groups responded highly in the lack of public recognition of nursing profession and hospital administrators support in establishment of nursing service management system. Further investigation is needed to define some relationship between the intrinsic and extrinsic factors which might give influence to the professional development. 2. while hospital nursing personnel responded on environmental pressure such as a heavy nursing load as the factor giving hindrance to independent nursing functions, the nurse educators responded highly on lack of nursing competence of individual nurses. An emphasis should be placed on the development of nursing interaction through professional education. If the professional model is not well established, nursing function will be limited to medical assistance. 3. 3. The patient-centered approach for nurse-patient communication had given positive respond for both group, tut lacks in team concept in problem solving process. There exist a social distance between nurses and other professional co-workers in the hospital hierarchy. 4. It was indicated that, as an intrinsic factor in the development of nursing service and nursing education, building up a philosophical basis is an utmost importance. This question is opened for further and extensive study to clarify whether existence of philosophical absence or philosophical stasis in nursing profession hinders the development.

• 간호행정학회지
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• 제17권3호
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• pp.327-335
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• 2011

Purpose: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. Methods: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. Conclusion: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients.

• 경영과정보연구
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• 제17권
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• pp.107-133
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• 2005

The purpose of this study was to analyze a trend of profitability classified by characteristics of hospitals and to analyze related factors. The data for this study were derived from survey material conducted by the Korean Hospital Association on 33 hospitals in Korea between 1993 and 2002. Profitability was measured in the aspect of investment profit rate and operation profit rate with net profit to total assets, normal profit to total assets and operating margin to gross revenue as dependent variables. Independent variables were classified by general factors (ownership, number of beds, period of establishment, region), financial factors (total asset turnover, liabilities to total assets, current ratio, fixed ratio, inventories turnover, personnel costs per operation profit, material costs per operation profits), composition of manpower and facilities(personnel and area per beds), productivity index(the number of daily patients per medical doctor, the number of daily patients per nurse), the score of quality assurance activities. First, Concerning the specialists per beds or area per beds and profitability of hospitals there was not statistically significant. Second, Those hospitals having the most daily patients per nurse had significantly higher profitability than the others, but the number of daily patients per medical doctor had little effect on the profitability. Thirds, Those hospitals having a higher proportion total asset turnover tended to show significantly higher profitability compared to other hospitals, but the liabilities to total assets and liquidity ratio had a little difference to the profitability. Those hospitals having a higher proportion personnel costs per operation profit and material costs per operation profits tended to show significantly lower hospital profitability compared to other hospitals. Fourth, In regression analysis, hospital profitability had negative relationship with personnel costs per operation profit or material costs per operation profits. While it had positive relationship with total asset turnover, the number of daily patients per nurse. In conclusion, private hospitals had higher profitability than that of public hospitals. Though factors related to profitability of hospital were different according to ownership, it is important for securing appropriate profitability by operating appropriate number of nurse, raising total asset turnover, and reducing personnel costs, material costs per operation profits. This study can be used as a baseline data for planning of hospital management. But the study may be limited in that the results cannot be generalized due to its small sample size. However, this longitudinal observation of 33 hospitals over ten year period has significant merit alone.

• 한국병원경영학회지
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• 제27권3호
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• pp.39-49
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• 2022

Purposes: This study purposed to analyze the relationship between patient safety and patient-centerendess. Methodology: The comprehensive scores from patient safety assessment program and patient experience survey conducted by Health Insurance Review & Assessment Service were used as independent variables and dependent variables. This study analyzed the relationship between 4 patient safety-related areas(i.e. risk standardized readmission ratio, intensive care unit, preventive antibiotic, the drug evaluation) and 6 patient experience areas(i.e. nurse services, doctor services, medication & treatment, hospital environment, patient's right, overall experience) by using robust regression analysis. Findings: According to results, the score in 'patient's right' and 'risk standardized readmission ratio' areas were found to have a significant relationship, and 'overall experience' and the 'preventive antibiotic' areas. The ratio of senior beds and specialists was a general characteristics of hospitals that had a significant relationship on patient experience assessment. Practical Implication: The relationships between patient safety and patient experience assessment were varied depending on areas. Further study is needed to make clear the supposed relationship.

• 간호행정학회지
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• 제21권1호
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• pp.43-52
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• 2015

Purpose: In this study, behavioral styles of Dominance, Influence, Steadiness, and Conscientiousness (DISC) were examined and differences in job satisfaction and clinical competence among newly hired nurses were explored. Methods: For this explanatory correlational research, 176 newly hired clinical nurses were recruited from three university hospitals and one general hospital located in Seoul and Gyeonggi province. Data were collected in August, 2013 though self-report questionnaires. Results: The distribution of behavioral styles was 11.4%, 42%, 29% and 17.6% for Dominance, Influence, Steadiness, and Conscientiousness respectively. DISC behavioral styles were associated with sub-areas of job satisfaction such as professional position and doctor-nurse relationship. DISC behavioral styles were significantly associated with the total score for clinical competence and sub-areas of data collection, basic nursing skills, critical thinking, education and leadership, and attitudes toward professional development and practical skills. Multiple linear regression analysis showed that DISC behavioral styles predicted clinical competence (Adj. $R^2$=.14, F=9.42, p<.001). Conclusion: A focus on cultivating influential and steady behavioral styles among newly hired nurses can be helpful in improving job satisfaction and clinical competence. There is a need to improve interpersonal relationships through a deeper understanding of each person's behavioral style based on the analysis of DISC behavioral styles.

• 간호행정학회지
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• 제8권3호
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• pp.381-392
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• 2002

Purpose : The purpose of this study was to examine the degrees of turnover intention among Korean staff nurses(N=175) and to identify discriminating factors of their turnover intention. Method : The data were driven from a larger study and staff nurses who had worked more than 1 year as nurses were included in the analyses. The original data were collected from May 1999 to March 2000. Descriptive and discriminant analyses were utilized. Results : 87% of the participants reported turnover intention. Nurses were grouped into three group(GP)s depending on the frequencies of turnover intention: Never GP(N=23), Sometimes GP(N=107), Frequent GP(N=43). With three GPs, two functions were produced and only function 1 was significant that significantly discriminated Never and Frequent GPs. Additional discriminant analysis with only Never and Frequent GPs produced function classified 93% of the participants correctly into two GPs. Sub-dimensions of work satisfaction were significant discriminating factors. Nurses who are satisfied with doctor and nurse relationship, pay, and hospital administration tend to report no intention in turnover. Conclusion : Based on the findings of this study, possible managemental intervention for increasing interpersonal skills and assertiveness of nurses, inviting medical residents in ward team meeting, increasing incentives or baseline adjustment of annual income for registered nurses were suggested.

• 간호행정학회지
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• 제1권1호
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• pp.97-111
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• 1995

In our society today, a variety of medical caring system, along with a scientific development in the area of oriental medical science plus national demand, has increased the augmentation and the opening of oriental wards and hospitals (Han Bang), which has come to create an additional requirement of nursing activity at oriental medicine wards should be different from that of the general wards or the same as the other. In view of this, various studies need to be made in this connection. The purpose of this study is to comprehend the number of nurses who want to work at oriental medicine wards and measure job satisfaction in nursing as compared with those working at general wards so as to provide basic materials for future assignment and supplementary training for the nurses. An attempt was made to contribute toward nursing administration on the one hand improving nursing training course on the other hand. A total of 72 nurses currently working at two oriental medicine hospitals available in Seoul and 82 general nurses were selected for this study using the questionaire from December 1993 to January 1994. An instrument for the study was based on the measurement of work satisfaction developed by Paula L. Stamps including 37 questions complemented by Kim for revision (1993) and 14 questions regarding general characteristics and oriental medicine wards. The instrument to test dependability showed Cronbach's=0.7711. The collected data have been processed by computer package SPSS. General characteristics of the two groups and the matters involved in oriental medicine wards were calculated into real figure and percentage an similarities between the two groups were analyzed by t-test and F-test according to the characteristics of variables. The comparative test on work satisfaction among the two groups including general characteristics and work factors were conducted by t-test and F-test. The major findings as a result of the study are as follows : 1. As general characteristics, age group of $26{\sim}30$ years are more than any segment of age. As to marital status, the number of those in single status is slightly higher than the married. Approximately 80% of them are graduates of nursing schools and nursing colleges. They are mostly in service for one to three years. There is no significant difference between the two groups. 2. The number of those who want to work at oriental medicine wards represents 40.3% against 58.4%, being in favor of general wards. 3. The reason for service at oriental medicine wards is that "there is room for potential research" which happened to rank first, followed by "easy job," "good working atmosphere" and "growing interest in oriental medicine." 4. Work satisfactions among nurses who work at oriental medicine wards prove greater than that of nurses who work at general wards. 5. Work satisfaction between the two groups by work factors is reflected with significant difference statistically on task requirement, interaction and doctor-nurse relationships. 6. The general charcateristics and the work satisfaction by work factors prove that there are significant difference in age, marital status, education and the period of work. They tend to be more satisfied with the work as they grow in age. Significant differneces are found in the work factors such as autonomy, adiministration and professional job in the relationship with doctor-nurse. As to marital status, the married are more satisfied than the unmarried. There are significant differneces in the factors respecting administration and doctor-nurse college graduates are highly satisfied with task requirement. However, satisfaction with the professional level has proven the highest degree for those having master degree. The period of work and satisfaction : There are significant differneces in task requirement, administration, interactions, professional level and doctor-nurse relationships. As a general rule, the degree of satisfactions is in proportion to the lengrh of service. The following conclusions are drawn based on the fndings mentioned above. Even though the work satisfaction of the nurse who work at oriental medicine ward is relatively high, it is desired that personal consultation be given as to disposition of nurses when they are assigned to oriental medicine wards. It is also recommended that lectures on oriental medicine be conducted through supplementary training and/or basic nursing course in order that they may be motivated for ingenious activities with an increasing sense of self-esteem which will eventually enhance positive changes for the patients who are in need of oriental medicine nursing and for the medical teams. In addition, joint reseaches involvingclinical care and education should be in constant process for unique and scientific development for those who are subject to oriental medicine nursing care.