• 제목/요약/키워드: Quality of Nursing Service

검색결과 531건 처리시간 0.027초

일개 시지역의 가정간호 수혜자들의 만족도 조사 (A Survey on Clients' Home Care Satisfaction in Taejon City in Korea)

  • 김선숙;소희영;이태용
    • 가정∙방문간호학회지
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    • 제5권
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    • pp.73-83
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    • 1998
  • This study enrolled one thousand five hundred twenty one clients that were receiving home care services at five health centers and a home care services center in the city of Taejon from November 17 through December 7, 1997. The purpose of this study was to analyze satisfaction levels, general characteristics and efficacies, of the client served home care. The main results were as follows; The age group of most of the subjects was 70-79 years: 76.9% of them were female and 87.3% were over 65 years. In education variables, over 90% of the clients were below primary school. In marital status variables, 63.4% of them had no spouse, 57.5% of them were widows and widowers. In living arrangement variables, alone(35.8%) was the most. In insurance status variables, medical aid(69.9%) was the most. In household income variables, below 000 won(72.6%) was the most. In hospitalization variables, 53% of the clients had no hospitalization. The satisfaction level of home care service of male and female was similar. The older the age, the higher the satisfaction level. The satisfaction level of the group having religion was higher than the group having no religion and the Christianity group had the highest satisfaction level(p<0.001). In education variables, the over high school group was the highest satisfaction level(p<0.01). In living arrangement variables, the other (sisters or neighbors etc.) group indicated the highest satisfaction level(p<0.001). In insurance status variables, the other group(except for medical aid) was the highest satisfaction level(p<0.001). In household income variables, below 390,000 won was the highest satisfaction level(p<0.001). In hospitalization variables, 'over 4 times' group indicated the highest satisfaction level (p<0.01). Home care took place more in health centers than in home care services center. In frequency of home care per month three times was the most. In opinion of home care frequency per month 82.8% of the people answered 'proper'. A lot of present illness was neuralgia, arthritis, digestive disease, hypertension & CVA. In contents of home care services variables, education & counselling was the most and medication was second. In duration of illness variables, over 10 years was the most. In place of treatment before home care service variables, hospital(57%) was the most. In illness condition after home care variables, 'moderate' was the most and 'much better'(85.5%) was second. In help of home care variables, 'much help'(71.5%) was the most and 'moderate'(28.1%) was second. In contents of counselling variables, treatment method of illness was the most. Home care services center indicated higher level of satisfaction than health center(p<0.001). In opinion of home care frequency per month variables, 'less' was the highest satisfaction level (p<0.001). In duration of illness variables, below one year was the highest and over 10 years was second(p<0.001). In place of treatment before home care service variables, health center was the highest (p<0.001). In illness condition after home care variables 'much better' was the highest and 'worse' was second (p<0.001). I n help of home care variables, 'much help' was the highest (p<0.001). In contents of counselling variables, cause of illness was the highest(p<0.001). According to the 14 items which consisted of 3 point scales the total level of satisfaction of home care service was very high, with total mean score 36. According to the above results, most clients taking home care services are satisfied. However, organization and a fund are required to support high quality home care services to those who need them. Furthermore, a follow-up survey should be accomplished to evaluate the status of clients.

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선택진료제도 개편에 대한 중요도-성취도 분석(IPA) - 서울시내 상급종합병원 의료종사자 인식을 중심으로 - (An Importance-Performance Analysis of the Healthcare Reform on a Doctor-Designation System - Focused on the Perception of Medical Providers' at Tertiary Hospital in Seoul -)

  • 박혜진;김효정;김영훈
    • 한국병원경영학회지
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    • 제23권1호
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    • pp.28-40
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    • 2018
  • Purpose: The purpose is to understand the perception of medical providers at tertiary hospitals in Seoul on the importance-performance of the reform on a doctor-designation system, and to provide the policy suggestion of the perception on such a system. Methodology: To achieve the purpose, this study utilized structured survey tools to conduct a questionnaire survey of nursing, administrative and medical technology professionals at six tertiary hospitals in Seoul. An importance-performance analysis was utilized for an analysis that showed the perception of the reform on a doctor-designation system. Findings: First, it was identified that those medical providers had the highest perception of the importance about the performance of the reform on a doctor-designation system. Second, according to the result of action grid of an importance-performance analysis (IPA), it can be identified that in the 2nd stage of 'Concentrate here' included are the items as to design and effect of medical care quality and subsidies & patient infection and safety and control fees, effect of income security of the method for compensating for loss established by the government and offering sufficient information on general medical services and doctor-designation medical services. In the 1st stage of 'Keep up the Good Work', and the 2nd stage of 'Concentrate here' included is the item as to the performance of patients of the reform on a doctor designation system. Practical Implications: There could be identified the effect of the reform bill on the perception of medical providers. It is expected that a better environment would be provided for patients to use a hospital and for medical providers to offer medical services, if the goverment makes efforts to improve methods for compensating for loss and continuous monitoring of the performance of patients.

응급실 재원시간과 관련된 환자의 특성 (Patient characteristics associated with length of stay in emergency departments)

  • 정설희;황지인
    • 보건행정학회지
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    • 제19권3호
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    • pp.27-44
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    • 2009
  • The length of stay in emergency departments has been used as a quality indicator to reflect the overall efficiency of emergency care. Identifying characteristics associated with length of stay is critical to monitor overcrowding and improve efficient throughput function of emergency departments. This study examined the level of waiting time for initial assessment by physician and length of stay in emergency departments. Furthermore, we investigated the characteristics of patients' attendance associated with length of stay. An observational study was performed for a sample of 1,526 patients visiting ten nation-wide emergency departments. A structured form was designed to collect information about patients' demographics, route of admission, time and mode of arrival, triage level, cause of attendance, initial assessment time by physician, departure time, and disposition. Multiple regression analysis was performed to determine factors associated with length of stay. The average length of stay was 209.4 minutes (95% confidence interval [CI]=197.1-221.7), with a mean waiting time for initial assessment of 5.9 minutes (95% CI=5.1-6.7). After controlling for emergency department characteristics, increasing age, longer waiting times, attendance due to diseases, higher acuity, multiple diagnoses($\geq$2) and requiring admission or transfer to other health care facilities were positively associated with length of stay in emergency departments. The findings suggest that both patients' characteristics and the flow between emergency departments and parent hospitals should be taken into account in predicting length of stay in emergency departments.

The Role of Pharmacists' Interventions in Increasing Medication Adherence of Patients With Epilepsy: A Scoping Review

  • Iin Ernawati;Nanang Munif Yasin;Ismail Setyopranoto;Zullies Ikawati
    • Journal of Preventive Medicine and Public Health
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    • 제57권3호
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    • pp.212-222
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    • 2024
  • Objectives: Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence. Methods: A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. Results: The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions. Conclusions: Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients' knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

요양보호사의 노인에 대한 지식정도, 태도 및 요양업무 능숙도에 대한 융복합적 접근 (Convergence Approach about the Knowledge, Attitude toward the Elderly, and Competence of Carers)

  • 박경옥
    • 디지털융복합연구
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    • 제14권9호
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    • pp.399-406
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    • 2016
  • 본 연구는 요양보호사를 대상으로 요양보호사의 노인에 대한 지식, 태도, 요양업무 능숙도 간의 관계를 파악하고자 장기요양시설에 종사하는 요양보호사 145명을 대상으로 2014년 6월부터 9월까지 구조화된 설문지를 사용하여 요양보호사의 노인에 대한 지식, 태도, 요양업무 능숙도에 대해 조사하였다. 본 연구에서 사용한 통계방법은 서술통계, ANOVA, 독립 t-검정, Pearson correlation coefficient를 사용하였다. 연구 결과 노인에 대한 지식수준, 태도와 요양업무 능숙도는 서로 양의 상관관계가 있음을 확인하였다. 따라서 요양보호사에 대한 교육내용을 개발할 때 요양보호사의 낮은 지식수준을 고려하여 쉬운 교육내용과 다양한 교육방법을 활용하는 것이 필요하다. 그리고 요양보호사의 근무환경 개선을 통해 노인에 대한 긍정적인 태도를 증진시켜 노인 요양서비스의 능숙도를 높이는 것이 필요하다.

가상현실과 포톤 네트워크를 이용한 고령 환자용 여행체험 콘텐츠의 구현 (Implementation of Traveling Contents for Elderly Patients using Virtual Reality and Photon Network)

  • 임수빈;조면균
    • 융합정보논문지
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    • 제8권6호
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    • pp.123-128
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    • 2018
  • 최근 고령인구 증가와 장기요양 보험의 도입으로 요양기관에 입주하는 고령 환자의 수가 빠른 속도로 증가하고 있다. 이러한 장기요양 환자들은 만성질환과 치매 등의 질환을 앓고 있어 거동이 불편하거나 인지력이 떨어지는 어려움을 겪을 뿐 아니라, 가족과 떨어져서 우울증에 시달리므로 심리 및 정서적인 지원이 절실하다. 그리하여, 본 논문에서는 거동이 불편한 고령 환자를 위하여 VR과 포톤네트워크를 이용하여 물리적으로 떨어져 있는 가족들과 함께 평소에 가보지 못했던 해외여행 체험을 가상으로 제공하고자 한다. 기존 VR을 이용한 여행체험 서비스는 혼자 체험하는 반면, 제안하는 콘텐츠는 포톤 네트워크를 통해 가족 및 친구들이 네트워크로 참여함으로써 여행 체험 시 대화는 물론 지인들의 옆모습을 보며 함께 경치를 즐길 수 있다. 이를 통하여 고령의 장기 요양환자로 하여금 심리적 안정감을 회복하고 치유의 의지를 높여서 투병생활에서 삶의 질을 높이는데 도움을 줄 것이라 기대한다.

질병군에 따른 요양병원 노인 입원환자의 의료이용 현황: 건강보험심사평가원 고령환자데이터셋(HIRA-APS)을 이용하여 (Status of Medical use of Elderly Inpatients in Nursing Hospitals According to Disease Groups: Using HIRA-APS)

  • 장윤정;박초열
    • 보건의료생명과학 논문지
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    • 제11권2호
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    • pp.351-360
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    • 2023
  • 건강보험심사평가원 2018년 고령환자데이터셋(HIRA-APS)을 이용하여 요양병원 입원환자 33,821명을 주요 질병군별로 구분하여, 의료이용 현황과 특성을 파악하여, 요양병원의 기능정립에 효과적인 정책 기초자료를 제공하고자 하였다. 첫째, 질병군에 따라 의료이용 특성에 차이를 보이고 있어, 환자의 질병군 특성에 맞는 치매 전문, 재활 전문, 호스피스 전문, 회복기 전문 등 특화된 요양병원 설립과 운영이 필요하다. 둘째, 요양병원 입원환자의 연간 입원일수에 영향을 미치는 요인 중 주상병별로는 마비군, 뇌혈관질환군, 치매군이 가장 길었으며, 환자분류군별로는 인지장애군이 가장 길어, 질병군별 장기 환자에 대한 의료 수요 및 질 관리가 필요하다. 셋째, 요양병원 입원환자의 치료결과 중 정상 퇴원에 영향을 미치는 요인 중 질병군별로는 근골격계질환군에서 가장 높았고, 마비군, 뇌혈관질환 순으로 퇴원 후 재가 프로그램 지원이 요구된다.

Rediscovering A Path to Aging in Place: Development of Housing Cooperatives for Rural Elderly

  • Lee, Hyun-Jeong
    • Architectural research
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    • 제13권3호
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    • pp.31-40
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    • 2011
  • Profit-keeping behaviors naturally occur in the market to satisfy consumers, and the logic behind it lies in the economies of scale. On the flip side, some commodities transacted in the market are not available or can not be easily acquired unless the demand is high enough. Under this proposition, some consumers rise and find their own solution to meet the services at a reasonable cost or at an adequate level. The commonly adopted way is to establish a cooperative, and it stirs purchasing power by pooling resources and further bargains price and service quality. As a consumer cooperative, housing cooperatives notably found in rural towns enable the elderly to continue independent living. This study is to take a closer look at residential life of the rural elderly in housing cooperatives. Utilizing in-depth focus group interviews with 40 residents in four housing cooperatives, this qualitative research draws main factors affecting the decision to move in, residential assessment, and strengths and weakness of living in a housing cooperative. The primary factor influencing the moving decision is to continue to independent living in a familiar community, and the bottom line is planning ahead. Frailty and bereavement are found to be the leading occasions for them to move. The participants are satisfied with the independent living arrangement, and particularly, cited such features as safety and security, elderly-friendly design, common spaces, freedom, social activities and efficient living. Also, it is stated that some cooperative natures such as control over the property and giving a voice on management render positive impacts on the satisfaction with communal living. In spite of all the benefits and strengths, participants face with a public notion that an independent living arrangement like a housing cooperative has never done before in rural towns, so that most people recognize it as part of dependent living arrangements like nursing home.

경도인지장애 노인에게 적용된 인지기반 중재연구의 분석적 고찰 (Cognitive-based Intervention for the Older Adults with Mild Cognitive Impairment: A Literature Review)

  • 임세현
    • 한국융합학회논문지
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    • 제12권2호
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    • pp.327-336
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    • 2021
  • 국내 경도인지장애 노인의 약 10%는 매년 알츠하이머병이나 다른 치매로 이환된다. 이를 예방하기 위한 중재는 다양하게 수행되었으나, 이에 대한 근거의 통합은 시도되지 않았다. 이에 본 연구는 체계적인 문헌 고찰을 통해 경도인지장애 환자를 위한 인지 기반 중재와 그 효과를 알아보고자 수행되었다. 문헌의 검색은 2010년부터 2020년 9월까지 학술연구정보서비스(Riss)와 KoreaMed를 활용하였다. 문헌의 선택 및 배제 과정을 거쳐 최종 12편이 선정되었으며, 비동등성 대조군 전후 유사 실험연구가 7편으로 가장 많았다. 본 연구의 분석 결과, 경도인지장애 노인을 위한 인지기반 중재는 인지기능과 우울, 신체 건강 상태, 자아존중감, 운동 시·지각 검사, 생활 만족도, 자기효능감, 뇌파, 삶의 질, 의사소통과 상호작용기술평가 등에 긍정적인 영향을 주는 것으로 나타났다. 본 연구 결과를 토대로 경도인지장애 노인을 위한 중재 프로그램의 효과를 검증하기 위한 반복 연구를 제언한다.

병원 간호사의 선호근무시간대에 관한 연구 (A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours)

  • 이경식;정금희
    • 대한간호
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    • 제36권1호
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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