병원 간호사들의 근거활용 경험 및 장애요소와 촉진요소에 대한 탐색 (Hospital Nurses' Uses of Evidence, and Barriers to and Enablers of Evidenced-based Practice)
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- 간호행정학회지
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- 제19권2호
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- pp.292-303
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- 2013
Purpose: The purpose of this study was to explore nurses' experience of evidence-based nursing practice in general hospitals. Methods: Data were collected from 13 nurses through in-depth interviews about their experiences with evidence-based practice. The research questions were "What kind of evidence are you using in your practice?" and "What are the barriers to and enablers of evidence-based practice that you have experienced?" Qualitative data from field and transcribed notes were analyzed using qualitative content analysis methodology. Results: Major themes of using evidence were identified as 'research as primary valid evidence', 'information from local context and internet as realistic evidence', and 'clinical experience as pragmatic evidence'. Patient experience was not used as evidence in solving nursing problems. Barriers to and enablers of evidence-based practice were linked. They included both external, organizational factors and individual factors. Main issues were 'lack of evidence and poor work environment', and major facilitating factors were 'improving knowledge and skills related to evidence-based practice' and 'communicating and sharing evidence'. Conclusion: The study findings provide useful information for understanding nurses' experience of using external and internal evidence along with their meaning. A multidimensional approach is needed to overcome barriers to and implement evidence-based practice.
Purpose: This study was designed to describe the burnout experiences of nurses counseling people living with HIV/AIDS (PLWHA) in hospital-based counseling services in Korea. Methods: A qualitative research technique with focus group interviews was used and the data were collected in 2012. Participants were 13 counseling nurses from 16 medical hospitals in South Korea who had worked full-time for more than six months as a counseling nurse for PLWHA. The 13 nurses made up 68.4% of all 19 official HIV counseling nurses in South Korea. Data were collected using focus group interviews and analyzed with the content analysis methodology of Downe-Wamboldt. Results: Burnout experience of counseling nurses for PLWHA was analyzed for two domains-causes of, and effects of burnout. Each domain was classified into three categories; personal, job-related, and relationships. Further 17 sub-categories and 47 concepts were discovered. Conclusion: In this study various causes and effects of burnout experienced by nurses counseling PLWHA were identified. These findings can be used in developing effective strategies for nurses, administrators, and health policy makers to solve the burnout of counseling nurses. Further research is required to develop detailed and practical job description for nurses counseling PLWHA.
The purpose of this study is analysis of 52 dissertations on assertiveness training which presented from 1982 to 1997 in Korea. It was diversified the research purpose to by 1) time of publication or presentation 2) research design, characteristics of subjects used in each study 3) related concepts, the effects of nursing interventions according to related concepts 4) the effects of nursing interventions according to the subjects 5) the effects of nursing interventions according to the frequency and the period of assertiveness training 6) the effects of nursing interventions according to the group size. 7) the effects of nursing interventions according to the necessary time per round. Findings obtained in the study were as follows : 1. At the point of the numbers of studies presented by year, the number of the studies tend to increase, especially the most plentiful papers were presented during five years from 1991 to 1995. 2. Research design of the studies belong to experimental research. The subjects of research consists of 5 Nursing related subjects and 47 Non-nursing related subjects so that Non-nursing related subjects contain much large proportion. 3. When studies were classified by the related concepts, they were classified that 17 studies were by assertiveness & assertive behaviour, 15 ones anxiety, 9 ones self & ego, 7 ones depression. It can be inferred that studies related to assertive behaviour, self & ego, sociality and power of learning were increasing. Otherwise, studies related to anxiety, depression, aggression, shyness and anguish were decreasing. 4. At the point of the nursing intervention effect by the subjects, the concepts of assertive behavior, feeling of self-respect and sociality were increasing, but the concepts of conflict and interpersonal stress were decreasing and the concepts of anxiety and sociality were ineffective in the subjects related Nursing. On the contrary, the concepts of assertive behavior, sociality and personalty were increasing, but the concepts of anxiety, depression, aggression, shyness, self-estranged feeling were decreasing and the concepts of assertive behavior, aggression, personalty, power of learning, anxiety, self-concepts and self-expression were ineffective in the subjects related Non-Nursing. 5. 18 studies can be found, which investigated 10 times for 5 weeks from the point of the nursing intervention effect by the times and the period of assertiveness training. In case of over 5 times of assertiveness training, assertiveness, assertive behavior and personality(tranquility, depression) increased. In 6 times, feeling of self-respect & egorespect increased but depression, interpersonal stress and anxiety decreased. In over 10 times, shyness, shame and feeling of self-estrangement decreased. In over 12 times, interpersonal anxiety decreased. 6. In the event of nursing intervention effect by the size of the group, it was greatest within 10 persons in 21 studies. In case of within 10 to 20, only feeling of self-expression were ineffective. Particularly, in case of over 31 persons, there were no ineffective concepts. 7. At the viewpoint of nursing intervention effect by the necessary time of one time, it was greatest within 1 to 2 hours in 32 studies. In case of within 1hour, aggression, power of learning and assertiveness were ineffective. In case of within 1 to 2 hours, assertive behavior, self-expression, personality and anxiety were ineffective. Particularly, in case of within 2 to 3 hours, there were no ineffective concepts.
Today's rapidly changing healthcare environment and increasingly professional nursing practice indicate that identifying leadership characteristic of nursing leaders and executives is a vital importance in today' s time and also mandate innovative leadership for nursing service. Therefore, the purpose of this study is to examined the transformational, transactional leadership styles of the Nurse Administrators. The sample consisted of sixteen mid-level nurse administrators, fifty head nurses of 5 General Hospital. Data for this study was collected from Sep. 20 to 29 by Bass' MLQ Questionnaire. The data was analyzed by frequency, percentage, one-way ANOVA. Major findings are as follows : Appropriate one-way ANOVA tests revealed that the differences for transformational and transactional leadership styles of nurse executives, mid-level nurse administrators as perceived by their immediate subordinates were statistically significant(P<.05). The scores of transformational and contingent reward behaviors were declined of the mid-level nurse administrators. The transactional scores of nurse administrators were lower than transformational ones, which is a desirable findings. The result of this study, the mid-level nurses administrators were perceived as the highest transformational leader by their subordinates. The nurse executives received the lower transformational leadership scores than mid-leval administrators. These results were opposit to the previous studies. Leader can aspire to these qualities of transformational leadership, building on the more traditional transactional dimensions. We can think that transformational leadership suggests a direction for developing a creative and rewarding approach to the leadership of professionalnursing practice environments. More research on transformational qualities in nursing service and controlled designs would be desirable for nursing service administration.
A cost analysis for hospitalized patients was performed based on the RBRVS in order to determine an appropriate nursing fee schedule. The study was conducted through three phases as follows: 1) Nursing activities provided for the inpatients currently in Korea were identified and classified using a taxonomy which was developed by our research team through the Delphi process. 2) The resource-based relative points for every nursing activity according to nursing time, mental effort and judgement, technical skill, physical effort and stress were determined through a survey of 300 clinical RNs working at 5 tertiary hospitals from May 25 to July 25. 1998. 3) The nursing cost of every nursing activity for hospitalized patients was estimated based on the RBRVS. As a result, 136 nursing activities were identified and classified by nursing processes and nursing domains. However, our classification system of nursing activities should continue to be refined, and all nursing practices should be standardized. The nursing activities were given resource-based relative points ranging from 100 to 400 points, then each nursing activity was assigned a value for the RBRVS, which was determined by the exponential function of 2resource-based relative point/100. Thus, a value of 2 was calculated for 100 points, 4 for 200 points, 8 for 300 points, and 16 for 400 points. Meanwhile, the unit cost of nursing was calculated as 170 Won. The nursing cost of 136 nursing activities was estimated using the RBRVS as shown in