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Research Papers
Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design
Kim, Hyun-Joo , Lee, Sun-Hee , Lee, Jai-Jung , Seong, Sun-Suk , Yang, Hee , Lee, Hyang-Yuol
J Korean Acad Nurs 2024;54(2):237-249.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.22142
AbstractAbstract PDF
Purpose
This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload.
Methods
The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively.
Results
The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload.
Conclusion
These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.
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Effects of Clinical Nurses’ Job Crafting on Organizational Effectiveness Based on Job DemandsResource Model
Lee, Eun Young , Kim, Eungyung
J Korean Acad Nurs 2023;53(1):129-143.   Published online February 28, 2023
DOI: https://doi.org/10.4040/jkan.22138
AbstractAbstract PDF
Purpose
This study aimed to examine the mediating effects of clinical nurses’ job crafting on organizational effectiveness based on the job demands-resources model proposed by Bakker and Demerouti (2017).
Methods
The participants consisted of 393 nurses working in nursing units of a tertiary general hospital located in Cheongju region. The data, collected using questionnaire from August 9 to August 20, 2021, were analyzed using SPSS 23.0 and AMOS 27.0.
Results
The goodness-of-fit (GoF) test results on the modified model (χ 2 = 2.7, GFI = .94, SRMR = .03, RMSEA = .06, NFI = .92, CFI = .94, TLI = .92, AGFI = .90), indicated that the GoF index satisfied the recommended level. Regarding the effects of each variable on organizational effectiveness, job crafting showed statistically significant direct (β = .48, p < .001), indirect (β = .23, p < .001), and total effects (β = .71, p < .001). Burnout showed statistically significant direct effect (β = - .17, p < .001). Work engagement showed statistically significant direct (β = .41, p < .001) and total effects (β = .41, p < .001). The factors explaining organizational effectiveness were job crafting, burnout, and work engagement, which had an explanatory power of 76.7%.
Conclusion
Nurses’ job crafting is an important mediating factor for enhancing the organizational effectiveness of nursing organizations. Hospitals should develop job-crafting success cases and related education and training programs as a strategy for enhancing the job crafting of nurses and, consequently organizational effectiveness.
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Original Articles
Workload Measurement of Home Health Care Nurses' Services using Relative Value Units
Tae Wha Lee, Jung Sook Park, In Sook Kim
Journal of Korean Academy of Nursing 2000;30(6):1543-1555.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.6.1543
AbstractAbstract PDF

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.

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Estimating the Cost of Visiting Nursing Service by Visiting Nursing Model for Urban Public Health Center in Korea
Ho Sihn Ryu
Journal of Korean Academy of Nursing 2004;34(6):983-993.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.6.983
AbstractAbstract PDF
Purpose

This study focused on analysing costs per visiting nursing care based on nursing activities in a public health center.

Method

The Easley-Storfjell Instrument(1997) was used for a prospective descriptive analysis of self-records for workload data from 10 visiting nurses during 4 weeks on all nursing activities. In addition, analysis of the 478 visiting nursing records and cost data from 5 home visiting departments in public health centers during one year of 2003 was done.

Result

The workload of visiting nurses by the type of model was identified as follows: Type I showed that caseloads made up 32.9 % of all nurse activities, and type II showed that the caseloads made up 45.8 %. Second, The cost per visit in type I was 33,088 won and 31,323 won in type II. Third, the estimated budgets were 1,902,436 won to 12,057,696 won for the type I model. and 4,151,316 won to 17,432,712 won for the type II model for one year.

Conclusion

This study's results will contribute to baseline data used to establish on infrastructure for visiting nursing program and visiting nursing agencies based on the budget of visiting nursing services.

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A Workload Analysis of a Visiting Nursing Service based on a Health Center in Seoul
Ho Sihn Ryu, Eun Sook Park, Young Joo Park, Kuem Sun Han, Ji Young Lim
Journal of Korean Academy of Nursing 2003;33(7):1018-1027.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.7.1018
AbstractAbstract PDF
Purpose

This study focused on analysing the workload of visiting nurses based on a health center.

Method

A Prospective descriptive analysis of self-records for workload data from 115 visiting nurses during 4 weeks was done. In addition, a cross-sectional analysis of linked data to grasp the priority of visiting nursing services from 155 visiting nurses at the 25 health centers in Seoul.

Result

Time allocation that was performed on all nursing workload of visiting nurses was identified as follows: First, the inside workload of the health center took up 60% of all visiting nurse activities. Second, providing direct nursing care(caseload) took up 25%. Third, outside nursing activities excluding the caseload provided in the health center took up 15% of all working time. Fourth, the core works to have a high priority among visiting nursing activities were family health assessment, planning and evaluation of a visiting nursing program, personal health assessment, and so forth.

Conclusion

The workload of a visiting nurse suggests that the caseload of visiting nurses in a health center needs to be increased. Also, our results will contribute to baseline data used to establish a proper visiting nurses infrastructure based on the demand of visiting nursing services.

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