PURPOSE: The importance of human dignity in care is well-recognized. Care recipients' experiences with undignified care have been reported in many countries. However, few studies have measured these situations quantitatively, especially as there are no tools applicable to inpatients receiving ordinary daily care. This study aimed to develop a valid and reliable Inpatient Dignity Scale (IPDS) that can measure inpatients' expectations of and satisfaction with dignity in daily care. METHODS: We conducted a three-phase research project: item generation and a preliminary survey with 47 items related to patients' dignity in Japan, a main survey with 36 items with deliberate translation into English in Singapore, and a confirmatory survey with 35 items in England, with 442, 430, and 500 inpatients as participants in questionnaire surveys, respectively. Data from each survey were processed using factor analysis. RESULTS: Authors obtained a scale with a four-factor structure with acceptable reliability: (F1) respect as a human being, (F2) respect for personal feelings and time, (F3) respect for privacy, and (F4) respect for autonomy. CONCLUSION: The Inpatient Dignity Scale can be periodically used by hospital administrators or nurses to preserve inpatients' dignity in daily care by monitoring inpatients' views regarding their expectations of and satisfaction with dignity.
England ; Great Britain ; Hospital Administrators ; Humans ; Inpatients ; Japan ; Nursing ; Personhood ; Privacy ; Psychometrics ; Singapore

PURPOSE: This study was done to analyze the problems and desired work conditions of nursing organizations in small-medium hospitals. METHODS: Delphi Technique was used. In the first stage, the work conditions of nurses in small-medium hospitals were identified through a literature review. In the second stage, through 3 consultations with 20 nurse advisory groups, feedback was received on the desired work conditions for nurses in small-medium hospitals. In the third stage, 415 nurses and nurse managers were selected to examine the content validity and importance of the desired work conditions identified in the second stage. RESULTS: Sixty-four items were developed along eight domains of desired work conditions for nurses in small-medium hospitals. The survey on the desired work conditions revealed the following in order of importance: ‘wages’, ‘personnel’, ‘job’, ‘work hours’, ‘welfare’, ‘education’, ‘culture’, and and ‘other incentives’. CONCLUSION: The results of this study suggest that small-medium hospitals need to recognize the desired work conditions desired by nurses and accordingly change policies through the efforts of hospitals and professional groups.
Delphi Technique ; Health Facility Environment ; Humans ; Nurse Administrators ; Nursing ; Personnel Turnover ; Referral and Consultation

In November 2009, through Republic Act 9792, Davao Medical Center was renamed Southern Philippines Medical Center (SPMC). This act also provided for the increase in the bed capacity of the hospital from 600 to 1,200 beds.1 The set of implementing rules and regulations for the legislation subsequently specified the increase in the number of health human resources in SPMC to cope up with the hospital's growing number of clients.2 Currently, SPMC has a total of 4,737 personnel, composed of 3,329 employees with plantilla positions and 1,408 employees with non-plantilla positions, deployed to the different divisions of the hospital. Roughly a third of the total personnel are administrative staff, and two thirds are medical and allied medical staff. The Medical Center Chief (MCC) oversees the operations of the whole hospital. Five administrators directly assist the MCC in hospital management: the Chief of Medical Professional Services, the Chief Nurse, the Chief Administrative Officer, the Financial and Management Officer, and the Chief of Allied Professional Services. Due to the increasing bed occupancy rates and the pressing need to increase health human resources in SPMC, an increase in the institution’s bed capacity from 1,200 to 1,500 is presently being proposed through House Bill 7061.3 Once the bill is passed into law, it is expected that additional plantilla items will be created in order to meet the greater operational demands of a bigger hospital.
Hospital Administration ; Hospital Administrators

BACKGROUND: This study aims to conduct curriculum analysis on health management schools focusing on relationship with licence and certification in Republic of Korea. METHODS: Possible employment field, licence and certification as well as curriculum were collected from the home page of 30 health management schools. The subjects and credits of curriculum were analyzed using descriptive statistics. Main subjects by areas were drew using categorization and ranking within qualitative methods. Comparative analysis was conducted for checking relationship between main subject and possible employment field, licence and certification. RESULTS: First, major employment fields after graduation were public health officer, general hospital and clinic, and National Health Insurance Service. Possible licence and certificate were hospital administrator, medical recorder, health education specialist, and medical insurance specialist. Second, total graduate credits were 133.9 including 79.0 for major education, 30.5 for of general education, and 30.5 for elective courses. Third, main subjects were reviewed by areas including basic medicine, health management, hospital business & management, medical records & information, insurance billing & assessment, healthcare marketing & tourism, and health education. There were highest number of subjects on health education area among 8 categories. By subjects, many health management schools open health law, medical terminology, introduction to public health, and biostatistics. Relationship between main subjects and possible employment field, licence and certification in health management schools was strong. CONCLUSION: It is necessary to review curriculum and for improving educational quality in health management schools. Also, development of curriculum standards for courses in health administration and introduction of accreditation system can be considered.
Accreditation ; Biostatistics ; Certification ; Commerce ; Curriculum ; Education ; Employment ; Health Care Sector ; Health Education ; Hospital Administrators ; Hospitals, General ; Humans ; Insurance ; Jurisprudence ; Medical Records ; National Health Programs ; Public Health ; Republic of Korea ; Specialization

PURPOSE: This study applied the Q method to identify and describe the various types of nurse perceptions that are crucially associated with their engagement in evidence-based nursing (EBN). METHODS: The study participants were nurses at a medical center and a regional teaching hospital. A series of Q sorts was performed by nurses to subjectively rank the Q statements. Q statements were constructed based on the literature related to EBN adoption by nurses and face-to-face interviews. RESULTS: A total of 60 participants were invited to rank 44 Q statements related to EBN. Factor analysis was conducted on the rankings of the Q statements. The following are the five prominent shared perspectives: (1) emphasized the obstacles to evidence searching and reading ability; (2) emphasized the organizational promotive strategies; (3) emphasized the available supportive resources; (4) emphasized the significance of EBN; and (5) emphasized the evidence-searching ability and external incentives. The five identified groups of perspectives can enhance hospital administrators to acknowledge the barriers and incentives associated with EBN practices. CONCLUSION: The exploration of clustering nurses' perceptions may facilitate the development of customized strategies to enable more appropriate training.
Clinical Competence ; Evidence-Based Nursing* ; Hospital Administrators ; Hospitals, Teaching ; Humans ; Methods* ; Motivation ; Nursing Care ; Q-Sort ; Reading

PURPOSE: This study aimed to investigate clinical nurses' perception on nursing managerial competencies. METHODS: This was a descriptive study. The data were collected from 198 nurse managers who had worked in six general hospitals using a self-reporting questionnaire. Data were analyzed by descriptive statistics, t-test, ANOVA, and Importance-Performance Analysis. RESULTS: Only 32% of the participants had experienced nursing managerial competency training. The mean score for perceived performance of nursing managerial competency was lower than that for perceived importance. There were significant differences in perceived importance, performance, and importance-performance gaps among head, charge, and staff nurses. Importance-performance analysis showed that three of the 30 nursing managerial competencies require further development: staffing, human resources development and education, and nursing standard development competency. There were significant differences in importance-performance gaps according to age, career years in current hospital, work shift, position, nursing delivery system, and nursing managerial competency-education experience. CONCLUSION: A training program for developing and improving nursing managerial competencies which is focused on the gaps in importance and performance level is needed for clinical nurses. In addition, it should be considered to improve nursing work conditions such as nursing delivery system and formal appointment in order to increase the performance of nursing managerial competencies.
Education ; Head ; Hospital Administration ; Hospitals, General ; Humans ; Nurse Administrators ; Nursing* ; Professional Competence ; Staff Development

PURPOSE: The aim of this study was to develop the nursing management core task and competency matrix for hospital unit managers. The perceived level of importance and performance of identified core competencies by unit managers were also investigated. METHODS: Literature review and expert survey identified nursing management core task and competencies. Subsequently, the core task and competency matrix was developed and validated by expert panel. A survey of 196 nurse managers from 3 cities identified perceived importance and performance of core competiences. RESULTS: Thirty-eight nursing management core task and thirty-seven nursing management core competencies were identified comprising five categories; Clinical practice knowledge, Evidence-based practice, Employee development, Strategic planning and Initiative. Based on the core task and competencies, the task and competency matrix for unit managers was developed. In the analysis of importance and performance of core competencies, the mean score of importance (3.50±0.30) was higher than the mean score of performance (3.03±0.34). CONCLUSION: The development of core task and competencies for unit managers in hospitals provides a guide for the development and evaluation of programs designed to increase competence of unit managers.
Evidence-Based Practice ; Hospital Units ; Humans ; Mental Competency ; Nurse Administrators ; Nursing

PURPOSE: This study was done to build and verify a model of clinical nurses' turnover intention using organizational characteristics, job satisfaction and job embeddedness. METHODS: The study participants were 389 hospital nurses. SPSS and AMOS 22.0 program were used to analyze the data and the modeling of turnover intention. RESULTS: A total of 41% of turnover intention was explained by job satisfaction, job embeddedness and organizational characteristics. Nurses with higher job satisfaction and job embeddedness showed lower turnover intention, while organizational characteristics had an indirect effect on their turnover intention. It was found that organizational characteristics had positive effects on both job satisfaction and job embeddedness, and job embeddedness played a mediating role between organizational characteristics and turnover intention. CONCLUSION: To reduce nurses' turnover intention, hospitals' organizational characteristics should be considered. Nurse managers should strive to increase nurses' job satisfaction and job embeddedness through an understanding of the factors of organizational characteristics such as organizational fairness, nursing work environment, motivation, organizational citizenship behavior, and transformational leadership.
Health Facility Environment ; Humans ; Intention* ; Job Satisfaction* ; Leadership ; Models, Structural* ; Motivation ; Negotiating ; Nurse Administrators ; Nursing ; Organization and Administration ; Personnel Turnover

PURPOSE: The aim of this study was to examine the mediating effect of empowerment in the relationship of nurse managers' authentic leadership, with nurses' organizational commitment and job satisfaction. METHODS: The participants in this study were 273 registered nurses working in five University hospitals located in Seoul and Gyeonggi Province. The measurements included the Authentic Leadership Questionnaire, Condition of Work Effectiveness Questionnaire-II, Organizational Commitment Questionnaire and Korea-Minnesota Satisfaction Questionnaire. Data were analyzed using t-test, ANOVA, Scheffe test, Pearson correlation coefficients, simple and multiple regression techniques with the SPSS 18.0 program. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. RESULTS: There were significant correlations among authentic leadership, empowerment, organizational commitment and job satisfaction. Empowerment showed perfect mediating effects in the relationship between authentic leadership and organizational commitment. It had partial mediating effects in the relationship between authentic leadership and job satisfaction. CONCLUSION: In this study, nurse managers' authentic leadership had significant influences on nurses organizational commitment and job satisfaction via empowerment. Therefore, to enhance nurses' organizational commitment and job satisfaction, it is necessary to build effective strategies to enhance nurse manager's authentic leadership and to develop empowering education programs for nurses.
Adult ; Attitude of Health Personnel ; Hospitals, University ; Humans ; *Job Satisfaction ; *Leadership ; Nurse Administrators/psychology ; Nursing Staff, Hospital/*psychology ; Organizational Culture ; *Power (Psychology) ; Surveys and Questionnaires ; Young Adult

BACKGROUND: Over the last few decades, because hospitals in South Korea also have undergone dramatic changes, Korean hospitals traditionally have provided specialized health care services in the health care market. Inner Herfindahl-Hirschman Index (IHI) measures hospital caseloads based on patient proportions, independent of patient volumes. However, IHI that rely solely on patient proportions might be problematic for larger hospitals that provide a high number of diagnosis categories, as the patient proportions in each category are naturally relatively smaller in such hospitals. Therefore, recently developed novel measure, category medical specialization (CMS) is based on patient volumes as well as patient proportions. METHODS: we examine the distribution of hospital specialization score by hospital size and investigate association between each hospital specialization and length of stay per case and hospital cost per case using Korean National Health Insurance Service-cohort sample data from 2002 to 2013. RESULTS: Our results show that IHI show a decreasing trend according to the number of beds and hospital type but CMS show an increasing trend according to the number of beds and hospital type. Further, inpatients admitted at hospitals with higher IHI and CMS had a shorter length of stay per case (IHI: B=-0.104, p<0.0001; CMS: B=-0.044, p=0.001) and inpatients admitted at hospitals with higher IHI and CMS had a shorter hospital cost per case (IHI: B=-0.110, p=0.002; CMS: B=-0.118, p=<0.0001). CONCLUSION: this study may help hospital policymakers and hospital administrators to understand the effects of hospital specialization strategy on hospital performance under recent changes in the Korean health care environment.
Delivery of Health Care ; Diagnosis ; Health Care Sector ; Health Facility Size ; Hospital Administrators ; Hospital Charges* ; Hospital Costs ; Humans ; Inpatients ; Korea ; Length of Stay* ; National Health Programs