Establishing a Clinical Ladder System for Nurses in a Small and Medium-sized Hospital / 간호행정학회지

PURPOSE: This study was done to establish a clinical ladder system for nurses in a small and medium-sized hospital in Korea. METHODS: The study was carried from July, 2016 to May, 2018. Data collection was done in a general hospital with 250 beds located in Gyeonggi Province. The clinical ladder system was developed and operated according to the value system of small and medium-sized hospital. Focus group interviews and a satisfaction survey were conducted for evaluation. Collected quantitative data were analyzed using the SPSS/WIN 22.0 program and qualitative data underwent content analysis. RESULTS: The clinical ladder system is a 5-step ladder that includes 3 domains, 5 nursing competencies and 25 nursing behavioral indicators related to core values of the hospital. The operating system were promotion review system, education system and support/reward system. After conducting a pilot clinical ladder system, satisfaction of nurses was 2.86, out of a possible 4. Nurses who participated in the clinical ladder system experienced improvement in motivation, job performance, self-esteem, professionalism, recognition and were able to develop a goal in their minds. CONCLUSION: The results indicate that the clinical ladder system can be used as a strategy for professional development for nurses in small and medium-sized hospitals.

Relationship between Expectations of Clinical Ladder System, Career Commitment and Turnover Intention of Nurses in Small and MediumSized Hospitals / 임상간호연구

PURPOSE: This study was done to explore the relationship between expectations of the clinical ladder system (CLS), career commitment and turnover intention in nurses employed in small-medium sized hospitals. METHODS: Participants were 154 nurses from 3 small-medium sized hospitals in Gyeonggi Province and Gwangju City. From February, 8 to April, 14, 2017, self-report questionnaires were collected and analyzed using frequency, t-test, ANOVA, Scheffé test, and Person correlation coefficients. RESULTS: Of the participant nurses, 61% perceived the CLS as needed. The mean score for expectation of CLS, career commitment, and turnover intention on 5-point scale were 3.38, 3.17, 3.21, respectively. There were no significant differences in expectation of CLS according to general characteristics, but career commitment and turnover intention did show significant differences depending on age, position, type of work shift. Expectation of CLS correlated positively with career commitment (r=.23, p=.005), and career commitment correlated negatively with turnover intention (r=−.49, p < .001). CONCLUSION: The results of this study show that there is a need to adopt the clinical ladder system to improve career commitment.

Nutritional Status of Vitamin D and the Effect of Vitamin D Supplementation in Korean Breast-fed Infants

We investigated the vitamin D status and the effect of vitamin D supplementation in Korean breast-fed infants. The healthy term newborns were divided into 3 groups; A, formula-fed; B, breast-fed only; S, breast-fed with vitamin D supplementation. We measured serum concentrations of vitamin D (25OHD3), calcium (Ca), phosphorus (P), alkaline phosphatase (AP), intact parathyroid hormone (iPTH) and bone mineral density (BMD) at 6 and 12 months of age. Using questionnaires, average duration of sun-light exposure and dietary intake of vitamin D, Ca and P were obtained. At 6 and 12 months of age, 25OHD3 was significantly higher in group S than in group B (PS>B), but total intake of Ca and P were higher in group A than in group B and S (P<0.001). In conclusion, breast-fed infants show lower vitamin D status and bone mineralization than formula-fed infants. Vitamin D supplementation (200 IU/day) in breast-fed infants increases serum 25-OH vitamin D3, but not bone mineral density.

Nutritional Status of Vitamin D in Korean Mothers and their Newborn Infants / 대한주산의학회잡지

OBJECTIVE : To evaluate the vitamin D nutritional status and its influencing factors in Korean mothers and their newborn infants. METHODS : Maternal (n=181) and cord blood (n=180) serum concentrations of vitamin D (25OHD3), calcium, inorganic phosphorus, alkaline phosphatase, intact parathyroid hormone were measured at the time of delivery. We defined vitamin D deficient, insufficient, and sufficient as 25OHD3 30 ng/mL, respectively. Using questionnaires, average duration of sun-light exposure (minutes/day) and dietary intake of vitamin D (microngram/day) were obtained. RESULTS : 1) The mean 25OHD3 level in mothers was 23.4+/-9.9 (range 4~71.6) ng/mL, and in newborns, 16.9+/-7.5 (range 0.9~53.6) ng/mL. 2) 8.3% of mothers and 22.2 % of newborns were vitamin D deficient, and 70% of both mothers and newborns were insufficient. 3) Maternal 25OHD3 showed a strong positive correlation with cord blood 25OHD3 (r=0.727, p<0.001). 4) The most significant risk factor for low 25OHD3 levels was the season of birth (June through November) in both mothers and newborns. 5) In multiple logistic regression analysis, the season of birth and the mode of delivery remained significant for maternal vitamin D status, whereas maternal 25OHD3 and the mode of delivery remained significant for neonatal vitamin D status. CONCLUSION : In conclusion, vitamin D deficiency or insufficiency was relatively common in Korean mothers and their newborn infants, and the most significant risk factor for low vitamin D status was the season of birth.