This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.
Home health care is moving into a set of new realities. An era of competition and cost containment has arrived. Before nurses are able to contain costs or describe the relationship between nursing activities, cost must be accurately measured based on the nurse's workload. Nurses in home health care usually desire to measure expenses for one of three reasons : reimbursement, management, or research. The purpose of the study was to investigate the work input by Registered Nurse in each of the home health care activities by relative value units and identify the factors affecting the nurses' total work input in health care services. To measure the work input by nurses, work was defined by four dimensions: time, physical effort, mental effort, and stress. This study used a descriptive-correlational design. Data collection consisted of two phases. In phase I, data on home health activities performed by nurses were collected. In phase II, data on nurses' time, physical effort, mental effort, and stress in each of home health care activities discovered phase I were collected. In this method, the respondent was asked to rate a service in relation to a reference service using a ratio scale. The sample included 39 home health care nurses. The results of the study indicated that home health care activities performed by the nurses were in 10 categories and 69 items. Measuring the relative work inputs in each of home health care activities, and foley catheterization was selected as the reference to service. In terms of time and physical effort dimensions, full bath service was rated as the most strenuous among 69 activities by the respondents, and intramuscular injection was rated as least. It was found that emergency treatment required the highest mental effort and the highest stress, while blood sugar tests required the lowest mental effort. Approximately 91.3% of the variance in total work input was accounted for by the linear combination of time, physical effort, mental effort judgement, and stress. Examining the regression coefficients of those variables, physical effort, time, and stress were found as the predictors which were significantly associated with the total work of nurses in home health care. Professional nursing's next step in the conundrum of economic volatility is to develop a tool to reflect the interaction of functional deficiency and direct professional nursing care. And this will be a more accurate predictor of nursing resource use and ultimately a great forcaeter cost.
The purse of this to identify whether ethical values of Korean nurses are deontological or utilitarian. Nurse's ethical value questionnaire was developed from review of the literature and inter view of nurses in the clinical settings. Ethical problems are categorized into four areas 1) human life 2) nurse-patient relationship 3) nurse-nursing task relationship 4) nurse-collegue relationship. The data were obtained from 250 nurses in the clinical settings from Jun. to July in 1998 using the ethical value questionnaire developed by Lee(1990). The analysis of data was done by Pearson's correlation coefficient, t-test and anova. The results of this study were as follows: 1. The ethical values of human life slightly took up the position of utilitarian. 2. The ethical value of nurse-patient relationship slightly took up deontological position. 3. The ethical value of nurse-nursing task relationship slightly took up the deontological position. 4. The ethical value of nurse-collegue relationship greatly took up the deontological position. 5. The ethical values of nurses related to demographic characteristics of age, marital status, position. Therefore it is suggested that new strategies and continuing education programs be established to help clinical nurses formulate higher ethical values.
The purpose of this study was to identify the effects of a value clarification program on value clarification in juvenile delinquents. This study employed a two-group pre-post test study design. Data was collected from 16 subjects from Sept. 29 to Dec. 26, 2003 at N middle school in Seoul, Korea. 9 subjects constituted the control, while the experimental group was composed of 7 subjects.
The structured group therapy used in this study was developed on the basis of Raths et al. (1978) theory. The subjects participated in 10 sessions of therapy that lasted 60 minutes. The instruments used were value clarification Test (Lee, 1988), and SPSS Window.
The experimental group showed a significant increase in value clarification after their participation in the program.
Based upon the findings it was concluded that a value clarification program was effective in improving value clarification in juvenile delinquents in the study.
This research was an empirical study designed to identify precursors and interaction effects related to nurses' patient identification behavior. A multilevel analysis methodology was used.
A self-report survey was administered to registered nurses (RNs) of a university hospital in South Korea. Of the questionnaires, 1114 were analyzed.
The individual-level factors that had a significantly positive association with patient identification behavior were person-organization value congruence, organizational commitment, occupational commitment, tenure at the hospital, and tenure at the unit. Significantly negative group-level precursors of patient identification behavior were burnout climate and the number of RNs. Two interaction effects of the person-organization value congruence climate were identified. The first was a group-level moderating effect in which the negative relationship between the number of RNs and patient identification behavior was weaker when the nursing unit's value congruence climate was high. The second was a cross-level moderating effect in which the positive relationship between tenure at the unit and patient identification behavior was weaker when value congruence climate was high.
This study simultaneously tested both individual-level and group-level factors that potentially influence patient identification behavior and identified the moderating role of person-organization value congruence climate. Implications of these results are discussed.
This study was done to examine the effects of nurses' perception of servant leadership on leader effectiveness, satisfaction and promoting additional effort. The focus was the mediating effects of leader trust and value congruence.
Data were collected from 361 RN-BSN students and nurses participating in nationally attended in-service training programs. Data were analyzed using descriptive statistics and structural analysis with SPSS 17.0 windows program and Amos 7.0.
Direct effects of nurses' perception of servant leadership were negative, but mediating effects of trust and value congruency were positively correlated with leader effectiveness, satisfaction and additional effort, that is servant leadership should be effective through mediating factors.
The study results indicate that if the middle managers of nurses can build leader trust and value congruency between nurses through servant leadership, leader effectiveness, satisfaction and additional effort on the part of the nurses could result in a positive change in the long term.
The purpose of this study was to develop a resource-based relative value scale (RBRVS) and its conversion factor for advanced nursing practices carried out by critical care nurse practitioners (CCNP) in intensive care units.
The methodology was developed by calculating CCNP's RBRVS for 32 advanced nursing services based on CCNP's workload and time spent in the context of national health insurance. A cost analysis was performed to estimate the conversion factor of CCNP's RBRVS. The share of CCNP's contribution to fee-for-service in intensive care units was also analyzed.
Calculation of the RBRVS of 32 advanced nursing practices showed a range of points from 100.0 to 1,181.4 and an average of 296.1 points. The relevant conversion factor for advanced nursing practices in CCNP were estimated at 37.3-48.4 won. The contribution rate of CCNP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 0.1-31.3%.
Measuring the economic value of advanced nursing services will be a basis for esta-blishing a reimbursement system for CCNP's practices and thus encourage a social demand for advanced nurse practitioners.
The purpose of this study was to develop an instrument to measure nursing professional values.
Forty preliminary items were selected by classifying 223 basic items extracted via a literature study and in-depth interviews of subjects and testing the relevance of their contents. In order to verify the reliability and relevance of the preliminary instrument, data was collected from 504 nurses in 3 general hospitals.
As a result of the item analysis, 29 items were selected from a total of 40 items. Five factors were extracted by factor analysis, and the total variance was 51.5%. For the explanation of variances by factors, the 1st factor, ‘self-concept of the profession’ accounted for 14.8%, the 2nd factor, ‘social awareness’ 12.1%, the 3rd factor, ‘professionalism of nursing’ 9.8%, the 4th factor, ‘the roles of nursing service’ 9.1%, and the 5th factor, ‘originality of nursing’, 5.6%. Cronbach's Alpha of those 29 items was .9168, which was high.
This paper is meaningful in a way that it developed a tool capable of measuring nursing professional values, which reflects the characteristics of our country. In order to re-verify the relevance and stability of this tool, it is necessary that comparative studies should be conducted.