우리나라 간호사 인력수급 전망에 관한 연구

오영호 ( Young-ho Oh ) 한국보건사회연구원 2008 保健社會硏究 Vol.28 No.1

현재 정부는 노인인구 및 만성질환자의 증가 등에 대응하여 장기요양시설 및 서비스 확충, 가정간호제도의 활성화 등을 적극 추진하고 있다. 이러한 정책적 노력이 성공적으로 수행되기 위해서는 간호사 인력의 양성과 효율적 활용이 무엇보다 중요하다. 따라서 본 연구는 이와 같은 간호사 인력의 중요성을 감안하여 간호사인력 공급 및 수요 분석을 통해 향후 간호사 인력의 수급전망을 추계하여 간호사 인력계획 수립에 필요한 정책자료를 제공하는 것을 목적으로 한다. 간호사 공급은 기초추계(baseline projection) 모형에 근거한 인구학적 방법(demographic method)을 이용하여 추계하였으며, 간호사 수요는 간호사가 제공하는 의료이용량 기준 방법을 이용하여 추계하였다. 전반적인 간호사 인력수급 추계결과는 근무일수는 255일로 하고, 1일 담당환자수는 의료법규 기준으로 할 때 환자조사기준으로 간호사 수요추계 했을 때 발생한 간호사 공급과잉문제는 거의 사라졌고, 2020년 까지 간호사공급이 부족할 것으로 전망된다. 그러나 공급부족규모는 가용간호사의 8% 정도로 크지는 않는 것으로 나타나 유휴간호인력을 노동시장으로 끌어 낼 수만 있다면 총량적인 측면에서는 크게 문제가 되지 않는다고 판단된다. 그러나 우리나라 간호사 양적인 수준을 외국과 동일한 GDP수준에서 비교할 때 2004년 우리나라 인구 1,000명당 간호사 수는 1.8명으로 OECD평균인 7.9명보다 크게 부족한 것으로 나타났다. 향후 간호사 수요는 간호관리차등제의 정착, 법정정원 충족률 증가, 장기요양제도 확대, 보건간호사제도 도입, 보건의료시장 개방에 따른 간호사 해외진출 확대 등으로 증가할 것으로 전망된다. 따라서 정부는 입학정원 조정정책과 더불어 가용간호사를 적극 활용할 수 있는 정책을 수립해야 할 것이다. With an recognition of increases in the older population and chronic disease patients, the Korean government has been actively promoting the expansion of long-term care facilities and the revitalization of long-term and home-care services. The successful implementation of these policies, however, necessitates an effective national workforce planning which can assure adequate training and supply of registered nurses. Therefore, this study aims to forecast the supply and demand for registered nurses through a supply and demand analysis and provide preliminary data for policy development in adjusting the supply of registered nurses. Baseline Projection model combined with demographic method is adopted as the supply forecasting method and so is a derivative demand method called Health Resources and Services Administration`s demographic utilization-based model as the demand forecasting method. Under the most appropriate scenario for registered nurses with 255 working days per year and the number of patients per day set by current medical law, the supply and demand for active registered nurses are estimated to be 224,980 and 243,254 in 2020, respectively. Therefore, there will be an undersupply of 18,273 registered nurses in 2020. However, the seemingly supply shortage can be resolved if we succeeds in attracting available unemployed nurses into labor market since the size of the nursing shortage is just 8 percent of the total number of available registered nurses. When compared with other OECD countries with the same levels of GDP per capita, the number of registered nurses per 1,000 population in Korea is 1.8 in 2004 while the average number in other OECD countries is 7.9 at the same year, 4 times higher than that of Korea. The demand and supply for registered nurses will be influenced by various factors such as the stabilization of differential management price policy of nurses, the implementation of medical law standards for the number of patient per nurse, the expansion of long-term care system, the introduction of public health nurses and so on. Therefore, further studies will be necessary concerning public health environmental and institutional factors which can affect the demand for registeredconcerning public health environmental and institutional factors which can affect the demand for registered nurses. In addition, the Korean government should develop policies that can better utilize available unemployed nurses and increase the entrance quota of nursing colleges.

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.

2025년까지의 우리나라 간호사 인력의 수요 및 공급 전망

오영호 ( Young Ho Oh ) 한국보건경제정책학회(구 한국보건경제학회) 2010 보건경제와 정책연구 Vol.16 No.3

현재 정부는 노인인구 및 만성질환자의 증가 등에 대응하여 장기요양시설 및 서비스 확충, 가정간호제도의 활성화 등을 적극 추진하고 있다. 이러한 정책적 노력이 성공적으로 수행되기 위해서는 간호사 인력의 양성과 효율적 활용이 무엇보다 중요하다. 따라서 본 연구는 이와 같은 간호사 인력의 중요성을 감안하여 간호사인력 공급 및 수요 분석을 통해 향후 간호사 인력의 수급전망을 추계하여 간호사 인력계획 수립에 필요한 정책 자료를 제공하는 것을 목적으로 한다. 간호사 공급은 기초추계(baseline projection) 모형에 근거한 인구학적 방법(demographic method)을 이용하여 추계하였으며, 간호사 수요는 간호사가 제공하는 의료이용량 기준 방법을 이용하여 추계하였다. 전반적인 간호사 인력수급 추계결과는 생산성의 시나리오에 따라 간호사의 공급이 과잉되기도 하고 부족하기도 할 것으로 전망되었다. 이렇게 간호사수급비교 결과는 간호사 생산성 가정에 따라 달라지지만, 어느 시나리오를 선택할 것인가는 궁극적으로 정부의 정책방향에 따라 달라진다. 즉 간호사의 생산성을 현재보다 높게 채택하는지 혹은 낮게 책정하는지는 보험재정 여건 등을 고려해야 하는 정부 정책에 달려있는 것이다. 이에 본 연구에서 정부의 정책방향이 고려되지 않은 2007년 현재의 생산성을 기준으로 한 ``생산성 시나리오 3``을 살펴보면, 근무일수에 따라 2010년에 4,683명~10,363명의 간호사가 공급 과잉될 전망이며, 2025년에는 18,783명~29,349명의 간호사가 공급 부족 될 전망이다. 그러나 공급부족규모는 가용간호사의 8% 정도로 크지는 않는 것으로 나타나 유휴간호인력을 노동시장으로 끌어 낼 수만 있다면 총량적인 측면에서는 크게 문제가 되지 않는다고 판단된다. 향후 간호사 인력의 적정수급을 위해서는 입학정원을 증원하는 정책뿐만 아니라 비활동 간호사를 적극 활용할 수 있는 정책도 수립해야 할 것이다. Purpose: With recognition of increases in the older population and chronic disease patients, the Korean government has been actively promoting the expansion of long-term care facilities. The successful implementation of these policies, however, necessitates an adequate training and supply of registered nurses. Therefore, this study aims to forecast the supply and demand for registered nurse for policy implications. Method: Baseline Projection model combined with demographic method is adopted as the supply forecasting method and so is a derivative demand method called Health Resources and Services Administration`s demographic utilization-based model. Results: The results of this study show that the shortage and surplus of registered nurses might depend on the scenarios of their productivity. Under the ``scenario 3``, productivity of registered nurses in 2007, which do not consider future government policies, there will be a surplus of 4,683 ∼ 10,363 registered nurses in 2010 and an undersupply of 18,783 ∼ 29,349 registered nurses in 2020. Conclusions: The seemingly supply shortage can be resolved if we succeeds in attracting available unemployed nurses into labor market since the size of the nursing shortage is just 8 percent of the total number of available registered nurses. However, the Korean government should develop policies that can better utilize available unemployed nurses and increase the entrance quota of nursing colleges.

간호업무 관련 법령의 정합성 연구: 간호사, 조산사, 전문간호사, 간호조무사를 중심으로

김민지 ( Kim Minji ),김인숙 ( Kim Insook ),이유리 ( Lee Yuri ) 한국보건사회연구원 2018 保健社會硏究 Vol.38 No.3

간호업무와 관련하여 2015년 12월 의료법 일부개정이 이루어졌고, 2018년 3월 전문간호사 자격 기준 근거가 시행규칙에서 의료법의 법률 차원으로 상향되었다. 이렇듯 법령의 개정을 통하여 간호업무 규정을 수정 및 보완하고 있으나, 여전히 간호업무와 관련해 일선 간호현장에서 문제점이 나타나고 있다. 본 연구에서는 간호사, 조산사, 전문간호사, 간호조무사를 중심으로 간호업무 근거 법령들을 살펴보고, 여러 법령 간에 정합성을 이루고 있는지 고찰하였다. 간호업무 관련 규정사항이 존재하는 법률은 총 14개이다. 법의 완전성을 분석한 결과, 전문간호사 업무 등에 관한 규정이 없는 흠결을 보였다. 일관성 관점에서는 의료법과 타 보건의료법령에 명시된 간호업무 간 일부 충돌이 나타났다. 수평적 정합성 분석결과, 산발적인 법령 규정으로 인해 해석이 일의적이지 않아 실제 간호업무 수행에 있어 혼란 가능성을 확인하였다. 수직적 정합성 분석결과, 간호업무 관련 일부 조문에서 일정 사항을 위임하였으나 하위 법령에 해당 규정이 없는 입법미비가 나타났다. 본 연구에서는 비정합적 요소들의 확인을 통해 간호업무 관련법령 정합성 제고 방안으로 현행 법체계를 유지하면서 정합성 결여 요소들을 제·개정 및 삭제하여 보완해나가는 방안과 산재하여 있는 간호 관련 법령들을 통합하여 간호법으로 제정하는 방안을 제시하였다. 추후 보건의료관련법령 개정 혹은 간호법 제정 시법체계의 정합성 확보를 위해 본 연구 결과를 활용할 수 있을 것으로 기대한다. Related to nursing services, the Medical Services Act was amended in December 2015 and the grounds of advanced practice nurse’s qualification was ruled in the law in March 2018. Although legislations related to nursing services have been modified constantly, there remain problems of nursing staffs those are not covered enough by current legislations. The purpose of this study was to review nursing services laws and regulations, especially for nurse, midwife, advanced practice nurse and nurse assistant and to examine legal coherence among them. There are 14 acts that have provisions related to nursing services. In terms of completeness there is no regulation about nursing services of advanced practice nurse. With respect to consistency there is contradiction among legislations provisions in the Medical Service Act and those in other health laws regulating nursing services. Based on analysis of horizontal coherence, confusion may occur because legislations exist sporadically which causes different interpretation. Vertical coherence analysis shows absence of some lower statutes in spite of the delegation. This study suggests two ways to enhance coherence. One is to maintain current legislations while amending the provision preventing them coherent. The other is to enact the unified Nurse Act. This study is meaningful as there is only few preceding research on legal coherence in health system.

전국 병원간호사의 임금구조와 임금수준 결정요인 분석

김진현,하상근,박영우,김연희,이선미,권현정 병원간호사회 2019 임상간호연구 Vol.25 No.3

Purpose: The purpose of this study was to investigate the wage structure of hospital nurses in Korea and to analyze the factors that determine the level of nurses’ wages. Methods: First, a mobile survey on nurses’ wages was conducted with a total of 3,742 nurses working in hospitals. A literature review was also done. Second, a regression model was applied to analyze the determinants of nurses’ wages. Results: The average monthly wage of 3,742 nurses based on the survey was KRW 3,588,000 and the standardized monthly income of 3,742 nurses was estimated to be KRW 3,364,000 as of the end of 2018. The results of regression analysis(R2=61.7%) showed that gender, nursing experience, designated night duty, ownership, and number of beds were statistically significant variables for nurses’ wages at 1% significance level. The monthly wage of nurses working in total nursing care wards was not significantly different from those working in other wards at 5% significance level. Conclusion: The substantial difference in nurses’ wages according to job career, hospital size, region, etc may result in the low proportion of nurses with more than three to five years of service experience and the high turnover of less-experienced workers. Consideration should be given to adjust the gap in wage level and a standard nurse wage system could be effective measures.

임상간호사의 노인에 대한 태도와 노인간호실천의 관계

구미연(Mi Youn Koo ),권수혜(Suhye Kwon) 고신대학교 전인간호과학연구소 2015 전인간호과학학술지 Vol.8 No.-

Purpose: This Study was a descriptive correlational study conducted to identify the correlation between clinical nurses’ attitude toward and nursing practice for the elderly, Methods: 201 clinical nurses working in B metropolitan city were the participants, Data were collected from October 4, 2013 to February 19, 2014. The data were analyzed using SPSS/PC WIN 20.0 program with descriptive statistics, t-test, ANOVA, Scheffe Test, Pearson’s correlation coefficients. Results: The mean scores of nurse’s attitude toward and nursing practice for the elderly were 78.20±12.24(3.91±0.62:1-7) and 49.61±5.38(3.10±0.34:1-4) respectively. There were significantly differences in nurse’s attitude by work department and volunteer experience for the elderly There were significantly differences in nursing practice by marital status, education, position, experience of residing with the elderly, volunteer experience for the elderly, education about elderly care, A weak correlation (r=-.146, <i>p</i>=.038) was found between the level of nurse’s attitude toward and nursing practice for the elderly. Conclusion: Since there was a weak correlation between the nurses’ attitude toward and nursing practice for the elderly, more efforts and needed to identify the related factors and furthermore to develop nursing strategies to foster the nursing practice for the elderly in clinical nurses in future.

전문간호사 자격관리 전문기관의 조직 및 운영(안)

김기경,조재현 대한간호학회 간호행정학회 2004 간호행정학회지 Vol.10 No.4

Purpose: The study was done to develop the model of regulatory body of advanced practice registered nurse. Method: This was a descriptive study adopted a method of comparison and construction of laws. Result: The type of partnership of government and people were privatization, negotiated rule-making, standard-setting authority, self-regulation. The pattern of partnership were applied to the regulatory body's role; administration of certification and examination, setting standards for nursing education programs and approval nursing programs. The regulatory body of advanced practice registered nurse was organized according to it's role. Conclusions: It is needed to proceed to self-regulation step by step.

간호사 국가시험 기본 항목 개발

김조자,이향련,송지호,이숙자,강현숙,박성애,이정섭,전경자 한국보건의료인국가시험원 2004 보건의료교육평가 Vol.1 No.1

The purpose of this study is to develop a classification framework for the test elements of the National Registered Nurse' s License Examination and to divide the test items into standard and basic core on the basis of the RN' s job descriptions. And the adequa to proportion of the basic core test items is going to be identified. Method and results: In order to develop the classification framework of the National Registered Nurse' s License Examination, RN' s job descriptions, nursing standards, and the specific learning objectives of nursing courses were reviewed. And a survey was used to identify which entity would be appropriate for a reference to the basic core test items. 146 of professors from schools of nursing and members of each division of Korean Academic Society of Nursing(KASN) were participated in the survey. The study showed the 98% of respondents agreed to use RN' s job descriptions in selecting the basic core test items and 30% for the basic core test would be appropriate. And the contents, the selection criteria, and the proportion of the basic core test items were developed by the members of this research, the members of the National RN' s License Examination subcommittee, and the presidents of each division of KASN. The total of 1990 standard test items were selected among 3524 items, that 3 out of 7 members in the research team agreed to choose. Duplicated items in the standard items were deleted. 205 items out of the 1990 standard items were selected as the basic core test items. And 14 items were added in Medical Laws and Ethics which leads the total of 219 basic core test items. In conclusion, the 99 items, 30% of total current examination items were chosen as the final basic core test items using the delphimethod. Further studies are needed to validate the current National License Examination for RN on the basis of the 99 basic core test items.

일반간호사의 임금격차 현황과 표준임금 가이드라인 개발

김진현,하상근,박영우,김연희,이선미,권현정 병원간호사회 2020 임상간호연구 Vol.26 No.1

Purpose: The purpose of this study is to develop a nursing salary guideline for Korean hospitals. Methods: Literature review and a mobile survey were conducted regarding staff nurses’ salary. Regression analysis and simulation model were applied to develop the nurses’ salary guideline. Results: The United Kingdom, Australia, and Germany have standard salary guidelines which demonstrated the standard salary of nurses. These were determined mainly by nursing experience and expertise. The results of the mobile survey indicated that the maximum to minimum ratio of the salary was as high as 4.5 among staff nurses working in Korean hospitals. Two models (exponential and linear) for a standard nursing salary guideline were developed and the simulation results demonstrated an improved salary structure for staff nurses. Conclusion: This developed salary guideline for staff nurses is recommended to be applied in Korean hospitals which provide total nursing care services.

Obesity as a Possible Risk Factor for Lost-time Injury in Registered Nurses: A Literature Review

Jordan, Gillian,Nowrouzi-Kia, Behnam,Gohar, Basem,Nowrouzi, Behdin Occupational Safety and Health Research Institute 2015 Safety and health at work Vol.6 No.1

Time-loss injuries are still a major occurrence in Canada, injuring thousands of Canadian workers each year. With obesity rates on the rise across the country, as well as around the world, it is important that the possible effects of obesity in the workplace be fully understood, especially those effects linked to lost-time injuries. The aim of this paper was to evaluate predictors of workplace lost-time injuries and how they may be related to obesity or high body mass index by examining factors associated with lost-time injuries in the health care sector, a well-studied industry with the highest number of reported time loss injuries in Canada. A literature review focusing on lost-time injuries in Registered Nurses (RNs) was conducted using the keywords and terms: lost time injury, workers' compensation, occupational injury, workplace injury, injury, injuries, work, workplace, occupational, nurse, registered nurse, RN, health care, predictors, risk factors, risk, risks, cause, causes, obese, obesity, and body mass index. Data on predictors or factors associated with lost-time injuries in RNs were gathered and organized using Loisel's Work Disability Prevention Management Model and extrapolated upon using existing literature surrounding obesity in the Canadian workplace.