Journal of Korean Academy of Nursing

Research Paper

Pathway Analysis on the Effects of Nursing Informatics Competency, Nursing Care Left Undone, and Nurse Reported Quality of Care on Nursing Productivity among Clinical Nurses: Yu, Mi , Kim, Se Young , Ryu, Ji Min; J Korean Acad Nurs 2023;53(2):236-248. Published online April 30, 2023; DOI: https://doi.org/10.4040/jkan.22110

Abstract PDF: Purpose
Nursing informatics competency is used to manage and improve the delivery of safe, high-quality, and efficient healthcare services in accordance with best practices and professional and regulatory standards. This study examined the relationship between nursing informatics competency (NIC), nursing care left undone, and nurse reported quality of care (NQoC) and nursing productivity. A path model for their effects on nursing productivity among clinical nurses was also established.
Methods
Data were collected using structured questionnaires answered by 192 nurses working in a tertiary hospital located in J city, Korea, and analyzed using SPSS/WIN 23.0 and AMOS 21.0 program.
Results
The fit indices of the alternative path model satisfied recommended levels χ2 = .11 (p= .741), normed χ2 (χ2/df) = .11, SRMR = .01, RMSEA = .00, GFI = 1.00, NFI = 1.00, AIC = 18.11. Among the variables, NIC (β = .44, p < .001), NQoC (β = .35, p < .001) had a direct effect on nursing productivity. Due to the mediating effect of NQoC on the relationship between NIC and nursing productivity, the effect size was .14 (95% CI .08~.24). Meanwhile, nursing care left undone through NQoC in the relationship between NIC and nursing productivity, has a significant mediation effect (estimate .01, 95% CI .00~.03). The explanatory power of variables was 44.0%.
Conclusion
Education and training for enhancing NIC should be provided to improve nursing productivity, quality of care and to reduce missed nursing care. Furthermore, monitoring the quality of nursing care and using it as a productivity index is essential.

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Original Articles

Development and Application of Cost Management Program for Visiting Nursing Centers Using Time-Driven Activity-Based Costing: Juhang Kim, Ji Young Lim; J Korean Acad Nurs 2019;49(5):586-600. Published online October 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.586

Abstract PDF: Purpose
This study aimed to develop a web-based cost management program for visiting nursing centers (CMP-VNC), using time-driven activity-based costing (TD-ABC), and to analyze effects of the program.
Methods
The CMP-VNC was developed using the combined prototyping approach and system developing life cycle method following four stages: need analysis with comprehensive literature reviews and focus group interviews, design and development of program algorithm, evaluation of the developed program validity using experts and users group, and application and effects analysis. The non-equivalent control group pretest-posttest design was used to analyze the effects of the program. The program demonstration was conducted for four weeks with 60 visiting nurses in 35 visiting centers.
Results
The web-based program was developed. It has five interfaces with basic and special functions using TD-ABC, namely, input, visiting nursing activity, visiting nursing activity cost, cost efficiency, and cost calculation report. The experimental group showed significantly higher cost perception and cost confidence than control group.
Conclusion
We found that the CMP-VNC can be an effective tool to increase visiting nurses’ competency of costing and enhance efficiencies of visiting nursing centers.

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Predictors of Job Performance, Work Satisfaction, and Productivity among Korean Hospital Nurses: Hae Jung Lee; Journal of Korean Academy of Nursing 2001;31(4):571-583. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.4.571

Abstract PDF

PURPOSE: The purpose of this study was to examine the levels of burnout experienced by Korean hospital nurses (N=198), and to identify predictors of their nursing outcomes such as job performance, work satisfaction, and productivity. METHOD: Hierarchical multiple regression was used to identify predictors of each nursing outcomes. Included predictors were nurses' general characteristics, work- related characteristics (role stress and perceived control), and burnout. Results: Korean nurses experienced higher levels of burnout compared to the cutoffs suggested by Maslach and Jackson (1986) and to those in the USA. For each nursing outcome, predictor variables explained 39% of the variance in role performance, 30% of the variance in work satisfaction, and 38% of variance in productivity. Higher personal accomplishment, lower role ambiguity, being staff nurses, and lower emotional exhaustion were related to higher job performance, and higher productivity. Lower role conflict and role ambiguity were also related to higher work satisfaction. CONCLUSION: Based on the findings of this study, managemental interventions for nurses to reduce their burnout experience are needed. Further study in this area is warranted.

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Pathway Analysis on the Effects of Nursing Informatics Competency, Nursing Care Left Undone, and Nurse Reported Quality of Care on Nursing Productivity among Clinical Nurses
Mi Yu, Se Young Kim, Ji Min Ryu
Journal of Korean Academy of Nursing.2023; 53(2): 236. CrossRef
Influence of Emotional Intelligence, Communication, and Organizational Commitment on Nursing Productivity among Korean Nurses
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Journal of Korean Academy of Community Health Nursing.2019; 30(2): 226. CrossRef
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Se Young Kim, Eun-Kyung Kim, Heon Man Lim, Mi Young Lee, Kwang-Ok Park, Kyoung A Lee
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Path analysis of the Influence of Hospital Ethical Climate Perceived by Nurses on Supervisor Trust and Organizational Effectiveness: Yoon Goo Noh, Myun Sook Jung; J Korean Acad Nurs 2016;46(6):824-835. Published online December 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.6.824

Abstract PDF

Purpose

The purpose of this study was to analyze the paths of influence that a hospital's ethical climate exerts on nurses' organizational commitment and organizational citizenship behavior, with supervisor trust as the mediating factor, and verify compatibility of the models in hospital nurses.

Methods

The sample consisted of 374 nurses recruited from four hospitals in 3 cities in Korea. The measurements included the Ethical Climate Questionnaire, Supervisor Trust Questionnaire, Organizational Commitment Questionnaire and Organizational Citizenship Behavior Questionnaire. Ethical Climate Questionnaire consisted of 6 factors; benevolence, personal morality, company rules and procedures, laws and professional codes, self-interest and efficiency. Data were analysed using SPSS version 18.0 and AMOS version 18.0.

Results

Supervisor trust was explained by benevolence and self-interest (29.8%). Organizational commitment was explained by benevolence, supervisor trust, personal morality, and rules and procedures (40.4%). Organizational citizenship behavior was explained by supervisor trust, laws and codes, and benevolence (21.8%).

Conclusion

Findings indicate that managers need to develop a positive hospital ethical climate in order to improve nurses' trust in supervisors, organizational commitment and organizational citizenship behavior.

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Association between Efficiency and Quality of Health Care in South Korea Long-term Care Hospitals: Using the Data Envelopment Analysis and Matrix Analysis: Minsung Sohn, Mankyu Choi; J Korean Acad Nurs 2014;44(4):418-427. Published online August 29, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.4.418

Abstract PDF

Purpose

Objectives of this study were to investigate the association between efficiency and quality of health care in Long-term Care Hospitals (LTCH) and determine related factors that would enable achievement of both high efficiency and high quality at the same time.

Methods

Major data sources were the "2012 Korean Assessment of Propriety by Long-term Care Hospitals" obtained from the Health Insurance Review & Assessment Service. Cost variables were supplemented by a National Tax Service accounting document. First, data envelopment analysis was performed by generating efficiency scores for each LTCH. Second, matrix analysis was conducted to ascertain association between efficiency and quality. Lastly, kruskal-wallis and mann-whitney tests were conducted to identify related factors.

Results

First, efficiency and quality of care are not in a relationship of trade-offs; thus, LTCH can be confident that high efficiency-high quality can be achieved. Second, LTCH with a large number of beds, longer tenure of medical personnel, and adequate levels of investment were more likely to have improved quality as well as efficiency.

Conclusion

It is essential to enforce legal standards appropriate to the facilities, reduce turnover of nursing staff, and invest properly in human resources. These consequences will help LTCH to maintain the balance of high efficiency-high quality in the long-run.

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Structural Equation Modeling on Nursing Productivity of Nurses in Korea: Se Young Kim, Eun-Kyung Kim, Heon Man Lim, Mi Young Lee, Kwang-Ok Park, Kyoung A Lee; J Korean Acad Nurs 2013;43(1):20-29. Published online February 28, 2013; DOI: https://doi.org/10.4040/jkan.2013.43.1.20

Abstract PDF

Purpose

The purpose of this study was to propose and test a predictive model that could explain and predict nursing productivity.

Methods

A survey using a structured questionnaire was conducted with 360 nurses in Korea. The data were analyzed using SPSS Windows 18.0 and AMOS 19.0 program.

Results

Based on the constructed model, burnout and organizational commitment were found to have direct effects on nurses' turnover intention and nursing productivity. While nursing work environment was found to have indirect effects on nurses' turnover intention and nursing productivity.

Conclusion

This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with nursing productivity. Comprehensive organizational interventions to improve nursing productivity should focus on improving the nursing work environment. Findings from this study can be used to design appropriate strategies to decrease nurse turnover in Korea. Further studies are needed to prospectively verify these causal relationships with larger samples.

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Analysis of Cost and Efficiency of a Medical Nursing Unit Using Time-Driven Activity-Based Costing: Ji Young Lim, Mi Ja Kim, Chang Gi Park; J Korean Acad Nurs 2011;41(4):500-509. Published online August 31, 2011; DOI: https://doi.org/10.4040/jkan.2011.41.4.500

Abstract PDF

Purpose

Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit.

Methods

Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time.

Results

The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won.

Conclusion

These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

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