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시스템 다이내믹스를 이용한 간호단위별 간호인력 산정에 관한 연구
김문실,성영희,권경자,김도형,김정아,신덕신,유인자,유재국,이현숙 병원간호사회 2006 임상간호연구 Vol.11 No.2
Purpose: The purpose of the study was to forecast manpower by building the nursing manpower-staffing model(surgical-medical nursing unite). Method: The system dynamics approach was adapted to build a simulation model for calculating medical-surgical nursing manpower-staffing. The model was built up on Venism 5.0b DSS. Result: The results in the basic circumstance are in following. The level of nursing service quality, patientsatisfaction, and nurse job satisfaction maintains higher at medical-surgical nursing unit of the tertiary hospitals with the ratio of bed to nurse 2.5:1-3.0:1 than at any other situations. The level of nursing service quality, patient satisfaction, and nurse job satisfaction maintains higher at madical nursing unit of the secontary hospotals with the ratio of bed to nurse 3.0:1 and at surgical nursing unit of the secondary hospitals with the ratio of bed to nurse 3.0:1-3.5:1 than at any other situations in the fundamental from. The results in the simulation circumstance are in following, As author raises the operating rate of bed into 95-100%, and cut skilled nursing staff down, the level of nursing-service quality, patient satisfaction, and nurse job satisfaction drops slightly. Conclusion: In terms of economic efficiency on tertiary hospotals, the ratio of bed to nurse for the best reasonable medical-surgical nursing manpower-staffing is 3.0:1. In terms of economic efficiency on secondary hospitals, the ratio of bed to nurse for the best reasonable medical nursing manpower-staffing is 3.0:1 and surgical nursing manpower-staffing is 3.5:1
자원기준 상대가치를 이용한 혈액투석실 간호원가 산정 : 중증 대상자를 중심으로
김문실,김지현,한수정,김정아 대한간호행정학회 2005 간호행정학회지 Vol.11 No.1
Purpose: This study was aimed to estimate nursing cost for hemodialysis of tertiary hospitals using Resource Based Relative Value Scale(RVRBS). Method: First, we calculated nursing workload of the each hemodialysis-nursing behaviors compared with basic nursing behavior(check vital sign) for the most severe hemodialysis patients in general hospitals. Second, we measured each spent time according to each nursing behaviors. Third, we computed Resource Based Relative Value(RBRV) scores and nursing expenses of each 14 nursing behavior for hemodialysis. Finally, we estimated nursing cost of each hemodialysis-behavior for the most severe hemodialysis-patients in general hospitals. Result: The mean RBRV scores for each nursing behaviors were from 218.9 to 383.9 points. The highest RBRV socres were 383.9(Complication during hemodialysis). The Nursing behavior that spent the most time was "access the vascular(31.7 minutes)". Nursing cost per hemodialysis for the patient with severe condition was estimated 63,455(won). Conclusion: Total average workload was 347.6 points and total spent time was 306.5 minutes for 14 hemodialysis nursing behaviors provided to severe patients. There were clear differences in nursing workload and cost according to patient's severity-mild, moderate and severe class.
노인요양시설의 서비스 질 평가 지표 개발 및 적용: 구조-과정 측면의 질 평가
김문실,이승희 대한간호행정학회 2008 간호행정학회지 Vol.14 No.2
Purpose: The aim of this study was to develop service quality indicators to evaluate structure and process of the nursing home service. Method: On the basis of literature review and analysis of existing quality indicators, the researcher made a preliminary service quality indicators and verified content validity twice. The final service quality indicators were applied in 30 nursing homes. Results: Preliminarily, 3 domains, 24 sub-domains, and 156 indicators were generated. Through two content validity testings, the indicators scoring over .80 CVI for each testing were adopted and modified by discussion with a panel of experts. The final indicators consisted of 3 domains, 15 sub-domains, and 128 indicators. These indicators were applied in 30 nursing homes. The result showed that they were easily applicable and suitable for a evaluation of service quality in nursing home. Conclusion: This 'service quality indicators in nursing home' was verified by the content validity. This tool will be able to be used for evaluation and improvement of nursing home service quality. However, repeated researches are needed for further validity and reliability.