J Korean Acad Nurs Adm JKANA Journal of Korean Academy of Nursing Administration 1225-9330 Korean Academy of Nursing Administration 10.11111/jkana.2013.19.2.217 Original Article Effect of Changes in Nursing Delivery System on Satisfaction of Nurses and Patients and Direct Nursing Time Choi Eun Hee 1 Lee Hyun Su 2 Kim Jin Hee 2 Ko Mi Suk 2 Kim Bok Soon 2 Department of Nursing, Korean Bible University, Korea. Chung-Ang University Healthcare System, Korea. Correspondence: Lee, Hyun Su. Chung-Ang University Healthcare System, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, Korea. Tel: 82-2-6299-3960, Fax: 82-2-6299-2526, soo10000se@naver.com 03 2013 31 03 2013 19 2 217 226 18 09 2012 27 10 2012 23 12 2012 Copyright © 2013 Korean Academy of Nursing Administration 2013 Purpose

Purpose of this research was to identify effects of application of a modified primary nursing system.

 Methods

Measurement was done of direct nursing time and satisfaction of nurses and patients before and after one month of the modified primary nursing system in a surgery unit in C university hospital, Seoul.

 Results

There was no statistically significant difference between average for patient satisfaction (4.24) before and (4.11) after application of the modified primary nursing system. Total average for nurse satisfaction with the nursing delivery system was 2.89 before application and, 3.34 after, indicating some significant differences (t=-4.06, p<.001). The KPCS-1 was 10.19 before application of the modified primary nursing system and 9.52 after application. Recalculated into direct nursing time, the average direct nursing time for one patient was 92 minutes before application, and 85.98 minutes after, indicating no significant difference.

 Conclusion

Through this research an attempt was made to build and test a modified primary nursing system. Results indicate that the most important thing is to clearly regulate office work and safely implement the new system.

 Nursing models Job satisfaction Patient satisfaction Direct nursing time An SH Han SS Primary Nursing Delivery System J Cathol Nurs 1992 13 1 12 Hayman B Wilkes L Cioffi J Change process during redesign of a model of nursing practice in a surgical ward J Nurs Manag 2008 16 257 265 http://dx.doi.org/10.1111/j.1365-2834.2007.00774.x Kang MJ Kim JH Kim YS Park HS Lee HJ Development of patient classification tool using the computerizing system J Korean Acad Nurs Adm 2001 7 15 23 Kim DY Analysis of nurse's job in general hospital using hospital information system after introduction of electronic nursing record system 2006 Deagu, Korea Keimyung University Unpublished master's thesis Kim HK Nursing care delivery system satisfaction, job performance, turnover intention and nursing organizational culture in the nurses in university hospitals 2009 Seoul, Korea Catholic University Unpublished master's thesis Kim IS Jang KS Lee MH Ha NS Hong YM Lee TH Nursing management 2003 Seoul Hyunmunsa Kim JJ Hwang KJ Kim SH Rhee KS Lee JS Kim IY A Study about Developing Care Delivery System of Providing Efficient Patient Care Korean Nurse 1996 35 3 61 76 Kim SS Chae GS Kim KN Park KO Moon SM Survey on nursing care delivery systems of university affiliated hospitals in Korea J Korean Clin Nurs Res 2010 16 167 175 Kim YS Kim HS Kim CY Comparative Analysis of Structural, Process, and Outcome Indicators for Evaluating the Quality of Nursing Care J Korean Acad Nurs 1998 28 17 25 Lee CH Sung YH Jung YY Kim JS Kwon IG Lee SK The effect of the direct nursing care hours with establishment of the substation J Korean Acad Nurs Adm 1997 3 61 80 Manthey M Delivery System and Practice Models: A dynamic balance Nurs Manage 1991 22 1 28 30 Moon SH Supportive primary care model development and its effects on nurses' job satisfaction and job stress at hospital 2011 Pusan, Korea Catholic University Unpublished master's thesis Moon KH A study on restructuring to a patient-oriented primary care team model 2003 Seoul, Korea Yonsei University Unpublished doctoral dissertation Park GO A study of variables related to nursing productivity J Korean Acad Nurs 1994 24 584 596 Slavitt DB Stamps PL Piedmont EB Haase AM Nurses' satisfaction with their work situation Nurs Res 1978 27 114 120 Song KJ Kim EH Yoo CS Park HO Park KO Development of KPCS (Korean Patient Classification System for Nurses) based on nursing needs J Korean Clin Nurs Res 2009 15 5 17 Song KJ Kim EH Yoo CS Park HA Song MS Park KO Verification of reliability and validity of KPCS-1 and estimation of nursing time conversion index J Korean Clin Nurs Res 2010 16 127 140 Tiedeman ME Lookinland S Traditional models of care delivery: What have we learned? J Nurs Adm 2004 34 291 297 Yang TY The time and motion study of the evening duty nurse in a university hospital internal medicine dept 2002 Seoul, Korea Inje University Unpublished master's thesis Yom YH Ko MS Kim KK Kim TS Min S Park JS Nursing management 2009 Seoul Sumunsa

Homogeneity Test for General Characteristics of the Patient Satisfaction Survey Questionnaire (N=79)

Homogeneity Test for General Characteristics Patients Measured for Direct Nursing Care Time (N=204)

Comparison of Patient Satisfaction Before and After Application of the Modified Primary Nursing System (N=79)

Comparison of Nurse Job Satisfaction Before and After Application of the Modified Primary Nursing System (N=19)

Direct Nursing Care Time per Patient for 24 hours Using the Conversion Index for Korean Patient Classification System-1 Scores (N=204)