Kim J, et al. J Korean Acad Nurs Adm. 2017 Jun;23(3):312-322. https://doi.org/10.11111/jkana.2017.23.3.312

South Korea is one of the countries with a very low percentage of active nurses among the Organization for Economic Cooperation and Development (OECD) countries. Although the number of nurses has increased steadily, the number of active nurses has not increased more than expected due to continued turnover. This study used data of a longitudinal panel of Graduates Occupational Mobility Survey (GOMS) and performed survival analysis to determine the turnover rate of nurses and the average time of turnover. The turnover rate was the highest at 25% within first year and 50% of nurses left their first job during the study period. The hospital size and salary levels were major factors that affected the turnover rate, with small-scale hospitals and extremely low salary levels having the highest turnover. Dissatisfaction with the organization and dissatisfaction with the profession also directly impacted job turnover. Turnover rate of male nurses was higher than that of female nurses. Turnover of newly graduated nurses is highly inefficient personnel management. A strategy for reducing the turnover is needed.

Aim To analyze patient factors and nurse staffing‐related issues involving hospital‐acquired pressure ulcers (HAPUs) in patients at two types of hospital. Background HAPUs are important for the safety of hospitalized patients. HAPUs not only cause health problems, but also pose an economic burden to patients. In addition to patient factors such as mobility and skin integrity, hospital factors such as nurse staffing can also affect the management of such patients. Design This study is a retrospective review of patient data and analysis of factors related to HAPUs using stratified Cox proportional hazards regression. Results A total of 53,923 patients were included. The incidence of HAPUs was 0.98 per 1,000 days. HAPUs were affected by gender, age, previous falls, low oxygen levels, positioning, and toilet use. When the levels of nurse staffing was determined as one of the hospital factors, the daily hours of patient care was increased thereby contributing to the reduced incidents of HAPUs. Conclusion Strategies for preventing HAPUs should be based on the analysis of risk factors. Implications for nursing management Most individual risk factors for HAPUs identified cannot be modified easily in a short time. Nurse staffing should be set at adequate levels to prevent HAPUs.

Osteoporotic fractures (OFs) in the elderly are common worldwide, and the predicted number of the aging population is increasing the burden of OF on health care systems. To estimate the economic burden of OF in people older than 65 years in South Korea from a societal perspective. National Health Insurance claim databases were used to analyze health care utilization and medical costs of OF in the Korean population (49 million). We identified medical claims records with a diagnosis of OF and estimated the costs from 2007 to 2011. From 2007 to 2011, there were 244,798 patients with at least one medical insurance claim related to OF. Most patients had a single fracture (80%), whereas 20% of all patients had two or more. For fracture sites, vertebral fracture accounted for 75.6% of all fractures, followed by hip and wrist fractures. The societal cost of OF increased annually, from US $88.8 million in 2007 to US $149.3 million in 2011. Among the entire cost, the direct medical cost was US $134.9 million in 2011, which includes the cost of treatment (US $91.2 million) and long-term care (US $48.1 million). The direct nonmedical cost was US $9.9 million in 2011. Costs associated with morbidity and mortality of OF were excluded. The economic burden associated with OF in elderly is expected to rise with the predicted increase in life expectancy and the number of elderly in South Korea. Therefore, effective management of the disease is necessary to reduce the growth in the economic burden of OF.

Although there is considerable literature on job satisfaction among nurses in various settings, there is little research about contributing factors, including moral distress to job satisfaction among a certain group of nurses, such as nurses acting as physician assistants. The purpose of this study was to verify the impact of nurse–physician collaboration, moral distress, and professional autonomy on job satisfaction among nurses acting as physician assistants. Descriptive and correlational research was conducted on a convenience sample of 130 nurses from five general hospitals in South Korea. In the final regression model, the adjusted R square was significant, explaining 38.2% of the variance of job satisfaction (F = 8.303, p < 0.001), where ‘cooperativeness’ (β = 0.469, p = 0.001) from nurse–physician collaboration, ‘institutional and contextual factor’ from moral distress (β = −0.292, p = 0.014), and professional autonomy (β = 0.247, p = 0.015) were included. In hospital environments, a more cooperative inter-professional relationship between nurses and physicians led to less moral distress caused by organisational constraints. A higher level of professional autonomy among nurses acting as physician assistants is required to increase their job satisfaction.