• 한국보건간호학회지
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• 제31권3호
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• pp.421-435
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• 2017

Purpose: Public health centers (PHCs) provide a variety of healthcare services according to the Regional Public Health Act (RPHA). We aim to analyze the changes in public healthcare services according to the legislation and the number of public health nurse (PHN) involved in the service, and propose an alternative to effectively distribute the public health nursing workforce for protecting the health rights of people. Methods: This is a review study that deduced the results from literature review. Results: During the revision of the PHC law to the RPHA, several services were added. Health related laws have forced the PHCs to provide services for these legislations. Consequently, the workload on the PHNs has been increasing. However, the PHNs have been consistently lacking. In 2017, there are 16.2 full-time nurses per center. Furthermore, About 50% of the PHCs are not meeting the minimum requirements of licensed or qualified health professional workforce outlined in 1997. In addition, 43% of the nurses in the PHCs are part-time nurses. Conclusion: We suggest that the minimum requirements of health professional workforce should be modified to reflect the increase in the workload of PHNs, and a legislation to enforce PHCs to fulfill these requirements is needed.

• 대한간호학회지
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• 제27권4호
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• pp.880-891
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• 1997

The purpose of this study was (1)to undertake a survey to identify the profile of inactive nurses, who account for 42.2% of the 130,000 RN(Registered Nurses) in Korea, (2)to identify factors related to the inactivation of these nurses, (3)to identify reasons behind the high turnover rate of nurses, and (4)to delineate measures for inactive nurses to participate in professional nursing activities so as to upgrade the quality of the health care delivery system in Korea. For these purposes, this study surveyed existing literature on the turnover of nurses and, used the nominal group technique of action research, to collect ideas from hospital/nurse administrators, inactive nurses, nurses on the job, graduate students in nursing, part-time nurses, patients, and their families to formulate strategies to mobilize inactive nurses. The findings are as follows : Frist, institutional supports should be provided to mobilize inactive nurses. To be more specific : (1) A data-base needs be created at the Korean Nurses Association to link inactive nurses with jobs available. (2) Retraining programs need be established to equip inactive nurses for new jobs. (3) Comprehensive information related to employment needs should be made available. Second, a conducive environment needs to be created to draw in inactive nurses to the job market. To be more specific : (1) A system of part-time work needs to be introduced in hospitals. (2) Nurse-specialists need to be promoted. (3) Potential jobs need to be created. (4) Working environment and terms and conditions for nurses need to be improved. (5) Competent nurses need to be secured in the health care delivery system. To achieve the goals presented above, this paper presented 55 specific strategies that may help mitigate the turnover rate of nurses and, in turn, help make the Korean Nurses Association effective in implementing its policies.

• 한국직업건강간호학회지
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• 제7권1호
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• pp.97-114
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• 1998

The occupational health services for the minor enterprises are poor comparing with that of large enterprises in Korea. In 1997, Korean government announced officially the law on joint employment system of occupational health practitioners to solve the problems. This study is to develop the model on the joint employment system of occupational nurse practitioners for minor enterprises in Korea based on the opinions of occupational health nurses (OH Ns). The data were collected by questionnares from October to November in 1997. The number of subjects was 210 occupational health nurses who had participated the mandatory nursing education program provided by the Korean Occupational Health Nurses Association(KOHNA). The response rate was 47.1%. The contents of questionnaires were general characteristics, occupational & job characteristics of OHNs, and the views on the joint employment system. The SAS-PC program was used for the statistical analysis. The results were as followed, (1) The proper number of industies was 3 and the appropriate number of workers was 448 for one joint employed occupational nurse practitioner (J EONP). (2) 44.7% of the OHNs wanted that the Ministry of Labor monitored the way and content of contraction b/w JEONP and minor emterprises, 82.6% of the OHNs wanted that KOHNA managed the employment informations. (3) The OHNs of occupational health agencies showed more positive attitude than the OHNs of private industries on the joint employment system. (4) 88.3% of the OHNs wanted the education training for JEONP. Especially in occupational hygiene and safety control. (5) The OHNs expected the role expansion of Occupational Health Nursing by JEONP system. At the same time they worried the adverse effects. For the successful execution of this system, it is necessary the cooperation among the Ministry of Labor, KOHNA, the minor enterprises, and the OHNs.

• 간호행정학회지
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• 제6권2호
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• pp.259-279
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• 2000

This study is a descriptive analytic research measuring nursing service quality, using SERVQUAL model, to make fundamental data and strategies for nursing service improvement. Data were collected by self-reported questionnaire from 202 patients and 142 nurses, from June 7 to 14, 1999. The reliability of instrument were adequate(Cronbach ${\alpha}=.94$). SAS program was utilized for statistical analysis of collected data. The results were as follows; 1. There was a gab between patient's expectation and perception on nursing service(Gap B). Gap D was indicated an affecting factor to decide nursing service quality. Gap C was indicated an indirect affecting factor of nursing service quality. Because it was not statistically significant in total item analysis, but in individual item analysis, 7 items were appeared statistically significant. Gap A was not a gap occurrence factor of nursing service quality. 2. Focuses of nursing service quality improvement strategies were; (1) to direct qualitative improvement of nursing service in order to correspondence patient's nursing service expectation. (2) to make nurse's service activity modified because nurse's practice were not reached patient's expectation level. (3) to need internal, external factor analysis affecting nurse's service activity. 3. Nursing service quality was decided by rather environmental inappropriateness provided nursing service than itself. Therefore, to make nursing service quality improvement, it is required to improve nursing service environment. For this, followings are required; (1) to strengthen nurse's education on lower part of nursing service satisfaction and QI activities. (2) to balance demand and supply of nursing personnel. 3) to fix computerized system for reducing other duties weight except nursing care through analysis of nursing activity. (4) to construct rational cooperating system among related departments. 4. The important parts for nursing service quality improvement were indicated as follows: (1) Gap B: 'prompt reaction', 'examination symptom before patient's complaint', 'hearted nursing service reducing patient's dissatisfaction', 'explanation goals of nursing activities', 'having special Knowledge enough', 'maintenance position comfortably', 'management of patient's physical hygiene'. (2) Gap C: 'maintenance physical safety', 'explanation about hospital rules and facilities'. (3) Gap D: 'tender, safe injection and wound care'. Because above items are mostly improved through nurse's attitude change and quality improvement, it is required to establish nursing standardization and to strengthen nurse's clinical education. As the based on above results, followings are suggested; 1. SERVQUAL model is very useful to make strategies for nursing service quality improvement because it indicates multiple factors affecting hap occurrence. 2. At individual items analysis of Gap C, statistically significant 7 items appeared higher nurse's perception level than patient's perception level on nursing service were trouble perception level on nursing service quality improvement. So. it need further research to analysis about these difference occurring factors. 3. At analysis of Gap D, it is indicated that in nursing service performance process, multiple factors lowing nursing service quality were intruded. So it needs further research to analysis what these factors are and how each factors affect on nursing performance process. 4. nursing service quality measurement is changeable according to sample select time or sampled subject's characteristics. So to develope strategy for nursing service quality improvement is based on the results of periodical analysis.

• 한국의료질향상학회지
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• 제2권2호
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• pp.32-45
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• 1996

Background : A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care, and minimize delays. It can be thought of as a visualization of the patient care process. In this study, a review of appendectomy patient records was undertaken to identify a critical path for the management of this treatment. Methods: For this study, records of patients under 15 or over 65 years of age were excluded ; cases where the patient was pregnant, or where complications developed were also excluded. The remaining 21 cases were divided into two categories according to the indication for appendectomy : for acute appendicitis, and for perforated appendix or drainage of periappendical abscess. The time frame for the review was from patient examination immediately prior to operation, through discharge. The study team was composed of a surgeon, research head nurse, education head nurse, surgical part head nurse, and medical recorder. Following their review of the 21 charts, the team determined an appropriate progression and schedule for an appendectomy. Result : Through the chart and literature review, the following aspects of the care process were identified as typical and tracked : monitoring/assessment, treatment, lines/drains, medication, activity, diet, tests and patient education. Conclusion : From this study, the design team determined two separate critical paths : one for appendectomy only, and one for appendectomy plus drainage. Next, these paths must be validated and fine-tuned through clinical implementation. In addition, a comparison of our design with the critical paths determined at other hospitals would be extremely valuable for advancing research in this area. Lastly, the critical path approach to improving patient care and maximizing hospital resources should be applied to other procedures.

• 대한간호학회지
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• 제26권1호
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• pp.15-32
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• 1996

The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed include confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient /family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who have had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.

• 여성건강간호학회지
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• 제2권2호
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• pp.182-201
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• 1996

The purpose of this study is to examine a married nurse's experience of child rearing through being applied to phenomenological research method. By exchanging their experiences, helping and understanding one another, married nurses can work with delight considering their own present job as their lifelong job. In addition this study can help single nurses overcome the female crises such as marriage, childbirth, and child rearing they will experience in the future. The subjects of this research was 26 married nurses who work for a university hospital in affiliation in Seoul and have children. The period of materials collection was from Feb. 1st to Mar. 3, 1995. The method of materials collection was primarily to write down a questionary with openhearted contents. In collecting it, the respondents were allowed to say at their pleasure through further interview. The materials were analyzed by Giorgi's phenomenological analysis method. The findings of this study are as follows ; 1) The responses of married nurses' experience of child rearing-[pleasure] [family solidarity] [maternal-infant attachment] [understanding] [toilsome]-were induced. That is, at once affirmative experience and hard experience coexisted. 2) The method of married nurses' child rearing-[rearing politely] [raising understanding] [having the sense of family community] [rearing with praying the heart] [careless]-were induced. 3) The support system of married nurses' child rearing-[having help family] [having help from others]-were induced. According to the above findings, the married nursed showed affirmative responses about their experience of child rearing, but at the same time they expressed painful when stayed apart from their children on account of their job or when their children were sick. In the method of child rearing, they tried to grow their children polite because there was much time for them to stay apart from their children. And they tried to give a better explanation in order that their children can have an independence spirit. They tended to compensate through frequent physical touch with their children. As the support system of married nurses' child rearing, they asked their parents or their parents-in-law to take care of their children, hired a nursery governess in their houses, or used a children's home, if they can't afford to. That is, the only one who has a firm sense of her profession, tries to inspire her accomplishment, and is receiving her husband' love and understanding is considered to perform two things simultaneously with harmony, having an recognition of lifelong job. Suggestions 1. The method to solve mental troubles on child rearing should be groped. 2. Their economical burden should be reduced by establishing children's home in their working places, and the increase of maternal-infant interaction should be contrived. 3. The chance of education should be offered in order that married nurses themselves might inspire self-conceit and professionalism on clinical nursing. 4. The familiar mood should be created through planning the programs to be accompanied with children as an annual event in hospital. 5. The part-time nurse system should be suggested to utilize. 6. The system of circulation working should be converted into the system of fixing working according to the characteristic of each department. 7. Programs for special activities such as learning foreign languages and computer should be supported positively.

• 한국학교ㆍ지역보건교육학회지
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• 제6권
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• pp.89-107
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• 2005

The purposes of this study were to investigate the recognition and the needs and problems of in-service education for school nurse, and to suggest the desirable guidelines, for supples the basic data of in-service education for school nurse to upgraded the quality as school nurse's professional specialist. The subjects of this study were 376 school nurses who were working in Jollanamdo. The research instruments used in this study was 'Needs of In-service Education questionnaire'. 305 collected Data were analyzed with the frequency analysis, $x^2$-test. The conclusions were as follows; First of all, the most important motives for the school nurses to participate in-service education are the enhancement of their specialties on teaching profession, self-realizations as educators, and improvement of health teaching skill. However, the motives to obtain the skill for school management or to obtain a high rank qualification and promotion are quite low. School nurses are generally satisfied with duration, time, place of in-service education, But they are not satisfied with contents of in-service education, professional specialist and understanding of real educational situation of the instructors. On the urgent problem of school nurses, promotion of health teaching skill was highest in the rank, and establishment of firm educational philosophy and a sense of teaching profession, proceed to university and graduate school ranked next, respectively. Second, the need of a school nurses on in-service education direction ranked the application of teachers' character and need, practicable and concrete educational programs, planning of school health development, reinforcement of health education, expansion of practical knowledge and on reflection thought, respectively. The need of a school nurses on in-service education contents(major part) ranked health education, health promoting program of student, knowledge and practice of practical medicine and oriental medicine, consultation process, health education of advanced country, respectively. The need of in-service education supervisory organization, the need for a cities provinces educational office was highest in the rank. The need of in-service education type, duty training ranked high, and abroad training, qualification training, general training ranked next. the need for specialist for lecturer of in-serve education ranked among the highest, along with school nurses and university professor. The need of school nurses on education method(duplication answer), need for conference and discussion teaching was highest in the rank. The need on evaluation method, evaluation through a examination ranked the highest. On the needs of in-service education times, need for vacation during the winter and summer was the highest. As for the duration, 31 to 60 hours in duration of in-service education was need most, and most school nurses need cities and provinces in-service training institute as the location of in-service education. On the organization size, need for 21 to 30 people was the highest, where as need for 41 people was relatively low. Lastly, on the problem of in-service education for school nurses, lack of opportunity of in-service education for school nurses was highest in the rank, and improperness of in-service education contents and method, lack of incentive ranked next, respectively.

• 지역사회간호학회지
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• 제13권1호
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• pp.182-196
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• 2002

The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

• 한국콘텐츠학회논문지
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• 제16권7호
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• pp.439-450
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• 2016

간호사는 병원종사자 중 다양한 대상자에게 간호를 제공함과 동시에 여러 직종 간에 조정 역할을 하며 전문지식과 기술에 대한 요구 증가, 교대근무 등으로 심한 스트레스와 소진을 경험하고 이직에 대한 의도를 높이게 된다. 회복탄력성은 스트레스와 소진을 감소시키고 조직몰입을 높일 것으로 기대되어 연구가 필요한 시점이다. 본 연구는 간호사의 회복탄력성, 스트레스, 소진, 조직몰입간의 관계를 파악하여 회복탄력성이 스트레스, 소진, 조직몰입에 미치는 영향을 파악하고자 한 서술적 조사연구이다. 연구결과는 다음과 같다. 대상자의 회복탄력성은 최대 5점에서 3.38(${\pm}.38$)로 나타났으며, 스트레스는 최대 5점에서 3.73(${\pm}.50$), 소진은 최대 6점에서 2.74(${\pm}.68$), 조직몰입은 최대 7점에서 4.22(${\pm}.68$)로 나타났다. 본 연구에서 회복탄력성, 스트레스, 소진, 조직몰입의 상관분석을 실시한 결과, 회복탄력성과 스트레스, 소진 사이에는 부적 상관관계를, 회복탄력성과 조직몰입은 정적 상관관계를 보였다. 본 연구의 결과에 기초하여 간호조직에서는 간호사의 스트레스와 소진을 낮추고, 조직몰입을 증진시키기 위해 간호사의 회복탄력성에 관심을 가지고 간호사의 회복탄려성을 높이기 위한 노력으로 관련 프로그램 개발 및 적용이 필요하다.