Nursing Leadership Competencies among New Nurses: Perceptions of Nursing Managers’ / 간호행정학회지

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.

Study for Revision of the Korean Patient Classification System / 임상간호연구

PURPOSE: The purpose of this study was to revise the KPCS-1 and to standardize the three patient classification systems for general ward, ICU and NICU. The actual utilization of the KPCS-1 score and each nursing activity was evaluated and the relationships between KPCS-1 score and nursing related variables were reviewed. METHODS: The 47,711 KPCS-1 scores of 6,931 patients who discharged from 1st to 30th April 2017 were analyzed and the statistical significance between KPCS-1 score and nursing related variables was reviewed by Generalized Estimating Equation. The revision of the KPCS-1 was carried out by Partial Least Square model. The 3 patient classification systems (KPCS-1,KPCSC and KPCSN) were standardized by professional reviews. RESULTS: KPCS-1 was a valid instrument to express nursing condition adequately and was revised as a new version which has 34 nursing activity items. The names and terminologies of pre-existing 3 patient classification systems developed by KHNA were standardized as KPCS-GW, KPCS-ICU, KPCS-NICU. CONCLUSION: KPCS-1 was a valid instrument to represent diverse nursing conditions precisely and was revised as a 34-item KPCS-GW. The terminologies of the other patient classification systems by KHNA were standardized as KPCS-ICU and KPCS-NICU.

Effects of an Evidence-Based Practice (EBP) Education Program on EBP Practice Readiness and EBP Decision Making in Clinical Nurses / 간호행정학회지

PURPOSE: Today's clinical nurses deal with complex problems that need accurate evidence for practice and decision making. In this study the effectiveness of an EBP education program was examined. METHODS: A pre-posttest design was used for this study and participants were 46 nurses working at a tertiary hospital located in Suwon, Korea. Date collection was done before and after the education program, from July 27 to October 2, 2015. Data were analyzed using paired t-test and ANCOVA with SPSS 21.0. RESULTS: There were significant differences in scores before and after the EBP education program for EBP readiness: belief (t=-5.65, p<.001), implementation(t=-2.89, p=.006), competence (t=-4.21, p<.001), and for evidence-based decision making (t=-16.25, p<.001) by the nurses. CONCLUSION: The findings indicate that the EBP education program has positive effects on EBP belief, implementation, competence and evidence-based decision making. In the future, it is necessary to reinforce the content of the program in the clinical workplace and to provide continuous education for clinical nurses.

A Study on the Appropriateness of Health Insurance Fee in Main Nursing Practices / 임상간호연구

PURPOSE: This study was to present improvement strategy and the problems of the nursing fee in national health insurance system. METHODS: A total of 23 nursing activities performed by nurses were selected. Data were collected the relative value score and criteria of the Health Insurance Review & Assessment Agency. Sixty clinical nursing experts panels were composed and nursing time surveyed self-reported method. The actual fee was calculated through the nursing time, relative value score and actual labor costs. Nextly, the labor costs analyzed was compared with that in the national health insurance. RESULTS: Although the practices were mainly performed by the nurse, other occupations have been recorded as main practitioners and the time of the nursing activity is partially improperly reflected. Additionally, although the nurse practiced mainly in glucose (semi-quantitative) test, it was confirmed that the principal practitioner was described as a clinical pathologist. The the labor cost gap was estimated that is 9.3 times (median) and 11.9 times (average) in this analysis. CONCLUSION: This study suggests that it is necessary to legislate a policy that can improve the quality of clinical nursing by reinforcing the appropriateness and improving nursing fee through reflection of the actual time spent for nursing care.

Development of Resilience Scale for Nurses / 기본간호학회지

PURPOSE: This study was done to develop a measure resilience in nurses. METHODS: Forty preliminary items were extracted from a view of the literature on concept analysis and scale development, and from in-depth interviews with nurses. These items were examined for content validity, reliability and validity. The scale was verified with 496 nurses working in three advanced general hospitals located in Seoul and Gyeonggido. RESULTS: Factor analysis resulted in the creation of the final scale, which consisted of 30 items that were grouped into 5 factors: dispositional pattern, relational pattern, situational pattern, philosophical pattern and professional pattern. The explanatory variance was 56.25%. The reliability of the scale was Cronbach's alpha = .95. Correlation of the scale with the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC), established its construct and concurrent validity (r=.74, p<.001). CONCLUSION: The resilience scale for nurses was found to have reliability and validity, and as developed in this study reflects nurses' disposition and was confirmed as a basis for developing and evaluating programs to increase nurses' resilience.

Factors Influencing Competency in Evidence-based Practice among Clinical Nurses / 간호행정학회지

PURPOSE: The aim of this study was to describe competency in evidence-based practice (EBP) among clinical nurses and to explore critical thinking disposition (CTD) and organizational culture (OC) as possible predictors for competency in EBP. Also this study was conducted to identify baseline data for purpose of developing evidence-based OC to ensure safety of patients and to improve quality of nursing services in clinical setting. METHODS: With a descriptive correlation study design, a competency in EBP questionnaire was administered to a convenience sample of nurses (N=393) from a single general hospital in Gyeonggi Province. RESULTS: The overall mean score for competency in EBP was 3.03+/-0.53. Factors influencing competency in EBP were education (beta=0.23, p<.001), attendance at lectures on EBP (beta=0.18, p<.001), intellectual eagerness & healthy skepticism (beta=0.27, p<.001) among CTD, and hierarchy-oriented OC (beta=0.14, p=.005), which explained about 35% of the total variance. CONCLUSION: Critical thinking and competency in EBP should be part of nursing education especially for undergraduate students as well as strengthening clinical practice by activation of EBP. The results of this study that hierarchy-oriented OC, is a significant predictor for competency in EBP is difficult to accept. Its seemed to require further exploration.

Relations of Job Satisfaction with Emotional Labor, Job Stress, and Personal Resources in Home Healthcare Nurses

PURPOSE: The aim of this study is to identify effects of emotional labor, job stress and personal resources on job satisfaction in home healthcare nurses. METHODS: The subjects were 149 home healthcare nurses working for home healthcare centers at 61 hospitals. Data were collected using a structured questionnaire from November 22, 2010 to February 28, 2011 and analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation, Hierarchical multiple linear regression analysis. RESULTS: The mean score of emotional labor level was 4.23+/-0.95, that of job stress level 3.39+/-0.57, that of personal resources 3.38+/-0.36, and that of job satisfaction 3.31+/-0.40. There were positive correlations among emotional labor, job stress, personal resources and job satisfaction. After age, educational level, job position, and work period in home health care, and traffic accident were controlled, the variables, emotional labor (beta=-.198, p = .034) and personal resources (beta=.236, p = .005) turned out to account for 13.3% of the job satisfaction. But job stress was not a statistically significant predictor. CONCLUSION: Home healthcare nurses were needed to minimize emotional labor and revitalize personal resources in order to maintain a comparatively high level of job satisfaction. Furthermore, it is necessary to carry out systematic education and an organizational management scheme into practice.

Development of Nursing Practice Guidelines for Non-humidified Low Flow Oxygen Therapy by Nasal Cannula / 간호행정학회지

PURPOSE: The purpose of this study was to provide a basis for non-humidified low flow oxygen by nasal cannula and to provide a guide for consistent care in nursing practice. METHODS: A methodological study on the development of guidelines with experts' opinions on collected items, framing PICO questions, evaluating and synthesizing texts which were searched with the key words (low flow oxygen, nasal cannula, humidification of oxygen, guideline) from web search engines. RESULTS: Of the 45 researched texts on the web, 9 texts relevant to the theme were synthesized and evaluated. All patients with humidified or non-humidified oxygen therapy reported that they had no discomfort. CONCLUSION: The results indicate that there are no tangible grounds for patients' perceived differences between the humidified and non-humidified oxygen under 4L/min supplied by nasal cannula. with oxygen. Therefore, non-humidification oxygen therapy is strongly advised when suppling under 4L/min oxygen by nasal cannula (recommended grade A).

Relationship Between Intra-Organizational Communication Satisfaction and Safety Attitude of Nurses / 간호행정학회지

PURPOSE: Communication in hospitals is one of the major factors in patient safety. So, the purpose of this study was to identify the relationship between intra-organizational communication satisfaction and the safety attitude of nurses in hospitals. METHOD: A descriptive survey design with convenience sampling was used. Data collection was done using a self-report questionnaire answered by 278 nurses from one university hospital located in Kyeoung-gi Province, Korea. RESULT: Intra-organizational communication satisfaction positively correlated with safety attitude (r=.747, p<.01). Among the 6 sub dimensions of safety attitude, perceptions of management (r=.675, p<.01), job satisfaction (r=.640, p<.01) and teamwork climate (r=.600. p<.01) were strongly related to intra-organizational communication satisfaction. Multiple regression analysis was done to identify explanation power of intra-organizational communication satisfaction against safety attitude. The model was significant (F=48.540, p<.01). Intra-organizational communication satisfaction accounted for 60.9% of variance in safety attitude (Adj R2=.609). CONCLUSIONS: The results of this study indicate that higher levels of intra-organizational communication satisfaction promote positive safety attitude in hospital nurses and that communication media quality is an important factor in patient safety attitude. Therefore, developing interventions to revitalize intra-organizational communication level based on communication media quality will help in the construction of positive safety attitude in nurses.

A Comparative Study of Nurses' Recognition and Practice Level of General Nosocomial Infection, MRSA and VRE Infection Control / 기본간호학회지

PURPOSE: The purpose of this study was to describe nurses' recognition of, and practice level in management of general nosocomial infections, and methicillin resistant staphylococcus aureus (MRSA) and vancomycin resistant enterococci (VRE) infections. METHODS: A self-administered questionnaire was used to collect data. Data were collected on June, 2003 from 190 nurses in one university affiliated hospital located in Suwon. RESULTS: The mean score for nurses' recognition of general nosocomial infection control was 3.57, MRSA control was 3.54, and VRE control was 3.86. The mean score on practice for control of general nosocomial infection was 3.19, for MRSA control, 3.20, and for VRE control, 3.63. There were statistically significant relationships between the recognition level and practice level for general nosocomial, MRSA, and VRE infection control. According to the general characteristics of the nurses, the mean scores for both recognition and practice were higher for those nurses who had had infection control education, for those who had worked longer in nursing, and for those who worked in the ICU. CONCLUSION: It is suggested that appropriate hospital infection control programs should be developed through continuous education and practice to improve nurses' level of the practice in general infection control, and especially in MRSA and VRE infection control.

Comparative Study of Postoperative Analgesic Effect of IV-PCA According to Timing of Infusion in Patients with Total Abdominal Hysterectomy / 기본간호학회지

PURPOSE: This study was designed to verify preemptive effects of intravenous patient-controlled analgesia (IV-PCA) infusion on postoperative pain in women having a total abdominal hysterectomy. METHOD: The research design was a nonequivalent control group post test only design. The participants in this study were 50 women who were scheduled for a total abdominal hysterectomy at a University affiliated Hospital in Suwon, Korea. The subjects were divided into two groups. For the experimental group, IV-PCA infusion was started before the skin incision and for the control group, IV-PCA infusion was started after the skin was closed. Each group was evaluated in terms of pain score by the visual analogue scale (VAS) and the number of times they pushed the button for IV-PCA at postoperative hours 1, 2, 3, 6, 12, and 24. The data were collected from July 1 to December 10, 2001. Collected data was analyzed by SPSS/PC+ program. RESULT: 1. There was no difference between the two groups, over six points for the number of times the control button for IV-PCA was used. Group differences and interaction effect were not significant. 2. There was no significant difference in pain scores between the two groups, over seven time points. A significant interaction effect was observed between groups and measurement points in time. 3. There was a significant difference in the requirements for additional analgesia between the two groups, 32% of the control group received additional analgesia. CONCLUSION: Preemptive analgesics administration may have a better effect in relieving postoperative pain than the usual analgesic treatment which is started after surgery.

Efficacy of 1:1000 Diluted Heparin versus 0.9% Normal Saline for Maintenance of Intermittent Intravenous Locks / 기본간호학회지

The objective of this research was to compare the flushing effects using 1:1,000 diluted heparin or 0.9% normal saline in relation to needle gauge and frequency of IV medications. The comparative categories were clotting, duration of patency, and incidence of phlebitis. The design of research was a Nonequivalent Control group, Post test, Nonsynchrorized Design. The independent variable was 0.9% normal saline flushing the IV locks and the dependent variables were clotting, duration of patency, and incidence of phlebitis. Subjects were medical-surgical inpatients over 15 years old and with peripherally placed IVs who were hospitalized in a university medical center. Exclusion criteria included foreigners and those who were rejected for this research. The final sample for data analysis included 295 IV sites in 194 patients; 154 were in the saline group and 141 were in the heparin group. Subjects were assigned to have IV locks is flushed with 0.9% normal saline in the experimental group and to have IV lock flushed with 1:1,000 diluted heparin(100 units) in the control group. In order to increase reliability, the nurses who were assigned to the units involved in the study received an explanation on the standard method for locking an IV, recording method for observational data and criteria for the detection of phelbitis. Data were collected for a period of 2 weeks, from March 16, 2000 to March 29, 2000. Total duration of IV was defined the time of IV insertion to the time of discontinuation. Phlebitis was defined as the presence of the following : pain, swelling, erythema at the insertion site. Chi-square was used to determine the association between the degree of clotting, duration of patency, and incidence of phlebitis for the diluted heparine or the normal saline and needle gauge and frequency of IV medications. The results are summarized as follows : (a) There was difference in the degree of clotting between two groups(x2=5.882, p=.015). (b) There was no difference in the degree of duration of patency between two groups(x2=2.439, p=.295). (c) There was no difference in the incidence of phlebits between two groups(x2=0.190, p=.663). (d) There was difference in the degree of clotting(x2=6.209, p=.013) and in the degree of duration of patency(x2=6.978, p=.031) according the needle guage between the two groups. (e) There was difference in the incidence of phlebitis(x2=5.008, p=.025) according to the frequencies of IV injection between two groups.

The Effect of Preceptorship on OJT(On the Job Training)of New Nurses / 성인간호학회지

The purpose of this study was to examine the effect of preceptorship on On the Job Training of new nurses. The research design was a retrospective survey and one group pre-post test design. The subjects were 49 entry nurses and 49 preceptors. The data were collected from Feburary 1, 1998 to December 1, 1998. One questionnair applied in this study consisted of general characteristics, the responses of new entry nurses and their preceptors and their qualities. The other questionnair consisted of job satisfaction of new entry nurses and preceptors and their competencies. The data were analyzed for frequencies, mean score, standard deviation, t-test, and ANOVA. The results of the study were as follows: 1) Preceptees's responses were that the nurses' affiliation of unit, cooperation of other nurses, and competencies of nursing skills improved after OJT applied preceptorship. 2) Preceptors's answers were that preceptor- ship had a positive effect on their continuing education. 3) While preceptees's job satisfaction scores were high in interaction, administration, and organization, they were low in autonomy and pay. 4) Pre-competency scores were the same as post-competency scores. 5) After preceptorship, preceptors responded that their nursing skill & communication competency increased, but their nursing administration competency decreased. 6) Finally, preceptorship's other effects were as follows: 1. Checklists for preceptee education at the nursing unit were developed separately. 2. It was proved that 'preceptor interview note' was effective on manage preceptorship. 3. We obtained duty overlap periods; medical- surgical units-1 month, 5 ICU-2 months, operation room-3 months. 4. We prepared a preceptor program based on the study results.