• Korean Journal of Artificial Intelligence
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• v.9 no.1
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• pp.1-7
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• 2021

In this paper, We focused the issue of creating a socially problematic nurse schedule. The nurse schedule should be prepared in consideration of three shifts, appropriate placement of experienced workers, the fairness of work assignment, and legal work standards. Because of the complex structure of the nurse schedule, which must reflect various requirements, in most hospitals, the nurse in charge writes it by hand with a lot of time and effort. This study attempted to automatically create an optimized nurse schedule based on legal labor standards and fairness. We developed an I/O Q-Learning algorithm-based model based on Python and Web Application for automatic nurse schedule. The model was trained to converge to 100 by creating an Fairness Indicator Score(FIS) that considers Labor Standards Act, Work equity, Work preference. Manual nurse schedules and this model are compared with FIS. This model showed a higher work equity index of 13.31 points, work preference index of 1.52 points, and FIS of 16.38 points. This study was able to automatically generate nurse schedule based on reinforcement Learning. In addition, as a result of creating the nurse schedule of E hospital using this model, it was possible to reduce the time required from 88 hours to 3 hours. If additional supplementation of FIS and reinforcement Learning techniques such as DQN, CNN, Monte Carlo Simulation and AlphaZero additionally utilize a more an optimized model can be developed.

• Journal of Korean Academy of Nursing
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• v.25 no.1
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• pp.80-87
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• 1995

The critical problem of nurse scheduling in the hospital is determining the day-to -day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. As nurse scheduling involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. A PC - based decision support system, developed in Turbo - C/sup ++/, for nurse scheduling was introduced. The system is composed of 4 sub-systems : 1) Entering basic information for each nursing unit : 2) Generation of an appropriate initial schedule and revised schedule for a given period, maximally satisfying each nurse's duty requests : 3) Provision of variety of statistical information, and 4) Help messages for each modular function. Icons and a mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurses develop quick and easy schedule generation and allow more time for the patient care.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.2
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• pp.73-83
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• 1996

Scheduling for nursing personnel involves many factors and requirements. Therefore, manual scheduling requires much time and effort to produce an adequate schedule. This paper introduces a PC based nurse scheduling support system which was developed in Microsoft Access 2.0, an easy to use data base management tool. First step of this system is to determine necessary number of nursing personnel by medical law or by patient classification. Current Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization. In addition, necessary nursing personnel by patient classification was determined four nurses for seven patients in this system based on the authors' preliminary study. And the second step is to assign daily duty type for each nurse at every nursing unit automatically. The introduced system fully utilizes the GUI environment of Microsoft Windows and even makes the computer-novice nurses feel comfortable in using the system. This system can help nursing administrators improve nurse scheduling in a way of quick and easy schedule generation for the future, and allow nurses more time for patient care.

• Journal of Korean Academy of Nursing
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• v.26 no.2
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• pp.399-412
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• 1996

Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current nursing productivity of nurses is not desirable unless the quality of care considered. Moreover. nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. As for the nurse scheduling, the critical problem of it in the hospital is determining the day-to-day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. Nurse scheduling, however, involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. Under these backgrounds, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. This study was performed to develop a system computerizing nurse staffing and scheduling based on the patient classification. As a preliminary step for the system development, nursing workload in a secondary hospital was measured from Sep. to Oct. 1994. On the grounds of this result, computerization of nurse staffing and scheduling was proceeded with three options. First one is based on the current medical law. Second one is based on the assigned number of nursing staff. And the last is based on the request by patient classification. Computer languages used in this study were MS Visual Basic 3.0 for the staffing and Access 2.0 for the scheduling, respectively. Prospective users may operate this system easily because icons and mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurse administrators manage nursing manpower efficiently and nurses develop quick and easy schedule generation and allow more time for the patient care.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.4
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• pp.404-412
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• 2008

Purpose: To analyse hospital nurse staffing level of the general nursing unit, ICU, ER and OR in general hospitals. Method: The study sample was 105 acute general hospitals which had reported the bed size and number of nurses by the nursing units. Number of bed per nurse was analysed by the hospital characteristics and the staffing levels of the doctors and the nursing assistant personnels using t-test or ANOVA and Pearson's correlation. Results: Number of bed per nurse was 3.86 in general nursing units and 0.95 in ICU. Tertiary hospitals employed more nurses in general nursing units and ICU than general hospitals. Hospitals located in Seoul and public hospitals employed more ICU nurses. OR nurse staffing level was higher in academic hospitals. Hospital size was positively correlated with nurse staffing level of the general nursing unit, ICU, ER and OR respectively. Total nurse staffing level of the hospital was positively correlated with doctor and nursing assistant personnels staffing levels. Conclusion : Differentiated nursing fee schedule was needed to implement in ER or OR. Regulation policy should be needed for the hospitals which violated hospital nurse staffing level of the law.

• Journal of the Korea Society of Computer and Information
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• v.25 no.3
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• pp.57-64
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• 2020

Today, with the development of information technology, hospitals are actively researching hospital information systems that are not limited by time and space to integrate mobile computing technology into the medical field to manage the bulk data of medical information. Nevertheless, most hospitals still spend a lot of time and effort creating manual schedules. In this paper, we studied an optimization model for organizing nurses' shift work and constructed an automated nurse-type job organization system. For nurses working in S hospital, information data, requirements and constraints of nurses were constructed. By applying this, we proposed an optimized scheduling method and built a web-based platform used by head nurses and a mobile app platform used by general nurses to enable real-time interchange and sharing around web servers. Therefore, through the developed nurse needs type automated system, the head nurses will increase the convenience of the nurses to organize the work every month, and general nurses will help them to work more accurately through personal schedule management. It is also expected to increase work efficiency by sharing work schedules among nurses.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.19 no.3 s.31
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• pp.180-188
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• 2006

Objectives : The purpose of this study is to investigate the differences of skin disease, particularly Acne between the rotating shift work nurses and the nurses on a fixed day schedule. Methods : Questionnaries were distributed to 30 rotating shift work nurses(the rotating group) and 34 nurses on a fixed day schedule(the daytime group). The questionnaris included questions on general health concepts, insomnia skin disease(particularly Acne), gastroenteric trouble, menstrual irregularity. Result : 1. There was significant difference on skin disease(particularly Acne) between two groups. 2. There was no significant relation between Gastroenteric trouble and Acne. But, in particular, there was significant relation between Constipation, Gastritis and Acne. 3. There was no significant relation between menstrual irregularity and Acne. 4. In Acne group, more than 70% felt the necessity of treatment, but only 2.5% used Korean Oriental Medical therapy. Conclusion : Disorder of circadian rhythm affects the skin disease(particularly Acne) more than Gastroenteric trouble and menstrual irregularity. But in this study, the total number of the nurse is not enough. So we need more accurate study about the aspects of skin disease. And about the Acne, publicity of Korean Oriental Medical therapy is required.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.2
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• pp.361-375
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• 2001

This research aims to produce and implement web-based continuing nurse education programs in response to nurses' educational needs, and to verify them, thus preparing for the times that the program will be offered via web. This research designed, produced and implemented 'emergency nursing' and 'medical fee schedule management' subjects based on Jung, In-seong's(1997) web-based instructional system design, and then compared the learning achievements of web-based learning group of 38 people with those of face-to-face learning group of 39 people. The questionnaire have been developed by these researchers to measure pre-learning knowledge on 'emergency nursing' and 'medical fee schedule management.' Data collected for this research have been given statistical analysis, using SPSS 10.0 for Windows Program. As a result of giving Mann-Whitney test, with respect to pre-learning prior knowledge level, there was no significant difference between the web-based learning group and the face-to-face learning group(Z=-.092, p=.926), while after completing learning, there was a significant difference in the learning achievements between the web-based learning group and the face-to-face learning group(Z=-2.406, p=.008). That is, this research revealed this: the web-based learning group and the face-to face learning group with both having no significant difference in the pre-learning level, after receiving the continuing education each with different methods(face-to-face education and web-based education), showed that the web-based learning groups attained higher learning achievements than the face-to-face learning groups. This result proves the effect of the web-based education to be no worse or even better than that of the face-to-face education, provided that choices of appropriate themes and quality courses composition, as well as systematic design development effective implementation are guaranteed.

• Journal of Korean Academy of Nursing
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• v.20 no.3
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• pp.381-398
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• 1990

Nursing involves deep human interpersonal relationships between nurses and patients. But in modem Korea, the nurse - patient relationship tends to be ritualistic and mechanestic. Patients usually express the hope that nurses be more tender and kind. Patients expect nurses to express their warmth especially through nonverbal behaviour. This study was conducted to identify patients' preferences for nurse's nonverbal expressions of warmth. Through the confirmation of these preferences, nurses may learn how to enhance their interpersonal relationships with patients. Subjects for the study were 73 patients who had been admitted to a university teaching hospital for at least three days and agreed to be interviewed by the investigator. The interactions were studied nonverbal expressions of warmth during nursing rounds and administration of oral medication. The interview schedule was expecially designed by the investigator to measure the nurse's posture, the distance between the nurse and the patient, the nurse's eye contact, facial expression, hand motion and head nodding. Data analysis included frequencies, percentages and X²-test. The results of this study may be summerized as follows : 1. Patient's preferences for nurse's nonverbal expressions of warmth during nursing rounds. Preferred nurse's posture was sitting(50.7%) or standing(49.3%) opposite the patient. Preferred distance between the nurse and the patient was close to the bed(93.2%), less than 1m. Preferred eye contact was directed to the patient's eyes or their affected part (41.1%). Preferred facial expression was a smile(97.3%). Preferred hand motions were light gestures(41.1%). Patients preferred head nodding which approved their own opinions(69.9%). 2. Patient's preferences for nurse's nonverval expressions of warmth during administration of oral medication. Preferred nurse's posture was standing and waiting to confirm that the medication had been taken(58.9%). Preferred distance from the patient was at arm's length, 0.5-1m(64.4%). Patients preferred direct eye contact(58.9%) and a smile(94.5%). Patients preferred that the nurse put the medicine directly the patient's hand(64.4%). Whether the nurse nodded her head or not was not considered important. 3. The relation of general characteristics and patient's preferences for nurse's nonverbal expressions of warmth during nursing rounds and administration of oral medication. During nursing rounds, the age of subjects(p＝0.010) and the standard of education(p＝0.026) related to the distance between the nurse and the patient. The sick hospital ward related to the eye contact(p＝0.017) and facial expression(p＝0.010). During administration of oral medication, the age of subjects(p＝0.044) and days of hospital treatment (p＝0.043) and the sick hospital ward(p＝0.0004) related to the facial expression. From this study, nurses can learn what kind nonverbal expressions of warmth are preferred by patients during rounds and administration and thus will enhance nurse- patient interpersonal relationships.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.5-46
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• 1989

The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.