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Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion: The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses. 목적: 본 연구는 실제 및 적정 간호사 배치수준을 분석하고 이에 근거한 간호관리료 차등제 개정안을 제시하기 위해 시행되었다. 방법: 간호관리료 차등제 현황 분석을 위해 2022년 1분기 일반병동을 운영하는 상급종합병원과 종합병원의 배치등급과 입원환자 간호관리료를 분석하였다. 또한, 간호관리자와 일반간호사 대상 설문조사를 통해 실제 및 적정 간호사 배치수준, 근무일수, 보수월액을 조사하였다. 설문조사에는 상급종합병원과 종합병원에서 근무하는 간호관리자 101명과 일반간호사 588명이 참여하였다. 결과: 간호관리료 차등제 배치등급 분석 결과, 상급종합병원의 73.3%, 종합병원의 63.7%가 1등급에 해당하였다. 상급종합병원과 종합병원의 실제 간호사 배치수준은 각각 1:9.3과 1:10.4였다. 간호관리자와 일반간호사가 판단한 적정 배치수준은 상급종합병원에서 각각 1:7.6, 1:7.0이었으며, 종합병원에서는 각각 1:8.7, 1:8.8이었다. 일반간호사의 평균 추정 연간 근무일수는 상급종합병원 235.2일, 종합병원 240.0일로 나타났다. 일반간호사의 보수월액 중앙값은 상급종합병원 4,957천원, 종합병원 4,140천원이었다. 개정 간호관리료 차등제는 1:6 (1등급)에서 1:12 (5등급)을 제안한다. 개정 간호관리료는 배치등급별 환자 1일당 1일 간호시간에 따라 차등 지급할 것을 권고한다. 결론: 간호관리료 차등제 및 간호관리료 개정을 통해 간호사 배치수준과 간호의 질을 향상시키고 간호업무환경을 개선시킬 것으로 기대된다.
Purpose: The aim of this study was to analyze various nursing services of delivery room nurses by hospital level, and identify importance and frequency to provide baseline data to establish delivery room nurses' roles. Methods: Through DACUM analysis technique, service descriptions, duties, and tasks were derived from the literature. A survey was done of 242 nurses from delivery rooms of hospitals, general hospitals, superior general hospitals, and special hospitals. Importance and frequency of each service were measured using a 4point scale, and results were analyzed using SPSS. Results: Nursing services for delivery room nurses consisted of 18 duties and 86 tasks. Duties with the highest importance were 'labor support' and 'infection management', and those with lowest importance were 'collaborative care' and 'communication'. The duty with the highest frequency was 'labor support', and lowest frequency was 'communication'. There were differences between importance and frequency depending on the size of hospitals. Conclusion: Results of this first study on nursing services of delivery room nurses. delivery room nurses are performing a wide range of nursing services and the various types are clarified including importance and frequency. Purpose: 본 연구의 목적은 상급종합병원, 종합병원, 병원, 전문병원에서 근무하고 있는 분만실 간호사의 간호업무활동을 파악하고 의료기관 특성에 따른 분만실 간호사의 간호 업무활동 수행도와 중요도를 조사하는 것이다. Methods: 데이컴 직무분석 기법을 이용하여 분만실 간호업무를 임무, 일, 일의 요소로 분류하였으며 간호 수행도와 중요도를 조사하였다. 서울 및 경기, 인천의 상급종합병원, 종합병원, 병원, 전문병원의 32개의 병원에서 1년 이상 분만실에 근무하는 간호사 242명을 대상으로 하였다. Results: 분만실의 업무는 4개의 임무, 18개의 일과 86개의 일의 요소로 분류되었다. 일의 중요도가 높은 항목은 진통 중 간호, 감염관리였으며 낮은 항목은 협력적 간호, 의사소통으로 나타났다. 수행도는 진통 중 간호가 가장 높았고 의사소통이 가장 낮게 나타났다. 의료기관분류에 따른 일의 중요도와 수행도의 차이를 보면 산후관리, 감염관리가 중요도가 높게 나타났고, 진통 중 간호, 산후관리, 수술지원, 투약, 감염관리, 안전간호, 협력적 간호, 교육, 의사소통, 환경관리, 약물과 의료기구 관리 등 11가지 항목이 병상규모에 따라 업무별 수행도 차이가 있었다. Conclusion: 분만실 간호사의 업무를 목록화하고 분만실 간호사의 업무를 표준화하고 질 관리를 하기 위한 초석을 마련하였다는 것에 의의가 있으나 병원이상 의료기관과 지역적 제한의 한계점을 가지고 있다.
목적: 본 연구는 외국인 환자를 진료하고 있는 간호 관련 병원간호조직의 실태를 파악하여 외국인 환자 간호에 대한 간호정책을 수립하는데 기여하고자 시도되었다. 방법: 본 연구의 대상은 전국 36개 상급종합병원의 간호관리자 혹은 외국인 환자 담당부서 관리자이다. 설문문항은 외국인 환자 간호 관련 간호조직 실태, 외국인 환자 간호서비스에 대한 전반적 평가, 병원의 문화역량지지에 대한 내용으로 구성되었다. 최종 35개 병원의 자료를 분석하였다. 결과: 외국인 환자 간호조직을 위한 조직의 외국인 환자 간호서비스에 대한 전반적 평가점수는 10점 만점 중 6.49점이었다. 병원의 문화역량지지 점수는 4점 만점 중 평균 2.61점이었다. 외국인 환자에게 효과적인 간호서비스를 제공하기 위해 우선적으로 개선해야 할 과제는 통역서비스 제공, 보호자 없는 외국인 전용 병동 구비, 문화적 차이를 이해하고 적절하게 대처할 수 있도록 직원들의 태도와 인식 개선과 외국인용 서식 구비 등으로 나타났다. 결론: 외국인 환자 간호서비스를 향상시키기 위해 간호조직에 대한 투자와 외국인환자간호를 위한 정책을 강화시킬 필요가 있다. Purpose: The purpose of this study was to investigate the status of organizational nursing service for foreign patients in tertiary hospitals in order to build up a database for nursing care policy development for foreign patients. Methods: The subjects of this study were nursing managers or department managers of international care center in 36 tertiary hospitals nationwide. Questionnaires were consisted of the items measuring the details of and evaluations for nursing care for foreign patients within the given organizations and any organizational support for culturally competent care. The data from 35 hospitals out of 36 were analyzed finally. Results: The organizational nursing service for foreign patients was rated 6.49 points out of 10. Organizational support for culturally competent care was 2.61 points out of 4. Challenges to improving nursing care for foreign patients were listed such as developing interpreter services and international care units without accompanying by a family member, improving nursing staffs’ attitudes and behaviors for providing culturally competent care, and preparing various medical documents using multiple languages. Conclusion: In order to improve nursing care for foreign patients in tertiary hospitals, we need to be more aware of cultural knowledge and sensitivity toward the care needs of foreign patients.
Purpose: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. Methods: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. Results: The staffing grade for the general wards improved during 2008 -2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. Conclusion: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing. 목적: 본 연구는 의료기관의 일반병동, 성인 중환자실, 신생아 중환자실 간호등급을 의료기관 종별, 지역별로 구분하여 그 분포를 탐색하고, 간호등급 변화를 설명하는 것을 목적으로 한다. 방법: 건강보험심사평가원으로부터 구득한 자료를 분석에 활용하였다. 간호등급은 병상수 대 간호사수의 비를 바탕으로, 일반 병동은 1등급 내지 6등급 또는 7등급, 성인 중환자실은 1등급 내지 9등급, 신생아 중환자실은 1등급 내지 4등급으로 구분하였다. 결과: 일반병동의 간호등급은 2008년과 2016년 사이에 상급종합병원의 69.8%, 종합병원의 58.5%, 병원의 31.7%에서 향상되었다. 성인 중환자실의 경우 2008년과 2015년 사이에 간호등급이 향상된 기관은 상급종합병원이(48.8%) 종합병원(44.2%)보다 많았다. 결론: 간호등급 향상 여부는 의료기관 종별, 지역별로 차이가 있었다. 간호등급의 편차를 줄이기 위해 상급종합병원 이외의 의료기관과 비수도권 지역 의료기관의 간호등급 향상을 위한 정책이 요구된다.
목적: 국내에서 사용할 수 있는 근거기반의 “정맥혈전색전 예방간호” 실무지침을 개발하기 위한 것이다. 방법: 2012년 병원간호사회에서 개발한 “간호분야 실무지침 수용개작”방법론에 따라 24단계의 수용개작 과정을 진행하였다. 결과: 정맥혈전색전 예방간호 실무지침 권고안은 16개 영역, 163개 권고안으로 구성되었다. 영역별 권고안 수는 일반적 지침 4개, VTE 위험요인 사정 4개, VTE 발생의 중재 2개, VTE 예방을 위한 기계적 중재 14개, VTE 예방을 위한 약물적 중재 30개, 내과환자의 VTE 예방 19개, 뇌졸중환자의 VTE 예방 10개, 암환자의 VTE 예방 16개, 임산부의 VTE 예방 14개, 원거리여행자의 VTE 예방 6개, 외과환자-복부수술환자 VTE 예방 5개, 흉부수술환자 VTE 예방 10개, 정형외과 환자 VTE 예방 10개, 신경외과 환자 VTE 예방 5개, 기타 외과환자 VTE 예방 4개, 비뇨기과 수술환자 VTE 예방 2개, 이비인후과 수술환자 VTE 예방 1개, 성형과 재건수술 환자 VTE 예방 1개, 통원수술환자 VTE 예방 3개, 환자를 위한 VTE 예방 교육 3개로 총 163개의 권고안이다. 권고등급은 각 권고안별로 제시되었으며, 권고등급은 총 173개이고, 권고등급은 A 등급이 24개(13.8%), B 등급이 106개(61.3%)이고, C 등급이 43개(24.9%)였다. 결론: 정맥혈전색전 예방간호 실무지침의 확산은 보다 과학적인 근거를 기반으로 수행되고, 표준화되며, 간호업무의 효율성이 개선되는데 기여할 것이다. 이에 정맥혈전색전 예방간호 실무지침을 병원간호사회를 통하여 전국의 병원에 확산하여 실무에서 활용할 것을 제언한다. Purpose: This study was conducted to develop a useful evidence-based guideline for preventing venous thromboembolism(VTE) in Korea adapting previously developed VTE guidelines. Methods: The guideline adaptation process was performed using 24 steps according to the nursing practice guideline adaptation manual developed by Hospital Nurses Association in 2012. Results: The newly developed VTE prevention guideline was consisted of 16 domains and 163 recommendations. The number of recommendations in each domain were: 4 general issues, 4 risk factors, 2 intervention at occurrence of VTE, 14 mechanical interventions, 30 pharmacological interventions, 19 VTE prevention for medical patient, 10 stroke patient, 16 cancer patient, 14 pregnancy, 6 for long distance traveller, 5 for abdominal surgery, 10 thoractic surgery, 10 orthopedic surgery, 5 neurosurgery, 4 other surgical patient, 2 urological surgery, 1 ENT surgery, 1 plastic surgery, 3 day surgery, 3 education of VTE prevention. Fourteen point three percent, 61.1%, and 24.6% of the recommendations were graded A, B, and C, respectively. Conclusion: The findings suggest that the new VTE prevention guideline can be more efficiently used to prevent VTE in hospital settings.
Purpose: The purpose of this study is to investigate image of nurses among hospital staff members to promote hospital internal marketing. Method: Data collection and analysis had been executed from July, 1, to July, 20, 2003, with the help of SPSS/PC+. The questionnaire consisted of 36 questions. Out of total 460 questionnaire distributed, 393 were considered to be valid for final analysis. Result: There were significant differences in the image of nurses among groups of nurses, doctors, office workers, medical engineers and patients. Especially, medical engineers and office workers showed very negative image of nurses than patients and nurses. Conclusion: This study shows that to improve more positive image of nurses, we have to try to expand and show professional role for the public and internal customers. Additionally, we have to try to make positive relationship with hospital staffs working in the assisting department. It can be contributed to improve job satisfaction among staff members in each department, and it can be contributed to promote organizational effectiveness.
Purpose: Purpose of study was to compare job satisfaction, organizational commitment, and burnout by personalities of nurses in hospitals using Korean Enneagram Personality Type Indicators to provide the basic data for a nursing intervention program to improve tasks. Method: Subjects were 205 nurses, working at the hospitals in the D metropolitan city & K city in Chungnam province from July 9th to July 23th, 2004. The instruments used in this study were Korean Enneagram Personality Type Indicators by Youn(1998), job satisfaction scale by Lee(1998), organizational commitment scale by Porter(1979), and burnout scale developed by Pines et. al.(1981). The data were analyzed using descriptive statistics, ANOVA and LSD test. Result: Nurses in hospitals belong to type one : Reformers(47.3%), type nine : Mediators(21.0%), type two : Helpers(7.3%), type seven : Passionate persons(6.8%) et. al. Type eight : Leaders were showed higher scores in job satisfaction(F=2.334, p=.026)and organizational commitment(F=3.5591, p=.001), and lower scores in burnout(F=2.891, p=.007) than those of other types of personality. Conclusion: Because of being difficult to change the personality, but be helpful to job adaptation, nurses gradually need to endeavor to change the personalities to type eight. So Nurses' post prepares for nurses' developmental education program include changing personalities.
Purpose: This descriptive study was conducted to identify the effects of hospital organizational culture and work environment on nurses’ intent to stay at work. Methods: Participants of this study were 234 nurses who have worked at a local general hospital in the Chungcheong province for at least 6 months. The data were collected from July 17 to 28, 2017, using self-reported questionnaires and analyzed with multiple regression using SPSS version 22.0. Results: Clinical experience (β=.38, p<.001), institutional support (β=.33, p<.001), and relation-oriented culture (β=.24, p<.001) affected intent to stay at work among nurses. These variables accounted for 34.8% of the variance in intent to stay at work among nurses. Conclusion: This study confirms the effects of the work environment and organizational culture on nurses’ intent to stay at work. Efforts for improving the work environment and organizational culture need for retaining nurses in a hospital. We suggest further research to identify the other factors associated with intent to stay at work among nurses.
Purpose: This study investigated the effect of hospital based home care nursing antibiotic treatment on the adequacy of treatments, amount of patient payment, patients' satisfaction and length of hospital stay. Method: A total of 22 patients(5 hospitalized, 6 home care nursing, and 11 mixed care) who were treated with only Ganciclovir for CMV infection following kidney transplant were analyzed in a comparative way. These subjects underwent kidney transplant at S. General Hospital in the year of 2003. The number of serum CMV antigen, "payment investigation table", and LOPSS to measure the adequacy of treatment, amount of patient payment and patient satisfaction. Data were analyzed with SPSS program by using descriptive statistics and Kruscal-wallis test. Result: Serum CMV antigen for all patients in 3 groups was negative and there was no significant difference among 3 groups in terms of complication(p=.592). The amount of patient payment in 3 groups was statistically different(p<.05). The patient in the home care nursing group paid significantly less amount than the others. There turned out to be no significant difference in patient satisfaction among 3 groups(p=.250). 4. Since the estimated revenue by reducing 165 days of LOS was approximately 51,092,085 won, there was a possibility to increase 106,828,905 won of revenue by expanding home care nursing to all inpatients who were admitted to the hospital by their own choices. Conclusion: This study proves the positive effect of hospital based home care nursing antibiotic treatment on the adequacy of treatment, amount of payment and satisfaction for CMV infected patients following kidney transplant. It is also proven to have a beneficial effect on the revenue of the institute.
Purpose: This study investigated to provide basic data that construct an efficient prevention of the nosocomial infection through understanding the knowledge and the performance degree about preventive action of the nosocomial infection that nurse's recognize. Method: This study collected data through research paper. We examined all nurses(217 nurses)except nurses who work in outpatients ward in this hospital. The period of research was September to November, 2002. The data was analyzed by SPSS/PC_(+) with percentage, average, standard deviation, paired t-test. Result: The results of the study were as follows. These are general features of the objects; The average age was 32.6. According to the degree of education, graduation of college was 70.1%. The average period of career was 117.4 months. 94.4% answered that they were educted in hospital infection. 51.9% answered that they were educated at incumbent nursing education, 14% at continuing education. The knowledge was 3.92 point on the average and the performance was 3.72 point in preventive action of the nosocomial infection. There were statistically significant differences between knowledge and performance. Conclusion: The result of this study is that the performance degree was lower than the knowledge about preventive action of the nosocomial infection. Therefore, the continuous education that could enhance the performance is needed.