• Journal of Korean Academy of Nursing Administration
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• v.23 no.2
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• pp.211-222
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• 2017

Purpose: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. Methods: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. Results: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. Conclusion: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.1
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• pp.63-75
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• 2006

Purpose: This study was aimed to specify roles of nurses from the anesthesia and recovery room by analyzing nursing activities as well as anesthesia nursing during surgery. Method: The objects were 12 RNs working in the recovery room of a university hospital located in Incheon. Self-report was performed by measuring stop-watch for five days from May 17th to May 21st in 2004. Research method was designed to record the time and frequency of the nursing activity from anesthesia and recovery room based on nurses' statement and other references for five days. The data were analyzed with descriptive statistics, ANOVA, and t-test via SPSS Win 10.0 program. Result: Nursing activities in anesthesia recovery room were classified into two different characteristics such as direct and indirect nursing activity. The activities consisted of 11 direct nursing areas and 39 nursing activities in anesthesia preparation room. The indirect nursing was classified into 8 nursing areas and 32 nursing activities. The direct nursing was classified into 12 nursing areas and 55 nursing activity. Also, the indirect nursing was classified into 7 nursing areas and 21 nursing activities in recovery room. In terms of prevalence of nursing activities in the anesthesia preparation room, observation and cooperation of anesthesia was the most prevalent activity, drug and eqipment management the second prevalent, and drug administration the third. On the other hand, in the recovery room, the most prevalent activity was vital sign checking and observation, the second most prevalent activity informative activity, and the third body temperature control. Nursing activity time was recorded according to the nursing characteristics. In the anesthesia preparation room, the direct nursing spent for 8092.20 minutes was larger than the indirect nursing spent for 7198.50 minutes. Also, in the recovery room, the direct nursing spent for 2361.16 minutes was larger than the indirect nursing spent for 1134.13 minutes. 4. Nursing activity time was compared to duty shifts. In the anesthesia preparation room, the direct nursing was more prevalent on day shift and the indirect nursing was prevalent on evening shift. However, in the recovery room, both direct and indirect nursing activities were prevalent on day shift. Conclusion: The role of anesthesia and recovery room nurses was analysed according to the time, frequency, and its characteristics.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.236-247
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• 2017

Purpose: This study was to present improvement strategy and the problems of the nursing fee in national health insurance system. Methods: A total of 23 nursing activities performed by nurses were selected. Data were collected the relative value score and criteria of the Health Insurance Review & Assessment Agency. Sixty clinical nursing experts panels were composed and nursing time surveyed self-reported method. The actual fee was calculated through the nursing time, relative value score and actual labor costs. Nextly, the labor costs analyzed was compared with that in the national health insurance. Results: Although the practices were mainly performed by the nurse, other occupations have been recorded as main practitioners and the time of the nursing activity is partially improperly reflected. Additionally, although the nurse practiced mainly in glucose (semi-quantitative) test, it was confirmed that the principal practitioner was described as a clinical pathologist. The the labor cost gap was estimated that is 9.3 times (median) and 11.9 times (average) in this analysis. Conclusion: This study suggests that it is necessary to legislate a policy that can improve the quality of clinical nursing by reinforcing the appropriateness and improving nursing fee through reflection of the actual time spent for nursing care.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.2
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• pp.217-226
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• 2013

Purpose: Purpose of this research was to identify effects of application of a modified primary nursing system. Methods: Measurement was done of direct nursing time and satisfaction of nurses and patients before and after one month of the modified primary nursing system in a surgery unit in C university hospital, Seoul. Results: There was no statistically significant difference between average for patient satisfaction (4.24) before and (4.11) after application of the modified primary nursing system. Total average for nurse satisfaction with the nursing delivery system was 2.89 before application and, 3.34 after, indicating some significant differences (t=-4.06, p<.001). The KPCS-1 was 10.19 before application of the modified primary nursing system and 9.52 after application. Recalculated into direct nursing time, the average direct nursing time for one patient was 92 minutes before application, and 85.98 minutes after, indicating no significant difference. Conclusion: Through this research an attempt was made to build and test a modified primary nursing system. Results indicate that the most important thing is to clearly regulate office work and safely implement the new system.

• Journal of Korean Academy of Nursing
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• v.22 no.2
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• pp.185-206
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• 1992

In this study nursing activities were examined to determine the nursing cost. A professional nursing group developed a tool for the investigation. 128 nursing activities were identified by the tool in 16 nursing care areas as referenced in the literature. Each activity was examined for four essential factors to define nursing cost ; time consumed for the care, level of professional skill, degree of independency and performer of the care. The activity was rated by a five point Likert scale. This investigation was conducted with the nursing staffing working in the 21 university hospitals in Korea and having more than four years experience especially in medical or surgical wards. The participating nursing staff were screened on the basic of the recommendation of the nursing director. The data were gathered from June 12th to August 12th, 1989. All the data were analyzed for mean, standard deviation, percent, and correlation coefficients between items. The results are summarized as follows : 1. Direct nursing care was classified into 16 large areas and 128 small activities. 2. No significant correlation was found between the study items of each activity. 3. Among 128 nursing activities, Those performed less than 50% of the time by a nurse were excluded from the nursing cost. Also excluded activities which were given less than 9 marks in all three items, time consumed, level of professional skill, and degree of independency. As a result, 83 activities in 14 nursing care areas were selected for the proposal to estimate nursing cost.

• Quality Improvement in Health Care
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• v.19 no.2
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• pp.68-80
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• 2013

Background: This study investigates improvements in non-value-added nursing activities in clinical work, in order to improve the efficiency and quality of nursing activities. Methods: The study was performed as a quality improvement project at a tertiary general hospital. The nursing activities that needed improvements were categories into admission care, discharge care, supply management, diagnostic work-up related activities, and others. The nursing time and frequency of non-value-added activities were compared across nine nursing units before and after implementation of the quality improvement program. Post-implementation patient and nurse satisfaction were subsequently analyzed. Result: Post-implementation, the time spent on non-value-added nursing activities was reduced and patients and nurses were satisfied with the improvements. Discussion: Reducing non-value-added activities in nursing can increase the work efficiency and ensure time for patient care, thus improving the quality of nursing care. For further study, accurate surveys on nursing activities based on nursing time are required.

• Korean Journal of Occupational Health Nursing
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• v.19 no.1
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• pp.5-13
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• 2010

Purpose: This study aims to develop a tool to predict occupational health patients' nursing needs or nursing time. Method: A tool was composed based on the materials and opinion of experts, and to verify the reliability and validity of the tool, nursing time of total 311 inpatients in 2 occupational health hospitals were surveyed. Results: The developed tool was total 151 items and composed of physical function, cognitive function, communication, emotional and disturbance behavior, nursing skill, and rehabilitation need. The reliability of the tool was high, showing Cronbach's alpha coefficient of 0.95. But several items should be deleted for low corrected item-total correlation. According to the multiple regression analysis, physical function and rehabilitation need were shown to be the most powerful predictive variables for nursing time. Conclusion: The developed tool was appeared to have high reliability and validity. But further refinement of the tool is needed.

• The Journal of Korean Academic Society of Nursing Education
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• v.23 no.1
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• pp.76-85
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• 2017

Purpose: The aim of this study was to explore the effects of imagery training on outcomes of clinical competence, voluntary practice time and basic nursing skills performance during a core basic nursing skills course. Methods: The design was a pre-post test design with two groups consisting of 88 nursing 3rd-year students. Clinical competence was assessed with a pre-post test, and basic nursing skills' performance and voluntary practice time were assessed at the post-test point. Data were collected from March, 2016 to June, 2016. Results: The pre-post differences of all subcategories of clinical competence were significantly improved in the experimental group (p<.05). but the control group did not show significant differences in the teaching/coordinating and professional development areas (p>.05). The experimental group practiced 1.33 hours more than the control group in voluntary practice. The two groups showed no significant difference in basic nursing skills' performance (p>.05). Conclusion: Imagery training during a core basic nursing skills course showed positive effects on nursing students' clinical competence improvement and increase of voluntary practice time.

• Journal of Korean Clinical Nursing Research
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• v.16 no.2
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• pp.127-140
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• 2010

Purpose: This study was performed to verify reliability and validity of Korean Patient Classification System for nurses(KPCS-1), to estimate nursing time conversion index, and to classify patients into groups according to KPCS-1 scores. Methods: KPCS-1 was revised from KPCS by a professional review team. Interrater reliability and construct validity of KPCS-1 were verified by data from 433 patients. Direct and indirect nursing time of 204 patients were measured by stopwatch observation and self reports for 24 hours. Nursing time conversion index was calculated. Results: KPCS-1 consisted of 12 area, 50 nursing activities, and 73 items. The interrater reliability was tested between two nurse group (r=.88, p<.001) and construct validity was verified according to medical department (F=10.97, p<.001) and patient pattern (F=5.54, p=.001). The correlation of nursing time and classification score was also statistically significant (r=.56, p<.001). The nursing time conversion index was 9.03 minutes per 1 classification score. The patients were classified into 4 groups by the classification scores. Conclusion: KPCS-1 can be a useful factor type patient classification system for general ward. Further study is needed to evaluate validity and reliability for refining KPCS-1 and to develop ways connecting the scores with nursing outcomes.

• Journal of Korean Critical Care Nursing
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• v.6 no.2
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• pp.65-77
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• 2013

Purpose: The purpose of the study was to analyze the nursing activities related to continuous renal replacement therapy (CRRT) in the intensive care units (ICU). Methods: We developed a list of 31 CRRT related nursing activities based on literature review and reviewed by expert group. A total of 109 direct time measurement records by 43 ICU nurses were collected and analyzed in terms of total time per shift, frequency, standard time, difficulty and performance levels of each CRRT nursing activity. Results: The mean time for CRRT nursing activity was 85.60 minutes per 8 hour shift. Nurses have spent average $9.46{\pm}6.98$ minutes in a shift for "waste fluid bag change" activity. In addition, "check catheter location" was the most time consuming single activity. The most difficult activity was "counseling-answer" and the most competent one was "dialysis solutions change". Conclusion: The CRRT nursing activities accounted for a significant portion of total nursing workload. Practical allocation of nursing staff for CRRT patient along with development of a new nursing cost system need to be considered. Continuous nursing educational and training programs on CRRT should be developed.