Evaluation on the Performance of Nursing in according to the Nursing grade of Hospitals

병원 간호등급에 따른 간호수행 정도

As a cross-sectional study, this study was aimed to investigate and compare the job efficiency and satisfaction of nurses according to the hospital grade. Survey was conducted by mail on June 2009, and the respondents were 1,016 nurses working in 15 hospitals which are 9 high-grade general hospitals and 6 general hospitals. The percent of nurses acknowledging their hospital grades is 34.5%, and that is 20.5% at high-grade general hospitals. As the result of review of studies, it is concluded that under the circumstance that differential rates are contracted to calculate fees for hospital services and copayment of patients are according to nursing grades and hospital grades, the degree of nurses' awareness of insurance fees impact on their performance like recording of care and prescription. In order to improve nurses' performance, they need to be educated about the national insurance fee system. In hospitals with higher nursing grade and more beds, the levels of nursing quality and faithfulnes and their job satisfaction were higher. Nurses' awareness of their hospital nursing grade was related to the quality of nursing but not the faithfulness. Nurses working in higher nursing-grade hospital are more self-respect and satisfied at their jobs, and their job efficiencies are not significantly different. The current nursing fees based on the proper number of nurses per beds of nursing units should be changed to be based on the amount of job per nurse by their nursing protocol, and the nurse staffing standard should be differentiated between nursing grades. As the aspect of nursing, 24-hours patient care, it is difficult to improve nurses' job satisfaction, and in the other hand, that tends to depend on their income level. In the current circumstance, comprehensive research is required to investigate the propriety of 25% of the inpatient fees as the nursing management charge.