PURPOSE This study was done to investigate the relationships between nursing work environment, leader-member exchange(LMX), peer support, and organizational commitment in one city with a severe nurse shortage. METHODS Participants were 198 nurses who had worked for more than 6 months with the same head nurse. They worked in five general hospitals located in one city. In April 2016 participants completed a survey questionnaire about their nursing work environment, LMX, peer support, and organizational commitment. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and multiple regression. RESULTS There was a significant difference in nursing work environment by experience of turnover (t=−2.58, p=.010). LMX showed significant difference by department (F=3.81, p=.011). Factors influencing nurses' organizational commitment were nurse participation in hospital affairs (β=.23, p=.028) and nurse manager ability, leadership and support (β=.18, p=.022). Explanatory power was 18.2% in the regression model. CONCLUSION The results suggest that it is necessary to improve the nursing work environment in order to increase organizational commitment. Improvement of the nursing system should be considered along with supplementation of nurses particularly during a severe nurse shortage.
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PURPOSE The purpose of this study was to demonstrate effects of a critical pathway (CP) for stroke patients seen in emergency rooms (ER). METHODS The CP developed by the CP committee consisted of 8 criteria: behavior of doctors and nurses, laboratory tests, Image testing, medication, treatment, activity, and nutrition. According to application of CP, a control group (n=17) and experimental group (n=17) were defined. Time was checked by the electronic medical records. RESULTS Use of CP for stroke patients in the ER, resulted in a decreased length of stay in ER (t=2.341, p=.026), and time required for image testing (t=2.623, p=.021), and an increased number of patients using rtPA (chi2=4.802, p=.049). Time required for neurology doctor contact, for neurology doctor to see patient in the ER, and for report of blood tests decreased, but there were no statistical significance. CONCLUSION Quick responses are most important in the ER, so CP for these patients is a very effective patient management tool. To reduce delay in stroke diagnosis, continuous education programs for similar symptoms are necessary. CPs for other patients in the ER should be developed, and studies on cost and satisfaction, as well as length of stay, should be done.
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