This study was attempted to investigate effects of ethical climate and workplace bullying on nurses’ turnover intention of nurses working in medium to large sized general hospitals in Korea. This study was conducted on 187 full-time nurses working in the general hospitals with more than 400 beds. Data were collected from the online communities of nurses using Google Foam from April 22 to April 24, 2024. The average values were 3.64±0.64 (out of 5 points) for ethical climate, 2.43±0.75 (out of 4 points) for workplace bullying, and 3.33±0.95 (out of 5 points) for nurses’ turnover intention. While ethical climate had a non-significant relationship with nurses' turnover intention, workplace bullying had a significant relationship with nurses' turnover intention. Nurses’ turnover intention was influenced by verbal attack, inappropriate task, working department, and educational level. These four variables can explain 53.0% of nurses' turnover intention. To prevent the turnover of nurses working at medium to large sized general hospitals, nursing managers need to pay more attention to nurses with low educational level and working at comprehensive wards and special wards. In addition, nursing managers should provide communication training to nurses and assign nursing tasks and working departments according to the nurses' abilities and wishes.

Purpose: This study aimed to explore and describe the experiences of helper nurses deployed in COVID-19 dedicated wards, seeking a deeper understanding of the significance inherent in their experiences. Methods: Sixteen nurses with over one month of experience working as helper nurses in dedicated COVID-19 wards were selected as participants. Individual interviews were conducted between July and August 2023 using a semistructured questionnaire. Data were analyzed using the methods described by Elo and Kyngäs (2007). Results: The analysis revealed two categories comprising six themes derived from helper nurses’ experiences. These categories include “Confronting Professional Challenges” and “Growing as a More Professional Nurse”. Conclusion: Further studies are necessary to explore helper nurses’ experiences of infectious disease disaster situations. Nurses experience role conflicts, knowledge gaps, and burnout. Therefore, developing protocols for tasks and education is essential in highly uncertain situations and when new responsibilities arise. Establishing systematic support systems for stress reduction and enhancing social support among nurses is crucial. Therefore, additional research is required to understand the growth and impact of helper nurses.

Purpose: The study aim was to understand the experiences of intensive care unit (ICU) nurses in labor union activities. Methods: A descriptive qualitative study and content analysis were conducted. The participants included nine ICU nurses who shared their experiences with labor union activities. The data were collected through in-depth interviews. Results: The experiences of ICU nurses with labor union activities encompassed five themes: “The Initial Step in Union Activities”, “Benefits Derived from Union Participation”, “Concerns Regarding Union Activities”, “The Non-Omnipotence of Unions”, and “Achieving Mutual Benefits through Union Activities”. Conclusion: The study findings revealed that ICU nurses strive to improve their work and the nursing environment through labor unions, despite facing negative perceptions of union involvement.

본 연구의 목적은 종합병원 간호사의 임파워먼트와 직무소진이 감염관리 수행에 미치는 영향요 인을 확인하기 위한 서술적 조사연구이다. 대상자는 D시에 소재한 종합병원에서 근무하고 있는 간호사 총 210명을 대상으로 2023년 9월 15일부터 10월 31일까지 자료를 수집하였다. 수집된 자료는 SPSS/WIN 25.0 프로그램을 이용하여 기술통계, t-test, ANOVA, Sheffe, Pearson’s correlation, multiple regression을 이용하여 분석하였다. 연구결과, 임파워먼트와 감염관리 수행은 양의 상관관계를 보였으며, 임파워먼트가 감염관리 수행에 가장 영향을 미치는 요인으로 분석되었으며, 14.8%의 설명력을 보였다. 따라서 간호사의 임파워먼트를 향상시킬 수 있는 효율적인 감염관리 수행을 위한 프로그램 및 정책반영이 필요하다.

본 연구의 목적은 종합병원 간호사의 회복탄력성, 대상자 중심 의사소 통역량, 긍정 간호조직문화가 인간중심간호에 미치는 영향을 확인하기 위해 수행되었다. 본 서술적 조사연구는 전라남도 3개 시에 소재한 100 병상 이상의 종합병원 5곳에 근무하는 간호사 189명을 대상으로, 2022년 8월 31일부터 9월 14일까지 자기 기입방식을 이용한 설문지를 통해 자료 를 수집하였다. 수집된 자료는 SPSS/WIN 27.0 프로그램을 이용하여 기 술통계, 독립표본 t검정, 일원분류 분산분석 및 사후검정(Scheffé test), 피어슨의 상관관계, 다중 회귀로 분석하였다. 자료 분석 결과 간호사의 회복탄력성과 대상자 중심 의사소통역량 수준이 높을수록, 간호사가 소속 부서를 긍정 간호조직문화로 강하게 인식할수록 인간중심간호가 높아지는 것이 확인 되었다. 따라서 종합병원 간호사의 회복탄력성과 대상자 중심 의사소통역량을 향상시키고, 긍정 간호조직문화를 높이기 위한 전략과 프 로그램 개발이 필요하다.

본 연구는 종합병원 간호사의 감정노동과 감성지능이 소진에 미치는 영향요인을 확인하기 위 한 서술적 조사연구이다. 연구대상자는 종합병원에 근무하는 임상경력 6개월 이상인 간호사 150명이었다. 수집된 자료는 SPSS 21.0 프로그램을 이용하여 t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient, Multiple regression analysis로 분석하였다. 대상자의 소진에 미치는 영향요인을 검증하기 위해 다중회귀분석 결과, 감성지능(β=-.441, p<.001), 감정노동(β=.403, p<.001), 현 직위는 책임간호사 이상 이(β=-0.111, p<.018), 지각된 건강상태는 건강한 경우(β=-.100, p<.029) 순이었다. 또한 추정된 회귀모 형의 적합도에 대한 F통계량은 35.51(p<.001)으로 매우 유의하였고, 설명력은 79.7%인 것으로 나타났다. 따라서 간호사의 소진을 감소시키기 위해 감정노동을 줄이고 건강 및 감성지능을 향상 시킬 수 있는 방안 을 모색하고 소진을 낮추기 위한 중재프로그램을 개발하는데 기초자료로 유용하게 활용될 것으로 사료된 다.

This was written to introduce the case of establishment and implementation of the Disclosure procedure related to patient safety accidents at Hospital A. The process of establishing the Disclosure procedure of Hospital A consisted of a survey of professors in charge of Clinical Performance Improvement, the formation of consensus within the management, the establishment of procedures through discussion in the relevant departments and committees, and the enactment and implementation of regulations. In addition, in order to apply the regulations to the field, various education and public relations strategies for employees, as well as management procedures for cases of violation of the patient safety culture. And now, psychological support programs are being explored to protect the employees who are the second victims. Continuous efforts to improve “communication know-how” should be made by collecting data and analyzing cost effects. Therefore, legal support such as the Apology Act is also needed to activate and protect patient safety communication.

The purpose of this study was to examine the current satisfaction levels with nurse uniforms at Taizhou General Hospital in China and to find areas for improvement in order to develop nurse uniforms with improved comfort, fit and convenience. To investigate satisfaction with nurse uniforms, a survey was conducted of 150 nurses. The general characteristics of the nurses, uniform conditions, feelings of satisfaction, fit, preferred designs, inconvenient aspects of the uniforms, and areas for improvement were analyzed. Eight materials of cotton/polyester blended fabrics were selected according to Chinese nurse uniform regulations, and the physical properties of the materials were tested along with the materials used in current nurse uniforms. Four new nurse uniforms with increased aesthetics, functionality, and comfort were developed based on the survey results. Materials with excellent absorption, moisture permeability, and ventilation were used as main fabrics. According to the preferred designs of nurses at Taizhou City General Hospital, China, 4 types of nurse uniforms designed, consisting of design 1 (shirt and pants), design 2 (shirt and pants), design 3 (dress), and design 4 (shirt and skirt). The new nurse uniforms offered better functionality with an improved fit at the armpits, waist, hips, and knees based on product measurements.

Nurses help patients not lose their humanity to the end in the asymmetrical relationship between medical personnel and patients. Because the nurse's frequent judgments at the clinical site are associated with human dignity, the nurse is required to judge and act ethically, and is responsible for making ethical decisions. Therefore, nurses are trained from nursing colleges to have ethical competence, and such training should be carried out continuously and systematically even after graduation. A Medical Center Nursing Department implements various forms of ethical education to improve the ethical capacity of clinical nurses. Education is divided into four types: lectures, e-learning, workshops and clinical ethics counseling. All education was organized around real-life cases to realize that nursing ethics were not far from the actual work site but the closest problem encountered, and the core theories and issues were repeatedly and continuously exposed so that they could permeate into the nurse's ethical decision-making process. Of course, there are still more tasks to be carried out in the future, such as expanding debate-oriented education, promoting clinical ethics counseling, setting up a forum for sharing opinions on ethical issues such as the Ethics Round, but we hope that it will serve as a foundation for the development of better nursing ethics education programs by sharing specific cases of nursing ethics education currently implemented at a tertiary Hospital.

본 연구는 종합병원 간호사의 감정노동, 직무스트레스와 간호업무성과 정도를 살펴보고 간호업무성과에 미치는 영향을 확인하기 위한 서술적 조사연구이다. 연구 대상자는 G 광역시에 소재한 200∼400병상 규모의 종합병원 2곳에 근무하는 간호사 132명이었고 자료수집 기간은 2019년 8월 20일 부터 9월 2일까지였으며 본 연구자가 직접 구조화된 설문지를 이용하여 조사하였다. 수집된 자료는 SPSS 21.0 프로그램을 이용하여 빈도와 백분율, t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient 및 Multiple regression analysis로 분석하였다. 연구결과, 대상자의 간호업무성과에 미치는 영향요인은 회복탄력성(β=0.58, p<.001), 현 직위가 수간호사인 경우(β=0.21, p<.01), 현 근무지경력(β =0.18, p<.05)이었다. 또한, 추정된 회귀모형의 적합도에 대한 F통계량은 30.901(p<.001)으로 매우 유의 하였고, 설명력은 42.4%인 것으로 나타났다. 본 연구결과, 종합병원 간호사의 간호업무성과에 회복탄력성이 가장 큰 영향요인으로 확인되었고, 수간호사일수록, 현 근무지경력이 많을수록 간호업무성과가 높 은 것으로 확인되었다. 따라서 연구결과를 토대로 간호업무성과를 향상시키기 위한 방안을 모색하고 이에 대한 중재프로그램을 개발하는 기초 자료로 활용될 것으로 기대된다.

Purpose: The purpose of this study is to explore the turnover experience of nurses who moved from a tertiary medical institution to a general hospital and to understand the meaning of the move for them. Methods: This is a phenomenological qualitative study using Colaizzi's (1978) method. Semi-structured, open-ended questions and in-depth interviews were conducted to 11 nurses within 3 years after turnover to a general hospital at a tertiary medical institution, between April, 2018 to September, 2018. Results: The four theme clusters and thirteen themes emerged. The core theme licited I was “the journey to find-balance and leave.” Four theme clusters were; “advance to a dream job”, including ‘expectation for my work’, ‘my confidence and family pride’, “unstable my dream job” including ‘stand alone in a desert’, ‘crushed by extra work’, ‘torn protection’, ‘invisible future’, “my job that I wish to keep” including ‘unconditional patience for growth’, “I can't be a loser” is desperate selfinspiration’, ‘leaning on comfort and support', and finally “my place I found again.” including ‘being prepared to be by my side’, ‘restoring work-life balance’, ‘revealed my existence’, and ‘unsatisfied with new work’. Conclusion: Participants choose of turnover for physical and psychological well-being, instead of the romance of the tertiary medical institution. This showed the characteristics of the millennial generation that values the comfort and relaxation in one's life prior to professional vision of nursing care as a nurse, and success. The result is meaningful as an understanding of effective job management for current-generation clinical nurses.

본 연구는 종합병원 간호사의 직무스트레스, 조직몰입 및 이직의도 정도를 살펴보고 직무 스트레스가 이직의도에 미치는 영향을 파악하며 그 관계에서 조직몰입의 매개효과를 확인하기 위한 서술적 조사연구이다. 연구 대상자는 G 광역시에 소재한 200~400병상 종합병원 간호사 199명이었으며 자료수집 기간은 2017년 9월 1일부터 9월 20일까지 본 연구자가 직접 구조화된 설문지를 이용하여 조사하였다. 수집된 자료는 SPSS 18.0 프로그램을 이용하여 빈도와 백분율, t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient, Multiple regression analysis 및 Sobel test로 분석하였다. 연구결과. 대상자의 직무스트레스와 이직의도 관계에서 조직몰입의 매개효과를 검증하기 위해 회귀분석 결과, 1단계에서 독립변수인 직무스트레스가 조직몰입에 통계적으로 유의한 영향을 주었고(β=-.321, p<.001), 2단계에서 독립변수인 직무스트레스가 종속변수인 이직의도에도 유의한 영향을 주었으며(β=.389, p<.001), 3단계에서는 직무스트레스와 조직몰입이 이직의도에 유의한 예측요인으로 나타났다. 두 변수의 설명력은 45.5%이었다. 이때 독립변수인 직무스트레스는 3단계 β 값이 .203(p<.001)으로 2단계의 β 값 .389(p<.001)보다 작아 조직몰입이 이직의도에 매개효과가 있었다. 조직몰입의 매개효과 크기에 대한 유의성 검증을 위해 Sobel test를 실시한 결과 Z값은 -3.694이었으며, 직무스트레스와 이직의도의 관계에서 조직몰입의 매개효과는 유의하였다(p<.002). 따라서 본 연구는 직무스트레스를 감소시키고 조직몰입을 높여서 이직의도를 낮출 수 있는 방안을 모색하고 이에 대한 중재프로그램을 개발하는데 기초적 자료로 유용하게 활용될 것으로 기대된다.

2016 Gyeongju and 2017 Pohang earthquakes led Koreans to acknowledge that the Korean peninsula is not an earthquake-free zone anymore. Among various buildings crucial to after-shock recovery, general hospital buildings, especially existing old ones, are very significant so seismic retrofitting of those must be an important issue. Self-centering energy dissipative(SCED) brace is one of retrofitting methods, which consists of tendon with restoring force and friction device capable of dissipating seismic energy. The strength of the SCED brace is that the tendon forces a structure to go back to the original position, which means residual drift can be negligible. The residual drift is a very important parameter to determine usableness of general hospitals after shock. To the contrary, buckling-restrained braces(BRB) are also a very effective way to retrofit because they can resist both compressive and tensile, but residual drift may exist when the steel core yields. On this background, the seismic retrofitting effect of general hospitals reinforced with SCED braces was investigated and compared to that of the BRD in this study. As a result, although the floor acceleration cannot be reduced, the story drift and residual drift, and the shear demand of walls significantly decreased. Consequently, seismic retrofitting by SCED braces are very effective for domestic low-rise general hospitals.

The healing environment in hospitals is very important. Three factors must be satisfied to create a healing environment in the hospital. First, chemical elements such as pathogens and pollutants must be controlled. Second, physical factors such as temperature, humidity and airflow must be satisfied. Third, psychological factors must be satisfied. The purpose of this study was to evaluate the indoor thermal environment by conducting a questionnaire (Thermal Sensation Vote, TSV) and a Predicted Mean Vote (PMV) measurement. The questionnaires were distributed to 20 medical staff (nurse), 84 inpatients and 113 outpatients. Temperature, humidity, air quality and comfort were evaluated. Measurements were conducted in the waiting room and lobby of the first and second floors of the outpatient area as well as wards on 10th floor. Both south and north-facing wards were divided to analyze the PMV difference by the orientations. The survey results showed high satisfaction values in the outpatient department for temperature satisfaction and comfort. In the inpatient department, air quality satisfaction showed good values. Moreover, the humidity satisfaction level in the nurse station was high. The PMV measurement results showed that the PMV was lower in the ward than in the outpatient area. Comparison of the questionnaire and measurement results showed that the questionnaire results were lower than those of the measurement in the outpatient area. As a result, it is necessary to reduce the gap between questionnaire and measurement results It is also important to create an indoor environment that matches the thermal preferences of the occupant by operating the air handling unit (AHU).

The main function of the general hospital building is to provide medical facilities and service. However, damage to the non-structural elements such as architectural, medical, mechanical and other components will interrupt those functions after the earthquake. Especially, it is considered that, damage to the non-structural elements is a serious event because it is directly associated with the lives of patients. Therefore, this study evaluated whether the certain non-structural elements of general hospital building has the seismic performance to provide hospital medical services after the earthquake. The evaluation is conducted by selecting the non-structural elements used in general hospital which are sensitive to acceleration, such as cooling towers, air handler, MRI and CT. As a result, the non-structural elements located on the upper floor without suitable support method did not meet the performance objective. Therefore, adequate anchorage against the seismic event is required for such non-structural elements that are acceleration-sensitives.

The building which are essential for disaster recovery is classified as a special seismic use group. Especially, achievement of seismic performance is very important for the hospital, so the hospital should be able to maintain its function during and right after an earthquake without significant damage on both structural and non-structural elements. Therefore, this study aimed at checking the seismic performance of a hospital building, but which was limited to structural elements. For the goal, a plan with a configuration of general hospitals in Korea was selected and designed by two different seismic-force-resisting systems. In analytical modeling, the shear behavior of the wall was represented by three inelastic properties as well as elastic. Nonlinear dynamic analyses were conducted to evaluate the performance of structural members. The result showed that the performance of shear walls in the hospital buildings was not satisfied regardless of the seismic-force-resisting systems, while the demands on the beams and columns did not exceed the capacities. This is the result of only considering the shear of the wall as the force-controlled action. When the shear of the wall was modeled as inelastic, the walls were yielded in shear, and as the result, the demands for frames were increased. However, the increase did not exceed the capacities of the frames members. Consequently, since the performance of walls is significant to determine the seismic performance of a hospital building, it will be essential to establish a definite method of modeling shear behavior of walls and judging their performance.

Hospital costing has generally been using ABC costing method. However, based on increase of expensive equipment, the fixed cost is increased in the hospital industry. The most common equipment industry are using building block costing method for depreciation and equipment management costing elements. Additionally it presents three options that may be considered to be supported by the IT system to find the most appropriate alternative.

병원원가란 병원에서 진료, 수술, 교육 및 연구에 소비된 재화와 용역의 가치를 화 폐액으로 표시한 것으로 원가정보는 원가항목별로 표시되어 관리자와 경영자에게 제 공되어야 한다. 이러한 병원원가는 예산수립, 투자의사 결정 및 성과평가 등 내부 경 영관리를 위한 목적으로 유용한 정보를 제공해야 하고 외부적으로는 적절한 의료수가 결정의 기초자료로 활용될 수 있다. 그러나, 우리나라의 주요 병원에서 운영 중인 ABC 원가계산 방법은 병원원가 계산 의 거의 유일한 원가계산 방법 인정받고 있으며, 효과성이 우수함에도 불구하고 원가 계산 결과에 대한 신뢰성의 저하와 운영비용의 증가 등으로 인하여 활용도가 저조해 지고 경우에 따라서 폐기되는 사례도 발생하고 있다. 따라서 최근 병원에서 발생되는 비용의 구체적 특성과 병원의료 환경이 설비 의존형으로 변화됨에 따라 간접비가 증 가하고 있는 경영환경의 변화를 이해하여, 병원 원가계산 시스템의 발전적인 새로운 방식이 모색되어야 한다. 대안 중의 하나로 대표적인 장치산업의 하나인 통신업에서 사용되는 Building Block Costing 방식에 대한 적용 방식을 소개하고자 한다. Building Block Costing은 감가 상각비로 대표되는 자산관련 간접비와 설비와 시설 운영에 소요되는 인건비, 경비 등 의 비용을 ABC원가계산 방식과는 차별화된 원가계산 방식이다.

목적 : 본 연구는 암 환자의 특성에 따른 수단적 일상생활활동과 삶의 질 차이를 확인하고 이들의 상관관계를 확인하고 자 하였으며 암 환자가 필요로 하는 작업수행영역과 삶의 질에 영향을 미치는 요소를 확인함으로써 암 환자의 삶의 질 향상을 위하여 작업수행에 바탕을 둔 환자중심적인 작업치료의 필요성을 제언하고자 한다. 연구방법 : 암으로 진단을 받은 만 18세 이상의 입원이나 외래로 치료를 받고 있는 암 환자 33명을 대상으로 하였다. 설 문지를 통하여 대상자의 특성을 조사하였고 Frenchay Activities Index(FAI)를 이용하여 수단적 일상생활활동 정도를 측정하였으며, Canadian Occupational Performance Measure(COPM)으로 작업수행영역을 확인하고, SF-36으로 삶 의 질을 측정하였다. 대상자의 특성에 따른 수단적 일상생활활동 정도와 삶의 질은 독립표본 t-test와 ANOVA를 사용 하였고, 수단적 일상생활활동 정도와 삶의 질 간의 상관관계는 피어슨 상관관계분석(Pearson’s Correlation Efficient) 을 사용하였다. 그리고 작업수행영역에 따른 삶의 질을 확인하기 위해 기술통계와 ANOVA를 사용하였으며, 삶의 질 영향 요인은 위계적 다중회귀분석을 통해 분석하였다. 결과 : 대상자는 입원 여부에 따라서 수단적 일상생활활동 정도에 차이가 있었으며, 직업, 경제상태, 입원 여부에 따라 삶 의 질에 차이를 나타내었다. 수단적 일상생활활동 정도와 삶의 질은 정적 상관관계를 보였고, 작업수행영역 중 여가에 의의를 둔 대상자가 가장 많았으며 생산적인 활동에 응답한 대상자의 삶의 질이 가장 높았다. 삶의 질에 영향을 미치는 요소로는 수단적 일상생활활동과 경제 상태인 것으로 나타났다. 결론 : 암 환자의 수단적 일상생활활동과 삶의 질은 유의한 관계가 있으며 암 환자의 삶의 질 향상을 위하여 작업수행을 바탕으로 한 환자중심적인 작업치료의 역할이 강조된다.