The purpose of this study was to develop a new nursing unit which can meet changing health care needs, enhance patients' satisfaction and nurses' job satisfaction, and finally guarantee quality nursing care with present manpower.
For this, one medical unit was selected as a unit for quality care. And one medical unit which is similar in staffing and patients' characteristics was selected as a control unit. To assess present problems and identify the remdies to the
problems
a
hospital-wide survey and a workshop were perforemed. According to the survey results, educational programs and improvement of the facilities and equipment supply system, managereal support for interdepartmental cooperation and intensification of
bed-side nursing care were adopted as main principles for operating model unit. This model unit was operated for 3 months from Sep. 1, 1992 to Nov. 30, 1992.
To evaluate the effectiveness of the model unit, derect/indirect nursing care hours, patients' satisfaction to nursing care. nurses' job satisfaction, and quality care index were measured. Direct/indirect nursing care hours were compared with
that
of
the control unit, and patients' and nurses' satisfaction and quality care index were measured before and after operating model unit and compared with each other.
@ES The results of the study were as follows;
@EN 1. In the model unit mean direct nursing care hours per cach shift was 146.88 minutes and indirect nursing care hours was 354.72 minutes. The ratio of the direct nursing care hour to indirect nursing hour was 29.6 : 70.4 and that of the
control
unit
was 26.9 : 73.1. Direct nursing care hour in model unit was longer than that of the control unit. But, the difference was not significant. In subcategories of direct nursing care, the time spent in mobility and exercise, conservation of body
temperature, hygiene, and communication and health education were longer than that of the control unit.
2. Indirect nursing care hour in model unit was shorter than that of the control unit. But, the difference was not significant. In subcategories of indirect nursing care, the time spent in drug management and ward arrangement was shorter than
that
of
the control unit.
3. Patients' satisfaction to nursing care was increased significantly after operating the model unit (T=-3.48, P=0.002) and satisfaction to subcategories of physical comfort measure, psychological cate, and unit management components were
significantly
higher than before.
4. In the model unit, nurses' total job satisfaction was increased significantly after operating the model unit (Z=-2.1004, P=.0357) and satisfaction to subcategory of satisfaction to administration was significantly higher than before
(Z=-2.0732,
P=.0382).
5. After operating the model unit, quality care index was increased from 89 to 93.
With this results, it can be summarized that all the measures tried for quality care, such as educational programs, managereal support for interdepartmental cooperation, and improvement of the equipment and facility provision resulted in partial
increase in direct nursing care hours. nurses satisfaction to their job and patients' satisfaction to nursing care.
In can be postulated that managereal support and motivation without proper staff supplementation is not enough for increasing direct nursing care hours. And for the enhancement of the level in clinical nursing, and staff supplement must be
considered
sincerely and the measures for reducing indirect nursing care hours, such as computerization of nursing care activities, improvement of facilities and equipment and facilities supply system, must be instituted in addition.
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