• Title/Summary/Keyword: Nursing Hours

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A study on the Practical Education in Fundamentals of Nursing (기본 간호학 실습교육의 현황)

  • Yoo Jae-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.2
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    • pp.199-211
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    • 1995
  • This study analyzed the practical education in fundamentals of nursing, for the 36 nursing schools including 12 4-year nursing schools and 24 junior college nursing schools. This survey was done from september 5th to october 5th in 1995. The results of this study were as follows : 1. Required credit in fundamentals of nursing. 1) The highest incidence of the total required credit was 7 in 4-year nursing school and 9 in junior college. 2) For the lecture course credit, the large number of 4-year nursing school gave 5 credit lessons and 6 credits provided in junior nursing colleges. 3) For the credit of practical education the major portion of 4-year nursing school gave 2 credits instruction, however junior nursing school provided 3 credits. 2. Laboratory practice in fundamentals of nursing. In laboratory practice, the ratio of instructor and student was 1 : 20 in 83.4% of the 4-year nursing school and in 66.7% of the junior nursing school. 3. Contents and hours of fundamental nursing practice. 1) In the area of health assessment and nursing process, the large number of schools allocated following hours : 6 hours for vital signs, 4 hours for nursing process, 2 hours for recording but practice for physical examination and communication was done in few schools. 2) In the area of functional health pattern, the large number of schools allocated practice hours like followings : 2 hours for I/O, 2 hours for gavage feeding, 2 hours for elimination, 6 hours for catheterization, 6 hours for bed making, 2 hours for positioning, 6 hours for personal hygiene, 2 hours for R.O.M, 4 hours for moving turning lifting, 2 hours for inhalation and suction. But C.P.R and terminally ill patient care were taught in smaller number of schools. 3) In the area of special nursing measures, the major portion of nursing schools allocated hours like followings. It consisted of 6 hours for asepsis, 16-18 hours for medication, 2 hours for heat and cold application, 2 hours for wound care. 4) 22.2% of the nursing schools had total review practice time and 36.1% of the nursing schools had the students clinical practice. Based on above mentioned results, 4-year nursing school had faithful practical education of fundamental nursing than junior nursing school. But for the contents and allocated hours for practice education, junior nursing schools were much more contents and hours than 4 year school.

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A Study on the Classification of ICU Patients by K-DRG and the Nursing Care Hours and Costs of Craniotomy Patients (중환자실에서의 K-DRG 분류와 개두술환자군의 간호시간과 간호원가연구)

  • Cho, Jung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.1
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    • pp.229-246
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    • 1998
  • This dissertation classifies sample patients by a measure of K-DRG to identify the most frequent group. and investigates the differences in the dependency of nursing by patient classification system in the SICU of Seoul National University Hospital in Korea. It also calculates the mean nursing care hours and costs per craniotomy patient, who is shown to be the most frequent patient group. The results of the research can be used as basic data for the development of relevant nursing cost system in the future. The results of the research are as follows: 1. Using data from 97 sample patients, as many as 26 groups are identified when the patients are classified by K-DRG. KDRG-001 (craniotomy) is found to be the most frequent group(43.30%). 2. The result from patient classification system grouping in craniotomy patients shows homogeneity in terms of dependency of nursing with 35 patients in the 4th group, 145 patients(74.36%) are in the 5th group. and 15 patients are in the 6th group among the total 195 sample patients. 3. The direct nursing care hours for the 4th, 5th, and 6th patient classification system groups are found to be 381 minuites. 483 minuites, and 519 minuites, respectively, which shows that the nursing care hours increases as the dependency of nursing is intensified. The indirect nursing care hours are found to be 454 minuites(7.57 hours). The total mean nursing care hours, which is the sum of the direct nursing care hours(467 min.: 7.78 hours) and the indirect nursing care hours (454 min.: 7.57 hours), is 921 minuites(15.35 hours) per patient a day. 4. The nursing care cost is calculated to be 123,297 won per patient a day. Considering the average duration in the ICU, we can find the total nursing care cost is 610,318 won.

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Measurement of the Nursing Staff Needed for Two Specialized Nursing units in a University Hospital (간호업무량 측정 및 간호인력 수요산정)

  • 이윤신;박정호
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.589-603
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    • 1992
  • This study investigated a process to estimate the need for nursing staff on the basis of a patient elassification system and the required care needs and activities. The investigation was carried out in the following four steps. Step 1. Patients were classified according to the amount of nursing care need on each shift as class I (mildly ill), class II (mederately ill), class III (acutely ill), and class IV (critically ill). Step 2. Measurement of the direct nursing care hours needed for each patient class, and measurement of indirect nursing care hourse and personal time of the nursing staff. Step 3. Calculation of he total nursing workload in a nursing unit. Step 4. Estimation of the nursing staff needed. The investigation was carried out from July 17th to 30th, during 24hours every other day. The subjects were the patients and the nursing staff on two units of Seoul National University Hospital, Korea. Some of the results from the investigation are as follows : 1) Distribution of patient classification On the neuro surgical (N.S.), the distribution was class I, 22 patient, 3, class II, 27 patients, class III, 26 patients, and class IV, 25 patients, For the orthopedic surgical unit(0.5.), it was class I, 43 patients, class II, 43 patients, class III, patients, and class IV, 3 patients. 2) Direct nursing care hours per day On the N.S. unit, 3.2 hours of direct nursing care were needed for class I, 3.9 hours for class II, 5.1 hours of class III, and 6.2 hours for class IV patients, while 2.0 hours for class I, 2.5 hours for class II, 3.5 hours for class III, 5.0 hours class IV patients were needed on the 0.5. units. 3) Analysis of direct nursing care activities Activities were classified into assessment and observation(47%), medication(38.7%), communiontion(5.1%), exercise(2.4%), elimination and irrigation(1.3%), treatmemt(1.1%), hygiene(0.8%), nutrition(0.8%), and hot and cold compress(0.1%). 4) Average hours of indirect nursing care per day. On the N.S. unit 4.2 hours, and on the O.S. unit, 3.5 hours of RN indirect care was needed. 5) The average personal time used by the of nursing staff was 17 minutes for both RNs and nursing assistants in the N.S. unit, and 32 minutes for both RNs and nursing assistants in the O.S. unit. 6) Estimation of nursing staff needed on two specialized units of a university hospital For the N.S. nursing unit of 43 beds, 31 nursing staff would be indicated. For the 0.5. nursing unit of the same number of beds, 19 nursing staff would be indicated.

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Calculation of Optimum Number of Nurses Based on Nursing Intensity of Intensive Care Units (중환자 간호단위의 간호강도에 근거한 적정 간호사 수 산출)

  • Ko, Yukyung;Park, Bohyun
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.14-28
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    • 2020
  • Purpose: The purpose of this study was to calculate the total daily nursing workload and the optimum number of nurses per intensive care unit (ICU) based on the nursing intensity and the direct nursing time per inpatient using the patient classification. Methods: Two ICUs at one general hospital were investigated. To calculate the nursing intensity, patient classification according to the nursing needs was conducted for 10 days in each unit during September 2018. We performed patient classifications for a total of 167 patient-days in the Medical Intensive Care Unit (MICU) and 86 patient-days in the Surgical Intensive Care Unit (SICU). The total number of person-days for nurses who responded to the Nursing Time survey was 151 for MICU and 85 for SICU. In each unit, direct and non-direct nursing hours, nursing intensity score, and direct nursing hours were analyzed using descriptive statistics such as frequency, percentage, and average calculated using Microsoft Excel. The amount of nursing workload and the optimum number of nurses were calculated according to the formula developed by the authors. Findings: For the MICU, the average direct nursing time per patient was 5.59 hours for Group 1, 6.98 hours for Group 2, and 9.28 hours for Group 3. For the SICU, the average direct nursing time per patient was 5.43 hours for Group 1, 7.21 hours for Group 2, 9.75 hours for Group 3, and 12.82 hours for Group 4. Practical Implications: This study confirmed that the appropriate number of nurses was not secured in the nursing unit of this study, and that leisure time such as meal time during nursing work hours was not properly guaranteed. The findings suggest that to create working environments where nurses can serve for extended periods of time without compromising their professional standards, hospitals should secure an appropriate number of nurses.

Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital (일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정)

  • Kim, Kyeong-Uoon
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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The effects of the direct nursing care hours with establishment of the nurse substations (Nurse Substation 운영이 직접간호시간 증가에 미치는 효과)

  • Lee, Chug-Hee;Sung, Young-Hee;Kwon, In-Gak;Lee, Soon-Kyu;Jung, Yoen-Yi;Hoe, Sung-Hee;Ryoo, Sung-Suk;Kim, Jung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.2
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    • pp.61-80
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    • 1997
  • The purpose of this study is to measure the direct and indirect nursing care hours with establishment of nurse substations and compare the experimental nursing units with the existing nursing units For this study, two experimental nursing units: (1) a medical nursing unit and (2) a surgical nursing unit with a nurse substation were selected. And two control nursing units : (1) a medical nursing unit and (2) a surgical nursing unit without a nurse substation were selected. After a three-month experimental operation from June 1 to August 31,1996, research data were collected for three days from September 2 to 4, 1996. We investigated the effects of the direct & indirect nursing care hours with establishment of the nurse substations (improved nursing environment) without adding the staff nurses. The effect of establishment of the nurse sub-station was measured for the differences direct & indirect nursing care hours between experimental and control nursing units. An investigator measured the time for a staff nurse to practice each nursing activity and recorded it every minute. Percentage, average, standard deviation, t-test and ANOVA were used for data analysis. The results are as follows: 1. There was no significant difference between the experimental and control nursing units in staffs' working hours during their shift. 2. There were significant diffferences between the experimental and control nursing units in dierct nursing care hours (t=0.0288, p=0.0001) and indirect nursing care hours (t=0.3886, p=0.0103) per patient. 3. There was significant difference between the experimental and control nursing units in direct nursing care hours done by nurses(t=0.0012, p=0.0111) and aids(t=0.3011, p=0.0027). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0051, p=0.0253), nurses(t=0.0071, p=0.0024) and aids (t=0.3227, p=0.0351). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by nurses(t=0.0005, p=0.0015) and aids(t=0.2400, p=0.0013) per patient. There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0005, p=0.0379) and nurses (t=0.0035, p=0.0198) per patient. 4. Thre were significant differences between the experimental and control nursing units in direct nursing care hours (t=0.1134, p=0.0010) and indirect nursing care hours (t=0.7106, p=0.0008) per staff during the day shift. There were significant differences between the experimental and control nursing units in direct nunsing care hours during the day(t=0.0723, p=0.0003) and evening shift (t=0.0004, p=0.0285) per patient, and indirect nursing care hours during the day shift(t=0.5565, p=0.0036) per patient. 5. There were differences between the experiemental and control nursing units in dircet nursing activities including measurement and observation, medication, communication, teratment, hygiene, and nutrition, and in indirect nursing activities including confirmantion, communication, record, computer work, management of goods. But it was not statistically proven. 6. There was difference between the experimental and control nursing units in unmet-need nursing care hours per patient, but not statistically proven.

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A Study on the Curriculums of the Nursing Department of Junior Colleges in Seoul and Kyungin Area (간호교육 개선을 위한 교과과정 비교분석 - 서울$\cdot$경인지역 전문대학을 중심으로 -)

  • Lee Ae Kyung;Kim Jung Ae;Phang Suk Mung;Joo Mi Kung;Kim Young Hee;Chung Ann Soon;Choi Na Young;Chang Eun Jung
    • Journal of Korean Public Health Nursing
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    • v.11 no.2
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    • pp.180-193
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    • 1997
  • This study was designed to set up more developed curriculum in Nursing department of a junior college. The sample for the study were fifteen curriculums of fifteen selected junior colleges in Seoul and Kyunggi area. The credits and hours of each curriculum were analyzed into means and compared with the one of the example college. The data were categorized into seven sections; cultural subject, basic medical science, major subjects such as Nursing, Fundamental Nursing, electives, teaching and non-teaching subjects, and clinical practice. The data were analyzed by means of descriptive statistics. The results of the study were as follows; 1. Credit hours of Cultural subjects of each college ranges from $5.8\%\;to\;25.7\%$ of the total graduate credit hours; most commonaly lectured subjects are English 05 colleges), Korean (11 colleges), psychology (10 colleges), and computer (10 colleges). 2. In the case of the example college, Anatomy and Psychology were jointed as one subject, Basic Nursing Science, and some more study in depth should be made to develop more of this type of conjunction among related subjects on basic medical science. 3. As for the mendatory subjects of the example college, subjects on Adult Nursing was fourteen credits (14 hours), which was higher than the average 12.9 hours of other colleges compared. 4. Credit hours of Basic Nursing Laboratory were eight to ten credits (12-18 hours), which was higher than actual class hours. As more and more hospitals test clinical aptitude when recruiting nurses, more emphasis should be paid to the clinical practice. 5. Among fifteen sample curriculums six to twelve electives were offered with twelve to twenty-three credits. Most commonly opened subjects were Physical Examination (5), Nursing English (14). and Geriatrics Nursing (13). Nursing English are considered to be more important in the view of clinical practice. and Oriental Nursing, Nursing Information and Health Insurance Management should be considered as specialized subjects. 6. Teaching and Non-teaching subjects In case of the example school. Clinical Emergency Medicine, Introduction to Emergency Medicine were offered for these non-teaching class students so they could prepare for the qualification examination. 7. Clinical Practice The average credit hours for clinical practice of the sample college were 20.9 credit hours $(66.5\%)$ and the example school offered twenty credit hours which was slightly lower than the other forteen.

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Calculation of nursing care hours in a pediatric oncology nursing unit (일개 대학병원의 소아혈액종양 간호단위의 간호업무량 측정)

  • Kim, Young-Mee
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.513-524
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    • 1999
  • The shortage of nursing personnel was become one of the most serious problems in operating pediatric oncology nursing unit which was the first pediatric oncology nursing unit in Korea. The purpose of this study was to estimate the optimal number of nursing personnel by calculating nursing care hours. The subjects were 13 staff nurses and inpatients of pediatric oncology nursing unit at Seoul National University Hospital during the period of May 20, 1996, to June 2, 1996. The number of nurses' duty was 132, the number of patients treated was 1288 for these 2 weeks. The tools used for this study were pediatric patient classification indexes and direct & indirect care indexes. Each nurse measured the time that they spent for their activities by self record under the supervision of their nurse manager. The method used to calculate the number of nursing personnel was multiplication of the average number of nursing care hours per patient per day with the number of patients. Percentage, average, t-test, F-test were used for data analysis. The results of this study were as follows : 1) The distribution of patient class : Class I & II none, Class III 86.8%. Class IV 12.9% 2) Direct nursing care hours for a patient per shift according to patient classification: Class III : 27.64 minutes, Class IV : 54.64 minutes The average direct nursing service hours for a patient per shift(3 shift) was 31.54 minutes(94.62 m/day). The average indirect nursing service hours for each patient per duty(3 shift) is 21.3 minutes (63. 91 m/day). 3) The average nursing hours for a patient per duty was 52.80 minutes(2.64h/day). 4) The group of administering medications in direct care activities showed the highest percentage (38.9%). Checking vital signs among observation took the most time am.ong each direct care activity (6.88 minutes for a patient per duty). 5) Charting took the most time of each indirect care activity(52.53 minutes/ duty/nurse). 6) The average personal time per duty is 29.40 minutes, which 'was below 30 minutes of this hospital regulations. 7) The average nursing hours that a nurse provided for a duty was 8.60 hours, which meant that a nurse worked 1.10 hours overtime. 8) Standardizing to a 33 bed to a unit, 17 nurses were needed at the present nursing level.

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Nursing Hours and Nurse Staffing according to Korean Triage Acuity Scale and Patient Dependency (한국형 응급환자 분류도구 및 환자의존도에 따른 환자군별 간호시간과 간호사 배치수준)

  • Jung, Eun Hee;Cho, Sung-Hyun;Lee, Sang Lim;Choi, Min Jin;Kim, Sung Sook;Choi, Eun Kyung;Han, Kyeong Hwa;Jeon, Mi Young
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.3
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    • pp.395-406
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    • 2020
  • Purpose: The purpose of this study was to analyze nurse staffing according to patients' acuity and dependency by measuring nursing hours. Methods: The study sample included patients who visited the adult emergency departments (EDs) of three tertiary referral hospitals and nurses who worked on shifts for 48 hours from October 24 to 26, 2019. Hourly patient census and nurse staffing were analyzed. Patient acuity was measured using the Korean Triage and Acuity Scale (KTAS), ranging from Level 1 (highest) to Level 5 (lowest). Patient dependency was measured using six items (e.g., clinical attention and communication) and classified into four groups. Nursing activities were observed every 10 minutes and nursing hours per patient and nurse staffing were analyzed according to acuity and dependency. Results: Nurse-to-patient ratio ranged from 1:1.8 to 1:4.2 during the 48 hours of observation. The average work hours of nurses, excluding breaks and meals, was 8.57 hours; 42.5% of which was spent providing direct care. Higher acuity and dependency were associated with higher nursing hours and staffing level. Patients with KTAS Level 1 were provided 74.3 minutes per hour, 5.02 times higher than Level 5 (14.8 minutes). Patients in the highest dependency group were provided 87.4 minutes per hour, 5.75 times higher than the lowest group (15.2 minutes). Newly arrived patients received more nursing hours than continuously stayed patients within the same KTAS Levels. Conclusion: Large variations were found in hourly patient census, acuity, and dependency. Nurse staffing in EDs should be determined based on patient acuity and dependency.

Analysis of the Status of Nursing Shifts and Nurses' Perceptions of Work Schedules in General Wards Based on the Government Guidelines for Night Shift Work (보건복지부 야간근무 가이드라인에 따른 일반병동 간호사의 교대근무 현황과 근무표에 대한 인식)

  • Hong, Kyung Jin;Cho, Sung-Hyun;Jung, Eun Hee
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.2
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    • pp.165-178
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    • 2021
  • Purpose: To analyze nurses' shift work according to the government guidelines for night work and their perceptions of their work schedules. Methods: The study sample included 487 nurses who provided information on their schedules, including the normal working hours of each shift, and overtime per shift during September 2020. Nurses' perceptions were measured in terms of satisfaction, appropriateness for work-life balance, and fairness to their work schedule. Results: One-third of the respondents worked more than 40 hours per week. The average overtime hour was 1.14 hours per shift. Unsocial hours (8 pm to 6 am on weekdays, midnight to midnight on weekends and public holidays) accounted for 56.4% of all working hours. During their last night shift, on average, nurses worked 9.62 hours and had a break of 39 minutes, although 20.5% reported no break. Sixty-eight percent of nurses had at least one between-shift break shorter than 48 hours after a consecutive night shifts. Fifty-seven percent were satisfied with their schedule. One-third perceived their schedule as appropriate for work-life balance, and two-thirds perceived that days off on weekends and nights were fairly distributed within the unit. Working and overtime hours had an inverse relationship with all three aspects of nurses' perceptions. A higher proportion of unsocial hours and having no breaks during the night shift were associated with lower perceptions of fairness. Conclusion: Reducing working hours, ensuring breaks during night shifts, and increasing rewards for unsocial hours are required to improve nurses' perceptions and reduce turnover due to shift work.