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서울 시내 보건소 보건간호원의 업무활동의 기능 구조에 관한 조사 연구(1970년도)

A Survey of the Functional activities of Public Health Nurses in Three Health Centers in Seoul(1970)

공중보건잡지 1970년 7권 2호 p.603 ~ 619
김화중 (  ) - 서울대학교 보건대학원

Abstract


An activity was under taken for the purpose of identifying the types of functions performed by Public Health Nurses in the City Health Clinics, in order to provide a basis for more systematic and regular studies in the future. Three of the nine Health Centers in the City of Seoul were selected, and one staff Nurse form each division(Maternal Health, Child Health, Family Planning, and Tuberculosis) was selected form each Health Center for observation during the present study. At the time of the study there was an outbreak of Cholera in the southern parts of the country, therefore the activities of the Nureses in two of the Health Centers were observed in a time of increased emergency activity. These two centers were the Joong Ku and the Yong san Health Centers. Activities were normal at the third center, Tong Tae Moon Health Center.
1) The nursing activities of each nurse were observed by herself in Joong Ku Health Center and by a student nurse in the others for two week Period. The observations were recorded on a simplified version of the WHO form 3032, which had been adapted to include home visiting. The observations of the staff nurse functions may be summarized as follows:
30∼45% Patient care activities.(Composed mainly of interviewing and consultation).
25∼30% Visiting Nurse Services(visits to home, orphanages, industrial and educational agencies, etc. Consisted mostly of home visits)
15∼25% Management activites
10∼20% Personnel activities (educational and administrative activities. Consisted mainly of student nurse education, record-keeping and other clerical activities).
10∼20% Miscellaneous(rest and personal time. Includes transportation in Health Center.)
2) Because of an outbreak of cholera in the summer of 1970, the activities of the nurses at the Joong Ku and Yong San Health Centers were concentrated on emergency prevention during the period of observation. Such activities made up 25 to 50% of the Total. For this reason, such routime activities as patient care, home visits, etc. were less in proportion to the total when compared with the Tong Tae Moon Center. The actual amount of time spent on these activities however, did not differ significantly in the three Health Centers. This can be accounted for by the fact that the nurses worked overtime to meet the demands of the emergency situation. There was a decrease in the time spent in home visiting among the Maternal and Child Health Nurses at the time of the emergency.
3) In reviewing the above findings concerning the type of service as outlined in the WHO form 3027, the fixed assignments,(that is, those concerning the clinic operation), occupied from 50 to 75% of the total activities of each staff nurse, in Tong Tae Moon Health Center, decreasing the amount of time available for home visiting. In the two Health Centers in which emergency activities were being carried on this proportion was decreased to less than 50%, although the actual amount of time spent in these activities was not decreased. In contrast, the home visiting activities in these two centers decreased not only in proportion but also in the amount of actual time devoted to them.
4) In the Tuberculosis prograns the home visiting function was not performed by the nurse directly, but dedlegated to a health aide. The nurses observed in the Family Planning Programs spent the largest proportion of their time in home visiting.
5) When the level of skill required is considered, non-professional activities make up 15 to 30% of the total time spent by the nurses at the Tong Tae Moon Health Center. In the other two Health Centers the actual time spent on such activities was not decreased during the emergency period, but the proportion of the total work time spent on these activities decreased. It seems reasonable to assume that the use of non-prefessional personnel for these functions would enable the nursing staff to devote more time to professional activites, espcially home visiting.

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