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Original Articles
Influencing Factors and Consequences of Near Miss Experience in Nurses’ Medication Error
Jin Hee Park, Eun Nam Lee
J Korean Acad Nurs 2019;49(5):631-642.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.5.631
AbstractAbstract PDF
Abstract Purpose

This study aimed to predict the influencing factors and the consequences of near miss in nurses’ medication error based upon Salazar & Primomo's ecological system theory.

Methods

A convenience sample of 198 nurses was recruited for the cross-sectional survey design. Data were collected from July to September 2016. Using the collected data, the developed model was verified by structural equation modeling analysis using SPSS and AMOS program.

Results

For the fitness of the hypothetical model, the results showed that χ 2 (χ 2=258.50, p<.001) was not fit, but standardized χ 22/df=2.35) was a good fit for this model. Additionally, absolute fit index RMR=.06, RMSEA=.08, GFI=.86, AGFI=.81 reached the recommended level, but the Incremental fit index TLI=.82, CFI=.85 was not enough to reach to the recommended level. With the path diagram of the hypothetical model, caution (β=-.29 p<.001), patient safety culture (β=-.20, p=.041), and work load (β=.18, p=.037) had a significant effect on the near miss experiences in nurses’ medication error, while fatigue (β=-.06, p=.575) did not affect it. Moreover, the near miss experience had a significant effect on work productivity (β=-.25, p=.001).

Conclusion

These results have shown that to decrease the near miss experience by nurses and increase their work productivity in hospital environments would require both personal and organizational effort.

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A study of the Nursing Service Quality and Satisfaction that Admitted Patients Perceived: being used SERVQUAL
Mi Aie Lee
Journal of Korean Academy of Nursing 2002;32(4):506-518.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.4.506
AbstractAbstract PDF

PURPOSE: This study was performed to measure the nursing service quality being used SERVQUAL model and satisfaction that the admitted patients perceived. METHOD: The questionnaire founded on the SERVQUAL was developed and distributed to 300 patients at the three general hospitals in three provincial city, Korea. For data analysis, Cronbach's alpha frequencies, percentages, paired t-test, Pearson Correlation Coefficient were used. RESULT: In expectation, patients most highly perceived the assurance factor that was one among the 5 factors being constituted nursing service. In performance, patients most highly perceived the responsiveness factor. The performance degrees of the 5 factors and 20 attributes being constituted nursing service did not exceed the expectation degree of those. So the calculated figures for nursing service quality of the three subjected hospitals were all minus. In relation of the patients' demographics and nursing service characteristics to their general satisfaction, patients' sex, age, income and the all factors and attributes of nursing service had relation to their general satisfaction. CONCLUSION: It could be concluded that the nursing service quality of the three subjected hospitals was poor and the patients' demographic and nursing service characteristics had relation to their general satisfaction.

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A Study of the Perception Gap on Nursing Service between Consumers and Providers
Mi Aie Lee
Journal of Korean Academy of Nursing 2001;31(5):871-884.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.5.871
AbstractAbstract PDF

PURPOSE: this study was to investigate the perception gap on nursing service between consumers and providers.
METHOD
the questionnaire founded on the SERVQUAL was developed and distributed to 300 patients and 210 nurses at the three subjected general hospitals in three provincial city, Korea during February to March, 2001. For data analysis, Cronbachs' Alpha, frequency, t-test, and paired t-test were used.
RESULT
1. In the gap analysis on the 20 properties constituting nursing service, providers almost all perceived higher than consumer in quality. Among them, the number of properties being statistically significant was 7 in the expectation, 18 in the important and 7 in the performance. 2. In the comparison analysis of the perception gap on the expectation-performance and the important-performance, it turned out that the subjected hospitals had to improve their equipment and facilities immediately. It was suggested a good strategy to strengthen the responsiveness factor and the assurance factor of nursing service.
CONCLUSION
it could be concluded that nurses have to recognize the blind spot of their perception and endeavor to take away the perception gap between consumers and providers.

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Development of Clinical Performance Indicators for Establishing a Connecting System between Hospital Performance Management and Quality Improvement
Keum Seong Jang, Sam Yong Lee, Yun Min Kim, Sun Young Hwang, Nam Young Kim, Se Ang Ryu, Soon Joo Park, Ja Yun Choi
Journal of Korean Academy of Nursing 2005;35(7):1238-1247.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.7.1238
AbstractAbstract PDF
Purpose

This study aimed at developing integrated clinical performance indicators(CPIs) through the analysis of quality improvement(QI) activities of a hospital and literature review about performance measures.

Methods

The CPIs were developed through the following three stages; 1)Identifying preliminary CPIs 2)A staff validity test in preliminary CPIs 3)Developing final CPIs.

Results

One hundred twenty-three preliminary CPIs were developed through QI activities of the target hospital for 8 years and literature review. The results of the validity test for the preliminary CPIs supported ninety-one items. Sixty-two CPIs were selected through integration, reclassification and renaming. Then, eighteen items were deleted on account of an imprecise calculation method. Finally, forty-four CPIs were confirmed. They consisted of twenty-six items at the hospital level and eighteen items at the department level.

Conclusions

CPIs can be used as criteria to evaluate the performance of healthcare organizations, and to decide the quality of healthcare for customers. This study may contribute to establishing an integrated system between QI activities and performance measurement of healthcare organizations.

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A Comparative Study of how Subjects' Characteristics and Nursing Service Quality Influence on Hospital Revisiting Intent between Patients and Nurses
Mi Aie Lee
Journal of Korean Academy of Nursing 2005;35(7):1210-1220.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.7.1210
AbstractAbstract PDF
Purpose

This study was aimed to examine how subjects' characteristics and nursing service quality influence hospital revisiting intent, to compare perceptions of patients with those of nurses.

Methods

The questionnaire was developed and distributed to 300 patients and nurses at six general hospitals in a provincial city, Korea. For data analysis, the SPSS/PC program was used.

Results

The nursing service quality's scores of patients is 3.61, that of nurses is 3.77, and there is a significant difference. The hospital revisiting intent's score of patients is 4.84, that of nurses is 4.61, and there are no significant differences. In subjects' characteristics, patients perceive that the hospital is the only different factor, and place hospital revisiting intent at 3.6%. Nurses perceive that education level and position are different factors, and place hospital revisiting intent at 3.3%. In nursing service quality, patients perceive that 2 attributes explain hospital revisiting intent at 17.8% and 2 factors explain it at 16.5%; whereas, nurses perceive that 2 attributes explain hospital revisiting intent at 15.3% and 3 factors explain it at 12.2%.

Conclusions

There are perception gaps between consumers and providers. So nursing and hospital managers must recognize these facts and provide various marketing strategies to overcome them.

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A Study of the Nursing Service Quality and Gap Perceived by Consumers
Mi Aie Lee
Journal of Korean Academy of Nursing 2004;34(2):225-234.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.2.225
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a tool that measures the quality of nursing service, to measure the quality of nursing service perceived by consumers, and to identify the gaps between ideal and actual nursing services.

Method

A questionnaire was developed and distributed to 300 people who had been hospitalized in one of six general hospitals with quality of nursing services in five provincial cities in Korea. For data analysis, the SPSS/WIN(ver 10.0) program was used.

Result

The 20 attributes included in the instrument of quality of nursing service is abstracted into 2 factors : tangibility and intangibility. In quality analysis, 15 of 20 attributes are minus scores, meaning that those nursing services are perceived as generally low. However among the minus scores' attributes, only two attributes are significant statistically. Gaps between importance and performance of the nursing service exists in 19 among 20 attributes.

Conclusion

Nursing service quality (performance-expectation) needs to be improved, and Gaps (importance-performance) reduced. In addition, a tool measuring nursing service quality has to be developed so nurses can deal successfully with the quality and gaps of nursing service perceived by consumers.

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The Development of Certificates Criteria and Curriculum in Home Healthcare Nurse Specialist Program
Kyung Rim Shin, Su Kyung Ju, Duk Yoo Jung, Hye Young Kim, Bun Han Kim, Suk Ja Yang
Journal of Korean Academy of Nursing 2003;33(3):395-404.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.3.395
AbstractAbstract PDF
Purpose

To make a contribution to raising the quality of nursing and home healthcare services through reviewing the present state of home healthcare nurse specialist training institutions and education programs and creating concrete measures to establish high-quality education courses.

Method

International comparative study of accreditation criteria and curriculum in home healthcare nurse specialist program.

Result

The Authorization Standards of home healthcare nurse training institutions consists of 8 items, 23 evaluation criteria and 72 evaluation indexes. Proposal to develop a specialist training program: Curriculum. Modify and complement a present homecare nurse education program. Curriculum 1. Designate two forms of certification. The first certification has been granted the authority to serve as a manager and open a home healthcare agency to nurses having masters degrees and clinical experience for five years. The second certification is allowed to perform general home healthcare after having completed a short term training course. Currculum 2. To meet increasing demands, granting a certification to perform home healthcare to registered nurses having clinical experience of more than three years.

Conclusion

These results can be utilized in the home healthcare educational program for raising the quality of nurses and home healthcare services.

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Analysis of Factors Affecting Unmet Healthcare Needs of Married Immigrant Women
Su Hee Kim, Chung Yul Lee
J Korean Acad Nurs 2013;43(6):770-780.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.770
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the factors affecting the unmet healthcare needs of married immigrant women.

Methods

This study was a secondary data analysis using data from the 2009 National Survey of Multicultural Families. Data collected from 58,735 married immigrant women who had spouses were analyzed using descriptive statistics, Chi-square test, and logistic regression.

Results

Overall, 9.9% of married immigrant women have unmet healthcare needs. The significant predictors related to unmet healthcare needs were young age, high level of education, employed, country of origin, long period of residence, low income, uninsured, urban area, low level of subjective health status, and illness experience over past two weeks. In particular, four variables (long period of residence, low income, subjective health status, and illness experience over past two weeks) significantly predicted unmet healthcare needs for women from all countries of origin.

Conclusion

The results of the study indicate that common predictors related to unmet healthcare needs of married immigrant women are a long period of residence, low income, subjective health status, and illness experience over past two weeks. Therefore intervention strategies to decrease unmet healthcare needs should focus on these significant predictors.

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Prerequisite for Korean Advance Directives: From the View of Healthcare Providers
Shin Mi Kim, Sun Woo Hong, Young Eun, Su Jin Koh
J Korean Acad Nurs 2012;42(4):486-495.   Published online August 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.4.486
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the main prerequisite for Korean Advance Directives [KAD] to ensure their better use.

Methods

Data were collected from two focus group interviews and individual email responses. Study participants were 5 doctors and 6 nurses. All interview data were transcribed and analyzed using qualitative content analysis.

Results

Three main themes emerged; establishing a philosophy of KAD, protocol to practice KAD, and the KAD document itself. A philosophy is needed to ensure individual needs, consensus to practice AD and identify principle agents. The core of protocol was found to be as follows; 1) process, 2) premise, 3) procedure, 4) contextual preparation, 5) timing, 6) feasibility. Component and feasibility need to be established for the document itself.

Conclusion

For a positive acceptance of KAD in Korean society, a culture sensitive, reality based, and user friendly AD needs to be developed.

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A Study on Participation in Clinical Decision Making by Home Healthcare Nurses
Se Young Kim
J Korean Acad Nurs 2010;40(6):892-902.   Published online December 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.6.892
AbstractAbstract PDF
Purpose

This study was done to identify participation by home healthcare nurses in clinical decision making and factors influencing clinical decision making.

Methods

A descriptive survey was used to collect data from 68 home healthcare nurses in 22 hospital-based home healthcare services in Korea. To investigate participation, the researcher developed 3 scenarios through interviews with 5 home healthcare nurses. A self-report questionnaire composed of tools for characteristics, factors of clinical decision making, and participation was used.

Results

Participation was relatively high, but significantly lower in the design phase (F=3.51, p=.032). Competency in clinical decision making (r=.45, p<.001), perception of the decision maker role (r=.47, p<.001), and perception of the utility of clinical practice guidelines (r=.25, p=.043) were significantly correlated with participation. Competency in clinical decision making (Odds ratio [OR]=41.79, p=.007) and perception of the decision maker role (OR=15.09, p=.007) were significant factors predicting participation in clinical decision making by home healthcare nurses.

Conclusion

In order to encourage participation in clinical decision making, education programs should be provided to home healthcare nurses. Official clinical practice guidelines should be used to support home healthcare nurses' participation in clinical decision making in cases where they can identify and solve the patient health problems.

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Quality of Pediatric Nursing Care: Concept Analysis
Miyoung Choi, Kyungsook Bang
J Korean Acad Nurs 2010;40(6):757-764.   Published online December 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.6.757
AbstractAbstract PDF
Purpose

This paper is a report of a concept analysis of 'quality of pediatric nursing care'.

Methods

Rodgers's evolutionary method of concept analysis was used. Data were collected from published literature related to quality of pediatric nursing care.

Results

Quality of pediatric nursing care was identified with three dimensions and seven attributes: 1) nurse's character: technical competence, interpersonal competence, 2) nurse's activities: developmentally appropriate care, attentiveness, entertainment, 3) nurse-parent interaction: nurse-parent partnership, emotional support. Antecedents of quality of pediatric nursing care were 'child and parent's expectation about pediatric nursing care', 'previous caring experience of pediatric nurses'. Consequences of quality of pediatric nursing care were 'meet child and parent's needs' and 'better health outcomes.'

Conclusion

'Quality of pediatric nursing care' is a core concept in pediatric nursing practice. Appropriate instruments to operationalize the concept need to be developed.

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