Journal of Korean Academy of Nursing

Invited Paper

Lessons from the US Advanced Practice Registered Nurse system: Eun-Ok Im, Dongmi Kim; J Korean Acad Nurs 2025;55(4):492-505. Published online November 27, 2025; DOI: https://doi.org/10.4040/jkan.25120

Abstract PDF ePub: Purpose
This review compares the development of South Korea’s Advanced Practice Registered Nurse (APRN) system the well-established APRN system in the United States and provides recommendations for future improvements to the APRN system in South Korea.
Methods
To compare the APRN systems between the two countries, an integrative literature review was conducted using multiple databases and professional nursing organization documents and reports from both the United States and South Korea.
Results
Issues were identified in five major domains: (1) research evidence, (2) education and training, (3) the scope of practice, (4) financial mechanisms, and (5) public awareness and acceptance.
Conclusion
Recommendations are made in four areas: (1) building evidence to support APRN programs; (2) strengthening APRN education; (3) establishing legal support and reimbursement mechanisms; and (4) improving public awareness and acceptance of APRNs.

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Original Article

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

Abstract 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.

Citations

Citations to this article as recorded by

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