Search

At present, patient safety nursing by nurses is important and the risk of patient safety incidents is high. However, the comprehensive nursing service ward in Korea has no guardians. To prevent patient safety incidents and its recurrence, it is necessary to accurately report patient safety incidents. Patient safety incident reporting may be different depending on an individual's critical thinking disposition and patient safety culture (organization, department, individual). This study was a descriptive survey and aimed to suggest ways to improve the reporting of patient safety incidents in Korea. The study participants were 130 nurses working in the comprehensive nursing service ward of a Korean university hospital. From October 5–18, 2023, we conducted a survey of nurses' critical thinking dispositions, patient safety culture, and patient safety incident reporting. The mediating effect of patient safety culture on the relationship between critical thinking disposition and patient safety incident reporting was analyzed using PROCESS Macro Model 4. The results show that the patient safety incident report of nurses in the comprehensive nursing service ward was related to nurses' critical thinking disposition and the nursing department's patient safety culture. In particular, it was found that the department's patient safety culture had a mediating effect (β = 0.11, 95% CI = 0.01~0.22) on the relationship between critical thinking disposition and patient safety incident reports. To encourage patient safety incident reports in nurses in the comprehensive nursing service ward, it is necessary to improve the organizational culture of the department (presenting free opinions or problems) and to develop strategies to promote critical thinking among nurses. [ABSTRACT FROM AUTHOR]

Purpose : In this study, we aimed to assess the impacts of grit, patient safety competence, and patient safety culture on the patient safety nursing activities of nurses in comprehensive nursing service wards. Methods : Here, a self-reported survey of 179 nurses from three tertiary hospitals was performed. Data from 171 valid responses were analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Pearson's correlation, and stepwise multiple regression analyses. Results : The key sub-factors influencing the patient safety nursing activities were attitude (β=.30, p<.001) and skill (β=.26, p<.001) in the patient safety competence factor and safety environment (β=.26, p<.001) in the patient safety culture factor. The regression model explained 42.7% of the variance in patient safety nursing activities (F=43.29, p<.001). Conclusion : Overall, these findings highlight the importance of improving the nurse attitude and skills related to patient safety as well as the safety environment in hospitals to enhance the patient safety nursing activities in comprehensive nursing service wards. Targeted educational and training programs should be provided along with organizational support to establish a safe and supportive nursing environment in comprehensive nursing service wards. [ABSTRACT FROM AUTHOR]

Background and objectives: As is well known, cancer patients require extensive medical attention as they undergo surgery, chemotherapy, radiotherapy, and supportive care. The importance of high-quality cancer-directed nursing, combined with precision medicine, to maximize their survival outcomes and help them achieve a better quality of life cannot be overemphasized. In this context, we offered a new cancer-oriented comprehensive nursing system to our inpatients and reviewed its clinical outcomes in comparison with those from the preexisting general cancer ward. Materials and Methods: From March 2019 to February 2020, a total of 102 cancer patients and 42 nurses were enrolled in this pilot study. We aimed to analyze their performance in three main categories: structure, process, and patient/nurse outcomes. Results: First, structural (nurse staffing and environment) upgrades were installed in the cancer-oriented comprehensive nursing ward, including an improved nurse-patient ratio (1:8 in the comprehensive ward as compared with 1:14 in the general ward), wider space between beds (1.5 m versus 1.0 m), fully automatic beds with fall prevention sensors, etc. Second, the nursing process was improved (missed care 0.1 event/month vs. 1.3 event/month). Third, both patient and nurse outcomes showed preferable results in the comprehensive ward. The patient satisfaction level was higher in the comprehensive nursing ward than in the general ward (willing to revisit: 91.7% and 78.4%, respectively; willing to recommend to others: 95.0% and 76.8%, respectively). Pressure ulcers, as a patient safety indicator, were also decreased (0.3 events/month vs. 0.8 events/month). However, the fall incidence was similar in both groups (1.6 events/month vs. 1.5 events/month). In terms of nurse outcomes, turnover intention was stabilized and nurses’ job satisfaction in the comprehensive ward was superior to that of their counterparts. Conclusions: Our study was a pilot study to demonstrate that cancer patient-oriented comprehensive nursing services can be helpful in improving the quality of cancer treatment and nurses’ job satisfaction. Continued interest in and efforts to improve nursing care delivery are also crucial in achieving and maintaining the best possible cancer patient care.

The government of the Republic of Korea (hereafter, Korea) introduced the National Health Insurance Service (NHIS) system in 2008. Due to the rapidly increasing number of individuals aged 65 years and over, the system requires reform to ensure its financial sustainability and reduce the financial burden on individuals. Thus, this study conducted an in-depth investigation of the financial burden on older individuals in Korea under the current NHIS system. The aims of this study were to present an overview of long-term services and support in Korea and to report on the challenges for older Koreans in receiving informal care. Based on the results, four suggestions were proposed to provide affordable long-term services and support: establish an integrated care and medical needs assessment system, introduce a comprehensive nursing service system, expand home and community-based care services (HCBS), and implement national-level long-term care workforce development and management. [ABSTRACT FROM AUTHOR]

Purpose : This study aims to identify job stress, emotional intelligence, and exhaustion of the nurses in comprehensive nursing service units and then verify the moderating and mediating effects of emotional intelligence on the relationship between job stress and exhaustion. Methods : Participants are 118 nurses working in two general hospitals. The collected data are analyzed using the SPSS WIN 27.0 and AMOS 18.0 programs by assessing frequency and percentage, mean and standard deviation, independent t-test and one-way ANOVA, Scheffé test, Pearson correlation coefficient, and hierarchical multiple regression analysis and bootstrapping. Results : Exhaustion has a statistically significant positive correlation with job stress (r=.40, p<.001) and a statistically significant negative correlation with emotional intelligence (r=-.26, p=.004). A partial mediating effect of emotional intelligence is found between job stress and exhaustion, however, there is no moderating effect. Conclusion : It is expected that to reduce the exhaustion of nurses in comprehensive nursing service units, it is necessary to assess job stress and emotional intelligence, and strengthen emotional intelligence along with job stress intervention. [ABSTRACT FROM AUTHOR]

Background: Organizational well-being is a critical issue that should be addressed within nursing organizations as it boosts the morale and work motivation of its members by enhancing their satisfaction and happiness. Aim: This study aimed to evaluate the levels of positive psychological capital, shared leadership, and organizational well-being among nurses, and examine the impact of positive psychological capital and shared leadership on organizational well-being. Methods: A descriptive survey research design was used, involving 177 nurses with at least one year of work experience at highly specialized hospitals in Korea treating patients with severe conditions. Data were collected via an online survey from July 1 to August 31, 2023, using a questionnaire that included items on general characteristics, job-related characteristics, positive psychological capital, shared leadership, and organizational well-being. The collected data were analyzed using the SPSS 29.0 software, employing statistical measures such as frequency, percentage, mean, standard deviation, t-test, ANOVA, Pearson correlation coefficient, and hierarchical regression analysis. Results: The participants' scores were 3.32 ± 0.51 out of 5 for organizational well-being, 4.12 ± 0.58 out of 6 for positive psychological capital, and 3.64 ± 0.59 out of 5 for shared leadership. Factors identified that influenced organizational well-being included positive psychological capital (β = 0.462, p <.001) and shared leadership (β = 0.442, p <.001), which explained 58% of the total variance in the model (F = 48.74, p <.001). Conclusions: To improve the organizational well-being of nurses, it is essential to develop capacity-building and intervention programs that boost positive psychological capital and shared leadership. Achieving this goal necessitates not only the individual efforts of organizational members but also robust organizational support, engagement, and proactive management. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare and identify factors affecting delirium nursing stress among nurses in comprehensive nursing care service wards and general wards. Methods: Using structured questionnaires, data were collected from 230 nurses working in two tertiary university hospitals. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficient, and multiple regression analysis using SPSS/WIN 27.0. Results: The average delirium nursing stress score for nurses in comprehensive nursing care service wards was 2.98±0.30 out of 4 points, which was significantly higher than 2.89±0.29 points for nurses in general wards (t=2.17, p=.031). Factors influencing delirium nursing stress among comprehensive nursing care service ward nurses included nursing work environment (β=-.58, p<.001) and conflicts with medical staff and other departments related to delirium patients (β=.24, p=.006), explaining power of 44% (F=12.13, p<.001). For general ward nurses, the nursing work environment( β=-.39, p<.001) was the main influencing factor, explaining power of 17% (F=3.93, p<.001). Conclusion: Both types of nurses require improvements in their work environment. Strategies to reduce conflict between medical staff and other departments are essential in comprehensive nursing care service wards. [ABSTRACT FROM AUTHOR]

between resilience and clinical competence among new graduate nurses. Methods: A survey was conducted from March 14 to July 14, 2023, targeting 210 new nurses with 3 to 12 months of experience, working in three general hospitals in Seoul and Gyeonggi-do. Data from 193 respondents were analyzed using descriptive statistics, correlation, and hierarchical regression. Results: The resilience of new graduate nurses was moderate and their clinical competence was rated as good. They perceived a strong hierarchy-oriented culture, followed by a relationship-oriented culture, an innovation-oriented culture, and lastly, a task-oriented culture. Clinical competence was higher with greater resilience (β=.40, p<.001) and stronger perception of hierarchy-oriented culture (β=.16, p=.013). The interaction between resilience and innovation-oriented culture (β=.22, p=.012) was statistically significant, indicating that the effect of resilience on clinical competence was significantly higher when the innovation-oriented culture was strongly perceived. Conclusion: To improve the clinical competence of new graduate nurses, it is essential to enhance their personal resilience and, at an organizational level, to strengthen the positive aspects of hierarchy-oriented and innovation-oriented cultures. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore and assess the experiences of cancer patients and their caregivers who had been admitted to comprehensive nursing care service wards. Methods: Data were collected from 10 patients and 10 caregivers by in-depth interviews. The data were analyzed using content analysis of Downe-Wamboldt. Results: Three categories and seven subcategories were extracted. 1) Realizing institutional limitations of comprehensive nursing care service: 'Wishing for precise operating systems based on patient severity,' 'Anticipating active caregiver participation in treatment process,' 'Requiring a countermeasure for safety accidents,' 2) Professional nursing service which provides relief: 'Patient-centered professional nursing service,' 'Inpatient service that provides relief for patients and caregivers,' 3) Anticipating continuous use of the service: 'Inpatient service which users are willing to reuse,' 'Wishing for expansion and reinforcement of the service.' Conclusion: Cancer patients and their caregivers experienced institutional limitations while satisfied with professional nursing service and willing to reuse the service. To improve this situation, institutional support such as separate wards for severe patients, measures for active caregiver participation and prevention of safety accidents, and adequate staffing would be helpful for relatively severe level cancer patients and their caregivers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the experience of turnover to a long-term care hospital nurse. Methods: Data were collected using in-depth interviews and analyzed using a Giorgi’s phenomenological approach. The participants were ten nurses who worked on the wards of a longterm care hospital in Busan metropolitan. Results: The results were summarized into five themes and seventeen core meanings. The five themes were ‘A choice based on one’s convenience’, ‘Feeling overwhelmed by tasks beyond the scope of nursing duties’, ‘Thinking about turnover from time to time’, ‘An environment where personal growth as a nurse cannot be expected’ and ‘Becoming a nurse for long-term care’. Conclusion: To ensure patient safety and prevent nurse turnover in long-term care hospitals, it is necessary to improve the nursing environment, establish clear job manuals, and create a reasonable salary system. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the main keywords, network structures, and topical themes in patient safety incident reports using text network analysis. Methods: The study analyzed patient safety incident reports from a general hospital in Seoul, covering a total of 3,576 cases reported over five years, from 2019 to 2023. Unstructured data were extracted from the text of the incident reports, detailing how the patient safety incidents occurred and how they were managed according to the six-part principles. The analysis was conducted in four steps: 1) word extraction and refinement, 2) keyword extraction and word network generation, 3) network connectivity and centrality analysis, and 4) topic modeling analysis. The NetMiner program was used for data analysis. Results: The analysis of degree, betweenness, and closeness centrality revealed that the most common keywords among the top five were "confirmation," "medication," "inpatient room," "caregiver," and "condition." Topic modeling analysis identified three main topic groups: 1) incidents caused by a lack of awareness of fall risk, 2) incidents of non-compliance with basic medication principles, and 3) incidents due to inaccurate patient identification. Conclusion: To prevent patient safety incidents, it is necessary to promote a culture of safety in hospitals, standardize patient identification procedures, and provide basic training in medication safety and fall prevention to healthcare staff. Furthermore, empirical research on patient safety practices is necessary to encourage active participation in patient safety activities by patients and family caregivers. [ABSTRACT FROM AUTHOR]

Purpose : In this study, we aimed to identify factors influencing the inpatient satisfaction in integrated nursing care service wards. Methods : Using data from the 2020 and 2021 healthcare service experience surveys conducted by the Ministry of Health and Welfare, this study analyzed a weighted sample of 416,020 participants using descriptive statistics, pairedt-test, Pearson's correlation, and multiple linear regression analyses. Results : Inpatient satisfaction in integrated nursing care service wards was most significantly affected by the experiences with nursing services and perceived health status, followed by experiences with doctor services, length of hospitalization, age, experiences with medical institution services, education level, gender, presence of chronic diseases, type of hospital, and occupation. Most significant positive impacts were associated with experiences with nursing and doctor services, especially in general hospitals and high-level facilities, among males and elderly patients > 60 years old. In contrast, high education level, presence of chronic diseases, and unemployment were associated with low inpatient satisfaction. Conclusion : Effective programs and guidelines must be developed and implemented to expand and promote the integrated nursing care and medical services and overall utilization of healthcare institutions, with a special focus on person-centered care. [ABSTRACT FROM AUTHOR]

Nurses in South Korea experience high work intensity and poor working environments, which worsened during the COVID‐19 pandemic. This study aimed to evaluate the work changes and grievances of nurses who provided direct care for patients at tertiary hospitals during the pandemic. The nurses' perceptions of their organizational culture and its impact on nurses' health were also explored. A three‐round Delphi study was conducted with 36 expert group participants from six South Korean tertiary hospitals. Overall, 36, 35, and 33 participants responded in the first, second, and third rounds, respectively. Nursing work was divided into three categories: "work related to COVID‐19‐positive and close contacts," "work related to COVID‐19 negative patients," and "work related to common nursing tasks." Organizational culture had the highest average for "increased compliance," followed by "increased conflict," "decreased collegiality," and "growing sense of community." The identified health problems of nurses during the pandemic were the highest for physical health, followed by mental and social health. These results showed that the workload and work intensity of hospital nurses increased significantly, and their physical, mental, and social health deteriorated during the pandemic. To overcome the crisis, the nursing organizational culture had a strong inclination to comply with the COVID‐19‐related guidelines with an increased sense of community. As conflicts between employees and departments grew, these were able to be overcome through trust and communication between departments, in which the nursing leadership played an important role. To protect the health and lives of people, it is important to secure skilled nurses in preparation for future disasters. In addition, support is needed to protect the safety and health of nurses and to cultivate effective nursing leadership. [ABSTRACT FROM AUTHOR]

Background. In 2016, the South Korean Integrated Nursing‐Care Service, covered by national insurance, was initiated, with a particular focus on cancer‐oriented units. Integrated Nursing‐Care Service Wards denote facilities wherein nursing professionals deliver holistic care, in the absence of paid informal caregivers (hereafter will be called caregiver). Aim. This study, framed within Demerouti's Job Demands‐Job Resources Model, aimed to analyze variables influencing nurses' work engagement in Integrated Nursing‐Care Service wards. Methods. From April to June 2022, 375 participants working at three certified tertiary hospitals operating Integrated Nursing‐Care Service wards completed the survey. Of the 400 distributed questionnaires, 375 were used for analysis, resulting in a response rate of 93.75%. The remaining 25 questionnaires were excluded due to insufficient responses. Job demands, job resources, and personal resources were assigned as exogenous variables that predicted burnout and work engagement of nurses, while burnout and work engagement were assigned as endogenous variables. In this model, 32 hypotheses were established, and to verify the hypotheses, the direct effect of each exogenous variable on work engagement and the indirect effect through burnout as a medium were analyzed. Results. Burnout partially mediated the impact of exogenous variables on work engagement. The subfactors revealed partial mediation between emotional labor and work engagement, full mediation for satisfaction with the recognition from patients and caregivers, and partial mediation for resilience. Conclusion. Emotional labor had the highest impact on nurses' burnout in Integrated Nursing‐Care Service wards, followed by resilience and satisfaction with the recognition from patients and caregivers. Nurses' burnout, work environment, emotional labor, work overload, and resilience significantly influenced their work engagement. Implications for Nursing Management. The results of this study are useful as basic data for research on intervention programs that reduce burnout and increase nurses' work engagement in Integrated Nursing‐Care Service wards. [ABSTRACT FROM AUTHOR]

Background: Nurses' satisfaction has an impact on organizational and patient outcomes. Integrated care system in South Korea was established in 2015 to improve care quality and decrease caregiving burden. Since then, nurses' satisfaction has increased due to an increase in nursing staffing. However, besides nurse staffing, various work environments still affect nurse satisfaction. Methods: Individual online surveys were conducted with participants to determine their personal characteristics, work environments, and hospital characteristics. We used mixed-effects linear regression equation contained both fixed and random effects. Results: This study included 2,913 nurses from 119 hospitals. Their average job satisfaction was less than 6 points out of 10 points. Age, shift type, perceived workload, and delegation criteria were significant factors influencing nurses' satisfaction. There was no significant factor among hospital characteristics. The satisfaction level of nurses was high for no-night rotating shift, low perceived workload, and clear delegation criteria. Conclusions: Nurses' satisfaction is affected by several work environmental factors. Low nurse satisfaction has a substantial impact on both patients and nurses. Therefore, nurse managers and hospitals should determine factors influencing their satisfaction and develop strategies to improve their satisfaction. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the impact of work environment, missed nursing care, and non-nursing tasks on the job stress of hospital nurses. Methods: A descriptive, cross-sectional survey of 164 nurses working in three hospitals was conducted. Data were collected using structured questionnaires and analyzed using descriptive statistics, t-test, one-way analysis of variance, Pearson's correlation coefficient, and multiple regression analysis using SPSS/WIN 26.0. Results: Hospital Nurses' job stress was negatively correlated with the work environment (r=-.37, p<.001). Job stress had a statistically significant positive correlation with non-nursing tasks (r=.34, p<.001); however, it had no significant correlation with missed nursing care (r=.05, p=.552). Regression model analysis revealed that the variables associated with job stress were non-nursing tasks (β=.29, p<.001) and the foundation for quality nursing care (β=-.25, p=.034), which are subdomains of the work environment. In contrast, missed nursing care was not determined to be a significant factor. Conclusion: To effectively manage nurses' job stress, nurse managers should provide higher quality care by reducing the number of non-nursing tasks and creating a positive work environment, especially by providing adequate nursing workforce and material support. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the importance and performance of hospital nurses for patient experience evaluation items from the perspective of care providers and to identify the items that need improvement., Background: Patient experience includes customized treatment and services that focus on patient satisfaction and needs, with healthcare providers participating as partners., Methods: The study was conducted using a cross-sectional survey design, and data were collected on the importance and performance of 15 out of 24 patient experience evaluation items. The sample population consisted of 193 direct care nurses from two hospitals in South Korea., Results: The results showed the items with significant differences in importance and performance ('concentrate here' areas) such as 'description of a drug' (t = 2.26, p = .025), 'listening to patients' (t = 6.64, p < .001), 'description of adverse drug reactions' (t = 10.19, p < .001), 'clean hospital environment' (t = 2.95, p = .004) and 'easy notification of complaints' (t = 8.37, p < .001)., Conclusion: The findings highlight the importance of awareness and performance in patient experience evaluation items from the nurses' perspective. While some items were recognized as important but not performing well, others were identified as important and performing well., Implications for Nursing Management: As identified in this study, nursing managers should strive to develop nursing practice standards and educational programs for nurses to improve patient experiences. It is crucial that these changes are reflected in policies., (© 2022 John Wiley & Sons Ltd.)

Purpose: This study aimed to investigate the relationships among nursing skill mix, missed nursing care, and adverse events according to the nursing skill mix and the factors influencing. Methods: This study is a descriptive survey that used survey data were collected from 158 nurses working in comprehensive nursing care wards in small and medium-sized hospitals. The data were analyzed using the t-test, analysis of variance, and multiple regression analysis. Results: The average age of the study participants was 37.9 years, and they had over 10 years of experience. The average mean ratio of nursing skill mix 1 was 69.98. For nursing skill mix 2, the average mean ratio was 68.44%. The mean score for missed nursing care was 1.33, and the mean score for adverse events was 1.90 points. The factors affecting adverse events experience were missed nursing care, total work experience of >3 years, number of beds between ≥200 and <300. Conclusion: Our findings suggest that patient safety and management education should consider the nurses' age and total work experience. Furthermore, nursing workforce management, particularly focusing on nursing assistants in small- and medium-sized hospitals, is essential for fostering a safer healthcare environment. [ABSTRACT FROM AUTHOR]

Purpose: The aim was to develop guidelines for delegating nursing tasks among nurses in integrated nursing care wards. Methods: This was a methodological approach. Literature reviews were conducted on delegation policies and practices for nurses in Korea and other countries to explore the area of nursing delegation. Focus group interviews were performed with nurses to identify the strength and weakness of the delegation of nursing tasks in clinical practice, and qualitative content analysis was conducted based on the interview. Ten areas and 115 items were derived through these steps, and their validity was confirmed using the Delphi technique. Results: The delegation guidelines of nursing tasks consisted of nine domains, 21 sub-categories, and 101 items, including Nurses and nursing assistants' duties, the necessity of delegation, definition of terms, scope of delegation, considerations for delegation, procedure, characteristics, and principles of delegation, and educational content for delegation. Conclusion: These guidelines can help nurses to make decisions about delegating nursing tasks according to the delegation procedure. Education on the delegation of nursing tasks is necessary for both nurses and nursing assistants. The guidelines developed in this study can serve as a standard for delegating nursing tasks to ensure patient safety. [ABSTRACT FROM AUTHOR]

Background: This study aimed to understand the experiences of nurses working in the integrated nursing care service, a relatively recent addition to the Korean hospital infrastructure, to suggest ways in which to address their grievances and needs and improve their job satisfaction, thereby reducing turnover. Methods: This study adopted a qualitative approach to explore subjects' vivid experiences. Data were collected through in-depth interviews with 17 nurses with over one year of experience working in integrated nursing care wards. The main question asked was "Can you describe your experiences in the integrated nursing care ward?" All interviews were recorded, transcribed, and analyzed using Colaizzi's method for phenomenological research. Results: Six theme clusters were derived from the analysis: "distorted perceptions of the integrated nursing care ward," "challenges owing to distorted perceptions of the integrated nursing care ward," "loneliness and fighting alone," "being ridiculed," "practicing textbook holistic care," and "the satisfaction felt only in the integrated nursing care ward." For the overarching theme, we identified "Satisfaction in providing holistic care despite the challenges." Conclusions: While working in the integrated nursing care ward, nurses practiced holistic nursing care, which in turn built their self-esteem. However, they experienced greater levels of stress as a result of misinformation. Therefore, dissemination of accurate information is necessary to correct public misunderstandings of the integrated nursing care wards. Further, adequate compensation and support systems are needed to relieve the stress nurses felt because of such misunderstandings. Additionally, nurses should be motivated to continue to provide quality care for the patients and take pride in their work. Future research should explore the physical and mental concerns of nurses working in integrated care wards. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to propose revised inpatient nursing fee schedules that address three discrepancies between actual nurse staffing levels in general wards and the corresponding patient payment structures. Methods: A total of 45 tertiary hospitals, 329 general hospitals, and 1,379 hospitals from publicly released data for 2021-2022 were analyzed. This analysis focused on three primary discrepancies between (1) the staffing grades under which patients were hospitalized and the corresponding grades for which they were charged; (2) the staffing grades determined by bed-to-nurse and patient-to-nurse criteria; and (3) the current differentiation rates of nursing fees and the expected differentiation rates based on the number of nurses required for each grade. Results: The first discrepancy occurred in 8.9% of tertiary hospitals, 21.0% of general hospitals, and 26.0% of hospitals. The bed-to-nurse and patient-to-nurse grades differed by 2.23 and 2.29 grades on average in general hospitals and hospitals, respectively. The current differentiation rates were higher than the expected differentiation rates. New nursing fee schedules were suggested to resolve those discrepancies. Conclusion: Nursing fees should be charged to reflect the staffing levels under which patients were cared for and proportionate to the number of nurses required to provide the corresponding staffing levels. [ABSTRACT FROM AUTHOR]

Purpose: To examine the characteristics, core variables, and their correlations in articles published in the Journal of Korean Academy of Nursing Administration (JKANA) from 2012-2021 and suggest future directions for nursing management research. Methods: A total of 506 articles were analyzed according to study design, participants and setting, statistical methods, keywords, and core concepts and variables. Results: Quantitative research accounted for 73.5%, and most participants were staff nurses (66.8%) and nursing students (9.1%). Furthermore, 318 studies (62.8%) conducted surveys, and settings were mainly acute hospitals(81.5%) and nursing schools (9.7%). Statistical methods for data analysis included independent t-test (81.2%), one-way ANOVA (77.2%), Pearson correlation coefficients (77.2%), post-hoc testing (74.3%), and linear regression(65.9%). Among 2,058 keywords, the most frequent were "nurses" (49.2%), "job satisfaction" (10.7%), and "personnel turnover" (9.1%). The most frequently core concepts were job satisfaction (10.5%), turnover intention(9.5%), organizational commitment (8.5%), and job stress (7.5%). The most frequently variables with significant correlations were turnover intention, work environment, job satisfaction, job stress, burnout, and emotional labor. Conclusion: Most JKANA studies examined nursing-related outcomes and performance. Future research should examine the effects of nursing practice and policy on patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Emergencies are a form of health service in emergency or urgent situations that require immediate action from medical personnel working to overcome potential risks and dangers to life. Various forms of emergency services require nurses in hospitals to save time in the process of providing nursing care. One form of emergency service in hospitals is the Early Warning Score (EWS). The use of technology in developing the Early Warning Score such as application mobile can certainly help in improving the quality of emergency services in hospitals, so it can minimize the severity of patients' conditions in the emergency phase. Method: The method in this research is quantitative descriptive research, in this case, the Androidbased mobile Early Warning Score application. This research was conducted to measure the level of user satisfaction where there are 3 dimensions in measuring the level of satisfaction with application use: quality of application information, quality of application use, and impact of application use. Results: The results of the research show that the satisfaction level of the Early Warning Score mobile application at Pontianak Hospital obtained a total score of 419 or 50,60% satisfied, and very satisfied with a total score of 217 or 26.21%. Conclusion: The Early Warning Score mobile application is suitable for use by nursing staff as a medium for improving excellent nursing services. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the factors influencing job satisfaction among nurses working in integrated nursing care wards. Methods: The study participants were 196 nurses working in integrated nursing care wards at four general hospitals and one tertiary hospital. Data were collected using structured questionnaires from April 11 to 25, 2022, through an online survey. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation, and stepwise multiple regression with SPSS/WIN 26.0. Results: The factors influencing job satisfaction of participants were team structure (β=.32, p<.001), role conflict regarding nursing practice (β=-.24, p<.001), mutual support (β=.23, p<.001), master's degree or higher(β=.16, p=.004), and spousal presence (β=.15, p=.005). Conclusion: The findings of this study suggest that the tasks and roles of team members should be clarified, and a supportive team culture of mutual cooperation should be fostered to improve the job satisfaction of nurses working in the integrated nursing ward. In addition, it is necessary to reduce role conflict by providing support focused on allocating tasks that can strengthen the role of professional nurses. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the mediating effect of patient participation culture in the relationship between ethical leadership and performance in patient-engaged nursing services. Methods: This study employed a cross-sectional descriptive online survey design. The sample comprised 104 nurses from small- and middle-sized Korean hospitals. Data were collected between May 10 and September 10, 2019 using the Smart Patient Engagement Assessment Checklist, Korean versions of the Patient Participation Culture Tool for healthcare workers, the Ethical Leadership Scale, and a questionnaire about nurses' demographic and work characteristics. A mediation analysis was conducted using multiple regression and a simple model applying the PROCESS macro using SPSS/WINdows software version 26.0. Results: Ethical leadership directly affected (c'=0.28, p<.001) performance in patient-engaged nursing services. Patient participation culture partially mediated the relationship between ethical leadership and performance in patient-engaged nursing services (a x b=0.51x0.20=0.10, 95% Boot CI=0.18-0.20). Conclusion: Optimizing the patient participation culture and adherence to ethical leadership among hospital administrators and managers can improve nurses' performance in patient-engaged nursing services. Nurse managers' ethical leadership should be strengthened, and patient participation culture should be encouraged at policy levels through systematic nurse education on patient safety and engagement to enhance performance-engaged nursing services. [ABSTRACT FROM AUTHOR]

Background: Inpatients commonly experience problems with elimination due to incontinence, urinary retentions, and complications with indwelling catheters. Although elimination care (EC) is an important nursing area, few studies explore the burden of EC on nurses.Aim: To identify the burden on EC by analyzing nurses' opinions using sequential explanatory mixed method.Methods: This research was conducted using a sequential explanatory mixed-methods design. A total of 59 nurses at a tertiary hospital in South Korea participated in the study from January 1 to March 31, 2022. For quantitative analysis, information about number of delays of work due to EC, required time for serving bedpan or diaper changes, percentage of EC per shift, and percentage of patients who need EC was collected through a survey. For qualitative analysis, focus group interviews were conducted to identify factors that put a burden on EC. Important themes were derived by analyzing nurses' opinions on EC.Results: For nurses in intensive care units, general wards, and integrated nursing care wards, the number of work delays due to EC was 3.6 ± 1.5, 2.3 ± 1.2, and 4.8 ± 2.4 (p< 0.01), respectively. The mean percentage of EC work out of total nursing tasks per shift was 36.2 ± 19.0, 29.3 ± 14.4, and 43.8 ± 14.1 (p=0.02), respectively. The mean percentage of patients requiring EC out of patients a nurse cares was 85.4 ± 16.6, 41.3 ± 26.1, and 58.8 ± 21.9 (p< 0.01), respectively. Following qualitative analysis, four themes related to nurses' EC burden were derived: physical burden, frequent care needs, delay of other jobs due to EC, and complications. Among them, frequent care needs were found to be the primary factor requiring consideration to reduce nurses' burden.Conclusion: This research found that EC is one of the most burdensome tasks that nurses want to avoid. To alleviate their burden, effective EC protocol or smart medical devices assisting with EC should be developed. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the differences between patient and nurse perceptions of nursing needs and performance in integrated nursing care service wards within small to medium-sized hospitals. Methods: The participants of the study were 116 patients and 116 nurses in the integrated nursing care service wards of small and medium-sized hospitals in U and Y cities. Data collection was conducted between July 18 and August 12, 2022. The collected data were analyzed using descriptive statistics, the paired t-test, the independent t-test, and the importance-performance analysis. Results: Only the difference between nurse-perceived nursing needs and nursing performance (gap 2) was statistically significant (t=4.18, p<.001). Patients' physical needs were higher than what nurses perceived, and patients' financial were higher than nursing performance as perceived by both nurses and patients. In addition, nurses' performance was lower than the perceived nursing needs in all domains. According to the importance-performance analysis, the "concentrate here" areas included infection control, respect for patients' rights, and education of patients and families about diseases and treatment plans. Additionally, financial issues in nursing were identified as a "low priority" area requiring long-term intervention. Conclusion: It is crucial to prioritize nursing care that addresses patients' needs for infection control, respect for rights, and education. Nurses should also meet the physical and economic support needs of patients. Furthermore, it is recommended to adjust the nurse staffing ratio and foster systematic collaboration among hospitals, taking into account the circumstances of small to medium-sized hospitals. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to provide essential data for measures to enhance the professionalism of nursing experts and improve understanding of the explanationnurse's identity by examining their working experience in depth. Methods: Data were collected from August 12 through October 07, 2021. Participants were 13 explanation nurses with more than five years of nursing experience. Verbatim transcripts were analyzed using Colaizzi's phenomenological analysis. Results: Three theme clusters emerged from the data analysis: "Confusion from work that does not affect the identity of an explanation nurse", "Entirely fulfilling role as a nursing professional", and "Crave for the organization's support system for independent job performance". Conclusion: Earlier in the department change, nurses had difficulty establishing their identity regarding the explanation duties they must perform. Still, they wanted to continue their explanation work after struggling to pioneer and carry out their duties with expertise . Therefore, hospitals must support explanation nurses with a structural system as they begin their role to adapt to their work and strengthen their professionalism so that these nurses may provide a higher level of explanation nursing and patient-centered care. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To determine predictors of fall events in hospitalized patients with cancer, and identification of fall risk. Methods: An analysis of medical records was conducted together with a review of standardized fall reports of 565 patients admitted between January 1 and December 31, 2020. The collected data were analyzed with the chi-squared test, Fisher exact test, independent t-test, and logistic regression analysis using STATA 17 program. Results: There was a statistically significant increased fall risk; accompanied by a guardian (OR=10.30 CI=2.66~39.94), number of attachment devices (OR=1.30, CI=0.46~0.64), medication (OR=0.17, CI=0.04~0.84), pain (OR=4.73, CI=1.59~14.0), walking problem (OR=29.85, CI=9.31~95.74), chemotherapy (OR=5.20, CI=1.81~14.89), and fall risk score (OR=1.83, CI=1.50~2.24). Conclusion: These findings can serve as academic evidence to support the role of nurses in assessing the risk of fall events/accidents with regard to cancer patients and the development of individually adjusted fall assessment tools. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to confirms the relationship between nurses' professional autonomy, job satisfaction, perceived patient-safety culture, and patient-safety management activities; it also identifies factors that influence their patient-safety management activities. Methods: A cross-sectional study design was adopted. The participants were 164 nurses from at five hospitals in two G provinces, Korea, who participated in the study voluntarily. Data were collected between November and December 2022 via a 120-question structured questionnaire and analyzed using SPSS/WINdows software version 25.0. The data were measured by frequency, percentage, and mean and standard deviation, using an independent t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression analysis. Results: The average age of the participants was 35.54±8.42 years; 143 (87.2%) were women. The following factors influenced their patient-safety management activities: level of education (β=16, p=.018), experience of patient-safety education (β=.15, p=.014), and perceived patient-safety culture (β=.56, p<.001). The explanatory power of the nurses' patient-safety management activities was 44.0%. Conclusion: Hospital managers should enable nurses to carry out patient-safety procedures competently by providing continuous patient-safety education; they should also revise regulations and systems to promote good patient-safety management practices and create an environment that supports patient safety. In addition, a program should be designed and implemented to improve nurses' perceived patient-safety culture. [ABSTRACT FROM AUTHOR]

Aims: To examine the association of nursing hours given to patients with stroke with clinical characteristics to predict the nursing care needs. Design: Twenty‐four‐hour observational study Methods: Nursing hours per patient day (NHPPD) of 171 stroke patients were measured by 146 nursing personnel who worked on the day of the observation. Cognitive function, balance ability and dependency level were assessed using the Korean version of the Mini‐Mental State Examination (K‐MMSE), the Korean version of the Berg Balance Scale (K‐BBS) and the Korean version of the Modified Barthel Index (K‐MBI), respectively. Results: The NHPPD were moderately correlated with K‐MMSE (r = −.450), K‐BBS (r = −.529) and K‐MBI (r = −.549). The worse the cognitive function, balance ability and dependency level, the more were the nursing hours given to the patients. Therefore, these factors can be considered to be factors that predict nursing care needs for patients with stroke. [ABSTRACT FROM AUTHOR]

Background and objectives: As is well known, cancer patients require extensive medical attention as they undergo surgery, chemotherapy, radiotherapy, and supportive care. The importance of high-quality cancer-directed nursing, combined with precision medicine, to maximize their survival outcomes and help them achieve a better quality of life cannot be overemphasized. In this context, we offered a new cancer-oriented comprehensive nursing system to our inpatients and reviewed its clinical outcomes in comparison with those from the preexisting general cancer ward. Materials and Methods: From March 2019 to February 2020, a total of 102 cancer patients and 42 nurses were enrolled in this pilot study. We aimed to analyze their performance in three main categories: structure, process, and patient/nurse outcomes. Results: First, structural (nurse staffing and environment) upgrades were installed in the cancer-oriented comprehensive nursing ward, including an improved nurse-patient ratio (1:8 in the comprehensive ward as compared with 1:14 in the general ward), wider space between beds (1.5 m versus 1.0 m), fully automatic beds with fall prevention sensors, etc. Second, the nursing process was improved (missed care 0.1 event/month vs. 1.3 event/month). Third, both patient and nurse outcomes showed preferable results in the comprehensive ward. The patient satisfaction level was higher in the comprehensive nursing ward than in the general ward (willing to revisit: 91.7% and 78.4%, respectively; willing to recommend to others: 95.0% and 76.8%, respectively). Pressure ulcers, as a patient safety indicator, were also decreased (0.3 events/month vs. 0.8 events/month). However, the fall incidence was similar in both groups (1.6 events/month vs. 1.5 events/month). In terms of nurse outcomes, turnover intention was stabilized and nurses' job satisfaction in the comprehensive ward was superior to that of their counterparts. Conclusions: Our study was a pilot study to demonstrate that cancer patient-oriented comprehensive nursing services can be helpful in improving the quality of cancer treatment and nurses' job satisfaction. Continued interest in and efforts to improve nursing care delivery are also crucial in achieving and maintaining the best possible cancer patient care. [ABSTRACT FROM AUTHOR]

Background: Since the quality of work life of healthcare workers is affected by various factors, an improvement in their work environment can reduce the burden on them, increasing their performance. This study aimed to identify the current problems in working environments for registered nurses (RNs), nurse aides (NAs), and caregivers using the 5th Korean Working Conditions Survey (KWCS), presenting measures to improve working conditions by analyzing their predictors: 1) degree of exposure to work-related risk factors (musculoskeletal and mental), 2) working patterns, 3) work-family balance, 4) work situations, and 5) self-rated health. Methods: The sampling frame was a list of apartment and general survey zones, excluding islands, dormitories, special social facilities, tourist hotels, and foreigner zones, among the total survey zones of the 2010 Population and Housing Census. The KWCS was given to 50,205 participants of various occupations, and responses from 494 RNs, 201 NAs, and 505 caregivers were extracted to compare their 1) degree of exposure to work-related risk factors (musculoskeletal and mental), 2) working pattern, 3) work-family balance, 4) work situations, and 5) self-rated health. Results: The response rate was 0.449. There were significant differences in all the variables (exposure to musculoskeletal and mental work-related risk factors, working pattern, work-family balance, work situations, self-rated health, and satisfaction with working conditions) among RNs, NAs, and caregivers (p < 0.001). The degree of work-related musculoskeletal and mental risk exposure was higher among caregivers and RNs than among NAs; irregular working patterns, challenges with work-family balance, and work environment satisfaction were higher among caregivers than among NAs. In addition, work situations were poorer among caregivers and NAs than among RNs. Self-rated health was the highest among caregivers, followed by RNs and NAs. The most potent predictor of self-rated health was occupation, followed by work environment satisfaction and work-family balance; the most potent predictor of work environment satisfaction was self-rated health, followed by degree of exposure to work-related musculoskeletal and mental risk factors, occupation, work-family balance, work situation, and working patterns. Conclusion: This study confirmed that a variety of factors influence work environment satisfaction. Thus, practical and realistic measures to improve work environments tailored to each healthcare occupation should be developed at the national and community levels. Further qualitative studies are needed to analyze the work environments of nurses and other care workers in depth. [ABSTRACT FROM AUTHOR]

Aim: In‐hospital fall is one key safety issue in a healthcare setting. Although healthcare providers apply several strategies for preventing falls, falls still occur in hospitals. The aim of this study was to investigate patient‐level and organizational‐level factors influencing in‐hospital falls. Design: A multicentre retrospective observational study. Methods: This study used the national healthcare database and supplemented with organizational data obtained through a survey. Data extraction and survey were conducted between July and August 2020. A mixed‐effect logistic regression model was used to analyse factors influencing in in‐hospital falls. Results: A total of 43,286 patients admitted in 86 hospitals were included in this study. Fall rate was 0.85 per 1000 days. Length of stay was significantly longer for fall patients than for no‐fall patients. Patient‐level factors (including age, mobility impairment and surgery) and organizational‐level factors (including nurse staffing and proportion of new nurses) were significant factors influencing in‐hospital falls. Conclusion: Since in‐hospital falls increase economic burden to patients, we should consider various fall prevention strategies to reduce falls. For a strategy to be applied stably to patients, organizational factors must be supported. Impact Proactive fall management in acute settings is essential to ensure patient safety. Considering that the number of patients with fall risk is increasing due to ageing, organizational factors should be supported to provide quality nursing care for fall risk patients. Therefore, nurse leaders should primarily ensure an appropriate level of nurse staffing. They also need to make efforts to strengthen clinical competency of nurses. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the educational needs and analyze the priorities of infection control education content related to COVID-19 among nurses at a medium-sized hospital. Methods: In total, 110 nurses at a general hospital in G metropolitan city participated in the survey. Data were collected using structured questionnaires from February 14 to 21, 2022. The priorities of COVID-19 infection control education content were identified using a three-step analysis method, including the paired t-test, Borich priority formula, and the Locus for Focus model. Results: Seven content items with high educational needs were identified using the Locus for Focus model and the Borich priority formula. These included "use of personal protective equipment (PPE) when conducting a COVID-19 test", "criteria and methods for ventilation of the test space", "method of disinfecting the test space", "facility management", "isolated patient management", "how to transfer patients within medical institutions", and "how to transfer patients to other medical institutions". These content items, as educational needs, should be considered as priorities among the 31 content items of COVID-19 infection control education. Conclusion: The results are significant in that this study investigated the educational needs for responding to and preparing for COVID-19 in nurses, who are directly engaged in conducting COVID-19 infection control activities at a small and medium-sized hospital. Furthermore, a priority analysis of needs for COVID-19 infection control education content was performed to realistically reflect the educational needs. These findings can be used for the development of infection control education programs for nurses. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to analyse the policy formation process of South Korean Integrated Nursing Care Service System (INCSS). Background: Due to the shortage of chronic nursing staff in Korea, many nursing services have been overlooked, which has led to a customary caregiving culture that relied on inpatient families. To improve this, Korea legislated the INCSS in 2015. Methods: This study retrospectively analysed policy formation process of the INCSS using Kingdon's Multiple‐Streams Framework from on–offline materials generated between 1994 and 2015. Results: The caregiving culture, which was raised as one of the main causes of the Middle East Respiratory Syndrome coronavirus (MERS‐CoV) infection spread, has garnered intensive attention from media and politicians. The streams of problem, politics and policy that each flowed independently were coupled, the policy window finally opened leading to successful legislation. Conclusions: The leading political activities of the United Healthcare Civic‐Group, in which general nurses were the core, were effective in introducing the system. Implications for Nursing Management: This study's results could be used for promoting hospital‐based healthcare policy intervention by enhancing general nurses' political competence. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the new nursing policy's effect on improving overall nurse staffing levels in Korean acute care hospitals. Background: The Korean government introduced the Integrated Nursing and Care Service policy, which adopted advanced staffing standards. Under the new scheme, reimbursement of nursing fees was differentiated by the patient‐to‐nurse ratios, and financial incentives were provided to policy participating hospitals to promote additional employment in overall hospitals. Methods: We analysed 1362 acute care hospitals. The probability and degree of improving nurse staffing levels for each hospital were examined using a two‐part model. Whether policy participation had affected to improve nurse staffing levels was evaluated by the difference‐in‐difference approach. Results: Policy participating hospitals were 3.89 times more likely to enhance nurse staffing levels compared to non‐participating hospitals. The policy participation effect was found to improve average nurse staffing levels by 1.12 grades. Conclusion: Korean nurse staffing policy reform was successful to encourage hospitals to improve their overall nurse staffing levels. Implication for Nursing Management: Nursing leaders and policymakers should understand that providing incentives could affect hospitals' employment behaviour change under the market‐oriented healthcare system. For developing future nursing policies, these strategies should be considered appropriately. [ABSTRACT FROM AUTHOR]

This study investigates the mediating effect of communication competence in the relationship between compassion and patient-centered care (PCC) in clinical nurses. We used a descriptive research approach, and our sample comprised nurses (n = 204) with more than one year of experience in patient nursing in a general hospital in South Korea. The data were collected between December 2020 and June 2021 and analyzed using descriptive statistics, t-tests, one-way analysis of variance, Pearson's correlation coefficient analysis, and hierarchical multiple regression using SPSS 24.0. The Sobel test and PROCESS macro in SPSS were applied to verify the mediating effect. The mean scores for communication competence, compassion, and PCC were 3.67 ± 0.42, 64.04 ± 7.71, and 3.75 ± 0.46, respectively. Communication competence was found to partially mediate the relationship between compassion and PCC (z = 6.977, p < 0.001), and its explanatory power was 63.9%. To improve nurses' PCC, developing a step-by-step and differentiated PCC improvement program that includes communication competence and compassion is necessary. [ABSTRACT FROM AUTHOR]

Aim: To analyse patient factors and nurse staffing‐related issues involving hospital‐acquired pressure ulcers in patients at two types of hospital. Background: Hospital‐acquired pressure ulcers are important for the safety of hospitalized patients. Hospital‐acquired pressure ulcers not only cause health problems, but also pose an economic burden to patients. In addition to patient factors such as mobility and skin integrity, hospital factors such as nurse staffing can also affect the management of such patients. Methods: This study is a retrospective review of patient data and analysis of factors related to hospital‐acquired pressure ulcers using stratified Cox proportional hazards regression. Results: A total of 53,923 patients were included. The incidence of hospital‐acquired pressure ulcers was 0.98 per 1,000 days. Hospital‐acquired pressure ulcers were affected by gender, age, previous falls, low oxygen levels, positioning and toilet use. When the levels of nurse staffing were determined as one of the hospital factors, the daily hours of patient care was increased thereby contributing to the reduced incidents of hospital‐acquired pressure ulcers. Conclusion: Strategies for preventing hospital‐acquired pressure ulcers should be based on the analysis of risk factors. Implications for Nursing Management: Most individual risk factors for hospital‐acquired pressure ulcers identified cannot be modified easily in a short time. Nurse staffing should be set at adequate levels to prevent hospital‐acquired pressure ulcers. [ABSTRACT FROM AUTHOR]