Yeon Hee Kim

Background: Nurse‐led rapid response teams (RRTs) significantly improve patient safety. However, the absence of specific job standards can precipitate role ambiguity and compromise care quality. Therefore, establishing tailored job standards that reflect the distinct healthcare context of the Republic of Korea is imperative to optimize RRT performance and clinical outcomes. Aim: To identify nurses′ activities in nurse‐led RRTs and to develop job standards that define the desired performance levels of RRT nurses and enable task evaluation within the Korean healthcare context. Methods: This study used a two‐step methodological approach, guided by a conceptual framework integrating Hamric’s advanced practice nursing model with nine Korean advanced practice nursing core competency domains: (1) identifying the nursing activities of nurse‐led RRTs through an integrative evidence review, benchmarking of domestic and international institutions, and in‐depth interviews with domestic nurses; and (2) developing draft standards and validating them through a two‐round Delphi survey and field verification of practical suitability. Results: A total of 210 potential activities were initially identified and refined into 55 nursing activities across nine core competency domains: advanced nursing practice, education, counseling, consultation, ethical decision‐making, research, collaboration, evidence‐based practice, and leadership. Draft job standards comprising 9 standards, 16 criteria, and 53 indicators were developed and validated through a two‐round Delphi survey with eight experts; after Round 1 revisions and two added indicators, all items met the retention criteria in Round 2 (I‐CVI ≥ 0.88, mean I‐CVI = 0.96, S‐CVI/Ave = 0.94). In field verification with 62 RRT nurses across 19 hospitals nationwide, all items showed practical suitability above 90%, and 9 standards, 16 criteria, and 55 indicators were ultimately confirmed. These standards integrate internationally accepted competency frameworks while reflecting the distinctive Korean context, such as EMR‐based screening and the absence of independent nurse prescriptive authority. Conclusion: This study identified nurse‐led RRT work activities and developed job standards for desired performance levels of RRT nurses. This provides a foundational framework for performance evaluation and continuous quality improvement. As a methodological study, it did not empirically test clinical outcomes; rather, the developed standards may support future outcome evaluations using metrics, such as cardiac arrest rates, unplanned ICU admissions, and failure‐to‐rescue, and may thereby provide a basis for advancing nursing care quality and professionalism in managing ward patient deterioration. Implications for Nursing Management: The job standards provide practical guidance for new and experienced RRT nurses and offer a foundation for defining job skills, structuring task instructions, workforce planning, and conducting performance evaluations across diverse hospital environments, while also informing qualification criteria. They may also serve as a useful framework to inform future empirical research evaluating the impact of nurse‐led RRTs on patient outcomes. To support consistent adoption, a phased implementation strategy involving nursing associations, professional bodies, and the Ministry of Health and Welfare is proposed.

책임간호사는 일반간호사 중에서 업무를 잘 해내고, 조직에 헌신하는 사람들 중에서 선정해왔던 관례를 잘 알고 있었기에 책임간호사로 임명된 것은 자신이 해왔던 경력을 인정받았다고 생각하게 되었다.

Lee YJ, et al. J Korean Acad Nurs. 2024 Aug;54(3):386-402. https://doi.org/10.4040/jkan.24010

욕창은 한번 발생하면 치료가 어려울 뿐만 아니라 치료 과정에서 막대한 경제적 비용이 발생한다. 그러므로 욕창의 발생을 예측하는 것은 환자의 고통 측면과 경제적 측면에서 중요하다. 본 연구에서는 척수손상환자의 혈액검사를 통해 얻은 임상 정보들과 욕창 간의 상관관계를 분석하여 욕창 예측에 있어 유의미한 특징 정보를 제공한다. 특징 선택 기법에서 주로 쓰이는 피어슨, 스피어만, 켄달타우의 상관계수를 비교 분석하였을 뿐만 아니라, 머신러닝 기법인 XGBoost와 LightGBM을 사용하여 특징의 중요도를 구하였다. 마지막으로, 특징의 중요도 관점에서 상위 5개의 특징들을 입력 값으로 활용한 장단기메모리 모델을 통해 다른 주요 특징들을 예측하게 한 결과, 우수한 예측력을 보이는 것을 확인하였다. 본 연구결과를 통해 의료인들에게 욕창 조기 예측 모델에 있어 주요한 임상 특징들에 대한 가이드라인을 제공할 수 있을 것으로 기대된다.