Work competence of nurse aides" in a skill-mixed model hospital: the perspectives from both nurse aides and nurses

Hsiang-Wen Kung,Hui-Chen Hsu,Bih-O Lee 한국간호과학회 2021 한국간호과학회 학술대회 Vol.2021 No.10

Aim(s): Nurse aides provide a major support for long-term care services. However, research findings regarding the various aspects of nurse aides’ work competence that may facilitate or impede their work performance remain inconsistent. To compare th-e differences between the nurse aides’ and registered nurses’ perceptions of the nurse aides’ work competence. Method(s): This study was designed as a cross-sectional study, and convenience sampling w-as employed to recruit a sample that comprised 220 nurse aides and registered nurs-es who had served for more than three months at a regional teaching hospitalin southern Taiwan. The instruments consisted of the demographic data and the 36-it-em Nurse Aides’ Work Competence Scale. Result(s): There are no significant differences between the self-perceived and the nurse-s’ reported overall work competence of nurse aides. The results showed that th-e nurse aides had room for improving their work competence in terms of “pro-blem solving” and “activity design”. The nurse aides and resisted nurses differe-d significantly in terms of “activity design” because the nurse aides’ perception of their work competence in “activity design” was more positive than that repo-rted by the registered nurses. Conclusion(s): Nurse aides should be incorporated into cross-disciplinary teams. Activity design could be handled by other healthcare providers such as physical therapists or senior social workers.

Examining the Predictors of Turnover Behavior in Newly Employed Certified Nurse Aides: A Prospective Cohort Study

Chen Hsiao-Ching,Wang Jiun-Yi,Lee Ya-Chen,Yang Shang-Yu 한국산업안전보건공단 산업안전보건연구원 2023 Safety and health at work Vol.14 No.2

Background: The turnover rate of nurse aides in Taiwan is high. However, the predictors of turnover behavior in the newly employed are still unclear. Objective: To examine the predictors of turnover behavior in newly employed licensed nurse aides. Methods: A longitudinal study design was used and subjects were newly employed certified nurse aides from a nurse aid training association in Taiwan. A total of five questionnaire surveys were conducted. The questionnaire was mainly used to collect information on turnover behavior, personal socioeconomic background, workplace psychosocial hazards, worker health hazards, and musculoskeletal disorders. Results: A total of 300 participants were recruited in the study. Cox regression analysis results showed that short working experience (hazard ratio [HR] = 0.21, p < 0.01), work as non-home nurse aides (HR = 0.58, p = 0.01), low monthly salary (HR = 0.68, p < 0.01), high work mental load (HR = 1.01, p = 0.01), low workplace justice (HR = 0.97, p < 0.01), high workplace violence (HR = 1.60, p < 0.01), high burnout (HR = 1.01, p = 0.04), poor mental health (HR = 1.06, p = 0.04), and high total number of musculoskeletal disorder sites (HR = 1.08, p = 0.01) contribute to a higher risk of turnover. Conclusion: The results indicated that employment period, work as a home nurse aide, monthly salary, work mental load, workplace justice, workplace violence, work-related burnout, mental health, and total number of musculoskeletal disorder sites are predictors of turnover behavior in newly employed certified nurse aides.

간호법 단독입법을 통한간호인력의 합리적 재편 방안

김종호 ( Jongho Kim ) 건국대학교 법학연구소 2015 一鑑法學 Vol.0 No.32

평균수명의 연장으로 인한 건강보험 진료비 증가, 의료기관 증가, 의료기관의 적정한 간호 인력확보의 필요성 증가와 같은 급격한 보건의료환경의 변화로 간호인력 수요가 증가하고 있다. 인구의 고령화로 인한 노인의료비 증가, 만성질환자 관리의 필요성 증가에 비용효과적인 대응을 위한 간호인력 수요도 커지고 있다. 또한 노인장기요양보험제도의 도입· 확대 등으로 간호서비스 제공영역이 의료기관에서 지역사회로 변화하면서 간호의 역할범위도 보다 확장되고 있다. 중동호흡기증후군(MERS) 사태에서 보는 바와 같이 포괄간호서비스 수요도 반드시 충족되어야 할 상황이다. 그러나 현재 우리나라 간호사는 다른 의료인력과 함께 의료법에 포괄적으로 규정되어 있어 명확한 법적 지위와 규제 내용이 부재하며 간호인력 간 업무와 책임한계가 불명확한 상황이다. 이는 급변하는 간호 관련 보건의료 환경변화에 간호서비스가 적절히 대응하지 못하게 할 뿐만 아니라 간호서비스의 질 저하를 초래할 우려가 있다. 특히, 진료보조업무에 있어서 간호사와 간호조무사간의 업무중복과역할혼란의 문제가 발생하고 있어 명확한 업무규정이 요구된다. 대부분의 국가들이 간호관련 단독법에 기반하여 간호인력 양성을 위한 교육과정과 업무를 명확히 규정함으로써 간호서비스의 책임성을 담보하고 있으며, 간호사가 간호보조인력에 대한 지도·감독의 권한을 부여함으로써 간호인력 간 업무중복의 문제를 피하고있다. 우리나라도 간호행위 관련 서비스의 책임강화와 간호인력 관련 문제발생 가능성을 최소화하고 간호인력 양성을 활성화함과 동시에 보건의료 환경변화에 적절히 대응할 수있는 인력수급 시스템을 구축할 수 있는 간호사 관련 단독입법이 필요하다. 이를 위하여 간호업무의 개념정의와 구체적인 행위구분, 면허·자격 응시기준, 교육기관 및 교육기간, 간호사중앙회, 보수교육 및 면허·자격신고제, 간호정책의 심의·의결을 위한 간호정책심 의위원회, 인력처우개선 및 복지증진, 인력확보와 취업촉진을 위한 간호인력개발센터 설치 등을 주요내용으로 하는 간호법 제정이 필요하다. More than 65 years ago, governments enacted laws which protect the public’s health and doctors assistant by overseeing and ensuring the safe practice of nursing. It is not uncommon to find various complementary therapies available at hospitals, either as part of nursing care, or as an extended health care service. Currently many hospitals and other healthcare facilities, such as long-term care facilities are being constructed to replace those at the end of their life and to meet the demand as the baby boomer population grows older in Korea. Many of these are designed according to a new understanding of the healing environment and the research behind evidence-based design. Small sized clinics are also beginning to change, not least because the Korean healthcare system can no longer afford a system that focuses on disease-based care. Healthcare is beginning to recognize the central place that wellbeing of mind, body, and spirit plays in health. In this rapidly changed medical environment, the nursing resources are most crucial factor to meet the broadly varied conditions. The nurse workforce generally consists of licensed nurses and nurses-aides. The physical setting is the patient’s first impression of a healthcare facility and one of the most important factors in the patient’s perceptions of the quality of care and their overall satisfaction. One of the key factors driving changes in healthcare is the concept of patient-centered care. Each of the items are necessary to satisfy patients by appropriate nursing care service. Nursing-sensitive outcomes are one indicator of quality of care and may be defined as variable patient or family caregiver state, condition, or perception responsive to nursing intervention. However, Korea has no Nurse Act separated from the Medical Service Act since 1951. This study discussed the necessity of single Nurse Act enactment independent from the Medical Act by arguing and comparing foreign jurisprudence and legislative connection between lower levels of nurse staffing and higher rates of adverse events. Complementing this study is a providing number of other research agendas addressing the growing nurse workload and rising rates of burnout and job dissatisfaction. Many stakeholders within the health care system, especially governments, hospitals and hospital organizations, doctor and nurse associations, nurse-aides foundations, and accreditation organizations, are aware of the lack of qualified nursing staff and related problems and are actively seeking solutions. High level general hospitals may cut spending for other personnel, such as unlicensed caregivers, housekeepers, and other support staff to enhancing their medical reputations. On the other hand, local clinic and small sized medical firms are insist that revise or enactment of new law may increasing cost of health care and they against preparing new bill. If no renovation is made in the medical law, the amount of nursing work performed by non-licensed nurse-aides in inpatient units could increase, and investments in medical technology and facilities to improve the quality of care could be deferred. Accordingly, researching a reasonable nursing resources reorganization plan through enactment of Nurse Act is summons in our time.

간호사 이미지와 이미지 결정요인 -간호조무사와 조무사교육생 비교

하주영,유미화 사단법인 인문사회과학기술융합학회 2017 예술인문사회융합멀티미디어논문지 Vol.7 No.2

This study was to examine nurse image and image determinants perceived by nurse aids and student of nurse aid training course. The data were collected from 700 subject of heath nursing in Specialized high school students, institute students and nurse aids. The nurses' image and image determinants were measured by the instrument developed by Yang(1998). The collected data were analyzed with descriptive statistics and t-test. There was no statistically significant difference between the two groups in nurse image. The area of positive image were in the order of professional image, traditional image, media image and social image and the item with the most positive statistically significant difference item was ‘Nurse is clean and tidy’. There was no statistically significant difference between the two groups in image determinants. In the order of subjective factors, Institutional factors and media factors influenced image determinants and the item with the most influential statistically significant difference item was ‘Immediacy of nurse’. The higher score were nurse aids than nurse aid students that nurse image and image determinants, but this study result showed lower score than the other groups of precedence studies. Nurse aids and nurse aid students are required curriculum development and intervention to improve the nurse image and image determinants. 본 연구는 간호조무사와 조무사 교육생이 지각하는 간호사 이미지와 이미지 결정요인에 대한 연구이다. 자료 수집은 특성화 고등학교 보건간호과 학생과 간호조무사 학원생 및 간호조무사 700명을 대상으로 실시하였다. 간호사의 이미지와 이미지 결정요인은 Yang(1998)에 개발된 도구로 측정되었고, 수집된 자료는 기술통계와 t-test로 분석하였다. 간호사 이미지는 두 군간 통계적으로 유의한 차이가 없었다. 긍정적 이미지가 높은 영역은 전문적 이미지, 전통적 이미지, 매체적 이미지, 사회적 이미지 순이었으며, 통계적으로 유의한 항목 중 가장 긍정적인 항목은 ‘간호사는 깨끗하고 단정하다’로 나타났다. 이미지 결정요인에서 두 군간 통계적으로 유의한 차이는 없었다. 주관적 요인, 제도적 요인, 매체적 요인 순으로 간호사 이미지 결정에 영향을 미치는 것으로 나타났으며, 통계적으로 유의한 항목 중 ‘간호사의 신속성’이 영향을 많이 미치는 것으로 나타났다. 간호사 이미지와 이미지 결정요인에서 간호조무사가 조무사 교육생 보다 높은 점수를 보이고 있으나, 선행 연구의 다른 집단보다 낮은 점수를 보이고 있다. 간호사 이미지와 이미지 결정요인을 향상시키기 위해 간호조무사와 조무사 교육생을 위한 교육과정과 중재방안의 개발이 필요하다.

간호조무사의 직장행복감에 영향을 미치는 요인

김미진 ( Kim Mi Jin ),황주희 ( Hwang Ju Hee ) 경희대학교 경영연구원 2022 의료경영학연구 Vol.16 No.4

The purpose of this study is to understand the effects of mental health, emotional intelligence, and occupational stress on work happiness of nurse’s aides. In October 2019, a survey was conducted targeting total 227 nurse’s aides working for long-term care hospitals and clinics. Using the IBM SPSS 25 Statistical Program, the collected data was analyzed through the t-test, ANOVA, Pearson’s correlation coefficient, and multiple linear regression analysis. The results of this study are as follows. The factors affecting the work happiness of nurse’s aides were occupational stress, mental health, and emotional intelligence, and the explanatory power was 64.5%. When the occupational stress was higher, and when the mental health was lower, the work happiness was not good. Thus, for the work happiness of nurse’s aides, there should be some intervention programs that could reduce their occupational stress and also improve their mental health. Also, when selecting the subjects of programs, it would be necessary to consider the degree of emotional intelligence and resilience of nurse’s aides.

외국의 에이즈 전문간호사제도 비교 연구 : 미국, 영국, 일본을 중심으로

전경자,권영미,주혜주,김성재,조경미,박은희 대한간호행정학회 2007 간호행정학회지 Vol.13 No.4

Purpose: The purpose of this study was to compare the role and the certification system for nurses working in HIV/AIDS care among the U.S., the UK, and Japan. Method: The searching for the internet website and literature was used and visiting the institutes and interviewing the key informants were done from August, 2006 to February, 2007. Results: In the U.S., there are two types of nurse specialist in HIV/AIDS care. One is the HIV/AIDS Certified Registered Nurse which is without any academic degree requirement, and the other is the Advanced HIV/AIDS Certified Registered Nurse which requires master level degree and 5 years career. There are three level of nurses' role in HIV/AIDS care in the UK. Also, the National HIV Nurses Association of the UK developed generic competencies and specialist competencies according to this three level of nurse's role. In the case of Japan, the certification system is not formalized yet, but the AIDS coordinator nurses are working as a specialist in the Japan International Medical Center. Conclusion: Based on this result, it is suggested that the comprehensive role of nurses in HIV/AIDS should be developed under the governmental support.

사회극이 간호학생의 AIDS 관련 태도 및 AIDS 환자 간호의도에 미치는 효과

강명옥 ( Myung Ock Kang ) 한국사이코드라마.소시오드라마학회 2010 한국사이코드라마학회지 Vol.13 No.2

본 연구는 AIDS 교육 프로그램이 간호학생들의 AIDS 관련 지식, 태도 및 간호의도에 미치는 효과를 알아보기 위한 목적으로 시행하였다. 연구대상은 56명(사회극군 27명, 강의군 29명)이었고 프로그램은 5일에 걸쳐 총 10시간동안 진행되었다. 본 연구에서 사용한 측정도구는 AIDS관련 지식측정도구와 태도평가 질문지이다. 교육 2주 전과 교육 후 사전?사후검사를 실시하였다. 자료분석은 SPSS WIN 17.0을 사용하여 χ2-test, t-test , paired t-test, ANCOVA로 검증하였다. 이러한 절차를 통하여 얻은 결론은 다음과 같다. 사회극군과 강의군 모두 AIDS환자에 대한 편견을 제외한 지식, 간호에 대한 태도 및 간호의도에서 유의하게 호전되었다. 또한 사회극군은 강의군보다 지식, AIDS환자에 대한 편견, 간호의도에서 유의하게 더 큰 변화를 보였다. 따라서 사회극은 AIDS에 대한 지식, 태도 및 간호의도를 증진시키는 유용한 방법으로 생각된다. Background: The negative attitude and poor nursing intention to AIDS in health care personnel are the major barriers to provide adequate care. The increase in AIDS-related knowledge by the traditional AIDS education methods has not always been accompanied by a positive attitude or improvement of nursing intention. Purpose: To investigate the effects of sociodrama on AIDS-related knowledge, attitudes to AIDS and nursing intention among nursing students. Method: Fifty-six nursing students (sociodrama: 27 case, lecture: 29 case) were recruited from Chodang University, Korea. A session of AIDS lecture using slides was given to both groups. After then, the sociodrama group had 4 sociodrama sessions additionally. Data was collected before and after the experiment by using self-rating questionnaire consisted of 89 items. Results: The AIDS-related knowledge (p=.001), attitude to AIDS care (p=.001), discrimination (p=.000) and intention of AIDS care (p=.000), but not prejudice to AIDS client (p=.097), were significantly increased after the sociodrama. Similar results occurred after the lecture only. However, the sociodrama group showed significantly higher knowledge (F=2.581, p=.010), lower prejudice to AIDS client (F=2.202, p=.022), less discrimination (F=2.452, p=.018) and intention of AIDS care (F=2.202, p=.022), but not attitude to AIDS care (F=1.541, p=.134), than the lecture group did. Conclusion: AIDS education through sociodrama is very useful to improve AIDS-related knowledge, attitude to AIDS clients, discrimination, and intention of AIDS care in nursing students.

의사와의 관계에서 간호사와 간호조무사의 갈등수준 비교

이문재(Lee, Mun-Jae),최만규(Choi, Man-Kyu) 한국산학기술학회 2011 한국산학기술학회논문지 Vol.12 No.11

본 연구는 간호사와 간호조무사의 동기를 제고하고 효과적인 간호서비스 제공을 촉진하기 위해 의사와의 관계에서 간호사와 간호조무사가 느끼는 직무 및 대인관계의 갈등 정도와 원인을 파악하고자 수행하였다. 이를 위해 중소규모 병원에 근무하고 있는 간호사와 간호조무사 271명을 대상으로 직무 및 인간관계 갈등 정도, 원활한 의사소 통 여부, 갈등 원인과 해결방법 등에 대해 설문조사를 실시하고 분석하였다. 분석 결과 의사와의 관계에서 간호사와 간호조무사가 느끼는 갈등의 내용과 정도는 대체로 비슷하였으나 의사와 간호직의 역할이 중복되거나 모호한 부분이 있다고 느낀다는 점에서는 간호사가 간호조무사 보다 더 많은 스트레스를 받고 있었다. 의사와 갈등이 발생했을 때 해결하는 방법으로는 간호사와 간호조무사 모두 적당히 피한다는 의견이 가장 많았다. 그 다음의 갈등해결 방법은 간호사와 간호조무사 간에 차이가 있었는데 간호사는 상대방에게 나의 의견을 따르도록 함, 노조를 통해 해결 등의 순이었고, 간호조무사는 상사에게 해결하도록 함, 서로 조금씩 양보해서 타협함 등의 순이었다. This study seeks to measure the level and root causes of occupational and interpersonal conflicts between nurses and nurse aids against hospital doctors, in order to help increase motivation of both groups in their workplace and enable more effective nursing care to patients. 271 nurses and nurse-aids working in smalland medium-sized hospitals were therefore given a series of surveys on topics such as conflicts with doctors, communications, cause of conflicts and solutions. Analysis of the survey result shows that both nurses and nurse-aids share relatively similar level and causes of conflicts in their place of work; however, nurse-aids felt more stress when their responsibilities seem to be duplicated or blurred from those of doctors and nurses. When conflicts actually occur with doctors, both groups would first try to avoid it one way or another. Then, nurses would make others cave in or file complaints through union, while nurse aides would seek help from supervisors or try to meet them half way.

간호사의 강박신념, 경험회피, 에이즈에 대한 지식 및 태도와 에이즈 공포 간의 관계

서경현,양승애 한국건강심리학회 2012 한국심리학회지 건강 Vol.17 No.3

This study examined how obsessive beliefs, such as threat overestimation and intolerance of uncertainty, experiential avoidance, and AIDS-related knowledge/attitude are related to AIDS phobia among nurses. Participants were 326 nurses at general hospitals, whose ages ranged from 21 to 54. The psychological tests used in this research included the following: Multicomponent AIDS Phobia Scale, Obsessive Beliefs Questionnaire-87, Acceptance and Action Questionnaires-16, and Questionnaire for AIDS-related knowledge and attitude. The results indicated that attitude toward AIDS was closely correlated to the nurses’ AIDS phobia, whereas knowledge of AIDS was not significantly correlated. Both threat overestimation and intolerance of uncertainty among obsessive beliefs were positively correlated to the nurses’ AIDS phobia. Emotional avoidance and emotion-focused inaction factors of experiential avoidance were positively correlated to the nurses’ AIDS phobia; yet, those variables were not significantly correlated to the fear of AIDS infection among those with AIDS phobia. A stepwise regression analysis revealed that attitude toward AIDS was a determinant variable of the nurses’ AIDS phobia, and accounted for around 20% of the variance. Additionally, threat overestimation accounted for more than 5% of the variance in the nurses’ AIDS phobia. Moreover, intolerance of uncertainty and emotional avoidance had partial covariance with the nurses’ AIDS phobia independently. Moreover, attitude toward AIDS partly mediated the relation of the threat overestimation as well as emotional avoidance and the nurses’ AIDS phobia. These results was discussed with previous studies as well as with the theory of reasoned action and the theory of planned behavior. 본 연구에서는 위협에 대한 과대평가와 불확실에 대한 인내력 부족과 같은 강박신념과 경험회피, 에이즈에 대한 지식 및 태도가 간호사의 에이즈 공포증과 어떤 관계가 있는지를 검증하였다. 본 연구의 참여자는 종합병원에 근무하는 간호사 326명이었으며, 연령 분포는 만 21세에서 54세 사이였다. 본 연구에서 사용된 심리검사는 중다성분 에이즈 공포증 척도, 강박신념 질문지, 수용-행위 질문지, 에이즈 지식 질문지, 에이즈 태도 질문지이다. 분석 결과, 에이즈에 대한 태도는 간호사의 에이즈 공포와 밀접한 관계가 있었으나 에이즈에 관한 지식은 유의한 관계가 없었다. 강박신념 중에 위협에 대한 과대평가와 불확실에 대한 인내력 부족 모두 간호사의 에이즈 공포와 정적 상관을 보였다. 경험회피의 요인인 정서 회피와 정서중심 반응도 간호사의 에이즈 공포와 정적 상관이 있었으나 에이즈 공포의 요인 중에 에이즈 감염에 대한 두려움과는 유의한 상관을 보이지 않았다. 단계적 회귀분석에서는 에이즈에 대한 태도가 간호사의 에이즈 공포에 대한 가장 강력한 변인이었으며, 변량을 약 20% 가량 설명하는 것으로 나타났다. 위협에 대한 과대평가도 그것에 더해 간호사의 에이즈 공포의 변량을 5%이상 설명하고 있었다. 불확실에 대한 인내력 부족과 정서 회피에도 간호사의 에이즈 공포를 독립적으로 설명하는 부분이 있는 것으로 나타났다. 또한 에이즈에 대한 태도는 위협에 대한 과대평가나 정서 회피와 간호사의 에이즈 공포 간의 관계를 부분적으로 매개하고 있었다. 본 연구의 결과를 선행연구들과 합리적 행위이론과 계획된 행동이론을 바탕으로 논의하였다.

간호과오의 유형별 분석과 법적 책임

신국미(Shin, GookMi) 한양법학회 2010 漢陽法學 Vol.32 No.-

There has been lots of developments in the medical fiels along with the development of scientific techniques and medical equipments. Simultaneously, there has also been a lot of medical accidents. Accordingly, medical malpratice of lawsuit has been increased because of some mistakes through medical treatment and surgery. In fact, medical dispute will be occurred continuously as the sense of peoples about medical accident is getting higher for their rights and they don’t want to overlook about it. In the past the nurse in legal responsibility was regard as doctor’s helper(performer aid). So a nurse’s intentionㆍmistake was regard as a doctor’s, too. However the legal responsibility is not limited to nurses in advanced pratice in these days. Actually medical pratice is not an individual action but a collective action by a team that needs close cooperation among the team members. A nurse, one of team, is an assistant to a doctor. Recently nurse’s role and important are increasing in development of the science of nursing and the improvememt in nursing quality and so their responsibility is also increasing. And then, we don’t regard a nurse as only a doctor’s helper because their specially and independence are very increasing. To define nurse’s civil liability in medical in medical malpratice, it is necessary to identify both legal nursing behaviors and nurse’s due care in those nursing behaviors. So this paper focused on nurse’s civil liability in nursing malpratice and it would be helpful to the study in nursing specialist. And I would like to examine legal responsibility of a doctor and a nurse independent rank.