| Sung Hyun Cho | 8 Articles |
PURPOSE
To determine nurse staffing by classifying patients based on their nursing care needs and to benchmark current staffing against the Safer Nursing Care Tool (SNCT) staffing requirements. METHODS Cross-sectional data were collected from four general wards at a tertiary hospital. Nursing activities conducted by 86 registered nurses were observed at 10-minute intervals. The nursing care needs of 780 inpatients were measured with two dimensions: acuity (10 nursing activities) and dependency (four activities of daily living). RESULTS Nurses worked for 9.3 hours per shift on average, reflecting overtime work of 1.3 hours per nurse. Nurses spent 37% of their time on direct care, 54% on indirect care, and 9% on associated work. Nursing hours per patient day increased as nursing care needs became higher. Patients were classified into four groups based on their level of nursing care needs. The staffing ratio of groups 1-4 was 1:9.8, 1:8.0, 1:7.0, and 1:4.6, respectively. The current staffing (i.e., nursing hours) was as low as 53% of the SNCT benchmark, resulting in informal caregiving by patients' family or their privately hired attendants. CONCLUSION Appropriate and safe staffing is required to meet patients' nursing care needs and to improve the quality of nursing care. Citations Citations to this article as recorded by
PURPOSE
This study was conducted to identify the effect of crowding and nurse staffing on time to antibiotic administration for pneumonia patients in an emergency department (ED). METHODS The sample included pneumonia patients visiting an ED from November 1, 2014 to February 28, 2015. Crowding was measured using ED occupancy rate, nurse staffing was measured as total length of stay per nurse and number of patients per nurse and the time duration was measured for the following processes: from patient arrival to prescription, from prescription to blood culture and antibiotic administration, and from blood culture to antibiotic administration. Data collected from the electronic medical records were analyzed using multivariate analyses. RESULTS The mean times from arrival to antibiotics administration, from prescription to antibiotic administration, and from blood culture to antibiotic administration were 128.31, 47.29, and 15.60 minutes, respectively. Crowding, nurse staffing, work experience of the nurse and severity of the patient influenced the time duration of each process from patient arrival to antibiotic administration. CONCLUSION The results reveal that crowding and nurse staffing affect length of time to antibiotic administration in pneumonia patients. Guidelines for safe nurse staffing in ED are required to improve patient outcomes. Citations Citations to this article as recorded by
PURPOSE
This study was carried out to develop simulation scenarios for the management patient falls and to evaluate the effects of using the scenarios with student nurses. METHODS The research design was a quasi-experimental study using a methodology study. Study participants were 30 students who were in 4th year of nursing at one College of Nursing. RESULTS When comparing knowledge of falls before and after the simulation program, it was found that knowledge increased by 4.90 (from 24.60 pre-test to 29.50 post-test). For clinical performance of fall management, the score for assessment was 10.17 out of 16, for intervention 5.97 out of 10, and for evaluation 7.33 out of 8. The average score for reporting a fall to the doctor was 19.87 out of 30 based on SBAR. Prior to the implementation of the simulation program, the confidence of reporting to the physician was less than 5 in all four areas, but self-confidence improved by more than 6 points in all four areas after the program was implemented. CONCLUSION Findings indicate that results of fall management simulation practice can contribute to nursing students' knowledge of falls, as well as to nursing interventions and post-treatment following a patient fall. Citations Citations to this article as recorded by
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. Citations Citations to this article as recorded by
PURPOSE
To analyze the proportion of medical institutions meeting the legal standard for nurse staffing. METHODS Data collected from 29,282 institutions between 1996 and 2013 were analyzed. Nurse staffing was measured as daily patient census per registered nurse (RN). The standard for general hospitals, hospitals, and clinics is 2.5 or less, and that for long-term care hospitals is 6.0 or less of the daily patient census per RN. Clinics may substitute nursing assistants for RNs by 50% or 100% depending on their daily inpatient census; long-term care hospitals may substitute nursing assistants for RNs by two thirds of the required number of RNs. RESULTS The proportion of general hospitals, hospitals, clinics, and long-term care hospitals meeting the standards was 63%, 19%, 63%, and 94%, respectively, in 2013. While general hospitals had an increase in the proportion during the 1996-2013 period, small changes were found in hospitals and clinics. In 2013, nurses were estimated to care for 16 (interquartile range: 12~24) patients per shift in general hospitals. Three quarters of clinics had no RNs in 2013. CONCLUSION Many medical institutions did not meet the legally mandated minimum staffing level. The government must implement policy actions for all medical institutions to meet the legal standards. Citations Citations to this article as recorded by
PURPOSE
In this paper issues and challenges of the workforce policy for nursing were explored and appropriate policy responses identified. RESULTS Many countries, including South Korea, are facing a shortage of nurses. In South Korea, the number of practicing registered nurses is about half the average for Organization for Economic Cooperation and Development (OECD) member countries. The shortage of nurses is not necessarily a shortage of individuals with nursing qualifications but also includes complex issues, such as lack of well-educated nurses, shortage of nurses willing to work, and geographical imbalances of nurses. The present nurse workforce policies are to increase number of nursing schools, to reduce the length of training, and to replace nurses with nursing assistants. However, the findings of many studies have shown that these attempts resulted in a worsening of patient outcomes and increasingly low quality of care. CONCLUSION The findings in this study indicate that nurse workforce policy should have a multi-faceted approach in order to address the many factors affecting nurse shortages. Citations Citations to this article as recorded by
PURPOSE
The purpose of this study was to review journal articles, master's theses, and doctoral dissertations on self-leadership in nurses in order to identify overall trends in nursing self-leadership and to suggest strategies to improve self-leadership. METHODS Twenty-six papers on self-leadership in nurses were reviewed. RESULTS These papers were journal articles, master's theses, and doctoral dissertations regarding nurses who worked in general hospitals, university hospitals, and public health centers. Self-leadership was measured by using instruments developed by Manz (1983), Prussia, Anderson, & Manz (1998), and Houghton & Neck (2002). The instrument was composed of 18 items, with a 5-point Likert scale developed by Manz (1983) and modified by Kim (2002). Nurses' self-leadership was found to be related to job satisfaction, organizational commitment, nursing performance, and citizenship behavior. General characteristics of nurses, including age, education, marital status, position, and career, were also associated with self-leadership. CONCLUSION The study findings provide data on recent trends in nurses' self-leadership. These results serve as basic data to provide a standard for developing self-leadership and indicate directions for further research. Citations Citations to this article as recorded by
PURPOSE
To analyze trends in salaries for registered nurses when compared with salaries for elementary school teachers from 2002 to 2009 and identify salary gaps of nurses according to workplace size and geographic location. METHODS Data were obtained from the Occupational Employment Statistics collected by the Korea Employment Information Services each year from 2002 to 2009. The study sample consisted of 2,281 registered nurses and 2,578 elementary school teachers. Linear multiple regression analyses were conducted to analyze salary trends and differences. RESULTS Elementary school teachers had higher monthly salaries than nurses with a baccalaureate degree after adjusting for years of work. Salary differences increased significantly by 40,000 won every year (p<.001). Nurses working in large facilities in Seoul had the highest salaries, whereas those in small/medium, non-Seoul facilities had the lowest salaries consistently over time. Salary differences between the two groups increased by 47,000 won every year (p=.001); salary differences between nurses in large, non-Seoul facilities and those in small/medium, non-Seoul facilities also increased by 40,000 won annually (p=.001). CONCLUSION Geographical imbalances in the nurse workforce and nurse shortages in small/medium, non-capital facilities could be reduced by increasing the salary of nurses working in those facilities. Citations Citations to this article as recorded by
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