Purpose This study was aimed to identify the effects of professional autonomy and teamwork on clinical performance to improve the clinical performance of tertiary hospital nurses.
Methods: Data were collected from June 1 to June 30, 2017 and a total of 172 nurses from three tertiary hospitals participated in this study. The collected data were analyzed with descriptive statistics, t-test, ANOVA, Scheffé test, Pearson’s correlation and stepwise multiple regression analysis using SPSS 25.0.
Results: Clinical performance showed a statistical difference depending on the number of education session for competency, and it showed a positive correlation with professional autonomy and teamwork. The factors affecting the clinical performance of the tertiary hospital nurses included in teamwork (β=.40, p<.001), professional autonomy (β=.27, p<.001). These factors accounted for 31% of clinical performance (p<.001).
Conclusion: It is important to find ways to improve clinical performance of tertiary hospital nurses. Furthermore, there is a need to include continuous and systemic education programs for professional autonomy and suitable programs to elevate teamwork.
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Purpose This study examined the association between nurse staffing and in-hospital 30-day mortality among stroke patients considering the stroke type in the intensive care units in Korea using the Health Insurance Review and Assessment Service-National Inpatient Sample 2018 (HIRA-NIS 2018).
Methods: The data included a total of 2,876 stroke patients admitted to intensive care units across 72 general hospitals and 39 tertiary hospitals between January and November 2018. Nurse staffing levels were measured using the nurse staffing grades of adult intensive care units in the 2nd quarter of 2018. The relationship between nurse staffing levels and mortality were analyzed using multi-level logistic regression analysis after controlling for patient and hospital characteristics.
Results: In patients with ischemic stroke, the risk of death was lower in nurse staffing Grade 5 to 6 compared to Grade 1 (Odds ratio [OR] 0.43, 95% Confidence interval [CI] 0.24~0.75). In hemorrhagic stroke patients, the risk of death tended to be higher in nurse staffing grade 5 to 6 compared to Grade 1 (OR 2.11, 95% CI 1.00~4.45), which was marginally significant (p=.050).
Conclusion: Health policies for adequate nurse staffing in intensive care units should be implemented to enhance the quality of care and lead to better outcomes in patients with stroke.
Purpose This study examined the subjective frame of patient satisfaction in the comprehensive nursing care services and explored future directions by investigating subjective frame types.
Methods: P-Samples were collected from 30 patients who underwent the comprehensive nursing care service. To enable a forced normal distribution, 31 Q-samples were classified on a 9-point scale considering the degree of agreement. The collected data were analyzed by principal component factor analysis and varimax rotation using the PQ method program.
Results: The subjective frame of patient satisfaction with the comprehensive nursing care service was divided into four types. Considering the characteristics of each, the types were labeled as “the formation of relationships with the surroundings”, “autonomous decision-making”, “non-verbal empathy”, and “therapeutic support resources”. Each type can be classified into therapeutic relationship and therapeutic process categories.
Conclusion: This study revealed changes in expectations regarding new medical services and that the subjective frames that affect the formation of satisfaction are diverse. The study results are expected to be used as basic data to develop strategies for creating a therapeutic environment that improves patient satisfaction in the comprehensive nursing care service.
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Purpose This study aimed to examine the factors influencing the degree of harm caused by fall incidents in hospitals. Methods This cross-sectional descriptive study used secondary data from the “Korean Patient Safety Incident Report 2019” and was based on the International Classification for Patient Safety conceptual framework. We analyzed a total of 4,176 fall incidents between January 1 and December 31, 2019, in Korea. Multinomial logistic regression analyses were conducted to identify the factors that influence the degree of harm from these incidents. Results Among the fall incidents, 443 (10.6%) were sentinel events, 2,514 (60.2%) were adverse events, and 1,219 (29.2%) were near misses. The factors associated with sentinel events were old age (≥60 years), gender, patient diagnosis, medical department, early detection after falls, long-term care hospital, and reporters. Adverse events were significantly associated with diagnosis, medical department, nurses’ night shift time, large bed size, location (i.e., operating room, recovery room, and intensive care unit), and reporters. Conclusion Both patient and incident characteristics are significantly associated with the degree of harm in hospitals. Therefore, multiple factors should be considered to establish healthcare policies and thus prevent fall risks and minimize damage following falls in hospitals.
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Purpose This study to identify valuated the competency in nursing leadership among new nurses through the perception of nursing managers.
Methods: This a total of 136 nursing managers from two general hospitals in the Seoul metropolitan area were included in this study. Nursing leadership competencies in new nurses were measured using the Student Leadership Practices Inventory developed by Kouzes and Posner. We identified priorities in the development of nursing leadership competencies for new nurses.
Results: The overall importance and performance of nursing leadership competencies for new nurses were assessed by nursing managers at an average of 3.92±0.37 and, 2.84±0.50, respectively. Of the 30 nursing leadership competencies, 11 would need to be maintained and strengthened, seven would need to focus on improvement efforts, and 11 would have low priority. The last one was overdone.
Conclusion: Of the 18 items of high importance based on the nursing leadership competencies among new nurses identified, for seven items indicating low performance, the performance of nurses should be improved by introducing nursing leadership development programs after they enter the work environment. Eleven low-priority nursing leadership competencies require a long-term strategic approach and need to spread the understanding of nursing leadership throughout the nursing organization.
Purpose This study aimed to compare the value congruence of nurse-patient assignment (NPA) with work performance in the neonatal intensive care unit (NICU).
Methods: Data were collected with 30-items on factors that affect NPA and 17-items on work performance. Two questionnaire surveys each were conducted with 79 nurses from the NICU. The difference between expectations and actual experience on NPA were analyzed, and the effects of NPA on work performance and overtimes were investigated. The collected data were analyzed with a paired t-test, analysis of variance, and Pearson’s correlation coefficients using the SPSS software version 20.0.
Results: The NPA criteria were surveyed with 30 items, with 13 patient-related, and 17 nurse-related. The validity of the tool was S-CVI .95 and the reliability (Cronbach’s ⍺) was .942. There were significant differences based on age (F=3.69, p=.029) and caring for patients on an artificial ventilator (t=2.55, p=.013). The higher the patient-related actual assignment score, the higher the nurse-related actual assignment score (r=.68, p<.001) and work performance (r=.48, p<.001). As the nurse-related actual assignment score increased, work performance also increased significantly (r=.36, p=.001).
Conclusion: It was confirmed that the value congruence of NPA is positively correlated with work performance.
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Purpose This study aimed to assess the effect of a job crafting intervention program for hospital nurses to confirm the effect on the organizational commitment of clinical nurses, and their embeddedness and organizational well-being in the workplace. Methods: The study used a non-equivalent control group pre-test and post-test design, which included 68 nurses working at a general hospital. The job crafting intervention program was held for a total of 5 weeks from May 27 to June 27, 2019, and the program lasted for 2 weeks including 2 h each. The program effectiveness was assessed through a self-reporting survey of program participants 2 weeks prior to application, 2 weeks after application, and 6 weeks after application. Data were analyzed using the Kolmogorov-Smirnov test, chi-squared test, independent t-test, and repeated measures multivariate analysis of variance using the SPSS 26.0 for Windows. Results: Significant differences were observed between the experimental and control groups regarding job crafting (F=6.20, p=.003), task crafting (F=8.37, p<.001), cognitive crafting (F=6.29, p=.003), embeddedness (F=8.49, p<.001), and organizational well-being (F=4.90, p=.009). Conclusion: The job crafting intervention program can be actively utilized to induce efficient nursing staff management in hospitals, expanding it into hospital nurse's work area and developing nurse's job crafting further.
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Purpose This study aimed to analyze the effects of infection control education (ICE) prospectively, based on isolation room simulation for nursing college students.
Methods: From September 21 to 30 2020, a total of 97 students in the 4th grade of nursing college located in D city, were enrolled (48 in the experimental group and 49 in the control group).
The experimental group received an isolation room simulation for ICE. The control group conducted an objective structured clinical evaluation for the same education. The effects after education were evaluated using the items of awareness of standard precaution, knowledge of wearing personal protective equipment (PPE), and confidence in wearing it.
Results: There was no statistically significant difference in the awareness of standard precautions between the two groups, and the knowledge of wearing PPE was significantly higher in the experimental group (t=-3.41, p<.001) after education. The confidence score for wearing PPE was also significantly higher in the experimental group (t=-2.23, p=.028).
Conclusion: The ICE using the isolation room simulation can be effective for knowledge and confidence regarding the aspect of wearing PPE for nursing students, during and after the pandemic.
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Purpose The purpose of this study was to identify the relationship between career management, organizational justice, and job rotation attitude among tertiary hospital nurses.
Methods: A cross-sectional descriptive design was used. The participants were 195 nurses with more than one year of experience working at tertiary care hospitals.
Data was collected with self-reported questionnaires from April to May 2018. Data was analyzed using SPSS Statistics version 25.0 for windows including descriptive statistics, bivariate analysis, and multiple regression analysis.
Results: The mean score of career management of participants was 3.14±0.49 (range 1~5), organizational justice was 2.95±0.53 (range 1~5), and job rotation attitude was 4.02±0.97 (range 1~7). There were significant positive correlations among the participants' career management, organizational justice, and job rotation attitude. 37% of job rotation attitude was explained by position, organizational justice, career management, and the frequency of job rotation experience in the regression model.
Conclusion: This study provided the empirical evidence that it is necessary to improve the perception of organizational justice, and to establish a systematic job rotation in order for nurses to positively recognize job rotation.
Purpose This study aimed to construct and test a hypothetical model of turnover intention for clinical nurses based on affective events theory.
Methods: Data were collected from 375 clinical nurses working in an advanced general hospital. The exogenous variable of the hypothetical model was emotional labor, and the endogenous variables were negative emotional events, emotional intelligence, positive affect, organizational commitment, and turnover intention. Data were analyzed using the SPSS/WIN 23.0, and AMOS 22.0.
Results: The final modified model demonstrated a good fit. This model explained 70.6% of the variance in the turnover intention of clinical nurses. The statistically significant explanatory factors for turnover intention were emotional labor, negative emotional events and organizational commitment. As for the significant pathway affecting nurses’ turnover intention, emotional labor showed a decreasing effect on turnover intention and was mediated by emotional intelligence, positive affect, and organizational commitment (B=-.33, p=.002). Emotional labor showed a decreasing effect on turnover intention through organizational commitment (B=-.40, p=.006).
Conclusion: Various opportunities for education and multiple-approach institutional support must be provided to nurses to increase their vocation about the profession, emotional intelligence, positive affect, and organizational commitment.
Purpose This study aimed to develop a strength coaching program and verify its effects on positive psychological capital, coaching leadership, and organizational commitment for front-line nurse managers.
Methods: The participants were first-line nursing managers working in two general hospitals, and a total of 25 participants comprised the experimental (n=12) and control (n=13) groups. The strength coaching program was implemented for 6 weeks from November 13 to December 18, 2017, and the intervention group received the strength coaching program for 2 h, once a week. Data were collected pre, post, and after (4 weeks later), and analyzed by repeated measures analysis of variance using the SAS 9.4 program.
Results: The strength coaching program was developed as a process of understanding, reflecting, and utilizing the concepts and characteristics of positive psychology and strengths, and applied to nursing managers, but it did not affect their positive psychological capital, coaching leadership, and organizational commitment.
Conclusion: The results of this study were not significant, but the study is meaningful in that the strength coaching program was developed and applied to front-line nursing managers, and various methodological aspects to be considered in future studies were presented.
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Purpose This study aimed to confirm the association between job crafting and quality of nursing services among Korean clinical nurses, as well as the mediating effect of work engagement.
Methods: Data from 194 hospital nurses were surveyed in this descriptive cross-sectional study. They were collected from May 17 to May 28, 2021, using self-report questionnaires. The collected data were analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Scheffé test, Pearson's correlation coefficient analysis, and multiple regression using the SPSS/WIN 24.0.
Results: Job crafting was positively associated with work engagement (r=.55, p<.001) and quality of nursing services (r=.66, p<.001). Furthermore, work engagement had a mediating effect on the relationship between job crafting and quality of nursing services (Sobel test: Z=2.58, p=.010). These variables explained 45.0% of the variance in the quality of nursing services.
Conclusion: The impact of job crafting on the quality of nursing services among clinical nurses was mediated by work engagement. Therefore, to improve the quality of nursing services, it is necessary to develop an educational program to increase job crafting and work engagement.
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Purpose This descriptive correlation study explored the moderating effect of social support and coping in the correlation between experiences of verbal violence and turnover intention among operating room nurses.
Methods: The data collection for this study was conducted from July 22 to August 2, 2019, covering 213 operating room nurses working at six general hospitals. Data were analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Pearson’s correlation coefficient, and multiple regression with the SPSS/WIN 25.0 program.
Results: The mean scores on the experiences of verbal violence by doctors and nurses, social support, coping and turnover intention were 2.52, 2.33, 3.42, 2.61 and 3.90, respectively. Experiences of verbal violence by doctors (r=.21, p=.002) and nurses (r=.25, p<.001) showed a statistically significant positive correlation with turnover intention. In the relationship between the experiences of verbal violence and turnover intention, social support from coworkers (β=.80, p=.018) and coping (β=-.87, p=.005) had a moderating effect.
Conclusion: The experience of verbal violence among operating room nurses affects turnover intention; therefore, there is a need to reduce verbal violence at medical sites, support programs to encourage social support from coworkers, and an effective system to cope with verbal violence.
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Purpose This study aimed to estimate the unmet demand for INCS and the number of needed beds for fulfillment.
Methods: Annual data from the Korea Health Panel (2015~2018), Health Insurance Statistical Yearbook (2015~ 2019), and published statistical data (2015~2019) were used. To measure the unmet demand, the utilization of informal nursing care services, which can be a market substitute for INCS, was used. The number of needed beds was calculated by dividing the demand by the bed occupancy rate multiplied by 365 days.
Results: The unmet demand decreased every year and was estimated to be 31~47 million person-day as of 2019. It was the highest in Gyeonggi (6~8 million) and the lowest in Jeju (160~220 thousand), while the fulfilled rate was the highest in Incheon (52~61%) and the lowest in Jeonbuk (6~8%). For each type, general hospitals showed the highest unmet demand (6~10 million), followed by hospitals (5~8 million) and tertiary hospitals (4~7 million). Gyeonggi province (37,212~48,882) and general hospitals (54,955~70,962) were most needed additional INCS beds.
Conclusion: Tailored bed expansion strategies are necessary to satisfy each region's and hospital’s demand. Considering the multi-layered causes of unmet demand, a healthcare system reform that increases the regional self-sufficiency of INCS is required.
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Purpose This study aimed to define and clarify the concept of colleague solidarity experienced by nurses during the COVID-19 pandemic.
Methods: A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical phase, 20 articles selected through literature review by including nursing and related disciplines were analyzed. For the fieldwork phase, in-depth interviews were conducted with nine nurses who took care of infected patients with COVID-19 at Infectious Diseases Specialized Hospital.
Results: The dimensions identified were consistently observed in the field phase, however, more attributes were found newly from the fieldwork phase. In the final phase, the concept of colleague solidarity among the nurses was found to have three dimensions with nine attributes. The interaction dimension had four attributes as voluntary support, mutual respect, open communication, and virtuous circle. The motivation dimension had two attributes of sense of communion and calling. Lastly, the relationship dimension had three attributes of unity, mutually equal relationship, and comradeship.
Conclusions: This study is meaningful in observing how the concept of colleague solidarity, which is relatively unfamiliar to domestic nurses, appears in the clinical field during a national crisis and analyzing the concept.
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