PURPOSE: The purpose of this study was to develop a structural model for patient safety management activities and to identify the influencing factors of organizational and individual dimensions that promote patient safety management activities and to suggest effective intervention plans.METHODS: A structured self-report questionnaire was used to measure organizational factor, attitude, subjective norm, perceived behavior control, and patient safety management activities. The questionnaires were distributed to 300 nurses and 275 were included in the analysis. SPSS 25.0 and AMOS 21.0 were used to analyze the model fitness, indirect effect, and direct effect of the model.RESULTS: The hypothetical model for patient safety management activities was appropriate. Among the 8 pathways, 6 direct pathways were significant. Organizational factor affected individual attitudes, subjective norms, and perceived behavior control. Perceived behavior control, and subjective norm affected behavioral intention. Behavioral intention affected patient safety management activities. Perceived behavior control did not affect patient safety management activities.CONCLUSION: Organizations and individuals must change together to promote patient safety management activities. The organization should establish practical education and training, systems and regulations. Individuals should increase behavioral intention by strengthening perceived behavioral control and subjective norm.
Behavior Control ; Education ; Humans ; Intention ; Models, Structural ; Nurse Clinicians ; Patient Safety ; Safety Management ; Social Control, Formal

BACKGROUND: Although clinicians, nurse specialists, pharmacists, and nutritionists expend significant time and resources in optimizing care for patients with diabetes, the effectiveness of integrated diabetes care team approach remains unclear. We assessed the effects of a multidisciplinary team care educational intervention on glycated hemoglobin (HbA1c) levels among diabetes patients. METHODS: We conducted a matched case-control study in Korean patients with type 2 diabetes, comparing the propensity scores pertaining to the effectiveness in reducing HbA1c levels between a group receiving an educational intervention and a control group. We included 40 pairs of patients hospitalized between June 2014 and September 2016. HbA1c values measured at baseline, 3 months, and 6 months were compared between the two groups. RESULTS: The educated group showed an improvement in HbA1c levels compared to the control group at 3 months (6.3 ± 2.3% vs. 9.5 ± 4.0%; P = 0.020) and at 6 months (7.5 ± 1.5% vs. 9.6 ± 3.0%; P = 0.106). There was a significant difference in the change in mean HbA1c from baseline to 3 months between the two groups (−35.7 ± 26.1% vs. −9.1 ± 20.5%; P = 0.013). CONCLUSION: A multidisciplinary team care education intervention was advantageous for improving glucose control in patients with type 2 diabetes, and may help to optimize glycemic control in clinical practice.
Case-Control Studies ; Diabetes Mellitus ; Education* ; Glucose ; Health Education ; Hemoglobin A, Glycosylated ; Humans ; Nurse Clinicians ; Nutritionists ; Pharmacists ; Propensity Score ; Specialization

PURPOSE: This study aimed to investigate the current statistics of professional medical support staffs(PMSSs) working in general hospitals with less than 500 beds. METHODS: This study was conducted on 35 general hospitals with less than 500 beds from September 11th to October 27th, 2017. RESULTS: Four hundred fifty one PMSSs were currently providing medical support. The number of clinical nurse experts was the highest among the roles, followed by Physician Assistants(PA) and Advanced Practice Nurses. The mean job satisfaction score was 3.07 out of 5. In the case of PA group, most of the delegated prescriptions were performed, however the delegated roles were not much documented in written format. The paucity of documentation requires a development of a committee for PMSSs, including a development of selection criteria and a scope of practice in each institution. CONCLUSION: The results of this study suggested the composition of a committee for PMSSs in the medical institutions and renaming the specified titles of PMSSs.
Hospitals, General ; Humans ; Job Satisfaction ; Nurse Clinicians ; Nurse Practitioners ; Nursing ; Patient Selection ; Physician Assistants ; Prescriptions

PURPOSE: This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS).METHOD: The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others.RESULTS: Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics.CONCLUSION: To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.
Counseling ; Education ; Humans ; Job Description ; Leadership ; Methods ; Nurse Clinicians ; Physician Assistants ; Work Performance

Nursing research in the United States (US) spans several decades. Many of the priorities/trends have stayed through the years. Today, the goal of producing evidence to support nursing care interventions coupled with the drive for Magnet Recognition has encouraged academic nurses (faculty) to work with nurse clinicians to form research teams. Interdisciplinary research teams have also formed to address growing concerns over patient safety and quality care. These issues are not just US issues but global ones. This article addresses US trends with the link to global research trends. The role that organizations such as the International Council of Nurses (ICN), the World Health Organization (WHO), and the Council of International Neonatal Nurses, Inc. (COINN) pay in shaping research agendas and promoting nursing research is highlighted. It emphasizes the key role that nurses, especially nurse leaders/administrators play in changing health outcomes through support of nursing research.
Delivery of Health Care* ; Humans ; International Council of Nurses ; Nurse Clinicians ; Nursing Care ; Nursing Research* ; Nursing* ; Patient Safety ; United States ; World Health Organization

BACKGROUND: This study was conducted to develop a pre-discharge group education program for liver transplant patients, and to contribute to improving the knowledge and performance of self-management after discharge. METHODS: This investigation was a methodological study consisting of analysis, design, development, operation, and evaluation stages. RESULTS: The constituent items of the pre-discharge group education program for liver transplant patients include medication management, infection management, emergency management, outpatient management, complication management, nutrition management, exercise management, wound and drainage management, disability registration, and sex life. The pre-discharge group education program for liver transplant patients was conducted once a week, 30 minutes for the coordinator, 40 minutes for the clinical nurse specialist (including 10 minutes for wound and drainage management), 30 minutes for pharmacists, 20 minutes for the nutritionist, and 20 minutes for social workers. Additionally, the contents of the lecture announced by PowerPoint were made the same as the booklet. The overall knowledge level before and 3 months after the pre-discharge group education program for liver transplantation patients increased significantly from 17.32±1.53 to 19.74±0.89. At the 3-month time point, the overall compliance was 77.39±3.04 out of 80. Overall satisfaction was 9.32±0.93 on a scale of 10. Finally, the need for medication was the highest at 3 months. CONCLUSIONS: It is expected that this program can be utilized in the clinical field as an effective nursing education intervention.
Compliance ; Drainage ; Education* ; Education, Nursing ; Emergencies ; Humans ; Liver Transplantation ; Liver* ; Methods ; Nurse Clinicians ; Nutritionists ; Outpatients ; Pamphlets ; Pharmacists ; Self Care ; Social Work ; Social Workers ; Wounds and Injuries

PURPOSE: This study was to investigate the nationwide operational status of the professional medical support staffs (PMSS) who practice the expanded roles in the hospital setting. METHODS: The data were obtained through survey from 36 hospitals with over 500 beds from 25th May to 12th July 2016. Data from 1,666 PMSS were analyzed. RESULTS: Since the job titles varied, we classified them into 5 groups according to their roles; advanced practice nurse, clinical nurse expert, PA (physician assistant), coordinator, and others. There were differences in the operation status of PMSSs depending on the region, nurse staffing grade and number of hospital beds. Qualification criteria varied from hospital to hospital, and almost half of the hospitals didn't have any qualification standards for them. There were differences in age, educational level, clinical careers, rewards, and job satisfaction in 5 groups. Especially PA group had low salary, poorer working conditions, more difficulties in performing their work, and lower job satisfaction than other groups. Most PMSS (99.5%) were using a delegated prescription authority, however only 68.3% had job description and 19.9% had documented delegated role. CONCLUSION: Adequate training curriculum, documented delegated roles, and the protocols for legal protection and efficient medical services are needed.
Curriculum ; Humans ; Job Description ; Job Satisfaction ; Nurse Clinicians ; Organization and Administration ; Physician Assistants ; Prescriptions ; Reward ; Salaries and Fringe Benefits

PURPOSE: This study investigated factors affecting the knowledge and attitude of organ procurement from brain dead patients in nurse clinicians.METHODS: A survey was conducted with 160 clinical nurses from a university hospital in Seoul. Descriptive statistics, t-tests, an ANOVA, Scheffé's test, Pearson's correlation coefficient, and a multiple regression analysis were used.RESULTS: The mean score for knowledge of organ procurement from brain dead patients was 12.41 ± 2.16 (mean correct answers = 62.1). Factors influencing the knowledge of organ procurement among nurse clinicians were working department (β = .454, p < .001), a recent family death (β = .187, p = .014), experience recognizing potential brain dead patients (β = .182, p = .033), and experience referring to potential brain dead patients (β = -.192, p = .048).CONCLUSION: To ensure effective organ procurement from brain dead patients, it is necessary to continually educate nurse clinicians to improve their attitude and knowledge concerning organ donation.
Brain Death ; Brain ; Humans ; Nurse Clinicians ; Seoul ; Tissue and Organ Procurement

Objectives: Low back pain (LBP) is one of the most common health problems faced by health care professionals due to their occupational lifestyle. This study aimed to quantify the prevalence of LBP among clinicians, and to identify its associated factors. Methods: A cross sectional study was carried out in King Khalid University Hospital (KKUH) among 460 clinicians from different specialties. A validated questionnaire of 21 items was used to collect data. Chi-square test and odds ratios were used to observe and measure the association between categorical variables. Binary logistic regression by Wald method was used to identify independent factors associated with LBP (yes/no). Results: The prevalence of LBP was found to be 59.4% (244) with 38% of them reported as severe. The distribution of prevalence among consultants, registrars and residents was 110 (45.1%), 91 (37.3%) and 43 (17.6%) respectively. Out of 114 (46.7%) surgeons who suffer from LBP we found, orthopaedic surgeons had 10.2% prevalence of LBP. Male clinician (odds ratio: 1.7; 95% Confidence Interval (CI): 1.1- 2.8), consultant (4.1; 95% CI: 2.1-8.3), registrar (2.2; 95% CI: 1.2-4.2), more than 10 hours/week near bedside (1.8; 95% CI: 1.1-3.0), bending backwards at work (8.3; 95% CI: 5.1-13.4) and pulling objects during work (3.1; 95% CI: 1.7-5.6) were found to be independent statistically significant associated factors of LBP. Conclusion: The high prevalence of LBP among clinicians and its associated factors indicates that clinicians should maintain good posture and avoid sudden movements during working hours in hospital to reduce this occupational health problem.
Low Back Pain ; Life Style ; Nurse Clinicians

PURPOSE: The purpose of the study was to explore and describe the job experiences of oncology nurse specialists. METHODS: Nine oncology nurse specialists participated in the study. Data were collected through in-depth unstructured interviews with individual participants from February to June, 2014. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Corbin and Strauss's grounded theory method. RESULTS: From open coding, 98 concepts, 24 sub-categories, and 11 categories were identified. Analysis revealed that the core category of the job experiences of oncology nurse specialists was 'tightrope walking of professionalism without safeguards', consisting of four phases: Enthusiastic beginning, conflict, exertion, and internalization. To manage the 'tightrope walking of professionalism without safeguards', participants utilized various action/interactional strategies such as 'keeping the balance point' and 'taking a step forward.' As a result, participants experienced falling into a habitual routine and professional self-actualization. CONCLUSION: In-depth understanding of the job experiences of oncology nurse specialists will guide hospital administrators to promote effective interventions and policies to better support Korean oncology nurse specialists.
Clinical Coding ; Hospital Administrators ; Humans ; Nurse Clinicians ; Oncology Nursing ; Qualitative Research ; Specialization* ; Walking