Carga laboral de profesionales de enfermería en Unidad de Cuidado Intensivo según Nursing Activities Score / Nurses' Workload in Intensive Care Unit according to the Nursing Activities Score / Carga de trabalho dos profissionais de enfermagem na Unidade de Cuidados Intensivos de acordo com a pontuação das Atividades de Enfermagem

Introducción: Nursing Activities Score ha sido utilizada como un instrumento principalmente en la Unidad de Cuidados Intensivos para medir las actividades de enfermería, siendo esta la unidad que maneja pacientes de mayor complejidad para el cuidado. Objetivo: establecer la carga de trabajo, evaluada por Nursing Activities Score, y factores relacionados a la misma en Unidades de Cuidado Intensivo. Metodología: Revisión cualitativa tipo scoping Review, utilizando el método PRISMA. Búsqueda en las bases de datos CINAHL, LILACS, SCOPUS, SCIENCE DIRECT, SCIELO y PUBMED. Resultados: La muestra final se compone de 87 textos, que van desde el año 2007 hasta 2021. Se clasificaron en cinco categorías: Carga de trabajo en UCI, comparación entre unidades, carga de trabajo relacionada al personal de enfermería, carga de trabajo relacionada a las características de los pacientes y consecuencias de la carga de trabajo. Discusión: La revisión revela una carga de trabajo mayor al 50% en la mayoría de los estudios, esto debido a diferentes factores: principalmente las características particulares de los pacientes, no se observó una diferencia significativa entre unidades generales y especializadas, las cargas de trabajo elevadas suponen un factor de riesgo para la ocurrencia de eventos adversos. Conclusiones: Los resultados de esta revisión permiten evidenciar que el personal de enfermería está expuesto constantemente a altas cargas de trabajo. Esta carga de trabajo puede verse influenciada o influenciar diversos factores, como lo son las características de los pacientes a quienes se brinda atención o puede afectar positiva o negativamente la calidad de la atención de enfermería.

Introduction: The Nursing Activities Score has been used mainly in Intensive Care Units as an instrument to measure nursing activities since this is the unit that receives the most complex patients. For this reason, this scoping review aims to establish the workload using the Nursing Activities Score and the factors related to it in Intensive Care Units. Methods: Qualitative scoping review using the PRISMA statement. Searches were conducted in CINAHL, LILACS, Scopus, Science Direct, SciELO, and PubMed databases. Results: The final sample consists of 87 texts published between 2007 and 2021. They were classified into five categories: ICU workload, inter-unit comparison, workload related to nursing staff, workload related to patient characteristics, and workload consequences. Discussion: The review reveals a workload greater than 50% in most of the studies due to different factors, but mainly to patients' particular characteristics. No significant difference was observed between general and specialized units; high workloads are a risk factor for adverse events. Conclusions: This review shows that nurses are constantly exposed to high workloads. It is possible for workloads to affect or be influenced by various factors, such as the characteristics of patients being cared for, or to impact the quality of nursing care positively or negatively.

Introdução: O Nursing Activities Score tem sido usado como um instrumento principalmente na Unidade de Tratamentos Intensivos para medir as atividades de enfermagem, sendo essa a unidade que lida com os pacientes mais complexos para o cuidado. Por esta razão, o objetivo desta scoping review é estabelecer a carga de trabalho, conforme avaliado pelo Nursing Activities Score, e fatores relacionados em Unidades de Cuidados Intensivos. Metodologia: Revisão quantitativa usando scoping Review, utilizando o método PRISMA. Pesquisa nos bancos de dados CINAHL, LILACS, SCOPUS, SCIENCE DIRECT, SCIELO e PUBMED. Resultados: A amostra final consistiu em 87 textos, variando de 2007 a 2021. Eles foram classificados em cinco categorias: carga de trabalho na UTI, comparação entre unidades, carga de trabalho relacionada ao pessoal de enfermagem, carga de trabalho relacionada às características dos pacientes e consequências da carga de trabalho. Discussão: A revisão revela uma carga de trabalho superior a 50% na maioria dos estudos, isto devido a diferentes fatores: principalmente as características particulares dos pacientes, nenhuma diferença significativa foi observada entre unidades gerais e especializadas, altas cargas de trabalho são um fator de risco para a ocorrência de eventos adversos. Conclusões: Os resultados desta revisão comprovam que o pessoal de enfermagem está constantemente exposto a altas cargas de trabalho. Esta carga de trabalho pode ser influenciada ou influenciada por vários fatores, tais como as características dos pacientes atendidos ou pode afetar positiva ou negativamente a qualidade dos cuidados de enfermagem.

Atividades avançadas de vida diária entre idosos: fatores preditores / Advanced activities of daily living among the elderly: predictive factors

A redução de atividades sociais pode resultar em incapacidades e piora da qualidade de vida. Objetivou-se caracterizar os idosos e descrever o nível nas atividades avançadas de vida diária; identificar a mudança entre os níveis de atividade (melhora, estabilidade, piora) e identificar os preditores de mudanças nos níveis de atividades avançadas de vida diária. Inquérito longitudinal, realizado com 353 idosos. Utilizou-se: Mini Exame de Estado Mental; dados socioeconômicos e morbidades; fenótipo de fragilidade; e questões das atividades avançadas de vida diária. Realizou-se análise descritiva e modelo de regressão multinomial (p<0,05). Identificou-se maior percentual do sexo feminino, 60 a 69 anos e no grupo de piora do nível de atividades avançadas de vida diária (41,1%). A melhora nas atividades avançadas de vida diária associou-se à renda de até um salário mínimo (p=0,004), não fragilidade (p=0,006) e pré- fragilidade (p=0,028); e na piora, residir só (p=0,038). A identificação dos preditores de mudança nas atividades avançadas de vida diária e das características dos grupos de piora e melhora podem direcionar intervenções precoces em saúde.

A reduction in social activities can result in incapacities and worsening of quality of life. The present study aimed to characterize elderly subjects, describe their level of advanced activities of daily living and identify the change between activity levels (improvement, stability, worsening) and the predictors of change in advanced activities of daily living levels. This is a longitudinal study carried out with 353 elderly subjects. The following were used: Mini Exam of Mental State; socioeconomic and morbidity data; frailty phenotype and questions on advanced activities of daily living. Descriptive analysis was carried out with a multinomial regression model (p<0.05). It was identified that there was a higher percentage of females, from 60 to 69 years old in the group at the worst level of advanced activities of daily living (41.1%). Improvement in advanced activities of daily living was associated with income of up to one minimum salary (p=0.004), non-frailty (p=0.006) and pre-frailty (p=0.028) while worsening was associated with living alone (p=0.038). Identification of predictors of change in advanced activities of daily living and of the characteristics in the groups that were worsening or showing improvement may direct early interventions in health care.

Relationship among Nursing Professionalism, Nursing Work Environment, and Patient Safety Nursing Activities in General Hospital Nurses / 간호행정학회지

PURPOSE: This study was done to identify the relationships among nursing professionalism, nursing work environment, and patient safety activities, and to analyze the factors influencing nurses' patient safety nursing activities. METHODS: This descriptive study included 270 nurses from six general hospitals. Questionnaires were used to collect data between August 20 and September 21, 2018, using questionnaires. Analyses included descriptive statistics, t-test, analysis of variance, Pearson correlation coefficient, and stepwise multiple regression, conducted using IBM SPSS/WIN 21.0. RESULTS: Mean scores on nursing professionalism, nursing work environment, and patient safety nursing activities were 3.51±0.41, 2.44±0.45, and 4.39±0.50, respectively. The patient safety nursing activities score was positively correlated with subscales of nursing professionalism variable: professional self-concept (r=.15, p=.019), social recognition (r=.10, p=.036), professional identity in nursing (r=.24, p<.001), role of nursing practice (r=.16, p=.012), nursing foundation for quality of care (r=.19, p=.003), and nurse manager's ability (r=.14, p=.031). Patient safety nursing activities were influenced by professional identity in nursing (β=.22, p=.001) and nursing foundation for quality of care (β=.15, p=.001), which explained 8.0% of the variance. CONCLUSION: These results suggest that nurse managers should focus on creating an appropriate nursing environment and facilitating nursing professionalism to enhance hospital nurses' patient safety nursing activities.

The Level of Performance, Frequency and Educational Needs of Nursing Activities in Long-term Care Hospital / 재활간호학회지

PURPOSE: This study was to explore the level of core nursing activities performed by long-term care hospital nurses and to investigate the frequency and educational needs of major nursing activities. METHODS: A cross-sectional descriptive research design was used. The subjects were 155 nurses working at seven long-term care hospitals in Korea. Data were collected in 2018 from September 15 to October 16 using a structured questionnaire. Data were analyzed using the SPSS program. RESULTS: The mean age of nurses was 45.19±10.99 years and the mean career of long-term care hospital was 49.84±40.52 months. Monitoring activity was shown as the highest score in the performance level and frequency, whereas infection control received the highest score in educational needs. A scatter plot revealed that physical examination, respiratory care, wound care, communication and education showed overall high scores in the performance level, frequency, and educational needs. Emergency care and infection control were the activities that were performed less frequently but had high performance level and educational needs. CONCLUSION: It is important to establish rules for requisite and delegable activities considering the performance level and frequency of nursing activities in long-term care hospitals in order to improve the quality of patient care.

Effect of Hospital Nurses' Perceptions of Organizational Health and Patient Safety Culture on Patient Safety Nursing Activities / 간호행정학회지

PURPOSE: This study was conducted to identify the effects of organizational health and patient safety culture on nursing activities for patient safety as perceived by hospital nurses. METHODS: A self-report survey was administered to staff nurses of one advanced general hospital and two general hospitals in South Korea. Of the questionnaires, 188 were analyzed. RESULTS: Organizational health had a significantly positive correlation with patient safety culture (r=.52, p<.001) and patient safety nursing activities (r=.31, p<.001). CONCLUSION: The findings in this study indicate that among the factors influencing patient safety nursing activities, organizational factors were more important than individual factors, and organizational health had a big effect on patient safety nursing activities.

Validação do Nursing Activities Score em unidades de cuidados intensivos portuguesas / Validación del Nursing Activities Score en unidades de cuidados intensivos portuguesas / Validation of the Nursing Activities Score in Portuguese intensive care units

RESUMO Objetivo: descrever o processo de adaptação e validação do Nursing Activities Score para o contexto português. Método: trata-se de um estudo-piloto de adaptação e validação do Nursing Activities Score, com amostra de 67 doentes internados em unidades de cuidados intensivos de três hospitais portugueses. A validade de constructo avaliou-se mediante procedimentos de análise fatorial e a consistência interna dos itens através do coeficiente Alpha de Cronbach. Resultados: obteve-se um valor médio da carga de trabalho de 63,04% (DP = 14,25; Mediana = 61,30). Os dados psicométricos revelaram um Alpha de Cronbach de 0,71, na escala total, indicando uma fidelidade aceitável. A análise fatorial confirmatória sugeriu um ajustamento adequado entre o modelo e os dados (χ2(199) = 214,5, p = 0,214; CFI = 0,95; RMSA = 0,035). Conclusão: neste estudo, a versão portuguesa do Nursing Activities Score revelou-se um instrumento válido, permitindo avaliar a carga de trabalho dos enfermeiros com segurança.

RESUMEN Objetivo: describir el proceso de adaptación y validación del Nursing Activities Score al contexto portugués. Método: estudio piloto de adaptación y validación del Nursing Activities Score, con muestra de 67 pacientes internados en unidades de cuidados intensivos de tres hospitales portugueses. La validez del constructo se evaluó mediante análisis factorial y por consistencia interna de los ítems evaluados a través del coeficiente Alpha de Cronbach. Resultados: se obtuvo un valor medio de carga de trabajo de 63,04% (SD=14,25; Mediana=61,30). Los datos psicométricos expresaron un Alpha de Cronbach de 0,71 en la escala total, indicando fidelidad aceptable. El análisis factorial confirmatorio sugirió un ajuste adecuado entre el modelo y los datos (χ2(199)=214,5; p=0,214; CFI=0,95; RMSA=0,035). Conclusión: en este estudio, la versión portuguesa del Nursing Activities Score demostró ser un instrumento válido, permitiendo evaluar la carga de trabajo de los enfermeros con precisión.

ABSTRACT Objective: to describe the process of adaptation and validation of the Nursing Activities Score to the Portuguese context. Method: this was a pilot study of adaptation and validation of the Nursing Activities Score with a sample consisting of 67 patients hospitalized in the intensive care units of three Portuguese hospitals. The construct validity was assessed through factor analysis procedures and the internal consistency of the items was measured through the Cronbach's alpha coefficient. Results: a mean workload value of 63.04% (SD = 14.25; Median = 61.30) was obtained. Psychometric data revealed a Cronbach's alpha of 0.71 in the total scale, indicating an acceptable accuracy. Confirmatory factor analysis suggested an appropriate adjustment between the model and the data (χ2(199) = 214.5, p = 0.214; CFI = 0.95; RMSA = 0.035). Conclusion: in the present study, the Portuguese version of the Nursing Activities Score was found to be a valid instrument, enabling a safe assessment of the workload of nurses.

Cumplimiento de las actividades de enfermería en la prevención de úlceras por presión / Accomplishment of nursing activities in the prevention of pressure ulcers

Introducción: las úlceras por presión prolongan la estancia hospitalaria, generan un impacto negativo en la persona hospitalizada y elevan costos de atención, por lo que constituyen un problema de salud pública y un indicador de la calidad del cuidado de enfermería. Objetivo: identificar el cumplimiento de las actividades de enfermería en la prevención de úlceras por presión. Método: estudio descriptivo, transversal, en tres instituciones de salud de Barranquilla durante 2010. Universo 97 enfermeras y auxiliares de enfermería. Se utilizó el instrumento cumplimiento de criterios básicos en la prevención de ulceras por presión a pacientes hospitalizado, formato F1PUPPH/05. Se conformó una base de datos en Microsoft Excel. Para evaluar el comportamiento de las variables del estudio se utilizó la estadística descriptiva (medidas de tendencia central y variabilidad, normalidad y detección de datos atípicos y ausentes). Resultados: los criterios de cumplimiento en la prevención de ulceras por presión más empleados fueron: ejecuta el plan de cuidados, utiliza los elementos disponibles en la prevención con un 54,53 por ciento y registra factores de riesgo con un 53,60 por ciento, los menos empleados: valora el riesgo utilizando las escalas reconocidas y revalora y ajusta de acuerdo al estado del paciente, con un 58,76 por ciento cada uno. El 45,36 por ciento de la muestra alcanza el nivel de No cumplimiento de las acciones de prevención y el 35,05 por ciento obtuvo un nivel de excelente. Conclusiones: la debilidad en la competencia de la aplicación de escalas de valoración de riesgo de úlceras por presión confirma la importancia del cumplimiento de las actividades de prevención como indicador de calidad del cuidado de enfermería, así mismo genera un aporte al currículo, investigación y práctica de enfermería(AU)

Introduction: pressure ulcers lengthen hospital stay, produce a negative impact on the hospitalized person and raise care costs, a reason why they constitute a public health concern and an indicator of the quality of nursing care. Objective: to identify the accomplishment of nursing activities in the prevention of pressure ulcers. Method: descriptive cross-sectional study carried out at three health facilities of Barranquilla during 2010. Target group: 97 nurses and nursing assistants. We used the instrument accomplishment of basic criteria for pressure ulcer prevention in hospitalized patients (F1-PUPPH/05). We created a database in Microsoft Excel. To assess the behavior of the studied variables, we used descriptive statistics (central tendency and variability measures, normality and detection of atypical and absent data). Results: the most used accomplishment criteria for pressure ulcer prevention were the care plan execution; the use of elements available in prevention, with a 54.53 percent; and risk factors recording, with a 53.60 percent. The least used were risk assessing by using the recognized scores; and reassessment and adjustment according to the patient's state, with 58.76 percent each. 45.36 percent of the sample reaches the level of unaccomplishment of the prevention actions and 35.05 percent obtained a level of excellent. Conclusions: competence weakness in applying pressure ulcer risk assessment scores confirms the importance of prevention activities accomplishment as a nursing care quality indicator, and produces a contribution to the resume, research and nursing practice(AU)

Investigation of status quo of nursing knowledge and behavior of cancer pain control among nurses in tumor department / 中国实用护理杂志

Objective To describe the current situation of oncology nurses' mastery of cancer pain-related knowledge and explore the correlation between the mastery of knowledge and nursing activities.Methods By convenient sampling,323 oncology nurses in four hospitals were recruited in the questionnaire study.Results Among the 40 pain-related knowledge questions assessed,the mean number of correctly answered questions was (19.33±3.96),with a range of 9 to 33,the correct answer rate for entire questionnaire was between 22.5％ to 81.5％,and the pass rate of the questionnaire was 0.62 ％; the score of the questionnaire had a positive correlation with pain assessment dimension and therapeutic communication and health education dimension;the self-rated score of pain-related knowledge had a positive correlation with the four dimensions; the times of nurses participating in cancer pain control study and the times of the department's cancer pain control study had a positive correlation with pain assessment dimension.Conclusions Oncology nurses did not grasp cancer pain-related knowledge well,and showed discrepancy in mastery of knowledge and nursing activities.Nursing management can strengthen nurses training in cancer pain management or increase the times of cancer pain control study to promote the implementation of cancer pain nursing activities,and to advance the quality of cancer pain nursing.

Research in measurement of nursing workload in ICU in municipal hospitals by using different / 中国实用护理杂志

Objective To measure the nursing workload in ICU,and provide the basis for the scientific distribution of human resources and reasonable scheduling in ICU.Methods ICU patients of the First and Third People's Hospital of Zigong from July to September,2011 were selected.The TISS-28 and NAS were applied to measure the nursing workload in the ICU.The number of staff nurses on each day and on each shift was recorded.Results The total nursing workload and the per capita nursing workload for each day in a week showed no significant difference,and the per capita nursing workload of different shifts and the needs of nurse-patient ratio of different patients in ICU were significantly different.Conclusions The allocation of nursing staff should be balance for each day in a week and different shifts for each day.The configuration of the nursing human resources should be based on actual nursing workload,no only considering the species of the diseases,the disease condition,self-care ability and cooperation of the patients,but also the proficiency of nurse skills.

Aplicativo informatizado com o nursing activities score: instrumento para gerenciamento da assistência em unidade de terapia intensiva / Aplicativo informatizado con el nursing activities score: instrumento para gestión de la atención en la unidad de cuidados intensivos / Computer application with the nursing activities score: an intensive care management instrument

A gravidade do paciente ou o número de intervenções nem sempre serão proporcionais à carga de trabalho de enfermagem. Este estudo descritivo teve como objetivo demonstrar a trajetória da construção de um aplicativo (software) com o conteúdo do Nursing Activities Score e suas características operacionais. Foi realizado um teste piloto com 12 pacientes seguindo-se a coleta de dados por 90 dias consecutivos em 123 pacientes. Houve compatibilidade na transmissão de dados do Personal Digital Assistent para o computador de mesa, via wireless. A construção do aplicativo resultou em um sistema com coleta e administração de dados e permitiu realizar a interface gráfica. A utilização do aplicativo possibilita o uso de um sistema tecnológico para aplicação diária, com alimentação de um banco de dados sobre as características dos cuidados requeridos. Conhecendo a evolução destas variáveis durante a internação, o enfermeiro poderá planejar, intervir e avaliar a qualidade do cuidado.

Patients severity or the number of interventions will not always be proportional to the nursing staff's work load. This descriptive study aimed at demonstrating the trajectory for designing a computer application (software) with Nursing Activities Score content and its operational characteristics. A pilot test was conducted with 12 patients, which was followed by data collection from 123 patients for 90 consecutive days. Compatibility was observed in wireless data transmission from the Personal Digital Assistent to the desk computer. This application's construction resulted in a data collection and administration system, as well as enabled graphic interface. The use of the software allows for the utilization of a technological system with daily applications, with the support of a database concerning the characteristics of required care. With better understanding of the development of such variables during hospitalization, nurses will be able to plan, intervene, and evaluate care quality.

La gravedad de la enfermedad del paciente o el número de intervenciones no son siempre proporcionales a la carga de trabajo de la enfermería. Este estudio descriptivo tuvo como objetivo demostrar la trayectoria de la construcción de un aplicativo (software) con el contenido del Nursing Activities Score y sus características operacionales. Se realizó un test piloto con 12 pacientes y se recolectaron los datos por 90 días consecutivos en 123 pacientes. Hubo compatibilidad en la transmisión de datos del Personal Digital Assistent para la computadora de mesa inalámbrica. La construcción del aplicativo resultó en un sistema con recolección y administración de datos y permitió realizar la interfaz gráfica. La utilización del aplicativo posibilita el uso de un sistema tecnológico para aplicación diaria, con alimentación de un banco de datos sobre las características de los cuidados requeridos. Conociendo la evolución de estas variables durante la hospitalización, el enfermero podrá planificar, intervenir y evaluar la calidad del cuidado.

Perceived Importance and Performance Frequency of Nursing Interventions and Nursing Activities in the Physiological Domains of Nursing Intervention Classification(NIC) in Home Health Care Nursing / 성인간호학회지

PURPOSE: To identify perceived importance and performance frequency of nursing interventions with nursing activities of 5 nursing interventions from the physiological domains of NIC used in the home health care nursing. METHOD: Five nursing interventions in the physiological domain of NIC were selected based on the previous finding. Data were collected from 85 nurses working in 54 home health care centers between August and October, 2004 using mailing survey(return rates : 41.5%). The questionnaire consisted of 96 nursing activities in 5 interventions with definitions, asking perceived importance and performance frequency of them. RESULT: Skin surveillance was perceived as the most important(3.52+/-0.36) intervention and also performed most frequently(4.43+/-0.45). All the nursing activities in skin surveillance appeared to be used frequently, which was rated over 4 out of 5 point Likert, while only 4 nursing activities in exercise therapy: joint mobility did. Correlations between perceived importance and performance frequency of 5 interventions were all significant (r=0.591-0.718, p=0.000). CONCLUSION: Identifying the use of particular interventions and nursing activities will help nurses simplify documentations and to deliver better care to the patients in home health care nursing.

The Effects of Nursing Information System on the Nursing Job: Focused on Direct and Indirect Nursing Time, the Number of Cases and of Patient's Treatment Fees / 대한의료정보학회지

The purposes of this study were to identify the effects of the Nursing Information System on time of the direct and indirect nursing activities, the frequencies of verbal and telephone order, the number of cases and patient's treatments fees before and after NIS. 10 nursing units in the S.N.U.H. were se lected. The data were colle cted for 6 month prior and pa st to NIS. The frequencies of verbal and telephone order were reported from staff nurses for 3 days. The numbers of cases and fees of patient's treatments were taken for 3 month before and after NIS. The results of this study were as follows: 1. 66.9% of participants said direct nursing activities were increased. Any changed nursing performances were patients education, nursing rounds, care of patient's hygiene, care for patient's movements, oral and tracheal suctioning, changing position, and feeding. 2. The difference of amount of time of dir ect and indirect nursing activities 1)There was 14 minutes increase indirect,4 minutes decrease in indirect. 2)NA's activities we re increased by 30minute in direct, decreased by 16 minute in indirect. 3. The frequency of telephone order decreased 16 and verbal order decreased 46 per day. 4. The difference of the number of patient treatment case before and after NIS was increased 9,907 per 3 months and of fees for patient treatment was increased 797,811,067 won per 3 months.

Comparison of Nursing Activities Reflected in Nursing Notes and In-depth Interviews of Nurses in an Acute Hospital / 간호학회지

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.

Estimation of Psychiatric Nursing Costs by Using the Resource-Based Relative Value Scale(RBRVS) / 간호학회지

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

Study on Mother's knowledge level of Breast feeding and Nursing Activities related to Breast feeding perceived by Mother / 아동간호학회지

The purpose of this study was to investigate the mother's knowledge level of breast feeding and nursing activities related to breast feeding perceived by mothers. The subjects were 77 mothers who within 3 days after child birth in 2 Obstetric Clinic in Seoul and P city from Dec 1 to 31, 1999. Data were collected by a questionnaire developed Jung et al.(1994). This study was statistically analyzed according to Frequency, t-test and ANOVA. The results are as follows : 1) The characteristics of subjects : The majority of subjects were aged 30-34 years(44.2%), high school & college graduate(93.6%), had one child(51.9%), had no religion(42.9%), jobless(72.7%) and had no experience of breast feeding(59.7%). 2)Mean score of mother's knowledge level of breast feeding was ranged from 7-16. Mean score of breast feeding was 11.56 points out of possible 20 points meaned that it was a low level. 3)General characteristics were significantly related to mother's knowledge level of breast feeding as follow : age(F= 3.99, P < 0.001) and religion(F= 4.30, P < 0.05). 4) Mean score of nursing activities related to breast feeding by mothers was ranged from 30-146. Mean score of nursing activities related to breast feeding perceived by mothers was 100.05 points out of 150 points meant that it was a high level.

The Effects of the Nurses' Knowledge to Breast-Feeding on the Nursing Activities for Breast-Feeding / 아동간호학회지

This study was attempted to identify the knowledge to breast-feeding and the performance of nursing activities for breast-feeding and to test "how does the degree of knowledge to breast-feeding influence the nursing activities for breast-feeding?" The subjects were 180 nurses working in delivery rooms, nursery, obstetrics & pediatrics wards or OPD of obstetrics & gynecology of 8 general hospitals in Pusan as of August 3 through 13, 1996. The results are abstracted as follows : 1) Subject nurses' age : 25-29 was 45.6%(the major), education levels ; graduates from junior college were 95.0%, unmarried status was 62.2%, 76.5% of married nurses had children, 39.7% in-service education for Breast-Feeding, 337% did nursing activities for breast-feeding actively, the reason for inadequate activities for breast-feeding was "too much other tasks." 2) The degree of knowledge to breast-feeding ; mean score was 13.54, the degree of performance of nursing activities for breast-feeding ; 92.38+/-20.93 points out of possible 145 points(3.19+/-.74 out of possible 5 points) meaned that it was a low level. 3) The hypothesis "the nurses who have higher degrees of knowledge to breast-feeding will show higher degrees of performance of nursing activities for breast-feeding than the nurses who have lowe degrees of knowledge to breast-feeding" was tested by t-test(t=-.01, P=.9888), but rejected because it turned out statistically not significant at the level of P<.05) Above results suggested the degrees of knowledge to breast-feeding and the degrees of performance of nursing activities for breast-feeding were generally low and the degree of knowledge didn't influence the nursing activities. Researchers believe that the education for breast-feeding by the nurses need to be performed systemically & practically and new-method of breast-feeding education program need to include hospital managers as well as nurses related mothers and their family. In addition, researchers propose the introduction of "lactation specialist system", for the specialist can change the attitude of feeding-mothers positively with their specialty and authority.

Paying attention to the evidence requirement by law in diagnosis, treatment and nursing activities / 中华医院管理杂志

With the adoption of the inversion of the burden of proof in medical malpractice disputes, it is imperative for hospitals to document, fix and keep intact evidence of their diagnosis, treatment and nursing activities in the course of delivering emergency care, testing and examination, diagnosis, treatment and nursing according to the evidence specifications for lawsuits and criminal suits and the demand for fixing and keeping intact evidence in an objective, genuine, timely, comprehensive and legal manner. This will enable hospitals to better deal with lawsuits involving medical malpractice disputes.