• Title/Summary/Keyword: direct care

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Direct Care Stress and Job Satisfaction in Home Care Nurses (가정전문간호사의 직접간호업무 스트레스와 직무만족도)

  • Kim, Hee-Seung;You, So-Young;Kim, Myung-Ja;Park, Chai-Soon
    • Women's Health Nursing
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    • v.10 no.3
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    • pp.261-265
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    • 2004
  • Purpose: This study was aimed to investigate direct care stress and job satisfaction in home care nurses. Method: Subjects were 139 home care nurses of hospitals in urban cities. Data was collected by a self report questionnaire. Direct care stress was measured by Community Health Nurses Perceptions of Work-Related Stressors Questionnaire. Job satisfaction was measured by a visual analogue scale. Results: The average score of direct care stress was 60.4. There were significantly high direct care stress in those who had less than that 3 years experience than in their counterparts. The average score of job satisfaction was 79.5. There were significant high job satisfaction in those who willingly chose to work. Direct care stress negatively correlated with the length of office experience of the home care nurse. Conclusion: A direct care educational program should be developed for those who have less than 3 years experience to decrease their stress level.

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Structural Relationships among Principals and Fellow Teacher's Emotional Support, Child Care Teacher's Active Motivation for Choosing the Teaching Profession, Self-Leadership, and Child Care Efficacy and Commitment (보육교사의 보육헌신에 대한 원장과 동료의 정서적지지, 능동적 교직선택동기, 셀프리더십 및 보육효능감 간의 구조적 관계)

  • Seo, Mi Jung;Lee, Kyung Nim
    • Korean Journal of Childcare and Education
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    • v.14 no.1
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    • pp.167-186
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    • 2018
  • Objective: The purpose of this study was to explore the structural analysis of the relationships among principals and fellow teacher's emotional support, teacher's active motivation for choosing the teaching profession, self-leadership, and child care efficacy and commitment. Methods: Data were collected from 465 child care teachers and analyzed by means of structural equational modeling(SEM). Results: First, principals and fellow teacher' emotional support was found to have a direct effect on teacher's child care commitment, as well as an indirect effect through teacher's self-leadership. Second, teacher's active motivation for choosing the teaching profession was found to have a direct effect on teacher's child care commitment, as well as an indirect effect through self-leadership and child care efficacy. Third, teacher's self-leadership was found to have a direct effect on teacher's child care commitment, as well as an indirect effect through child care efficacy. Fourth, teacher's child care efficacy was to found have a direct effect on teacher's child care commitment. Conclusion: These results suggest the need for a great deal of utility to improve teacher's child care commitment.

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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Nursing Time Use in a Newborn Intensive Care Unit (NICU) (신생아중환자실 간호사의 간호업무량 분석)

  • Jun, Eun-Kyoung
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.1
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    • pp.55-81
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    • 2000
  • This study examined nursing care in a Newborn Intensive Care Unit (NICU) by reviewing nursing activities for the newborns. Through direct observation, time used for nursing care according to the nursing activity, shift, day of the week, and position of the nurses was measured. This study was done on November 15, 21, 24, 1999 at a university medical center hospital and included eight nurses and 179 newborns as the study subjects. The data were collected from the medical records, and by using a nursing activity record for the NICU, and a nursing activity time record for the NICU. The first step in the data collection process was to develop a list of nursing activities which was done through a literature review, examination of medical affairs and duty records. Content validity was measured by a panel of three professors who were experienced clinicians. In the second step two pre-training sessions were held with three sophomore student nurses who then measured the time for each nursing activity using a stopwatch. The data were analyzed using frequencies for nursing activities, averages, percentages and ANOVA for differences between shift and between days of the week, and percentages and t-test for differences according to position of the nurse. The results are as follows: 1) The total number of activities was 156, direct or indirect nursing activities. Direct nursing activity classified according to physical, educational, emotional/social/economic/spiritual needs. There were 109 direct nursing activities in 16 fields. 2) The order of nursing activities, according to time required, was record keeping, nutritional care, measurement/observation, medication, hygiene care, examination and specimen collection, and checking supplies, and according to frequency, measurement/ examination, record keeping, nutrition care, hygiene care, elimination care and medication. 3) According to shift, direct care during the night shift at 313.4 minutes was the longest time and indirect nursing care during the night shift at 252.2 minutes was the highest time. 4) For days of the week, Monday had the highest time for direct care 275.8 minutes (34.6%) and Wednessday had the highest time for indirect nursing care 269.6 minutes (36.1%). 5) For nursing time according to position of nurse, general nurses had the highest for direct care (330.7 minutes), nurse managers for indirect nursing activities (239.0 minutes) and general nurses for individual private time (63.9 minutes). The results of this study show that the major nursing time consuming activities included record keeping, nutrition care and measurement/examination. For newborns, time needs to be allowed for care to be sensitive, sophisticated and specialized rather than concentrated on indirect nursing tasks such as record keeping. Therefore, it is imperative to develop computerized systems that support a systematic approach to record keeping which is more efficient. Moreover, nursing needs according to shift, day or position of nurse can be utilized in assessing nursing resources through a computerized process.

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Estimation of Nurse Staffing Based on Nursing Workload with Reference to a Patient Classification System for a Intensive Care Unit (중환자의 중증도에 따른 적정 간호인력 수요 산정)

  • Park, Young Sun;Song, Rhayun
    • Journal of Korean Critical Care Nursing
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    • v.10 no.1
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    • pp.1-12
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    • 2017
  • Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.

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Analysis of Nursing Care Activities of Nursing Students in Clinical Experience (간호학생의 임상실습 간호활동시간 분석)

  • Lee Chung-Hee;Sung Young-Hee;Jung Yoen-Yi;Kim Jung-Suk
    • The Journal of Korean Academic Society of Nursing Education
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    • v.4 no.2
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    • pp.249-263
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    • 1998
  • The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

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Impact of Computerization on Direct and Indirect Nursing Time (병원전산화에 따른 직접 및 간접간호 양상의 변화)

  • Hwang, Jee-In
    • Journal of East-West Nursing Research
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    • v.11 no.1
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    • pp.58-64
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    • 2005
  • The purpose of this study was to examine impact of hospital computerization on the nursing practice. The study was conducted using the repeated measured design. The subjects were 166 nurses working at surgical nursing care units in a tertiary teaching hospital. A questionnaire was developed based on the Burke's study, and reviewed by a committee for content validity. Eighty-eight nurses responded the questionnaire throughout the study. Indirect nursing care time significantly decreased(p<0.05) after the computerization. These decrease related to time saving in checking physicians' order and writing nursing records. However, the change in direct nursing care time was not clear. In conclusion, the computerization led to the decrease in indirect nursing care time but it did not link to increase in direct nursing care time. Therefore, nurse managers should take into account redesign of the nursing works after computerization.

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Classification of Nursing Activities and Workload Analysis in a New Open Hospital (환자중심 간호업무 향상을 위한 간호업무 측정에 관한 연구)

  • Lee, Young-Shin;Kwon, Young-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.2
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    • pp.123-136
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    • 1997
  • The purpose of this study was to confirm the classification of nursing activity and to analyze the time of nursing workload in a new open hospital. The data were collected from 20 nurses working in 6 general nursing units by 4 trained observers. The tools used for this study were an observation recording sheet and a classification sheet of nursing activity. The classification sheet was constructed to be adaptable to each hospital system based on the instrument described in the literature. The results of the study are as follows : The direct nursing activities consisted of 6 sections, 33 subsections and the indirect nursing activities consisted of 14 sections, 53 subsections. The direct nursing activities included medication, measuring and observation, care of therapies, care of physical comfort, laboratory and treatment. The indirect nursing activities included preparation of medical utensils, collection of information and assessment, recording, phone communication, professional interaction related to patients, personal time, assigning work to staff, patient eaucation and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. Nurses spent 127.6min for direct nursing activity during day duty. It was 24.5% of total nursing activity. Within that activity medication had the highest percentage of time(40.09%), followed by communication and education with patient(24.76%), measuring and observation (16.93%), laboratory and treatment (12.85%), care of therapies(3.21%) and care of physical comfort (2.16%). The time breakdown for indirect nursing activities is as follows ; the preparation of medical utensils 22.3%, collection of information and assessment 20.29%, recording 20.27%, phone communication 8.14%, professional interaction related to patients 7.33%, personal time 7.24%, with the remaining timeshared by staffing, patient education and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. In the analysis of the relationships between the working time and the work allocation characters of the nurses(including nurse's experiences. nurse-patients ratio, nurse-rooms ratio, and character of nursing unit) ; There were no significant differences in direct-indirect nursing times between nurse's career years. There was significant difference in direct nursing time between assigned patient numbers. The nurses assigned larger number of patients spent significantly more time in direct nursing care than that of the smaller. On the other hand, there was no significant difference in indirect nursing workload between the assigned patient numbers. There were no significant differences in direct-indirect nursing time between an allocated patient's room numbers. There was significant difference in working time between working places. The nurse in the medical unit spent more time in direct nursing care than her counterpart in the surgical unit. However there was no difference in direct nursing time between two groups. The study results indicate that nurses spent less time in the direct nursing care than in the previous studies even though the hospital system has been modernized. On the other hand they spent much more time for the coordinating role within the interdisciplinary team and for the overlapping paperwork. Therefore it is recommended that patient oriented job description and more efficient usage of modernized utilities be made.

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A Comparison of Cost between Home Care and Hospital Care - According to Subject′s General Characteristics - (뇌혈관질환자에서의 가정간호이용시와 병원입원시 비용 비교 - 대상자의 인구학적 특성을 중심으로 -)

  • 임지영
    • Journal of Korean Academy of Nursing
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    • v.33 no.2
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    • pp.246-255
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    • 2003
  • Purpose: This study was designed to compare direct cost and indirect cost between home care and hospital care according to subject's characteristics. Method: The subjects of this study were patients with cerebrovascular disease. They were 50 patients in six university hospitals and 49 in four home care centers. Data were collected by using two type of questionnaires and reviewing medical records, home care service records and medical-fee claims from April 4th to September 13th, 2001. Result: The results were as follows; First, there was a statistically significant difference of direct cost between home care and hospital care, however, there was not a statistically significant difference of indirect cost. Second, according to subject's characteristics, six variables had statistically significant differences; sex, age, marital status, economy, job and diagnosis. Conclusion: It was found that cost-saving effect of home care was affected by subject's characteristic factors. More study needs to be done to develop a more detailed selection criteria for home care subjects.

The Relations of Nurses' Job Stress and Knowledge, Attitude and Care Behavior for Elderly Patients (간호사의 직무스트레스와 노인에 대한 지식, 태도 및 케어실천행위)

  • Yoon, Sook-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.4
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    • pp.593-600
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    • 2009
  • Purpose: This study was to examine the relation of nurses' job stress and knowledge, attitude and care behavior for elderly patient in hospitals. Method: One hundred ninety one nurses caring the elderly patients in hospitals in Ilsan, Busan and Gyeongsangnam-do were subjects. The data was collected between Sept. 21 and 31, 2009. Data was analyzed using t-test, ANOVA, Pearson correlation with SPSS/Win 17.0 and the fitness of pathway models with AMOS 5.0. Results: The mean scores of job stress and knowledge were in middle range, and attitude and care behavior were in a little higher range. The fitness of hypothetical model was excellent. Job stress had direct effects on attitude and care behavior, knowledge had direct effect on attitude and attitude had direct effect on care behavior. But the pathways related to job stress and attitude and job stress and care behavior were not significant. In modified model deleted the pathway between job stress and attitude, the pathway related to job stress and behavior also was not significant. Conclusion: Education related to the elderly for nurses to improve care behavior is needed continuously.

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