• Title/Summary/Keyword: Security Program

Search Result 1,229, Processing Time 0.03 seconds

Constitutional Issue Review of Compensation for Inevitable Medical Accidents During Delivery (불가항력 의료사고 보상사업에 대한 헌법적 쟁점 검토)

  • JUN, HYUN JUNG
    • The Korean Society of Law and Medicine
    • /
    • v.21 no.1
    • /
    • pp.153-185
    • /
    • 2020
  • In principle, even if serious consequences such as death or serious injury of a patient occur as a result of a medical accident, if the medical malpractice of a health care worker is not recognized, the health care worker is not held liable for said consequences. However, with the opening of the Korea Medical Dispute Mediation and Arbitration Agency on April 7, 2012, a system was established to compensate health care personnel for their medical malpractices only in the case of "injuries caused by medical accidents in the course of childbirth" (hereinafter referred to as "program for compensation of medical accidents"). Article 46 paragraph 1 of the current Medical Dispute Mediation Act, which is the basis of the Force Majeure Medical Accident Compensation System, stipulates that "medical accidents under delivery" claims are to be determined by the Medical Accident Compensation Review Committee are subject to the compensation project. And the details of the compensation, ratio of sharing financial resources for compensation, scope of compensation, and the guidelines and procedure for the payment of compensations are prescribed by Presidential Decree. In other words, the Presidential Decree requires the state to pay 70 percent of the compensation funds, and 30 percent of the above funds among health care providers. The Constitutional Court has decided on the 2015Hun-Ga13 that the scope of the health care institution's founders and the share of the compensation funds cannot be directly determined by the law, and that the portion delegated by the Presidential decree does not violate the Principle of Legal Protection nor Comprehensive Nondelegation Doctrine. However, this can be seen as an exclusion of accountability for force-induced delivery accidents even if there is no negligence of the medical staff. If the nature of the system is a type of social security system with a social compensatory nature, it could consider eliminating the health care innovator's cost-sharing provisions, leaving the full cost to the state. However, it is also necessary to review institutional protocols that strengthen the efforts of medical institutions in areas such as analysis of the causes of medical accidents and measures to prevent their recurrence. In addition, I think that the conclusion of the Act is in line with the purpose of the Comprehensive Wage Support Regulations that at minimum the law sets an upper limit of the compensation funds that are to be paid by health and medical institutions. Moreover, it is reasonable for the Medical Accident Compensation Review Committee to specify gestational age and weight of births, which are the criteria for compensation, under the Enforcement Decree of the Medical Dispute Mediation Act, in relation to the criteria for payment of contributions by the Medical Accident Compensation Review Committee, and to set the detailed criteria.

Location Analysis of A Collective Consumption Facility with GIS: The Location of Gu-Office and Its Administrative District in Ulsan, South Korea (GIS기법을 이용한 도시공공서비스 시설의 입지분석 -울산시 구 관할구역과 구청입지를 중심으로-)

  • Cho, Sung-Ho;Park, Soon-Ho
    • Journal of the Korean association of regional geographers
    • /
    • v.2 no.1
    • /
    • pp.69-85
    • /
    • 1996
  • This research adoptes a spatial analysis function of the Geographic Information System[GIS] to analyze the location and the service district of a collective consumption facility, to discover the optimal location, and to redefine the service district. The location and spatial district of a collective consumption facility strongly influences the quality of life of residents. This research studies administrative offices and districts, especially Gu-offices in Ulsan. Ulsan would be raised to the status of Kwangyokshi in 1997; so that, the status of four Gus would be changed from a general administration into a self-governing administration. The summary of this research focuses on five significant points. First, the districts of four Gus were strongly required to be redefined to obtain the maximization of the degree of potential development as well as of the efficiency and equity of administring services. The spatial range of residents in a Gu was not in accord with its administrative district. The administrative districts of four Gus in Ulsan were not balanced in terms of area and population, and the high degree of disparity among Gus existed the efficiency and equality of a collective consumption service. Second, the current gu-offices were located based on security of land and accessibility of a main route; so, there was difficult to find the creteria and the principles of selections of the location of Gu offices. The social disparity of an administrative service existed in the accessibility into Gu-offices. Third, the administrative districts of Gus were redefined with spatial analysis tool of ARC/INFO. It was recommended that Ulsan maintain four Gus under the condition of five Kwangyokshi in South Korea. The redefined districts of administration reduced the disparity among four Gus in terms of area and population. improved the degree of harmony between the spatial range of residents of Gus and the administrative district of Gus, and increased the efficiency and equity of administrative service. Fourth, within the redefined adminis trative district of a Gu, the centroid reduced the maximum distance and mean distance; so, the efficiency and equity of public service provided by the Gu-office were improved. Last, the spatial analysis function of GIS helped to select the optimal location and to delineate the district of public service with more speedly and objectively. The function of spatial analysis of GIS was very useful to minimize the conflict in the determination of the location of a collective consumption facility and of the service district. To improve location analysis with GIS. non-spatial data base such as budget, thought of residents, and development policy and program, should be constructed.

  • PDF

Attitudes and Problems of Urban Parks, in Taegu City, Korea (도시공원(都市公園)의 속성(屬性)과 문제점(問題點))

  • Choi, Seok-Joo
    • Journal of the Korean association of regional geographers
    • /
    • v.2 no.2
    • /
    • pp.205-217
    • /
    • 1996
  • Today in the industrial society, the urban park is the place for citizens' health, recreation, exercise, and education. This is a very important place as a fine sight and maintenance of public security. As the results of rapid economic growth during the last thirty years, citizens are in the age of material civilization and are challenged with many serious urban problems such as pollution, noise, traffic congestion, human alienation, etc. Rapid material civilization brought to citizens' mental and physical diseases. To some of the problems, it is necessary that we should have proper leisure and recreation facilities, and that we should have the active, positive posture to them. Especially we need the out door recreational spaces and facilities. But nowadays the urban parks are given little thought in spites of the necessity of parks which should be used as a recreational spaces in the urban areas. So, This study attempt to comprehend the function, quantity and quality of the urban park system in Taegu. It is clear that the quantity is inappropriate. Because of inappropriate disposition and management, its coefficiency of utilization is low. In view of the population and park ratio, Dong Gu, Nam Gu, Suseong Gu and Dalseong Gun have comparative good, environments. However, Dalseo Qu, Seo Gu and Jung Gu have less geographical features. There are some methods to provide expansion of the aggregate of urban parks. We can use the school-grounds and their facilities. which were moved from C.B.D. to the outskirts of Daegu, or some parts of urban redevelopment, or the riverside of Sincheon river. In the urban park-program, users' satisfaction-factors are analyzed. We must reconsider the efficiency. The above problems are improved. Active administration and inhabitants' Positive participation are demanded so that the sound development of cities and daily life-surroundings are promoted.

  • PDF

Application and Effectiveness of a Preceptorship for the Improvement of Clinical Education (임상실습 교육개선을 위한 일 실습지도자 활용모델 (preceptorship model)의 적용 및 효과에 관한 연구 -암센타, 재활센타, 중환자실 실습을 중심으로-)

  • 이원희;김소선;한신희;이소연;김기연
    • Journal of Korean Academy of Nursing
    • /
    • v.25 no.3
    • /
    • pp.581-596
    • /
    • 1995
  • Clinical practice in nursing education provides an opportunity for students, through the process of ap-plying theoretical knowledge to practice, and to learn nursing skills as well as being socialized into nursing and as such decrease the reality shock of actual nursing practice. Because of a shortage of nursing faculty, the job of achieving the objectives of the clinical practice had been turned over to the head nurses. This resulted in many problems, such as, unclear location of responsibilities and inadequate feedback from head nurses. Therefore this study was done to introduce and evaluate the use of preceptors as a way to minimize the above problems, and to maximize the achievement of the clinical practice objectives. Using an adaptation of Zerbe's (1991) three-tiered team model, clinical practice was done using a preceptor, a head nurse and a clinical instructor, each with different and well defined roles. The subjects of this study were 67 senior students of the College of Nursing of Y University in Seoul whose clinical practice in adult nursing was carried out between May 1, 1994 and December 8, 1994. There were 22 preceptors who had at least two years of clinical experience and who were recommended by their head nurses. They were given additional education on the philosophy and objectives of the College of Nursing, on communication skills, on the theory and practice of education, and on nursing diagnosis and education evaluation. The role of the preceptor was to work one-to-one with students in their practice. The role of the head nurse was to supervise and evaluate the preceptors. The role of the clinical instructor was to provide the education program for the preceptors, to provide ad-vice and suggestions to the preceptors and to maintain lines of communication with the college. With each of these roles in place, it was thought that the effectiveness and efficiency of the clinical practice could be increased significantly. To evaluate the effectiveness of the preceptorship, the three - tiered model, Lowery's Teacher Evaluation Opinion Form translated and adapted to Korea was used to measure student statisfaction. The Clinical Practice Compentency Evaluation Tool developed by Lee et ai was also used to measure student competencies. The results of this study are as follows 1. The satisfaction with clinical practice was higher with the introduction of the perceptors than it was before they were used. (t=-5.96, p=<.005) 2. The clinical practice competencies were higher with the introduction of the preceptors than it was before they were used(t=-5.l3, p<.005) 3. In order to analyze areas not measured by the quantitative tools additional analysis of the open questions was done. The results of this analysis showed that : 1) The students felt positive about their sense of security, confidence, handling of responsbility, and being systematic. They also felt positive about improvements in knowledge, opportunities for direct care, and socialization. 2) The students felt negative about the technical part of their role, lack of knowledge by the preceptor, unprofessional attitudes on the part of the preceptor, difficulty in the role of the professional nurse(student). 3) The preceptors felt positive about their responsibility, motivation, and relationship with the college. 4) The preceptors felt negative about their bur-den. Introduction of the preceptorship model will lead to change and improvement in the negative factors discussed above, solve problems in the present clinical education system, increase continuity in the education of the students, help with socialization of the students and motivation of the preceptors to up-grade their education and increase their confidence. These objectives must be obtained to further the development of professional nursing, and thus, making the preceptorship a reality is our job for the future.

  • PDF

Comparative Analysis of Community Health Practitioner's Activities and Primary Health Post Management Before and After Officialization of Community Health practitioner (보건진료원의 정규직화 전과 후의 보건진료원 활동 및 보건진료소 관리운영체계의 비교 분석)

  • Yun, Suk-Ok;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
    • /
    • v.19 no.2
    • /
    • pp.141-158
    • /
    • 1994
  • To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

  • PDF

Prevalence of Metabolic Syndrome and Assessment of Food·Nutrient Intakes among Adult Visitors of a Public Health Center in Korea (일부 보건소 내원자의 대사증후군 발현과 식품 및 영양소 섭취 실태)

  • Jeong, Won-Hoon;Jin, Bok-Hee;Hwang, Eun-Hee
    • Journal of the Korean Society of Food Science and Nutrition
    • /
    • v.41 no.2
    • /
    • pp.205-212
    • /
    • 2012
  • This study was performed to investigate the prevalence of metabolic syndrome (MS) and assess nutrient intake levels for the purpose of improving MS risk factors. The participants in this study were 512 adults consisting of 271 men and 241 women aged 30 and over, who visited a public health center for a medical check up. The diagnosis of MS subjects was adapted from the NCEP-ATPIII guidelines and the WHO Asia-Pacific Area criteria for obesity. The MS group was defined as subjects displaying three or more risk factors, and the non MS group was defined as those displaying two or less risk factors. A dietary survey was conducted using the 24-hour recall method. The number of subjects displaying MS syndrome factors was 158 (30.9%), broken down into, 89 men and 69 women. Regarding risk factors in the MS group, the prevalence of waist circumference was 40.5%, hypertension 34.2%, hyperglycemia 31.0%, low HDL-cholesterol 24.7%, and hypertriglycemia 19.6%. BMI, sistolic blood pressure, blood glocose, blood triglyceride, and blood HCL-cholesterol of the MS group were significantly higher compared to the non MS group. Male subjects in the MS group reported high intakes of cereals, sugar, fruits, meat and poultry, oil and fats, and beverages and total food intake was significantly higher compared to the non MS group. Women in the MS group reported high intakes of meat and poultry, milk and dairy products, beverages, and seasonings, and total food intake was higher compared to the non MS group. Dietary diversity score (DDS) was 3.82~4.04, which was not significant among the groups. In men, dietary variety score (DVS) was 16.3 in the MS group and 19.4 in the non MS group, whereas in women, the DVS was 15.2 in the non MS group and 17.0 in the MS group. In GMVDF pattern, 11111 pattern was 30.7%, followed by 01111 for men and 11101 for women. Calorie, fat, and cholesterol intakes in men as well as, calorie, fat, and folate intakes in women in the MS group were higher compared to the non MS group. Intakes of protein, P, Fe, Na, vitamin $B_1$, vitamin $B_2$, niacin, vitamin E, and Zn were higher than the KDRIs. On the other hand, intakes of Ca, K, fiber, vitamin $B_2$, and vitamin C were below the KDRIs. Intakes of lipids, animal food, Na, and cholesterol in the MS group were higher compared to the non MS group, whereas intake of dietary fiber was lower. Our results indicate that continuous, systematic nutritional education program must implemented to reduce the risk factors associated with MS.

Suggestion of Learning Objectives in Social Dental Hygiene: Oral Health Administration Area (사회치위생학의 학습목표 제안: 구강보건행정 영역)

  • Park, Su-Kyung;Lee, Ga-Yeong;Jang, Young-Eun;Yoo, Sang-Hee;Kim, Yeun-Ju;Lee, Sue-Hyang;Kim, Han-Nah;Jo, Hye-Won;Kim, Myoung-Hee;Kim, Hee-Kyoung;Ryu, Da-Young;Kim, Min-Ji;Shin, Sun-Jung;Kim, Nam-Hee;Yoon, Mi-Sook
    • Journal of dental hygiene science
    • /
    • v.18 no.2
    • /
    • pp.85-96
    • /
    • 2018
  • The purpose of this study is to propose learning objectives in social dental hygiene by analyzing and reviewing learning objectives in oral health administration area of the existing public oral health. This study is a cross-sectional study. The subjects of the study selected with convenience extraction were 15 members of the social dental hygiene subcommittee of the Korean Society of Dental Hygiene Science. Data collection was conducted by self-filling questionnaire. The research tool is from 48 items of A division in the book of learning objectives in the dental hygienist national examination, and this study classified each of them into 'dental hygiene job relevance', 'dental hygiene competency relevance', 'timeliness', and 'value discrimination of educational goal setting' to comprise 192 items. Also, to collect expert opinions, this study conducted Delphi survey on 7 academic experts. Statistical analysis was performed using the IBM SPSS Statistics ver. 23.0 program (IBM Co., Armonk, NY, USA). Recoding was performed according to the degree of relevance of each learning objective and frequency analysis was performed. This study removed 18 items from the whole learning objectives in the dental hygienist national examination in the oral health administration area of public oral health. Fifteen revisions were made and 15 existing learning objectives were maintained. Forty-five learning objectives were proposed as new social dental hygiene learning objectives. The topics of learning objectives are divided into social security and medical assistance, oral health care system, oral health administration, and oral health policy. As a result of this study, it was necessary to construct the learning objectives of social dental hygiene in response to changing situation at the time. The contents of education should be revised in order of revision of learning objectives, development of competency, development of learning materials, and national examination.

Open Digital Textbook for Smart Education (스마트교육을 위한 오픈 디지털교과서)

  • Koo, Young-Il;Park, Choong-Shik
    • Journal of Intelligence and Information Systems
    • /
    • v.19 no.2
    • /
    • pp.177-189
    • /
    • 2013
  • In Smart Education, the roles of digital textbook is very important as face-to-face media to learners. The standardization of digital textbook will promote the industrialization of digital textbook for contents providers and distributers as well as learner and instructors. In this study, the following three objectives-oriented digital textbooks are looking for ways to standardize. (1) digital textbooks should undertake the role of the media for blended learning which supports on-off classes, should be operating on common EPUB viewer without special dedicated viewer, should utilize the existing framework of the e-learning learning contents and learning management. The reason to consider the EPUB as the standard for digital textbooks is that digital textbooks don't need to specify antoher standard for the form of books, and can take advantage od industrial base with EPUB standards-rich content and distribution structure (2) digital textbooks should provide a low-cost open market service that are currently available as the standard open software (3) To provide appropriate learning feedback information to students, digital textbooks should provide a foundation which accumulates and manages all the learning activity information according to standard infrastructure for educational Big Data processing. In this study, the digital textbook in a smart education environment was referred to open digital textbook. The components of open digital textbooks service framework are (1) digital textbook terminals such as smart pad, smart TVs, smart phones, PC, etc., (2) digital textbooks platform to show and perform digital contents on digital textbook terminals, (3) learning contents repository, which exist on the cloud, maintains accredited learning, (4) App Store providing and distributing secondary learning contents and learning tools by learning contents developing companies, and (5) LMS as a learning support/management tool which on-site class teacher use for creating classroom instruction materials. In addition, locating all of the hardware and software implement a smart education service within the cloud must have take advantage of the cloud computing for efficient management and reducing expense. The open digital textbooks of smart education is consdered as providing e-book style interface of LMS to learners. In open digital textbooks, the representation of text, image, audio, video, equations, etc. is basic function. But painting, writing, problem solving, etc are beyond the capabilities of a simple e-book. The Communication of teacher-to-student, learner-to-learnert, tems-to-team is required by using the open digital textbook. To represent student demographics, portfolio information, and class information, the standard used in e-learning is desirable. To process learner tracking information about the activities of the learner for LMS(Learning Management System), open digital textbook must have the recording function and the commnincating function with LMS. DRM is a function for protecting various copyright. Currently DRMs of e-boook are controlled by the corresponding book viewer. If open digital textbook admitt DRM that is used in a variety of different DRM standards of various e-book viewer, the implementation of redundant features can be avoided. Security/privacy functions are required to protect information about the study or instruction from a third party UDL (Universal Design for Learning) is learning support function for those with disabilities have difficulty in learning courses. The open digital textbook, which is based on E-book standard EPUB 3.0, must (1) record the learning activity log information, and (2) communicate with the server to support the learning activity. While the recording function and the communication function, which is not determined on current standards, is implemented as a JavaScript and is utilized in the current EPUB 3.0 viewer, ths strategy of proposing such recording and communication functions as the next generation of e-book standard, or special standard (EPUB 3.0 for education) is needed. Future research in this study will implement open source program with the proposed open digital textbook standard and present a new educational services including Big Data analysis.

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

  • Lee, Gyeong-Sik;Jeong, Geum-Hui
    • The Korean Nurse
    • /
    • v.36 no.1
    • /
    • pp.77-96
    • /
    • 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.

  • PDF