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조성현 ( Cho Sung-Hyun ) - Seoul National University College of Nursing
성지영 ( Seong Ji-Yeong ) - Seoul National University College of Nursing
정영선 ( Jung Young-Sun ) - Asan Medical Center Department of Nursing
유선주 ( You Sun-Ju ) - Mokpo National University Department of Nursing
심원희 ( Sim Won-Hee ) - Seoul National University Hospital Department of Nursing
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Abstract
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목적: 본 연구는 실제 및 적정 간호사 배치수준을 분석하고 이에 근거한 간호관리료 차등제 개정안을 제시하기 위해 시행되었다.
방법: 간호관리료 차등제 현황 분석을 위해 2022년 1분기 일반병동을 운영하는 상급종합병원과 종합병원의 배치등급과 입원환자 간호관리료를 분석하였다. 또한, 간호관리자와 일반간호사 대상 설문조사를 통해 실제 및 적정 간호사 배치수준, 근무일수, 보수월액을 조사하였다. 설문조사에는 상급종합병원과 종합병원에서 근무하는 간호관리자 101명과 일반간호사 588명이 참여하였다.
결과: 간호관리료 차등제 배치등급 분석 결과, 상급종합병원의 73.3%, 종합병원의 63.7%가 1등급에 해당하였다. 상급종합병원과 종합병원의 실제 간호사 배치수준은 각각 1:9.3과 1:10.4였다. 간호관리자와 일반간호사가 판단한 적정 배치수준은 상급종합병원에서 각각 1:7.6, 1:7.0이었으며, 종합병원에서는 각각 1:8.7, 1:8.8이었다. 일반간호사의 평균 추정 연간 근무일수는 상급종합병원 235.2일, 종합병원 240.0일로 나타났다. 일반간호사의 보수월액 중앙값은 상급종합병원 4,957천원, 종합병원 4,140천원이었다. 개정 간호관리료 차등제는 1:6 (1등급)에서 1:12 (5등급)을 제안한다. 개정 간호관리료는 배치등급별 환자 1일당 1일 간호시간에 따라 차등 지급할 것을 권고한다.
결론: 간호관리료 차등제 및 간호관리료 개정을 통해 간호사 배치수준과 간호의 질을 향상시키고 간호업무환경을 개선시킬 것으로 기대된다.
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Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels.
Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study.
Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade.
Conclusion: The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.
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KeyWords
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간호사, 수가체계, 일반병동, 간호서비스, 배치수준
Nurses, Fee Schedules, General Ward, Nursing Service, Staffing
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원문 및 링크아웃 정보
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등재저널 정보
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