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Research Paper
Factors Influencing Clinical Nurses’ Perception of Structural and Content Career Plateau
Ji Hye Kim, Ji Yun Lee
J Korean Acad Nurs 2024;54(4):534-546.   Published online October 23, 2024
DOI: https://doi.org/10.4040/jkan.24002
AbstractAbstract PDFePub
Purpose

This study was intended to provide basic data for reducing the career plateaus of clinical nurses.

Methods

The participants were 288 clinical nurses who worked at five hospitals, general hospitals, and tertiary hospitals in Seoul, Gyeonggi, and Chungcheong provinces and had more than one year of clinical experience. The research data were collected from December 26, 2022, to April 7, 2023, using structured questionnaires and analyzed using SPSS software. The study conducted mean, standard deviation, percentage, t-test, ANOVA, Pearson‘s correlation coefficient, and hierarchical regression analysis.

Results

Perceived organizational support was identified as the factor influencing structural career plateaus. Factors influencing content career plateaus included growth needs, skill variety, organizational justice, and perceived organizational support.

Conclusion

The above research results suggest that to increase the motivation of clinical nurses and reduce career plateaus, it is necessary to improve awareness and systems of human resource management at the organizational level.

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Original Articles
Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals
Yunmi Kim, Ji Yun Lee, Hyuncheol Kang
J Korean Acad Nurs 2014;44(1):21-30.   Published online February 28, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.1.21
AbstractAbstract PDF
Purpose

This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals.

Methods

A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators.

Results

Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable.

Conclusion

To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

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Geographical Imbalances: Migration Patterns of New Graduate Nurses and Factors Related to Working in Non-Metropolitan Hospitals
Sung-Hyun Cho, Ji Yun Lee, Barbara A. Mark, Han Yi Lee
J Korean Acad Nurs 2012;42(7):1019-1026.   Published online December 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.7.1019
AbstractAbstract PDF
Purpose

To examine geographical imbalances by analyzing new graduate nurses' migration patterns among regions where they grew up, attended nursing school, and had their first employment and to identify factors related to working in non-metropolitan areas.

Methods

The sample consisted of 507 new graduates working in hospitals as full-time registered nurses in South Korea. Migration patterns were categorized into 5 patterns based on sequential transitions of "geographic origin-nursing school-hospital." Multiple logistic regression analysis was conducted to identify factors associated with working in non-metropolitan hospitals.

Results

Nurses who grew up, graduated, and worked in the same region accounted for the greatest proportion (54%). Sixty-five percent had their first employment in the region where they graduated. Nurses tended to move from poor to rich regions and from non-metropolitan to metropolitan areas. Working in non-metropolitan hospitals was related to older age, the father having completed less than 4 years of college education, non-metropolitan origin, non-capital city school graduation, and a diploma (vs. baccalaureate) degree.

Conclusion

Admitting students with rural backgrounds, increasing rural nursing school admission capacities, and providing service-requiring scholarships, particularly for students from low-income families, are recommended to address geographical imbalances.

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Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals
Ju Young Yoon, Ji Yun Lee
J Korean Acad Nurs 2010;40(1):110-118.   Published online February 28, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.1.110
AbstractAbstract PDF
Purpose

To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea.

Methods

The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals.

Results

The inter-rater reliability of items was high (Kappa range: 0.66-0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month.

Conclusion

This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

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Effects of Case Management using Resident Assessment Instrument-Home Care (RAI-HC) in Home Health Services for Older People
Kyung Ja June, Ji Yun Lee, Jong Lull Yoon
J Korean Acad Nurs 2009;39(3):366-375.   Published online June 29, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.3.366
AbstractAbstract PDF
Purpose

To evaluate the effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health service for older people.

Methods

All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), Pain and the number of Clinical Assessment Protocols (CAP).

Results

Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression (odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL (OR: 4.423, CI: 1.151-16.999) and the number of CAP (OR: 11.443, CI: 3.805-34.410).

Conclusion

Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

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