This second study on the effectiveness of nursing organization was designed to test the relationships between effectiveness of nursing organizations and structural variables that had been significant variables in the first study, the group design variable and the personal characteristic variables that had not been analysed in the first study based on personal resource productivity model. The data were collected through self-reported questionnaires completed by 605 nurses working in hospitals in seoul and 782 patients being hospitalized in 5 tertiary hospitals in Seoul. The results showed that according to the canonical correlation analysis, the managing job design, nursing delivery system. nurse's age career, and formalization were revealed as predicting variables of a nurses' job satisfaction and patients satisfaction among the five hospitals. Hospitals in which the team nursing method was used showed a higher score in nurses' job satisfaction and patient satisfaction than in hospitals which used the functional nursing model.

This study was designed to test relationship between effectiveness of nursing organizations and structural and managerial variables of nursing organizations that are described in the Robbins Organizational theory model. The data were collected through self reported questionnaires from 605 nurses working in, and 782 patients hospitalized in, five tertiary hospitals in seoul. Results showed that according to MANOVA there was a significant difference in nurses job satisfaction and patient satisfaction among the five hospitals. According to cluster analysis of the structural and managerial variables of nursing organizations, the five hospitals were divided into two clusters and there was no significant difference in nurses job satisfaction or patient satisfaction between the two clusters. According to canonical correlation analysis the formalization and centralization of structural variables were shown to be predicting variables for nurses job satisfaction, and the managing job design and managing change of managerial variables were shown to be predicting variables for nurses job satisfaction.

The purpose of this study was to contribute to the development of clinical instruction by students' ratings of teaching effectiveness in clinical nursing education. The subjects were comprised of graduating class 618 students from 24 nursing colleges in the nation. The instruments used in this study were "general characteristics and status of clinical nursing education" developed by the researcher and "Instrument to Measure Effectiveness of Clinical Instructors " by Reeve (1994). The 50 questions used in the questionaire were categorized into 13 components subject to factor analysis. The 13 components were interpersonal relationships, communication skills, role model, resource for students, favorable to students, encouraging to think for selves, teaching methods, evaluation, finding assignments for objectives, organization of subject matter, professional competence, knowledge of subject matter and working with agency personnel. The results of this study are as follows 1. Status of clinical nursing educaion: 1) Clinical nursing education were led by nursing professors(44.9%), a team of both nuring professor and head nurse(6.8%), instructors from specific hospital(15.1%), instuctos for a specific subject(14.6%), and head nurse (6.8%). For 3-year program students, 34.6% of the clinical nursing education were led by instructors from specific hospital and 51.4% of the education by nursing professors for Bachelor's program. 2) The contents for clinical education comprised of Conference being the most frequent of 34.5%; a combination of Nursing skills, Orientation, Conference etc. 22.0%; Nursing process 21.7%; Orientation 13.5%; Inspection (making rounds) 6.4%, and Nursing skills of 2% being the least frequent. 3) Students' preference of clinical teachers from the highest to the lowest were instructors for a specific subject being the most desired(44.9%) followed by nursing professor, head nurse, a team of both nursing professor and head nurse, and instructors from specific hospital being the least desired. 4) Students felt that the qualification for clinical teachers should be at least a master's degree holder and 5 or more years of clinical experience. The reason they felt was because knowledge and experience are imperative for professional education. 2. Clinical teaching effectiveness: The total points for teaching effectiveness was 147.97(mean of 2.95 +/- 0.98) where the total score is considered to be an average rating. 3. Teaching effectiveness as status of clinical nursing education: 1) The score ratings for the clinical instructors from the highest to the lowest were as follows; instructors for a specific subject, instructors from specific hospitals, a team of both nursing professors and head nurses, nursing professors, head nurses, which resulted in significunt differ-ence(F=4.53, P<0.001). 2) The rating scores based on the teaching program from the highest to the lowest were as follws; nursing skills, nursing process, a combination of nursing skills, orientation, conference etc., conferences, orientation, inspection, which resulted in significunt difference(F-10.97, P<0.001). 4. Based on 13 categorized components from the questionaires, questions related to communication skills scored the highest points of 3.20 where inquiries regarding resource for students scored the lowest points of 2.38. 5. Among the 13 categorial components from the questionaire, Interpersonal relationship, Communication skills, Resource for students, Encouraging to think for selves, Evaluation, Teaching method, Finding assignment for objectives, Organization of subject matter, Professional competence, and Working with agency personnel, instructors for a specific subject scored the highest points and head nurse scored the lowest, which resulted in significant diference. Favorable for students, instructors for a specific subject scored highest points and nursing professor scored the lowest, which resulted in significant deference (F=5.39, P<0.001). Role model and Professional competence, instructors for a specific subject scored the highest points and head nurse scored the lowest, with minimum variation(F-1.29, p>0.05:F=1.64,P>0.05). 6. Based on 13 categorial components as a whole, the highest points scored among the 5 groups of clinical teachers was instructors for a specific subject and the lowest, by head nurse(F=1.94, P<0. 001). A team of both nursing professor and head nurse attained higher score in clinical education than their independent education.

Cost effectiveness is a recent and newly emerging approach in nursing evaluation studies. Nursing is in a unique position among health care providers to respond to these efforts and is ready to provide evidence of its cost-effectiveness because nurses has long advocated a holistic view of patient care, that means, nurses are unique position to identify the full range of costs and effects. The cumulative evidence showed that nurses provided cost-effective care that substituted for physician services in many situations and new and important services in long-term care and nursing homes. The purpose of this article is to review, critique, and synthesize research on the cost-effectiveness of nursing care from the research methodology perspective. Two major problems are apparent from this review. First, there is no uniform approach to identifying and valuing resources used in producing nursing intervention options. Second, although it is not difficult to find reports of cost savings, the cost to effect ratio was not used to evaluate the relationship between the cost and effects of alternative options. Based on my analysis, the nursing CEA literature seemed to have huge variation in methods, so that it is not easy to compare the CEA methods among studies. There are still such methodological problems as we found in the literature review. Many of the studies reviewed here would have profited from improved designs. Therefore, future cost-effectiveness analyses should include methodological progress in the context of nursing area application such as the definition and quantification of multi-attribute effectiveness measures, employment of sensitivity analysis, a concept of discount. Nurse and nurse researchers should consider cost-effectiveness questions when addressing other research questions. Because these efforts are forcing policy makers to consider the economics of nursing, nurses should demonstrate and document the value of nursing as compared to other uses of society's health care resources.

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