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Development a Tool for Evaluating Nurses' Performance in Hospital Units (간호단위 성과평가도구 개발)

  • Park, Sung Ae;Kim, Jin Hyun;Park, Kwang Ok;Kim, Myoung Sook;Kim, Se Young
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.5-21
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    • 2009
  • Purpose: This study was aimed to develop a tool for evaluating nurses' performance by using Balanced Score Card (BSC) in hospital units. Methods: Preliminary survey was done in 10 hospitals to investigate evaluation criteria for nurses' performance. For the main study, each of 14 nursing managers evaluated 2 nursing units (total of 28 nursing units) to verify the sensitivity of the tool criteria. The evaluation result drawn from the preliminary BSC tool was analyzed to verify the sensitivity and validity of the tool. Results: As a result, nurses' performance evaluation tool consisted of 4 categories, 8 objectives, and 14 criteria was developed. Conclusion: The BSC tool for nurses' performance evaluation provides meaningful data in evaluating nursing performance in hospital units.

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Determination of Nursing Costs for Hospitalized Patients Based on the Patient Classification System (종합병원에 입원한 환자의 간호원가 산정에 관한 연구)

  • 박정호;송미숙
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.16-37
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    • 1990
  • A cost analysis for hospitalized patients was carried out based upon Patient Classification System(PCS) in order to determine an appropriate nursing fee. The data were collected from 21 nursing units of three teaching hospitals from April 1 to June 30, 1989. first, all of the 22,056 inpatients were classified into mildly ill(Class Ⅰ), moderately ill(Class Ⅱ), acutely ill(Class Ⅲ), and critically ill(Class Ⅳ) by the PCS which had been carefully developed to be suitable for the Korean nursing units. Second. PCS cost accounting was applied to the above data. The distribution of inpatients, nursing costs, and nursing productivity were as follows : 1) Patient distribution ranged from 45% to class Ⅰ, 36% to class Ⅱ, 15% to class Ⅲ, and 4% to class Ⅳ, the proportion of class Ⅳ in ‘H’ Hospital was greater than that of the other two hospitals. 2) The proportion of Class Ⅲ and Ⅳ in the medical nursing units was greater than that of surgical nursing units. 3) The number of inpatients was greatest on Tuesdays, and least on Sundays. 4) The average nursing cost per hour was W 3,164 for ‘S’ hospital, W 3,511 for ‘H’ hospital and W 4,824 for ‘K’ hospital. The average nursing cost per patient per day was W 14,126 for ‘S’ Hospital, W 15,842 for ‘H’ hospital and W 21,525 for ‘K’ hospital. 5) The average nursing cost calculated by the PCS was W 13,232 for class Ⅰ, W 18,478 for class Ⅱ, W 23,000 for class Ⅲ, and W 25,469 for class Ⅳ. 6) The average nursing cost for the medical and surgical nursing units was W 13,180 and W 13,303 respetively for class Ⅰ, W 18,248 and W 18,707 for class Ⅱ, W 22,303 and W 23,696 for class Ⅲ, and W 24,331 and W 26,606 for class Ⅳ. 7) The nursing costs were composed of 85% for wages and fringe benefits, 3% for material supplies and 12% for overhead. The proportion of wages and fringe benefits among the three Hospitals ranged from 75%, 92% and 98% for the ‘S’, ‘H’, ‘K’ hospitals respectively These findings explain why the average nursing cost of ‘K’ hospital was higher than the others. 8) According to a multi- regression analysis, wages and fringe benefits, material supplies, and overhead had an equal influence on determining the nursing cost while the nursing hours had less influence. 9) The productivity of the medical nursing units were higher than the surgical nursing units, productivity of the D(TS) - nursing units was the lowest while the K(Med) - nursing unit was the highest in 'S' hospital. In ‘H’ hospital, productivity was related to the number of inpatients rather than to the characteristics of the nursing units. The ‘K’ hospital showed the same trend as ‘S’ hospital, that the productivity of the medical nursing unit was higher than the surgical nursing unit. The productivity of ‘S’ hospital was evaluated the highest followed by ‘H’ hospital and ‘K’ hospital. Future research on nursing costs should be extended to the other special nursing areas such as pediatric and psychiatric nursing units, and to ICU or operating rooms. Further, the PCS tool should be carefully evaluated for its appropriateness to all levels of institutions(primary, secondary, tertiary). This study took account only of the quantity of nursing services when developing the PCS tool for evaluating the productivity of nursing units. Future research should also consider the quality of nursing services including the appropriateness of nursing activities.

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Alveolar rhabdomyosarcoma with massive disseminated intravascular coagulopathy treated with systemic chemotherapy

  • Yoon, Byung Gyu;Baek, Hee Jo;Oh, Burm Seok;Han, Dong Kyun;Choi, Yoo Duk;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.58 no.12
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    • pp.505-508
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    • 2015
  • It is uncommon for pediatric patients with rhabdomyosarcoma to present with clinical and/or laboratory features of disseminated intravascular coagulation (DIC). We report a case of metastatic alveolar rhabdomyosarcoma with severe bleeding because of DIC in a 13-year-old boy. He experienced persistent oozing at the site of a previous operation, gross hematuria, and massive epistaxis. Two weeks after initiating combination chemotherapy consisting of vincristine, doxorubicin, and cyclophosphamide, the patients' laboratory indications of DIC began to resolve. During this period, the patient received massive blood transfusion of a total of 311 units (26 units of red blood cells, 26 units of fresh frozen plasma, 74 units of platelet concentrates, 17 units of single donor platelets, and 168 units of cryoprecipitate), antithrombin-III and a synthetic protease inhibitor. Despite chemotherapy and radiation therapy, he died 1 year later because of disease progression. In children with metastatic rhabdomyosarcoma and massive DIC, prompt chemotherapy and aggressive supportive care is important to decrease malignancy-triggered procoagulant activities.

Nurse Staffing Level Relating Factors of the General Nursing Units, ICU, ER and OR in Acute General Hospitals (종합병원의 일반병동, 중환자실, 응급실, 수술장간호사 확보수준 관련 요인)

  • Kim, Yun-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.4
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    • pp.404-412
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    • 2008
  • Purpose: To analyse hospital nurse staffing level of the general nursing unit, ICU, ER and OR in general hospitals. Method: The study sample was 105 acute general hospitals which had reported the bed size and number of nurses by the nursing units. Number of bed per nurse was analysed by the hospital characteristics and the staffing levels of the doctors and the nursing assistant personnels using t-test or ANOVA and Pearson's correlation. Results: Number of bed per nurse was 3.86 in general nursing units and 0.95 in ICU. Tertiary hospitals employed more nurses in general nursing units and ICU than general hospitals. Hospitals located in Seoul and public hospitals employed more ICU nurses. OR nurse staffing level was higher in academic hospitals. Hospital size was positively correlated with nurse staffing level of the general nursing unit, ICU, ER and OR respectively. Total nurse staffing level of the hospital was positively correlated with doctor and nursing assistant personnels staffing levels. Conclusion : Differentiated nursing fee schedule was needed to implement in ER or OR. Regulation policy should be needed for the hospitals which violated hospital nurse staffing level of the law.

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A study of the Consumer's Satisfaction and the Marketing Strategies of a General Hospital (일 종합병원의 소비자 만족과 마케팅 전략에 관한 연구)

  • Lee, Mi-Aie
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.25-40
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    • 2001
  • As the medical market has gradually changed from supplier-centered market to consumer-centered one, it makes hospital managers seek the consumer's satisfaction and the various marketing strategies for survival. Under the these changes, this study was accomplished to measure the consumer's satisfaction about the medial services which a general hospital provided, to identify the marketing strategies that a general hospital could establish for survival. For these purposes, a questionnaire was developed and distributed to 200 patients in general units and 100 patients in oriental units of a general hospital in Seoul. Among them, 163 reponses in general units and 71 reponses in oriental units were turned out to be useful. they were used for final analysis. The results of the survey were as follows : First, among all items of medical services which the hospital provided, patients were most satisfied by nursing services. Second, to Improve the hospital's medical service quality, it was very important for hospital staffs to be courtesy and to explain about a process of treatment or care sufficiently. Third, to decrease cost of medical service, it was very important to develop the various items and premiums of medical insurance especially in field of oriental medicine. Fourth, to make people come to the hospital easy, it was very important of fully utilize the public transportation such as subway. Fifth, to make hospital's image good, it was very important to develop well-prepared public relationship and to continuously provide the diverse medical service in the community.

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Comparing Satisfaction with Nursing Care and Factors Relevant to Hospital Revisit Intent among Hospitalized Patients in Comprehensive Nursing Care Units and General Care Units (포괄간호서비스 병동과 일반병동 입원 환자의 간호만족도와 병원재이용의도 영향요인 비교)

  • Shin, Sa-Rang;Park, Kyung-Yeon
    • Journal of Korean Academy of Nursing Administration
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    • v.21 no.5
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    • pp.469-479
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    • 2015
  • Purpose: The purpose of this study was to compare hospitalized patients in comprehensive nursing care units and general care units as to satisfaction with nursing care and factors influencing their intent to revisit the hospital. Methods: A cross-sectional study was conducted with 178 patients who had been hospitalized in a comprehensive nursing care unit and a general care unit in one hospital. Participants completed self-report questionnaires. Data were analyzed using SPSS 21.0. Results: There was a significant difference between the comprehensive nursing care unit and general care unit for intent to revisit the hospital (p=.036). Factors influencing intent to revisit the hospital for patients in the comprehensive nursing care unit were 'satisfaction with nursing care' (p<.001) and 'use of additional costs for comprehensive nursing care' (p=.041). The factor influencing intent to revisit hospital for patients in the general care unit was 'satisfaction with nursing care' (p<.001). Conclusion: Findings indicate that comprehensive nursing care service in which all care is provided by nursing staff only, without family or private caregivers, increases intent to revisit the hospital. These results can be used as the foundation of reviewing the operation and expansion of comprehensive nursing care service.

New techniques for wound management: A systematic review of their role in the management of chronic wounds

  • Bekara, Farid;Vitse, Julian;Fluieraru, Sergiu;Masson, Raphael;De Runz, Antoine;Georgescu, Vera;Bressy, Guillaume;Labbe, Jean Louis;Chaput, Benoit;Herlin, Christian
    • Archives of Plastic Surgery
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    • v.45 no.2
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    • pp.102-110
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    • 2018
  • Debridement is a crucial component of wound management. Recent technologies such as hydrosurgery (Versajet), ultrasound therapy (the MIST therapy device), or plasma-mediated bipolar radio-frequency ablation therapy (Coblation) seem to represent interesting alternatives for wound debridement. The purpose of this systematic review was to describe, evaluate, and compare these three recently developed methods for the management of chronic wounds. In January 2016, an electronic database search was conducted of MEDLINE, PubMed Central, and Embase for articles concerning these three innovative methods for the management of chronic wounds. A total of 389 references were identified by our search strategy, and 15 articles were included. We extracted data regarding the number and age of patients, indications, operating time, number of procedures, costs, wound healing time, decrease in exudation, perioperative blood loss, bacterial load, and the occurrence of complications. The 15 articles included studies that involved 563 patients who underwent hydrosurgery (7 studies), ultrasound therapy (6 studies), or Coblation (2 studies). Six randomized controlled trials were included that compared the use of a scalpel or curette to hydrosurgery (2 studies) or ultrasound therapy (6 studies). Hydrosurgery, in addition to being a very precise and selective tool, allows significantly faster debridement. Ultrasound therapy provides a significant reduction of exudation, and improves the wound healing time. No comparative study dedicated to Coblation was identified. Despite the obvious clinical interest of the topic, our review of the current literature revealed a lack of prospective randomized studies comparing these devices with each other or with standard techniques, particularly for Coblation and hydrosurgery.

Effects of Emotional Labor, Compassion Fatigue and Occupational Stress on the Somatization of Nurses in Hemodialysis Units (혈액투석실 간호사의 감정노동, 공감피로, 직무 스트레스가 신체화 증상에 미치는 영향)

  • Ryu, EunJin;Choi, So Eun
    • Korean Journal of Occupational Health Nursing
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    • v.26 no.2
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    • pp.65-73
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    • 2017
  • Purpose: The purpose of this study was to identify the effects of emotional labor, compassion fatigue and occupational stress on the somatization of nurses in hemodialysis units. Methods: The sample consisted of 139 nurses in hemodialysis units from a tertiary hospital, a general hospital, a dialysis clinic, and a care hospital in G province. Data were analyzed using frequencies, percentages, means and standard deviations, t-test, ANOVA, Duncan test, Pearson's correlation and hierarchical multiple regression. Results: There were significant correlations of the experience of emotional labor, compassion fatigue and occupational stress with the somatization of nurses in hemodialysis units. Factors influencing somatization intention were 'emotional labor' (${\beta}=.37$, p<.001), which explained 28% of the variance (F=10.00, p<.001). Conclusion: The results of this study indicate that the factor influencing the somatization of nurses in hemodialysis units was emotional labor. Therefore, strategies to decrease emotional labor of nurses in hemodialysis units are required.

A Study on Worker's Perception of Patient Safety Culture in a hospital (일개 병원의 환자안전문화에 대한 인식)

  • Lee, Hae-Won;Cho, Hyun-Sun;Kim, Sun-Hwa
    • Quality Improvement in Health Care
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    • v.17 no.1
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    • pp.89-105
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    • 2011
  • Background : The purpose of study in to grasp the level of perception of hospital workers on the patient safety culture, consider the difference in perception of patients safety culture according to medical service and finally find out a way to establish patient safety culture in hospital. Methods : As for the data, the analysis on frequency, t-test, ANOVA and tukey test were carried out by using SPSS 12.0. Result : The results of comparison among the positive response ratios on the patients culture of hospital workers showed that the subjects had perceived the teamwork within units most positively(74.1%), and perceived most negatively on the non-punitive response to error(16.2%)and the staffing(26.2%). 68.6% of subjects answered that the medical error were mostly of always reported. when daytime working hours are longer, perception of patient safety culture ranked low. In general, departments for direct medical service than departments for indirect medical service assessed patient safety culture high. Conclusion : Organizational learning and teamwork within units, communication openness, active support of hospital management for patient safety, and cooperation across the units would be crucial to promote the overall perceptions of patients safety of hospital workers and the level of patients safety in the units and to improve the quality of the event reporting system.

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Development of Performance Measure Indicators in Hospital Nursing Units (균형성과표를 이용한 병원 간호단위의 조직성과 평가지표 개발)

  • Kang Kyeong-Hwa;Kim In-Sook
    • Journal of Korean Academy of Nursing
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    • v.35 no.3
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    • pp.451-460
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    • 2005
  • Purpose: The purpose of this study was to develop performance measure indicators for hospital nursing units based on a Balanced Scorecard (BSC). Method: This study was a methodological study, The development process consisted of 3 stages. The first stage was setting up strategies for nursing units from a nursing department's mission and vision. The second stage was developing performance measure indicators after a validity check. The third stage was modifying developed performance measure indicators and classifying them. Results: 7 strategies were set up according to 4 perspectives of a BSC. 15 performance measure indicators for hospital nursing units were developed, and the indicators were divided into 8 independent indicators and 7 shared indicators according to the degree of performance responsibility. In addition, they were classified into two groups, 7 leading indicators and lagging indicators. Conclusions: The result of this study suggests that performance measure indicators for hospital nursing units provide a framework and method for nursing organizations' performance management. Also, the developed indicators are expected to provide valuable information for successful organization management.