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56 = Abstract = Time based job analysis of OPD nurses in a tertiary care hospital Joo Yeon Park Graduate School of Health Science and Management Yonsei University ( Directed by Professor Eui Sook Kim, D.N.Sc. ) Due to improved awareness level and development in the mass media, education level and living standard of people increased so that people demand high quality health care with improved medical information, awareness of hospitals and selectiveness of hospitals. In the future, the number of inpatients would decease whereas the number of outpatients would increase due to increased use of preventative management to care for patients. Moreover, the role of outpatient treatment would further increase since the development of medicine would drive patients into outpatient setting. The present study was conducted to review and to be aware the job of nurses again through understanding the job of nurses in outpatient setting and investigating the degree of job importance, and to provide basic data for the establishment of the roles of nurses through confirming the difference between

57 the current work load and future work load and replaning for future work. The tool used for the study was a work activity log of OPD nurses at Y University Hospital prepared through the literature study. From May 14 to May 21, 2001, the nurses were asked to record the work, degree of work importance, and workload on the log for 2 days. As for data analysis, the time spent on a job was calculated into ratio, the degree of work importance as OPD nurses was calculated into average, and the ratio of expected nursing work was calculated as ratio. These data were then compared. The results of the present study were as follows. Workload difference was present in 11 domains depending on the department and area. However, the total time spent in each domain of work was general outpatient affair ( min), treatment nursing (65.54 min), patient education/counseling (53.80 min), personnel management (25.60 min), stock/work environment management (15.43 min), paper work (14.88 min), communication (13.37 min), quality improvement (7.07 min), and patient advocacy (5.22 min). On the other hand, the order of work importance according to work domain was patient education/counseling (4.29), treatment nursing (4.19), and communication (3.96). According to work, drug administration (4.65) was highest, followed by solving patient problems (4.52), transfusion (4.48), CPR (4.43), consultation with the work department

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66 (4.43), new employee training (4.39), and ICU patient management (4.35). The order of expected future workload was patient education/counseling (21.3), treatment nursing (16.4), general outpatient affairs (16.3), communication (8.3), and work improvement (7.8). Nurses expected to decrease the workload in those domains with low importance including general outpatient affairs and paper work and to increase the workload in those domains with high importance including patient education/counseling, treatment nursing, quality improvement, and patient advocacy. Although a significant portion of time was spent on general outpatient affairs, they expected to increase the workload in the important professional areas of patient education/counseling and treatment nursing. The current change in nursing work showed that nurses play various and professional roles compared to the past when they were only assistants in patient treatment. Thus, professional nurses need to spend more time on patient education/counseling, treatment nursing and patient advocacy to increase outpatient treatment quality through delegating more of general outpatient affairs to assisting personnel. In order to adapt to the role demanded by changing hospital structure and various patients, nurses need to place active effort for more professional and independent work. Moreover, nurses need to play the role of nursing provider, manager, educator, advocate, and counselor but also the role of health maintenance personnel.

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