Park, Suin;Park, Sohee;Lee, Young Joo;Park, Choon-Seon;Jung, Young-Chul;Kim, Sunah
대한간호학회지
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제50권3호
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pp.333-348
/
2020
Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.
Purpose: The purpose of this study was to investigate perceptions of adequacy and job performance of the nurse assistants' nursing job as evaluated by registered nurses and nurse assistants in geriatric hospitals, and by caregivers from the same hospitals. Methods: Participants included 62 registered nurses, 57 nurse assistants, and 64 patient caregivers who completed a measurement scale on the job of nurse assistants. Data collection was conducted from October to December, 2015. Data were analyzed using descriptive statistics and one-way ANOVA by IBM SPSS/WIN program version 21.0. Results: There were significant differences by items in perception of adequacy of nurse assistants' nursing job of among the three groups. There was also a significant difference in perception of the nurse assistants' job performance among the three groups. Conclusion: For nurse assistants in geriatric hospitals, the Ministry of Health and Welfare needs to develop an appropriate job practice guideline. In addition, there should be periodic courses of retraining and continuing education for nurse assistants.
Purpose: The study was done to develop the model of regulatory body of advanced practice registered nurse. Method: This was a descriptive study adopted a method of comparison and construction of laws. Result: The type of partnership of government and people were privatization, negotiated rule-making, standard-setting authority, self-regulation. The pattern of partnership were applied to the regulatory body's role; administration of certification and examination, setting standards for nursing education programs and approval nursing programs. The regulatory body of advanced practice registered nurse was organized according to it's role. Conclusions: It is needed to proceed to self-regulation step by step.
Purpose: The study aimed to examine the effects of nurse staffing levels on patient outcomes in long-term care hospitals in South Korea using path analysis. Methods: We conducted a secondary analysis of national data, which included the 2021 hospital assessment results of long-term care hospitals from the Health Insurance Review and Assessment Service. Data collection was performed between June 19 and June 27, 2023. The study sample consisted of 1,215 hospitals, and we analyzed the data using SAS 9.4 and Mplus 8 software. Results: The average numbers of patients per registered nurse, certified nursing assistant, and nursing staff, including both registered nurses and certified nursing assistant, was 10.00, 7.43, and 4.00, respectively. Path analysis revealed that the number of patients per registered nurse had direct effects on improvements in activities of daily living and indirect effects on indwelling catheterization, pressure ulcer improvement, and weight loss. The number of patients per certified nursing assistant had direct effects on new pressure ulcer development and pressure ulcer improvement, with no indirect effects. The number of patients per nursing staff had direct effects on pressure ulcer improvement and no indirect effects on other patient outcomes. Conclusion: The findings suggest that establishing policies to evaluate staffing levels of registered nurse and certified nursing assistants separately is necessary in order to improve registered nurse staffing levels and patient outcomes in long-term care hospitals.
Purpose: This study is a descriptive study to investigate the relevance between pathophysiological subject and examination workbook items for national nurse licensure examination in South Korea and the United States. Methods: Eight registered nurse licensure examination workbooks published by the Korean nurses association were used for the analysis. Saunders comprehensive review for the national council licensure examination (NCLEX-RN) was used for analysis of those in the United States. The relevance between the subjects in the standard syllabuses of pathophysiology and the registered nurse licensure exam items of these workbooks in South Korea and the United States respectively was analyzed. Results: The Relevance rates in South Korea and the United States were : fundamentals of nursing 6.34% vs 32.12%, adult nursing 25.5% vs 25.92% child health nursing 7.81% vs 21.7%, woman health nursing 5.1% vs 17.07% psychiatric mental health nursing 2.7% vs 7.32%, and community health nursing 0.9% vs 0%. Conclusion: the relevance in pathophysiology between the registered nurse licensure exam in South Korea and the United States was high in adult nursing and fundamentals of nursing (especially in the United States). In developing integrated registered nurse licensure exam questions, we should consider pathophysiology as an important subject.
Every country in the world has been trying to expand the basic health right for the peoples as W.H.O has established the goal 'health for AU' by the year of 2000. Related to this goal, our government authority has establish the policy 'the insurance of health for all' into effect from July 198\). Recently hospitalshave been making a ceaseless effort for the plan for the rationalization of its management the academic World is making it a subject of discussion by doing the secure of manpower at a resonable level and the increase of productivity by the manpower. As a result of the efforts the study was established to secure the numbers of nursing manpower at a resonable level and use the unskilled persons at the utilizing field and seek the possible area of their activity for more efficient service through the investigation of ablity of simple nursing activities of regiestered nurses and nurse aides for rational function according to the educational levels and talents. The method of study was established by the registered nurses and nurse and nurse aides(R.N 229, N.A 226) who are working in 15 hospitals with over 200 beds. This surrey was conducted from Mar 29, 1989 to April 8, 1989. The method to test the degree of importance, difficulties, and the abillity of performance of a simple nursing activities was classified into 35 activities on the basis of references on this field. The degree of importance was composed from point l(Not so important) to 5(Very important). the degree of difficulties. was composed as follows; very easy - Point 1 very difficult and complicated - Point 5. and the ability of performance was composed from point 1 to 5. The materials gathered through the survey were analyzed with frequency, mean standard deviation, percentage. t-test, Anova, pearson's coefficient of correlation, stepwise multiple regression. factor analysis, discriminant analysis. The obtained results are summarized as follows: 1. The recognition values of the simple nursing activities of each group of registered nurse and nurse aides show; The degree of importance; 4.04 and 4.26 The degree of difficulties; 2.72 and 2.94 The ability of performance; 2.07 and 2.38 The brief summary shows there are little differences between who two groups the simple nursing activities turned out to be easy and simple work. 2. Regardless of the degree of importance, and difficulties, the ability of performance the important in fluencing of the degree of the simple nursing activities between the registered nurses and nurse aides was the order of educational level, hospital career, working career in wards and ages of the registered nurses and ages and hospital creer of nurse aides. The result was that the simple nursing activities could easily be familiar through the training of their working environment and period of experience. 3. Among the 35 simple nursing activities the items capable of resonable entrusting to the nurse aides are 5 that is helping bed-bathing, 8itz Bath, using bed pan, care while delivering patient, accompaying patient when visitor's check. There wasn't and differences between RN and nurse aides in performing the above 5 items. In anywhere. so we can say obviosuly that this nursing activities should be performed under the nursing system of which chief of nurse are supposed to supervise nurse aides as a possible function to be entrusted. In view of the above mentioned results, therefore, this partial functional job of the simple nursing activities can able be entrusted to the nurse aides through the regular training course. In case of these functional activities could be entrusted under, the responsibility of registered nurse, we can able suggest to for that there are the following advantages: 1.. In the nursing activities-affairs, the qualified guarantee of the nursing services can be kept and increased or promotoed with accommodation of the required nursing service and roles being expanded presently. 2. In the productivity of the hospital manpower, therefore, we have comt to view and consider in favourly that when an automational administration times would be come in the near future time to hospital affairs as a reality, to utilize the existing nures aides is better rather than investing so as to develop the other source manpowers or seek its for the efficient business management in the operational strategy or its policy.
Purpose: The role of registered nurses is expanding in scope as the healthcare paradigm shifts from acute, hospital-based care to community and population-based care. Given this paradigm shift, this study explores the legal aspects of the role of a registered nurse. Methods: We used document analysis for extracting laws and legal orders related to nursing from the entirety of Korean law. Using textualism approach, we examined the contents utilizing a framework that was developed based on the role classification of community nurses by Clark in this study. Results: A total of 119 items related to nursing were derived from 64 laws. Of these, 71.4 % can be performed by people in multiple types of occupations including nurses. As a result of analyzing required qualifications, 45.4% of 119 items required additional qualifications besides registered nurse license. Analysis of workplace and activity type demonstrated that 26.1% of the 119 items were related to medical institutions, with nurses performing mostly "Client-oriented role." More than half (68.9%) were non-medical institutions, with nurses performing mostly "Delivery-oriented role." Some, however, did not stipulate the nurse's roles clearly. Conclusion: Therefore, to match the enhanced scope and responsibilities of registered nurses and to appropriately recognize, guide, and hold these nurses accountable, laws and policy must reflect these changes. In doing so, these updated laws and policies will ultimately serve as a basis for improving the quality and safety of nursing services.
Purpose: This study was conducted to compare job satisfaction, self-esteem, and nursing task performance between registered nurses (RN) and nurse assistants (NA) in long-term care hospitals. Method: The sample consisted of 203 nursing personnel (RN 99 and AN 104), who were working in one of 5 long-term care hospitals in 5 different areas. Data were collected by structured questionnaires from March 15 to April 30, 2010, and analyzed using the descriptive statistics, independent t-test, One-way ANOVA, and Pearson correlation coefficients with SPSS/Win 17.0 program. Result: There was no significant difference between nurses and nurse assistants in job satisfaction and self-esteem. But nurses had higher levels of nursing task performance than nurse assistants. Conclusions: These findings demonstrate the necessity of developing programs that will help to improve job satisfaction and self-esteem in nurses and nursing task performance in nurse assistants. Strategies need to be developed to maximize the value of the existing workforce without impacting on the quality of care delivered.
Purpose: The aim of this study is to analyze the characteristics of family interventions based on a philosophy of family-centered care conducted in neonatal intensive care units through an integrative literature review. Methods: We searched the PubMed, CINAHL, RISS, KISS, and DBpia databases; a total of 20 studies, published between January 2013 and May 2018, was selected according to our criteria. Results: Mothers accounted for a greater proportion of participants in family interventions than did fathers. Family interventions described in the studies were categorized into four educational and sixteen non-educational interventions. Among non-educational interventions, skin-to-skin-contact interventions, such as kangaroo care, accounted for the highest proportion. Only one paper employed a theoretical framework. Conclusion: More family interventions based on theoretical frameworks should be conducted as these frameworks serve as guidelines for nursing research. As the stress patterns experienced by parents in neonatal intensive care units showed gender differences, more programs tailored for fathers are needed. Moreover, further research should be conducted to evaluate feasibility as an outcome variable, and studies of family interventions based on a philosophy of family-centered care should be performed more actively in the neonatal intensive care units in Korea.
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