본 연구는 노인환자를 돌보는 요양병원이라는 특수한 환경에서 정서 적, 윤리적 요인이 간호업무수행에 미치는 영향을 분석하고자 요양병원 간호사의 공감역량과 윤리적민감성, 환자중심간호, 간호업무수행 간의 구 조적 관계를 파악하고, 간호업무수행 향상을 위한 이론적, 실무적 기초자 료를 제공하기 위해 수행되었다. 연구대상은 국내 요양병원간호사 230명 을 편의표집 하였으며, 연구결과로 모형 적합도는 χ²/df=165.517, CFI=.945, TLI=.928, RMSEA=.092로 양호하였으며, 공감역량은 윤리적민 감성(β=.478, p<.001)과 환자중심간호(β=.716, p <.001)에 유의미한 영향을 미쳤으며, 간호업무수행(β=.431, p <.001)에는 간접적으로 영향을 미치는 것으로 나타났다. 윤리적민감성은 간호업무수행(β=.188, p <.001)에, 환자 중심간호는 간호업무수행에 매개요인으로 작용하였다(β=.477, p <.001). 간호업무수행 향상과 환자중심간호를 실천하기 위한 간호인력 배치 기준 을 재정비하고, 다학제 팀의료 상호 협업 중심의 전인적인 돌봄 지원 체 계를 구축하는 것을 제시한다.

Purpose: This study applied a mixed-methods design to examine the effects of the nurse shift system improvement pilot project, organized by the Ministry of Health and Welfare, on ward nurses’ quality of life, job satisfaction, and patient safety nursing activities, as well as to explore their overall evaluation of the project through in-depth interviews. Methods: Using a mixed-methods approach, this study simultaneously conducted quantitative analyses of ward nurses’ quality of life, job satisfaction, and patient safety nursing activities, along with qualitative research through in-depth interviews to explore overall perceptions of the nurse shift system improvement pilot project. Results: Patient safety nursing activities showed a significant positive correlations with quality of life (r=.24, p=.017) and job satisfaction (r=.21, p=.038). There was also a significant positive correlation between quality of life and job satisfaction (r=.63, p<.001). As a result of the qualitative analysis, eight facilitating factors and five hindering factors related to the pilot project were identified. Conclusion: Through the research, the effectiveness of the pilot project and the factors influencing nurses were identified. Accordingly, strategies are needed to enhance patient safety nursing activities by improving nurses’ quality of life and job satisfaction in pilot project wards.

Purpose: This study aimed to clarify the attributes of the concept of nurses' righteousness through concept analysis and to provide foundational data for fostering nurses' morality in nursing education and practice. Methods: Walker and Avant's (2004) concept analysis method was applied to identify the conceptual attributes, antecedents, and consequences. A total of 40 domestic and international studies published from 2010 to 2024 were analyzed. Results: The concept attributes were training for a righteous life, fulfilling the duties assigned to oneself, relationship-oriented nursing with concern and empathy, respect for human rights and fair nursing, acting for the benefit of the community, and courage to do the right thing. The antecedents of nurses' righteousness were nurses' moral values, ethical awareness, patient-nurse interaction, and patientnurse communication, consequences of nurses’ righteousness confirmed to be nurses' moral integration, nurses' personal growth, improved quality of nursing, improved patient satisfaction, and growth of nursing organizations. Conclusion: This study is significant in that it defines the concept of nurses' righteousness and presents a theoretical basis for developing basic qualities as a nurse. Based on these findings, education and the development of programs focused on nurses' righteousness are recommended.

Purpose: This study explored the comprehensive experiences of nurses who volunteered for medical services at Saemangeum Jamboree using a systematic qualitative Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis framework. Methods: Semi-structured in-depth interviews were conducted with 12 nurses between March and October 2024. The collected data were analyzed using a conventional content analysis methodology with ATLAS.ti 6.2 software. Subsequently, the derived subcategories were systematically organized and classified within a SWOT matrix framework to provide structured insights into the experiences of the volunteer nursing. Results: The comprehensive analysis yielded 125 meaningful codes, which were systematically categorized into 23 distinct sub-themes and ultimately structured into 14 overarching themes within the SWOT matrix framework. The identified strengths included nursing expertise and clinical competency, building therapeutic trust through patient-centered care, and creative problem-solving in crisis situations. The identified weaknesses included experiencing physical and emotional exhaustion, language barriers due to limited foreign language proficiency, and initial resource constraints that compromised the quality of care. The opportunities identified included patient thankfulness reinforcing commitment to duty and guardians, valuable experience in cross-disciplinary collaboration highlighting the importance of teamwork, and increased sponsorship resources throughout the event progression. The identified threats encompassed a lack of response from administrative organization, absence of standardized nursing protocols or manuals, occurrence of the coronavirus disease 2019, ambiguity in roles and responsibility, and insufficient measures to ensure physical safety in the service area. Conclusion: The comprehensive findings of this study suggest that maximizing the effectiveness of nurse volunteers and enhancing volunteer satisfaction in future large-scale international events requires strengthened pre-event training programs, establishment of a systematic resource management system, and development of comprehensive response protocols for various emergency situations. This study provides essential foundational data and practical insights for planning and operating medical volunteer programs at similar international events and contributes valuable knowledge to the field of disaster nursing and humanitarian healthcare delivery.

Purpose: This study aimed to explore the experiences, essence, and structure of charge nurses operating in rotational appointment systems in tertiary hospitals. Methods: This qualitative study adopted a phenomenological approach. The participants were 11 charge nurses with rotational role experience working in tertiary hospitals in a metropolitan area. Data were collected through individual in-depth interviews lasting an average of 40~60 minutes and, conducted between July 8 and August 30, 2024. Colaizzi's phenomenological method was used for data analysis, which led to the identification of 35 themes, 14 theme clusters, and five categories. Results: The study revealed five categories: (1) ‘Taking the first step as a charge nurse,’ (2) ‘Enduring the weight of being a charge nurse,’ (3) ‘Creating my own charge nurse role,’ (4) ‘Mixed emotions returning after completing the rotation,’ and (5) ‘Ready to take the leap to the next level.’ The findings indicated that charge nurses experienced significant personal and professional growth while performing their roles. They demonstrated leadership, coordinated tasks and personnel, supported staff development, resolved issues, and facilitated communication. This role had a positive impact on both individual professional development and organizational efficiency. Despite initial feelings of anxiety and fear, charge nurses embraced challenges and contributed to improvements in organizational culture and patient safety while setting new goals for continuous growth even after completing their roles. Even in the post-term, they continued to expand their perspectives as nursing managers, increased their influence, and set new goals while pursuing ongoing growth and development. Conclusion: This study provides an in-depth understanding of the experiences of charge nurses in rotational systems in tertiary hospitals. Given the crucial role of charge nurses in the nursing leadership pipeline, it is essential to establish comprehensive hospital-wide programs to nurture leadership skills among front-line nursing managers and create supportive policies that fully enable their engagement.

Purpose: This qualitative study aimed to explore and interpret the meaning and essence of end-of-life care as experienced by nurses in internal medicine wards caring for patients who had completed advance directives (AD). It sought to understand the psychological conflicts, ethical dilemmas, and evolving perceptions of care encountered by nurses during the end-of-life process. Additionally, the study focuses on providing foundational data to support the clinical implementation of the AD system, thereby contributing strategies that improve the quality of end-of-life care and uphold patients' rights and dignity in hospital settings. Methods: A qualitative content analysis was conducted using in-depth, semi-structured interviews with 12 nurses from internal medicine wards in tertiary hospitals located in Seoul and surrounding metropolitan areas. Participants had direct experience in providing end-of-life care for patients with ADs. Interviews focused on capturing nurses’ real-life experiences and reflections related to such care. Data were analyzed systematically following the eight-step qualitative content analysis method proposed by Downe and Wamboldt, allowing for the identification of meaningful categories, themes, and patterns. Results: Analysis revealed five major themes and 16 subthemes. The major themes included: (1) Experiences of repeated end-of-life care and advance directives in internal medicine wards, reflecting the frequent encounters of nurses with terminally-ill patients and their ADs; (2) Multifaceted experiences of end-of-life care based on ADs, suggesting the complexities of care shaped by the presence or absence of ADs; (3) Limitations and dilemmas in AD implementation, highlighting the ethical conflicts arising from low public awareness and inconsistent clinical practices; (4) Shifts in perceptions of life and death, including the development of practical attitudes towards death through repeated exposure to dying patients, illustrating the evolving views of nurses; and (5) Hopes for improving end-of-life care in internal medicine wards, emphasizing the need for enhanced care environments, educational support, and institutional backing. Conclusion: The findings underscore the importance of increasing awareness and improving the clinical application of ADs. Establishing systematic support structures is essential to respect patient autonomy and enhance the quality of end-of-life care in internal medicine wards.

Purpose This study aimed to develop and evaluate a simulation-based autotransfusion device training program to enhance the clinical performance, performance confidence, and educational satisfaction of post-anesthesia care unit (PACU) nurses. Methods: A single-group pretestposttest study was conducted with 30 PACU nurses. The program, based on the ADDIE model, included orientation, simulation training, and debriefing. Data were collected using validated tools before and after the program and analyzed using the Wilcoxon signed-rank test. Results: Clinical performance improved from a median of 30.00 to 43.00 (Z =−4.78, p < .001). Performance confidence increased from 31.00 to 47.50 (Z =−4.71, p < .001), while educational satisfaction rose from 26.00 to 40.00 (Z =−4.73, p < .001). Conclusions: The simulation-based program effectively enhanced the clinical performance, performance confidence, and education satisfaction of PACU nurses. These findings underscore the value of simulation-based training for enhancing nurses’ competence in using complex, high-risk medical devices.

Purpose: This study examined the effects of clinical nurses' communication skills, critical reflection, and professional self-efficacy on medication safety competency. Methods: The participants were 150 clinical nurses with at least 12 months of experience in a tertiary hospital. Validated scales for assessed communication skills, critical reflection, professional self-efficacy, and medication safety competency. Data were analyzed using SPSS 29.0 with descriptive statistics, t-tests, ANOVA, correlation, and regression analyses. Results: The mean medication safety competency score was 4.24 ± 0.49, with the highest subscale scores observed in crisis management, patient-centered medication management, and problem-solving. Nurses aged 36 years and older and with over 6 years of experience demonstrated significantly higher medication safety competency. Medication safety competency showed positive correlations with communication skills (r = .68, p <. 001), critical reflection (r = .70, p < .001), and professional self-efficacy (r = .61, p <. 001). Regression analysis revealed these factors as significant predictors, collectively accounting for 57.5% of the variance. Conclusion: Communication skills, critical reflection, and self-efficacy significant determinants of nurses’ medication safety competency. Educational programs targeting theses domains are essential to improve medication safety. Further research is needed to assess and refine such interventions, thereby supporting continuous professional development and improved patient outcomes.

Purpose: This study aimed to develop and evaluate a simulation-based nursing education program for respiratory emergencies in critically ill, extremely low birth weight infants (ELBWIs). Methods: A single-arm quasi-experimental study was conducted with 32 neonatal intensive care unit (NICU) nurses. The program was developed systematically using the ADDIE model, incorporating needs assessment, real-case scenario development, and pilot testing. Data were collected before and after the intervention and were analyzed using paired and independent t-tests, as well as a one-way analysis of variance (ANOVA) with Scheffé post-hoc tests. Results: The results showed statistically significant improvements in participants’ problemsolving ability (t = -3.49, p = .001), clinical performance confidence (t = -4.64, p < .001), and overall clinical performance competency (t = -13.79, p < .001) following the training. The clinical relevance and feasibility of the program were supported by pilot testing and positive evaluations of the practicality and educational usefulness of the simulation scenarios. Conclusion: These findings suggest that the simulation-based program was effective in enhancing NICU nurses’ clinical competence in managing respiratory emergencies in ELBWIs and can be used as a practical alternative to traditional on-the-job training.

Purpose: This study was aimed to explore and analyze the experiences of nurses regarding department transfers following the sudden closure of a ward due to the collective resignation of residents. Methods: Data were collected from November 1 to 29, 2024, and a qualitative content analysis was employed. The participants were 11 nurses who were transferred to different departments following a ward’s sudden closure owing to the residents’ collective resignation. Results: A total of six themes and 24 sub-themes were identified. the first theme is ‘After the resident left, the ward was closed’. The second theme is ‘Various job placements were assigned after the ward’s unfortunate closure’. The third theme is ‘Difficulty adjusting to the new environment and leaning to adapt’. The fourth theme is ‘Changes in the nurse-physician relationships’, and the subtheme is ‘Surprised by doctors seeking nurses' opinions due to the absence of residents. The fifth theme is ‘Become an expert at adapting’. The sixth theme is ‘Worries about the future and a faint glimmer of hope’. Conclusion: This study highlights the challenges nurses encountered in adjusting to new departments following the unprecedented mass resignation of residents and the ensuing ward closure. Nurses initially faced difficulties, feeling expendable in the new environment. However, through the support and collaboration of their colleagues, they demonstrated resilience and adapted effectively. The study also noted that, despite the absence of residents, direct communication between medical staff and patients continued to function smoothly, facilitating their involvement in treatment planning alongside specialists and professors. Although departmental transfers can lead to increased job stress for nurses, successful adaptation during these transitions fosters professional growth by enhancing their knowledge, skills, and influence. Furthermore, knowledge sharing among nursing staff contributes to the overall development of the organization. To promote both personal growth and organizational advancement, nursing managers must actively listen to nurses’ perspectives about departmental transfers and provide compassionate support to assist in their adaptation. Creating an organizational culture that recognizes and values the contributions of colleagues who have undergone transfers is essential. By establishing a systematic approach that facilitates successful adaptation and fostering a positive, accepting nursing culture, departmental transfers can be transformed into an effective strategy for enhancing the professionalism and capabilities of nursing staff.

Purpose: This study explored emergency nurses’ perception of and experiences with infection control in the emergency department (ED). Methods: This qualitative study employed focus group interviews and conventional content analysis. The participants were 19 nurses working in the ED of three general hospitals in the metropolitan area, and the data collection period was from July 1, 2024, to August 30, 2024. Four focus group interviews were conducted with each group consisting of 4~5 participants. Interviews were conducted for approximately 80 minutes per group. The interviews were audio-recorded and transcribed verbatim immediately afterward. Data were analyzed using conventional content analysis. Results: A total of 167 meaningful statements were extracted from the interviews. Five main themes and 15 subthemes were identified through interview analysis. 1) Limited information with “Limited information at the entrance of the ED” and “Challenges in sharing information”; 2) The gap between guidelines and reality with “Difficulty in adhering to guidelines due to a shortage of isolation rooms”, “Underestimating protective isolation”, “Skepticism due to practical limitations” and, “The need for infection control guidelines to fit ED circumstances”; 3) Application of guidelines that deviated from the principles with “Different nursing practice based on visual judgment”, “Guidelines that were overlooked in emergency situations” and, “Justifying the avoidance of tedious work by claiming to help prevent infection”; 4) Insensitivity to infection with “Performing only pretended infection control”, “Overlooking the importance of protective equipment”, and “Being became insensitive to infection”; and 5) The need to strengthen the organizational culture of infection control with “Interpreting the same guideline differently by individuals”, “The need for support from senior nurses to comply with the guidelines”, and “The need for practical training that reflects the reality of the ED”. Conclusion: ED nurses faced challenges in complying with infection control guidelines in the ED. These challenges were attributed to a combination of physical, structural, and personal factors. A unique feature of this study is its emphasis on the organizational culture of infection control. To improve compliance with infection control guidelines among emergency nurses, it is imperative to improve their physical and structural environment and provide regular practical training. This approach aims to foster an organizational culture that places a strong emphasis on infection control.

Purpose: The purpose of this study was to investigate the level of cultural competence of hospital nurses and identify factors influencing cultural competence based on general and cultural characteristics. Methods: This study used a cross-sectional descriptive design and 167 nurses who had been caring for foreign patients for past 1 year. Cultural competence, which is composed of four sub-dimensions (values related to cultural perception, cultural knowledge, cultural sensitivity, and cultural skills), personal and cultural characteristics were measured. Results: The participants were all women, with the mean age of 31.81±6.88 years, and clinical career was 8.76±6.81 years. Cultural competence score was 5.28±0.63 out of 7. Having a foreign friends, position, participation in foreign language classes, and working place had significant influence on hospital nurses’ cultural competence. The explained variance for cultural competence was 21.8%. Conclusion: The findings of this study indicate that nurses provide care by understanding patients with diverse cultural backgrounds and their health-related needs. To enhance the cultural competence of hospital nurses, systematic practical education and active organizational support based on standardized guidelines for caring for foreign patients are necessary.

Purpose: This study aimed to examine the impact of resilience and learning agility on organizational commitment among nurses who experienced job rotation. Methods: This descriptive correlational study was conducted with a convenience sample of 180 nurses who experienced job rotation within one year at a university hospital in C city. Data were collected from July to August 2022. A total of 176 valid responses were analyzed using scales measuring organizational commitment, resilience, and learning agility. Data analysis included descriptive statistics, Pearson's correlation coefficients, and multiple regression using the SPSS 27.0 program. Results: The results demonstrated that resilience emerged as the most significant predictor of organizational commitment among nurses who experienced job rotation, followed by satisfaction with their current department and the reason for departmental change. Conclusion: The results indicate that resilience significantly influences organizational commitment among job-rotated nurses. Future research should focus on developing and implementing programs to enhance resilience among nurses who experience job rotation, thereby improving their organizational commitment.

Purpose: This study aimed to measure the level of patient advocacy (the core attribute), nursing professionalism and ethical climate perceived by hospital nurses in Korea, and to identify factors influencing patient advocacy (the core attribute). Method: This study was conducted on 234 full-time nurses who had been working for more than 1 year at a general hospital located in a provincial city in Korea. Data were collected from November 15 to 30, 2024, using questionnaires. The collected data were analyzed using IBM SPSS/WIN 27.0. Results: Among patient advocacy, ‘safeguarding patients’ autonomy’ was explained by 30.0% by professional self-concept, patients, and professional identity in nursing, ‘acting on behalf of patients’ was explained by 34.0% by professional self-concept, role of nursing practice, patients, originality of nursing, and professional identity in nursing, and ‘championing social justice’ was explained by 36.0% by professional self-concept, patients, and managers. Conclusion: In order to improve patient advocacy of hospital nurses, it could be concluded that improving professional self-concept among the sub-factors of nursing professionalism and improving patients among the sub-factors of ethical climate are very effective. Therefore, nursing managers need to make managerial efforts to improve nurses’ professional self-concept and awareness of patients.

Purpose: This study aimed to identify the need for simulation education to strengthen patient safety competencies in nursing practice field experience and explore and analyze improvements in simulation education. Methods: Data were collected through focus group interviews with 31 participants from four groups of fourth-year nursing students and one group of new nurses from August 7, 2023 to February 11, 2024. Interview data were systematically reviewed by qualitative content analysis. Results: Five major themes were identified; (1) awareness of patient safety competencies among nursing students and new nurses, (2) awareness of patient safety education among nursing students and new nurses, (3) simulation education topics for strengthening patient safety competencies, (4) interfering factors of simulation education for strengthening patient safety competencies, and (5) facilitating factors of simulation education to strengthen patient safety competencies. Accordingly, 15 categories were derived, and the current status of simulation education for patient safety, educational needs, and improvements were reported. Conclusion: This study attempted to reflect on the needs of learners before developing a simulation education program and derive educational content to strengthen patient safety competencies.

Purpose: This single-group pre-post experimental study aimed to develop and apply a simulation-based infection control education program for neonatal intensive care unit (NICU) nurses to verify its effectiveness and provide baseline educational materials to strengthen NICU nurses’ infection control competencies. Methods: The educational program was developed according to the five phases of analysis, design, development, implementation, and evaluation models, with scenarios based on the educational needs of NICU nurses. To verify the program’s effectiveness, a study was conducted on 28 NICU nurses of general and tertiary hospitals. NICU nurses’ infection control knowledge, performance confidence, critical thinking disposition, and satisfaction with the education were surveyed after applying the education program. Results: The simulation-based NICU infection control educational program was effective for NICU nurses’ infection control knowledge (t=−7.35, p < .001), performance confidence (t=−6.30, p < .001), and critical thinking disposition (t=−5.12, p < .001). Conclusions: The infection control educational program can contribute to infection prevention and patient safety by improving the NICU nurses' infection control competencies and be used as a baseline educational material for infection control education.

Purpose: The purpose of this study was to investigate the effects of nursing professionalism, grit, and job satisfaction on the intention to stay of visiting nurses in public health centers. Methods: This study collected data through an online survey of 158 visiting nurses in charge of home visiting health care in public health centers. The collected data were analyzed using the SPSS/WIN program, t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficient, and hierarchical regression analysis. Results: The variables affecting the intention to stay of visiting nurses in public health centers were nursing professionalism (β=.33, p<.001), employment type (β=.20, p=.008), and job satisfaction (β=.17, p=.036), in that order. Conclusions: Based on the results of this study, in order to improve the intention to stay of visiting nurses in public health centers, the most important focus should be placed on strategies to enhance nursing professionalism, and measures should be established to improve employment type and enhance job satisfaction.

Purpose: In this qualitative descriptive study, we aimed to explore the experiences of nurses providing end-of-life (EOL) care in an emergency department (ED) setting and identify the associated challenges and implications for clinical practice. Methods: Twelve nurses with over 1 year of EOL care experience in the ED were interviewed. The collected data were analyzed using thematic analysis, as outlined by Braun and Clarke. Results: Five main themes with corresponding subthemes were identified: (1) Inadequate Environment for EOL Care, including physical environment barriers for a dignified death and emotional restraint in a chaotic setting; (2) Impact of Life-Sustaining Treatment Decision Complexity, encompassing complicated dynamics of family decision-making and compromised care quality in the decision-making process; (3) Managing Care Relationships in Physician-Limited Settings, manifested as navigating limited physician communication and bearing the emotional weight of EOL care; (4) Challenges in Protecting Patients’ Rights, characterized by powerlessness in the face of silent patients and confusion from reversed decisions by families; and (5) Actualizing Compassionate EOL Care, ensuring dignity through purposeful actions and navigating environmental barriers to dignified care. Conclusion: We highlight the need for systematic changes in the ED to better support EOL care, including the development of culturally sensitive communication protocols, shared guidelines for decision-making, and improved collaboration between healthcare professionals. These findings provide valuable insights into enhancing EOL care in EDs. Future efforts should focus on policy changes, tailored education programs, and support systems that address the multifaceted needs of patients, families, and healthcare providers.

Purpose: To highlight the experiences of nurses who are promoted through a career development system that recognizes and rewards their expertise based on their clinical experience. Methods: This study involved 11 nurses who voluntarily participated at Clinical Nurse III level or above from a tertiary hospital. Data were collected through individual in-depth interviews from March 4 to 28, 2024, using semi-structured and open-ended questions. Analysis was performed using the Colaizzi' phenomenological method. Results: The results of the study were derived into 32 themes, 13 theme clusters, and 5 categories: ‘The promotion process you chose to grow as a leader’, ‘A rugged climb to professional recognition’, ‘Glorious CN III title’, ‘Reborn as a professional nurse’, and ‘The career ladder system needs improvement but it is essential’. Conclusion: This study revealed the experiences of CN III nurses who were promoted through the career development system. Nurses hope that this system will allow them to articulate their expertise more clearly and be rewarded for their valuable experiences. By assessing the career development needs of the nurses, we aimed to better recognize their skills and enhance the significance of their experiences.

Purpose: This study aimed to identify the experiences of career nurses balancing clinical nursing with ongoing studies. Methods: This study was a qualitative study that used the content analysis method. Data were collected using focus group interviews with 17 career nurses with more than 5 years of clinical career at general hospital and above. Results: Six themes and 17 sub-themes were derived through qualitative content analysis. The themes included: “Chose nursing for practical reasons”, “A nurse profession that fits me”, “Seeking personal growth through ongoing studies”, “Practical challenges of being a nurse”, “The attributes that sustain commitment to clinical nursing”, “My future as a nurse”. Conclusion: This study confirmed the the driving force that enables career nurses who are pursuing academic degrees to sustain clinical nursing. The results of this study can be used as useful basic data for the management of career nurses.