임상간호연구 (Journal of Korean Clinical Nursing Research)

  • 제17권3호
  • /
  • Pages.363-374
  • /
  • 2011
  • /
  • 1598-9186(pISSN)
  • /
  • 2287-3694(eISSN)
병원간호사회 (Hospital Nurses Association)
권호 표지
DOI QR코드

DOI QR Code

비부가가치 간호활동(Non-Value-Added Nursing Activity) 유형과 발생원인 분석

Types and Causes of Non-Value-Added Activities in Nursing Practice in Korea

  • 최주순 (단국대학교병원 간호부) ;
  • 양영희 (단국대학교 의과대학 간호학과) ;
  • 백혜순 (단국대학교병원)
  • 투고 : 2011.09.19
  • 심사 : 2011.10.24
  • 발행 : 2011.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The purpose of this study was to identify the types and causes of non-value-added (NVA) activities in nursing practice, and to determine the frequency of each NVA type and causes of NVA in clinical area. Methods: This study was conducted using Delphi technique. First, in order to identify NVA and their causes, 24 nurses with 7 years or more of clinical experience were recruited from medical/surgical units in six general hospitals in Korea. Then the NVA types and causes were tested using a larger sample of 130 nurses with more than 3 years of clinical experience at two general hospitals in Korea. Results: NVA was categorized into 6 different types, which are repeating, duplicating, waiting, reverse-proxy working, reworking, and searching. The most prevalent NVAs were repeating and duplicating works. Reworking and searching were less frequent types than others. The causes of NVA were classified into personnel-related, supporting departments, records, regulations, information, materials or instruments, and others. Among them, personnel-related and supporting departments were reported with the highest scores. Conclusion: NVA leads to waste cost and time. These results demonstrated the situations and causes of NVA occurred in nursing practice. Further studies on the typology and moderation of NVA activities are warranted to improve the efficiency and quality of nursing care in day-to-day practice.

키워드

참고문헌

  1. 강경화(1999). 활동기준원가계산(ABC)을 이용한 간호활동 분석 및 간호서비스 원가분석-일 산부인과 간호단위를 중심으로. 간호행정학회지, 5 (2), 389-400.
  2. 고유경, 김병진(2008). 일반병동 간호인력 확보수준과 간호업무성과 분석. 간호행정학회지, 14 (4), 413-420.
  3. 김용우, 김광호(2008). 린 건설 관리방식의 공사 전 설계 진행에 관한 연구-미국벨뷰어린이병원사례조사-. 한국의료복지시설학회지, 14 (4), 47-54.
  4. 박성희(2001). 간호인력비율에 따른 직접간호활동 및 간호결과 분석. 고려대학교 박사학위논문, 서울.
  5. 박성희(2003). 입원환자 간호관리료 차등제에 따른 직접간호활동 및 환자결과 비교. 대한간호학회지, 33 (1), 122-129.
  6. 병원간호사회(2009). 2008 사업보고서: 병원간호인력 배치현황 실태조사. 서울: 저자.
  7. 병원간호사회(2010). 2009 사업보고서: 병원간호인력 배치현황 실태조사. 서울: 저자.
  8. 병원간호사회(2011). 2010 사업보고서: 병원간호인력 배치현황 실태조사. 서울: 저자.
  9. 송경자, 김은혜, 유정숙, 박혜옥, 박광옥(2009). 간호요구정도에 기초한 한국형 환자분류도구(KPCS)의 개발. 임상간호연구, 15 (1), 5-17.
  10. 장금성(2000). 간호사의 임상경력개발 모형구축에 관한 연구. 연세대학교 박사학위논문, 서울.
  11. Capuano, T., Bokovoy, J., Halkins, D., & Hitchings, K. (2004). Work flow analysis: Eliminating non-value-added work-. The Journal of Nursing Adminstration, 34 (5), 246-256. https://doi.org/10.1097/00005110-200405000-00008
  12. Cima, R. R., Brown, M. J., Hebl, J. R., Moore, R., Rogers, J. C., Kollengode, A., et al. (2011). Use of lean six sigma methodology to improve operating room efficiency in a high-volume tertiary-care academic medical center. Journal of the American College of Surgeons, 213(1), 83-92. https://doi.org/10.1016/j.jamcollsurg.2011.02.009
  13. Dickson, E. W., Singh, S., Cheung, D. S., Wyatt, C. C., & Nugent, A. S. (2009). Application of lean manufacturing techniques in the emergency department. The Journal of Emergency Medicine, 37 (2), 177-182. https://doi.org/10.1016/j.jemermed.2007.11.108
  14. George, M. L. (2006). 서비스 산업 분야를 위한 린 6 시그마(딜로이트 컨설팅 코리아 6시그마 그룹 역.). 서울: 한국맥그로힐(원저 2003 출판).
  15. Hasson, F., & Keeney, S. (2011). Enhancing rigour in the Delphi technique research. Technological Forecasting and Social Change, 78(9), 1695-1704. https://doi.org/10.1016/j.techfore.2011.04.005
  16. Hendrich, A. L., & Lee, N. (2005). Intra-unit patient transports: Time, motion, and cost impact on hospital efficiency. Nursing Economic $, 23(4), 157-164.
  17. Lambrinos, J., LaPosta, M. J., & Cohen, A. (2004). Increasing nursing hours without increasing nurses. The Journal of Nursing Adminstration, 34 (4), 195-199. https://doi.org/10.1097/00005110-200404000-00007
  18. Mito, S. (2004). 오노 다이이치와 도요타 생산방식(김현영 역.). 서울: 미래사(원저 2003 출판).
  19. Murman, E., Allen, T., Bozdogan, K., Cutcher-Gershenfeld, J., McManus, H., Nightingale, D., et al. (2008). 린 경영 전략(네오플럭스 역.). 서울: 가산출판사(원저 2002 출판).
  20. Ohno, T. (2004). 도요타 생산 방식(김현영역.). 서울: 미래사(원저1978 출판).
  21. Radnor, Z. J., Holweg, M., & Waring, J. (2011). Lean in healthcare: The unfilled promise? Social Science & Medicine, doi:10.1016/j.socscimed. 2011.02.011.
  22. Storfjell, J. L., Omoike, O., & Ohlson, S. (2008), The balancing act: Patient care time versus cost. The Journal of Nursing Administration, 38 (5), 244-249. https://doi.org/10.1097/01.NNA.0000312771.96610.df
  23. Storfjell, J. L., Ohlson, S., Omoike, O., Fitzpatrick, T., & Wetasin, K. (2009). Non-value-added time: The million dollar nursing opportunity. The Journal of Nursing Administration, 39 (1), 38-45. https://doi.org/10.1097/NNA.0b013e31818e9cd4
  24. Teichgraber, U. K., & de Bucourt, M. (2011). Applying value stream mapping techniques to eliminate non-value-added waste for the procurement of endovascular stent. European Journal of Radiology, doi:10.1016/j.ejrad.2010.12. 045.
  25. Tucker, A. L., & Spear, S. J. (2006). Operational failures and interruptions in hospital nursing. Health Services Research, 41 (3), 643-662. https://doi.org/10.1111/j.1475-6773.2006.00502.x
  26. Upenieks, V. V., Akhavan, J., & Kotlerman, J. (2008). Valueadded care: A paradigm shift in patient care delivery. Nursing Economic$, 26 (5), 294-300.
  27. Upenieks, V. V., Akhavan, J., Kotlerman, J., Esser, J., & Ngo, M. J. (2007). Value-added care: A new way of assessing nursing staffing ratios and workload variability. The Journal of Nursing Administration, 37 (5), 243-252. https://doi.org/10.1097/01.NNA.0000269744.17266.47