Needs of the Study:Military hospitals are calculating the direct nursing workload through both a patient classification system and the indirect nursing workload. The indirect nursing workload, especially, was yielded by inputting the unit number of items conducted by each nursing unit. However, some of calculating items of the nursing workload are restricted to high frequency items, which makeit impossible to measure the total nursing workload. Gye-hwa Park and Seon-joo Kang(2000) calculated the time of direct nursing activities targeting on 16 military hospitals. The results from the 2000 study was not reflected in the DEMIS(Defense Medical Information System). The DEMIS, however, has been installed in 14 hospitals with the plan of modernizing hospitals, which shaped the working environments and climates of the hospitals. In this context, we found more itemsof the direct/indirect nursing activities than those of previous study. We, also, categorized a list of direct/indirect nursing activities including newly-found items. On top of this, most importantly, we succeed in explaining each item of activities, and thenwe established a category including a grouped list. The study can be a standard when measuring nursing workload in militaryhospitals by utilizing the study results in connection with DEMIS.
Objectives of the Study: 1) Analyzing patient classification System and a list of direct/indirect nursing activity in DEMIS. 2) Categorizing the direct/indirect nursing activities that are suitable for general Nursing Unit Environment of Military Hospitals. 3) Producing the time of direct/indirect nursing activities in the general nursing unit of military hospitals.
Procedure and Tools for the Study: The Study was conducted with the 4 steps. In the first step, the direct/indirect nursing activities are categorized by referring to the patient classification system in DEMIS and reviewing previous results of studies and other related resources. We, basing on the found, explained each item of activities, and then we established a category including a grouped list. In the second step, the validity of contents was examined by an expert group composed of both 10 nursing professors and 5 head nursing officers with over 7 years experiences. In the third step, the time of direct/indirect nursing activities in the general nursing Unit of Military Hospitals was measured. In case of direct nursing activities, the measuring methods were conducted by observing nursing officers and by utilizing previous studied results. In case of indirect nursing activities, it was conducted by a self-reporting method. In the fourth step, the study averaged the nursing activity time by general nursing units of the third step. As a study tool, the survey form for measuring the time of direct/indirect nursing activities was made by analyzing data gathered in the first and second steps. The part of direct nursing activity is composed of 8 categories: checking & observation, respiratory nursing, nutrition & excretion, activity & individual hygiene, medication, treatment & procedure, patient education & support, and crisis management. On the other hand, the part of indirect nursing activities is composed of 4 categories: the operating nursing unit, reporting, supporting and other administration jobs.
Subject of the Study and Investigation Method: The gathering data for the direct nursing activities in 2 hospitals was conducted from Aug. 30th to Sep. 8th of 2006 by applying observation methods. Survey forms, also, for measuring the time of indirect nursing activities were distributed to 14 military hospitals from Sep. 7thto 15th of 2006, and the 90 percent of survey forms was returned.
Result of the Study: 1) Average Practicing Time for Direct Nursing Activities Survey forms for direct nursing activities were used in 2 military hospitals to measure the time spent for 163 nursing activity items. The period spent from preparation to closing of activities per a time was recorded as average practicing minutes. 2) Average Practicing Time for Indirect Nursing Activities Survey Forms from 14 military hospitals were used to check the minutes spent for 37 nursing activities. The average practicing minutes for indirect nursing was produced by applying self-reporting methods excluding minimum and maximum values.
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