PURPOSE: The purpose of this study was to develop performance measure indicators for hospital nursing units based on a Balanced Scorecard (BSC). METHOD: This study was a methodological study. The development process consisted of 3 stages. The first stage was setting up strategies for nursing units from a nursing department's mission and vision. The second stage was developing performance measure indicators after a validity check. The third stage was modifying developed performance measure indicators and classifying them. RESULTS: 7 strategies were set up according to 4 perspectives of a BSC. 15 performance measure indicators for hospital nursing units were developed, and the indicators were divided into 8 independent indicators and 7 shared indicators according to the degree of performance responsibility. In addition, they were classified into two groups, 7 leading indicators and lagging indicators. CONCLUSIONS: The result of this study suggests that performance measure indicators for hospital nursing units provide a framework and method for nursing organizations' performance management. Also, the developed indicators are expected to provide valuable information for successful organization management.
*Quality Indicators, Health Care ; Nursing Staff, Hospital/*standards ; Nursing Care/*standards ; Humans

PURPOSE: To develop and psychometrically test the Korean version of the Cultural Competence Scale for Nurses (K-CCSN). METHODS: A multi-phase questionnaire development method was used to develop the scale from November 2012 to April 2013. The item pool was generated based on literature review, existing scales and in-depth interviews. The content validity was evaluated twice by an expert panel. The scale validation was conducted with a convenience sample of 456 general hospital nurses recruited from five general hospitals and a nursing college in the Seoul Metropolitan Area of South Korea. The construct-related and criterion-related validity and internal consistency reliability of the scale were tested. RESULTS: The 33-item K-CCSN comprised four subscalesdcultural awareness, cultural knowledge, cultural sensitivity and cultural skillsdexplaining 53.96% of the total variance. The criterion-related validity was supported by a known-group comparison. The reliability analysis showed an acceptable-to-high Cronbach's alpha in total and for subscales ranging from .879 to .932. CONCLUSION: This preliminary evaluation of psychometric scale properties demonstrated acceptable validity and reliability. The K-CCSN is able to provide scientific and empirical data regarding the cultural competence of clinical nurses. However, further studies are needed to test the applicability of the scale in different settings and contexts.
Adult ; *Cultural Competency ; Culturally Competent Care/*standards ; Humans ; *Nursing Staff, Hospital ; Psychometrics/*standards ; Questionnaires ; Reproducibility of Results ; Republic of Korea ; *Students, Nursing

PURPOSE: This study was aimed to examine how subjects' characteristics and nursing service quality influence hospital revisiting intent, to compare perceptions of patients with those of nurses. METHOD: The questionnaire was developed and distributed to 300 patients and nurses at six general hospitals in a provincial city, Korea. For data analysis, the SPSS/PC program was used. RESULT: The nursing service quality's scores of patients is 3.61, that of nurses is 3.77, and there is a significant difference. The hospital revisiting intent's score of patients is 4.84, that of nurses is 4.61, and there are no significant differences. In subjects' characteristics, patients perceive that the hospital is the only different factor, and place hospital revisiting intent at 3.6%. Nurses perceive that education level and position are different factors, and place hospital revisiting intent at 3.3%. In nursing service quality, patients perceive that 2 attributes explain hospital revisiting intent at 17.8% and 2 factors explain it at 16.5%; whereas, nurses perceive that 2 attributes explain hospital revisiting intent at 15.3% and 3 factors explain it at 12.2%. CONCLUSION: There are perception gaps between consumers and providers. So nursing and hospital managers must recognize these facts and provide various marketing strategies to overcome them.
Questionnaires ; Patient Satisfaction ; Nursing Staff, Hospital/*psychology ; Nursing Service, Hospital/*standards ; Middle Aged ; Male ; Humans ; Female ; *Attitude of Health Personnel ; Adult

PURPOSE: The aim of this study was to develop a performance measurement scale for nurses in the hospital setting and to test the reliability and validity of the scale. METHODS: This study was conducted in three phases including an application of conceptual framework, development of scale items, and test of validity and reliability of the scale. In order to test validity and reliability, data was collected from 1,966 nurses who work in twenty eight hospitals nation-wide. The data was analyzed by the SAS 8.0 program using descriptive statistics, factor analysis, and reliability coefficients. RESULTS: The Performance measurement scale consisted of 4 factors which included competency, attitude, willingness to improve, and application of nursing process, and a total of 17 items. The Four factors explained 63.45% of the total variance, and Cronbach's alpha of the scale was .92. CONCLUSION: The performance measurement scale developed by this study is a reliable and valid instrument that is utilized effectively to evaluate the performance of hospital nurses. Furthermore, it could be used as a steping stone to assess educational needs of nurses, develop professionalism among nurses, and improve quality of nursing care in the hospital setting.
Adult ; *Employee Performance Appraisal ; Female ; Humans ; Models, Nursing ; *Nursing Evaluation Research ; Nursing Staff, Hospital/*standards ; Reproducibility of Results ; Task Performance and Analysis

PURPOSE: This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. METHODS: The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using chi-square-test, factor analysis, and the Analytical Hierarchy Process. RESULTS: Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. CONCLUSION: PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.
Adult ; *Employee Performance Appraisal ; Humans ; Models, Nursing ; Nursing Evaluation Research ; Nursing Staff, Hospital/*standards ; Task Performance and Analysis

PURPOSE: The purpose of this study is to explore problems of clinical nurse performance appraisal system. METHODS: This study employed a descriptive qualitative approach. The participants were purposively selected from clinical nurses working across all of the hospital units in a large metropolitan teaching hospital in Tehran, Iran in 2012. Data were collected using five focus group interviews, which were audio taped. The number of participants in each group ranged from 7 to 10. The semi-structured interviews were guided by a set of nondirective questions, and continued until the data reached saturation. Data were analyzed using framework analysis. RESULTS: Four major themes regarding the problems of clinical nurse performance appraisal system emerged from the analysis of textual data. These themes were contextual problems, problems related to performance appraisal structure, problems related to performance appraisal process and those related to performance appraisal results. CONCLUSION: The findings of this study reveal that the nurse performance appraisal system confronts with various problems. Some of these problems are related to organizational context while the others concerned structure, process and results of the performance appraisal system. In order to achieve high quality of patient care as the final goal of performance appraisal, changing and revision of this system is necessary.
Adult ; *Clinical Competence ; Employee Performance Appraisal/*standards ; Female ; Focus Groups ; Humans ; Iran ; Male ; Middle Aged ; Nurse Clinicians/*standards ; *Nursing Methodology Research ; Nursing Staff, Hospital/*standards ; Qualitative Research

PURPOSE: This study was done to evaluate the experience of securing patient safety in hospital operating rooms. METHODS: Experiential data were collected from 15 operating room nurses through in-depth interviews. The main question was "Could you describe your experience with patient safety in the operating room?". Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. RESULTS: The core category of experience with patient safety in the operating room was 'trying to maintain principles of patient safety during high-risk surgical procedures'. The participants used two interactional strategies: 'attempt continuous improvement', 'immersion in operation with sharing issues of patient safety'. CONCLUSION: The results indicate that the important factors for ensuring the safety of patients in the operating room are manpower, education, and a system for patient safety. Successful and safe surgery requires communication, teamwork and recognition of the importance of patient safety by the surgical team.
Adult ; Attitude of Health Personnel ; Female ; Humans ; Interviews as Topic ; Male ; Nursing Staff, Hospital/*psychology ; Operating Room Nursing/organization & administration/*standards ; Patient Safety/*standards

PURPOSE: This study was performed to give direction to quality improvement strategies of nursing services by comparing the differences in quality perceptions and satisfaction for nursing services between patients and nurses in small-medium sized general hospitals with 200 beds. METHOD: The subjects, who were 150 inpatients and 162 nurses of 4 general hospitals in a community, answered a self-report questionnaire with a SERVQUAL scale. RESULT: There were differences between patients' and nurses' expectations and perceptions of nursing service and satisfaction. In the service expectation, the highest factor was 'the responsiveness', and in the perceived performance, the highest was the 'assurance'. In addition, overall patients' perceptions on nursing services showed higher than nurses'. There were positive correlations among the expectations and perceptions on nursing service, and satisfaction. The correlation between perception and satisfaction was higher than the correlation between expectations and satisfaction. CONCLUSION: To improve the nursing service quality at small-medium hospitals, strengthening the 'assurance' factor and improving the nursing service support system is needed. Also, this study on nurses' perceived nursing service at small-medium sized hospitals should be duplicated.
Adolescent ; Adult ; Attitude of Health Personnel ; Female ; Hospital Bed Capacity ; *Hospitals, General ; Humans ; Korea ; Male ; Middle Aged ; Nursing Services/*standards ; Nursing Staff, Hospital/*psychology ; *Patient Satisfaction ; *Quality of Health Care

PURPOSE: The purpose of this study was to develop a balanced scorecard (BSC) for performance measurement of a Korean hospital nursing organization and to evaluate the validity and reliability of performance measurement indicators. METHOD: Two hundred fifty-nine nurses in a Korean hospital participated in a survey questionnaire that included 29-item performance evaluation indicators developed by investigators of this study based on the Kaplan and Norton's BSC (1992). Cronbach's alpha was used to test the reliability of the BSC. Exploratory and confirmatory factor analysis with a structure equation model (SEM) was applied to assess the construct validity of the BSC. RESULT: Cronbach's alpha of 29 items was .948. Factor analysis of the BSC showed 5 principal components (eigen value >1.0) which explained 62.7% of the total variance, and it included a new one, community service. The SEM analysis results showed that 5 components were significant for the hospital BSC tool. CONCLUSION: High degree of reliability and validity of this BSC suggests that it may be used for performance measurements of a Korean hospital nursing organization. Future studies may consider including a balanced number of nurse managers and staff nurses in the study. Further data analysis on the relationships among factors is recommended.
Adult ; Female ; Health Knowledge, Attitudes, Practice ; Hospitals ; Humans ; Korea ; Male ; Nursing Evaluation Research ; Nursing Staff, Hospital/organization & administration/*standards ; Questionnaires ; Task Performance and Analysis ; Young Adult

PURPOSE: The purpose of the study was to understand and describe the hospital workers' experience related to the hospital evaluation program implemented in Korea between 2004 and 2009. METHODS: During 2010, data were collected using focus group interviews. Four focus group interviews were held with a total of 28 hospital workers participating. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. RESULTS: Nine themes emerged from the analysis: 1) Positive change in the necessity of the evaluation; 2) Improvement in the hospital system, facilities, and human resources; 3) Unity through cooperation among departments; 4) Nursing work overload; 5) Lack of physicians' awareness and responsibilities; 6) Unfair and unrealistic evaluation items; 7) Lack of credibility of the outcome; 8) Shifting responsibility for negative outcomes to the workers; 9) Lack of pragmatic utility. CONCLUSION: The results of the study demonstrate that the hospital evaluation program played a key role in improving some work environments and communication among departments. At the same time, they show various negative themes resulting from the context of very authoritarian hospital systems and a connection-oriented society in Korea.
Adult ; Attitude of Health Personnel ; Female ; Focus Groups ; Hospitals/*standards/*statistics & numerical data ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Nursing Staff, Hospital/*statistics & numerical data ; Qualitative Research ; Tape Recording