• 제목/요약/키워드: 간호관리학

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고혈압, 당뇨병 성인의 뇌졸중 및 심근경색증 조기 증상 비인지 관련 요인: 질병 관리 관련 특성을 중심으로 (Factors Associated with Unawareness of Early Symptoms of Stroke and Myocardial Infarction in Adults with Hypertension and Diabetes: Focused on Management related to Disease)

  • 권영숙
    • 한국응용과학기술학회지
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    • 제38권1호
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    • pp.60-74
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    • 2021
  • 본 연구의 목적은 고혈압 및 당뇨병을 진단 받은 성인의 뇌졸중 및 심근경색증의 조기 증상 인지 정도를 파악하고 비인지와 관련된 요인을 분석하기 위함이다. 2017년 지역사회건강조사 원시자료를 활용하여, 40세 이상 성인 12,277명의 자료를 분석하였다. 뇌졸중 및 심근경색증의 조기 증상 인지율은 각각 53.6%와 46.8%였다. 뇌졸중 및 심근경색증 조기 증상 비인지 요인을 평가하기 위해 로지스틱 분석을 수행하였다. 고혈압 관리 교육, 혈압 수치 및 당화혈색소 수치 인식은 다변량 분석에서 인구사회학적 변수를 보정한 후에도 뇌졸중 조기 증상 비인지와 유의한 관련이 있었다. 혈압 수치 및 당화혈색소 수치 인식은 심근경색증 조기 증상 비인지와 유의한 관련이 있었다. 그러므로 고혈압과 당뇨병을 모두 관리해야 하는 고위험군에 대한 홍보 촉진 및 교육 강화 등 심뇌혈관질환 조기 증상 인지 수준 개선을 위한 중재 및 전략의 개발이 요구된다.

말기 폐암환자를 대상으로 한 가정 호스피스와 병원입원치료의 비교 -서비스 내용과 건강관리비용 중심- (Comparison of the Casts of Care and Nursing Services for Terminally III Patients Receiving Home Hospice Care in Comparison to Institutional Care)

  • 이태화;이원희;김명실
    • 대한간호학회지
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    • 제30권4호
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    • pp.1045-1054
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    • 2000
  • As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.

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모유수유관리 프로그램이 모유수유지속에 미치는 효과 (Effect of a Breastfeeding Management Program on Breastfeeding Duration)

  • 최양자;김미옥
    • 여성건강간호학회지
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    • 제13권4호
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    • pp.245-253
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    • 2007
  • Purpose: The purpose of this study was to measure the effects of a breastfeeding management program for promotion of breastfeeding. Method: The study design was a non-equivalent control group pre-post test. The study subjects were pregnant women receiving a breastfeeding education class in one hospital in Ilsan. The total number of study subjects was 153 pregnant women, namely 75 mothers in the experimental group and 78 in the control group. Data was collected between June and November, 2006. A breastfeeding management program was provided to the experimental group while admitted for delivery, and in weeks 2, 4, 8, 12, 16, 20, and 24 of the postpartum period. The rates of breastfeeding were measured in weeks 2, 4, 8, 12, 16, 20, and 24 of the postpartum period. Result: There were significant differences in the scores of rate of breastfeeding between the two groups(all cases), which were 93.1 in the experimental group and 85.8 in the control group at week 4; 88.1 vs 71.8 at week 8; 83.4 vs 56.7 at week 12; 71.4 vs 53.9 at week 16; and 65.7 vs 48.4 at week 20 respectively. However, there were not significant differences in the scores of rate of breast-feeding between the two groups, which were 97.7 in the experimental group and 96.0 in the control group in the early postpartum period at week 2, and 59.6 vs 45.3 at week 24. Add to this, the study analyzed only people who had jobs. As a result, the scores of rate of breastfeeding were 94.8 in the experimental group which were significantly higher than 88.5 in the control group at week 4; 93.2 vs 73.3 at week 8; 89.6 vs 57.2 at week 12; and 75.0 vs 46.0 at week 20 respectively. However, there were not significant differences at week 2, week 16 and week 24. Conclusion: The results of this study suggest that a breastfeeding management program during the last trimester of the perinatal period and postpartum period may increase the duration of breastfeeding in postpartum clients who intend to breastfeed. This study supports the literature which found that prenatal education and postpartum support are important to the outcome of breastfeeding.

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지역사회 중심의 산욕기 산모 추후관리 프로그램 개발을 위한 기초조사 (A Preliminary Study with the Objective of Developing a Community based Postpartum Women's Follow-up Program)

  • 김명희
    • 한국보건간호학회지
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    • 제15권1호
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    • pp.27-41
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    • 2001
  • The purpose of this study was to discern the level of satisfaction of postpartum care in hospitals. the level of importance of traditional postpartum care and the need for home health care for postpartum women. The study's design was to obtain data needed to develop a community-based postpartum care program and to improve the quality of nursing for postpartum care recipients. Data for the study was collected from 1 March to 31 June 2000 from 116 postpartum care recipients treated in Chung-Buk, Korea. Data analysis consisted of frequency, percentage, t-test, and ANOVA. using SPSS win program. The results the of analysis were as follows: 1) The level of satisfaction of postpartum care in the hospital (mean 1.31) was very low. The most laudable items of nursing care by category were: moderate satisfaction with 'perineal wound care' (2.04) and 'afterpain observation'(2.09). The overall level of satisfaction of postpartum care in the hospital. however, was very low. 2) Among other items of postpartum care in the hospital, 'postpartum exercise' $(25.9\%)$. 'assessment and support for postpartum depression' $(25.9\%)$, 'operation wound care for women who underwent Caesarean sections' $(24.5\%)$. and 'contraception and family planning' $(20.4\%)$ showed a need for home health care for postpartum care recipients above $20\%$. 3) The level of importance of traditional postpartum care (Sanhujori) was relatively high (mean 2.72). The importance of Sanhujori by category was as followed: 'the fourth principle: protecting the body from harmful strains' was the highest (2.88), 'the third principle: eating well', 'the first principle: invigorating the body by augmenting heat and avoiding cold', 'the second principle: resting without working', 'the fifth principle: keeping clean' and 'the sixth principle: handling with the whole heart' showed 2.85, 2.80, 2.70, 2.51 and 2.46 respectively. 4) The need for home health care with Sanhujori was very low. 5) The relationship between demographic factors and the level of satisfaction with postpartum care in the hospital was as follows: the satisfaction levels were significantly different among' delivery frequency' and 'health status' alteration after delivery'. 6) The relationship between demographic factors and the importance of the Sanhujori category was as follows: There were no significant differences in the level of importance of the first and the forth principle of Sanhujori. The level of importance of the second principle of Sanhujori was significantly different among 'income' and 'family type'. The level of importance of the third principle of Sanhujori was significantly different among 'having a boy'. The level of importance of the fifth principle of Sanhujori was significantly different among 'income' and 'feeding type'. The level of importance of the sixth principle of Sanhujori was significantly different among 'education background' and 'feeding type'. In conclusion. the findings of this study illustrate the nursing needs of postpartum care recipients. It provides a challenge to caregivers in the healthcare industry to develop a continuous postpartum care program and integrative postpartum care system that embodies the oriental and western paradigm for the promotion of women's health.

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소규모사업장 보건관리지원사업에 대한 평가연구 (An Evaluative Study of a Subsidiary Program in Small Scale Industries)

  • 이명숙;최병수;김명순
    • 한국보건간호학회지
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    • 제11권2호
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    • pp.12-37
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    • 1997
  • This study was performed to evaluate the subsidiary program on occupational health services in small scale industries. The survey of occupational health services was undertaken in 346 industries from July 1 to August 31. 1994. The major results were as follows ; 1. The subsidiary program on occupational health services The evaluation of working environments were conducted in 305 industries, $42.3\%$ of the industries had the harzardous agents exeeding TLV. Special medical examinations were done in 310 industries. the results were detected $C(33.3\%).\;D_1(0.8\%), D_2(5.4\%)$. Health management were done in 341 industries, the average visits for a industry were 3.8 times. The activities of health management were included to check of the workplace. health education, health counselling, etc. 2. The recognition of the employees and employers on occupational health services $91.5\%$ of employers and $87.0\%$ of workers felt healthy themselves. But $39.7\%$ of employers and $21.2\%$ of workers were under the stress from their jobs or home affairs. The workers perceived more harmful for the hazardous agents than the employers. $32.8\%$ of employers and $42.9\%$ of workers perceived that employer's efforts were the most important things to protect for the hazardous agents. The result of the evaluation of working environments were understood by $57.3\%$ of employers and $24.5\%$ of workers. The notification of medical examinations were recognized $83.9\%$ of employers and $50.3\%$ of workers. Many employers and workers felt the necessities of health management in small scale industries. The priorities of health manegement were different between employers and workers. Employers' priorities were as follows ; follow up care of medical examination$(97.3\%)$, health counselling$(93.7\%)$, planning of health$(93.5\%)$, health education of occupational diseases$(93.2\%)$, health education of chronic diseases$(93.5\%)$, etc. Workers' priorities were as follows ; follow up care$(93.4\%)$, health counselling$(94.3\%)$, health education of occupational diseases$(93.0\%)$. first aids$(92.0\%)$. etc.

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소규모 사업장 근로자와 사업주의 보건관리 기술지원사업에 대한 인식도 조사 연구 (Employees' and Employers' Awareness of Occupational Health Program in SSE)

  • 정혜선;백도명;김은희;김지용;하은희;전경자;김선민;박혜숙;이복임
    • 한국직업건강간호학회지
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    • 제7권1호
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    • pp.83-96
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    • 1998
  • The study was conducted to analyze employees' and employers' awareness of occupational health programs for the purpose of evaluating the effectiveness of the program employed in small-scale enterprises (SSE). The 400 SSE that have under 50 employees and have been supported by the Government were selected for mail survey, and 120 employers and 318 employees of 183 factories returned the questionnaires. The results are as follows; 1) 33.8% of employees were not aware of the fact that their factories have been supported by Government, and 69.1% of employees did not know who was the monitor of that program. Only 147% of employees and 35.5% of employers agreed that the supported program reflected their opinions well. 2) 45.1% of employees participated in health education classes more than once. But only 15.6% of them considered the classes as very helpful. 21.1% of employers were much aware of health education schedule, and 44.2% reported that it was helpful for the prevention of occupational diseases. 3) 68.8% of employers were aware of the possibility of occupational diseases that could occur in their factories. And 36.5% of employers reported that some criteria were used for job reallocation to their employees. But only 9.7% of employees were assigned new job based on the result of health status examination. 4) 65.6% of employees were aware of the periodic evaluation for work environment, and 43.3% knew the evaluation results. Among participated SSE, 5.9% have a planning department for improving work environment, and 46.2% actually carried out the program for improving work environment. The findings showed that the employers and employees of SSE had insufficient knowledge of the occupational health program that have been employed in their workplace. It is essential to lead more active participation of employers and employees in their occupational health programs so as that the programs are to improve their health status as well as work environment more effectively.

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보건관리자의 직능별 직업 및 조직 헌신도에 대한 비교 연구 (A Comparative Study on the Commitment of Health Manager Between Industrial Health Nurse and Industrial Hygienist)

  • 이경용;이기범;;조영숙
    • 한국직업건강간호학회지
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    • 제7권1호
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    • pp.65-82
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    • 1998
  • This study was carried out in order to confirm the reliability and validity of the commitment inventory developed by Meyer and Allen, and to investigate commitment level of health manager, to compare two different professionals of health manager such as industrial health nurse and industrial hygienist to find out some characteristics that have effect on commitment. This survey was done by self-administered questionnaire to 227 respondents as the trainees of Industrial Safety Training Center, KISCO from June to December 1996. Authors classified commitment into two categories ; professional commitment and organizational commitment, and these two types of commitments have three different aspects ; affective, continuance, and normative commitment based on Meyer's inventory. The results were as follows; 1. Items of whole scales of the both type of commitments have three factors that represent three aspects of commitment ; affective, continuance, and normative commitment. This means that each type of commitment was reliable to use as measurement tool of three different aspects of commitment. Classification of items by factor analysis was more consistent in professional commitment than organizational commitment. Among 16 items of organizational commitment, four items were classified into different aspects of commitment with similar factor loading. 2. Commitment level of industrial health nurse was higher than that of industrial hygienist in affective, continuance professional commitment controlled by other characteristics. These differences can be due to other characteristics of specific task and background of health managers that were not used in this study. 3. The level of affective professional commitment was statistically different in age, sex, educational level, and that of organizational commitment was statistically different in only two variables such as age, and job tenure. The level of continuance professional and organizational commitments were different in sex group, but past history of employment have effect on continuance organizational commitment. The level of normative organizational commitment was affected by only age. As the above results, the tools of measurement of commitment developed by Meyer and Allen can be useful to measure the level of commitment of health manager. Three aspects of two types of commitments were influenced by different characteristics of health manager. Authors suggested future study on the affecting variables to the commitment such as background, task of health manager and organizational characteristics.

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산업보건관리자의 직무능력에 관한 연구 - 서울$\cdot$경기 지역의 산업보건센타를 중심으로 (A Study on the Job Ability of Industrial Health Service Agency Members - with the Focus on the Industrial Health Service Agency in Seoul and Kyungki -)

  • 권순주
    • 한국보건간호학회지
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    • 제10권2호
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    • pp.37-50
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    • 1996
  • To analyze the roles by abilities between manpower through the analysis of industrial health service agency personnel, 115 industrial health service agency personnel in 19 Industrial Health Service Agency personnel scattered in Seoul and Kyungki areas have been investigated according to the questionnaires formulated in line with the Likert 5-point scale from September 1 through October 30, 1995 and the following significant result has been obtained: 1. The job abilities by fields. 1) In the field of health care, the level of medical personnel's job ability was 3.30 on average and that of industrial hygienists' was 2.54 on average, which showed that the level of medical personnel's job ability was higher. 2) In the field of health management, there was a difference between the level of medical personnel's job ability and that of industrial hygienists' only in the health education but there was not so much difference between manpower' which showed that it was 3.00 on average. 3) In the field of working environment management. the level of industrial hygienists' job ability was 4.03 on average and that of medical personnel's was 2.62, which showed that the level of industrial hygienists' job ability was higher than that of medical personnel's. 2. The job abilities by manpower. As for the job ability by manpower. on the health care the medical personnel's ability was more excellent than the industrial hygienists' and on the working environment management the latter's{industrial hygienists') ability was more excellent than the former's(the medical personnel's). However. the field that a difference between both manpower as mentioned above was not recognized was the health management. 3. As for the difference of potential factors between manpower. in Factor '1' the industrial hygienists' 80.7 points by percentage was higher than the medical personnel's 52.5 points and in Factor '2' the latter's(medical personnels's) 72.6 points by percentage was higher than the former's{industrial hygienists') 50.6 points in the level of job abilities. The above result shows that the industrial health service agency personnel can be classified into the job with a difference between manpower and that without any difference manpower. Therefore, the following issues: First: The field of health care shall be defined as the medical personnel's exclusive job. Second: The field of working environment management shall be defined as the industrial hygienists' exclusive job. Third: The field of health management shall be defined as a common job to lead the limits of time and space in the collective group occupational health management to be controlled effectively.

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한국농촌노인의 건강증진관리요구에 관한 연구 (A Study on Health Promotion Needs Assessment of the Rural Elderly in Korea)

  • 조소영;김점자
    • 한국보건간호학회지
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    • 제10권2호
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    • pp.146-161
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    • 1996
  • This study was purposed to find health promotion and care needs of the elderly in rural area of Korea. As the rural elderly are limited in accessibility to health care resources and could not immediately solve their health care needs when they need. health promotion and care services are expected to bring better and more practical solutions of their health care needs. Thus, the type of health care services to be developed in Korea rural area is discussed to have emphasis on health care service component in addition to health promoting components. Methods of this study was based on survey data analysis : total 322 persons aged older than 55 living at one 'Kun' in Korea administrative unit were interviewed by health workers working at the region and also get trained for this study data collection. The data collection interview was continued from February till May in 1996. The interview questions were modified with adjustment to Korea situation. with basis of the WHO's health promotion program components. The collected data were analyzed using SAS program for frequency, correlation, regressions. The major findings were as follows : (1) $74.8\%$ of the surveyed were sick at the survey time point. and $95.9\%$ known the diagnosis name of the disease. The most frequently complained diseases were Muscular-Skeletal diseases $(43.7\%)$. $34\%$ of those sick had never treated or discontinued therapeutic procedures. so that shown the necessity of systematic and usual health care services with health promotion program development for the elderly. (2) The percent of those who make social participation was $95.3\%$. and the activities were visiting neighbors $(70.4\%)$ and lack of qualified social activity programs. (3) $78.1\%$ of the surveyed had health counseling and education from professional health workers. Those ceased smoking and drinking were $59.6\%,\; 60.3\%$. respectively. Those had no application of therapeutic drugs or nutrion supplements was $40.7\%\;and\;94.1\%$ had regular meals. Those practiced exercises was low remarking $17.7\%$. (4) Positive health behaviors were better carried out by sick groups than by the healthier. except smoking. regular meals. and exercise. $17.5\%$ of sick group smoke more than one case of cigarettes. in contrast to $9.5\%$ of the healthier. (5) Mental health status was heathier among positive health behavior earners. Health counseling and education shown better score of mental health than those never counseled. (6) Positive health behavior practice frequency did not show significant differences when crossed by social activity participation status. (7) Health behaviors of the rural elderly people were carried out better when they had positive 'continuency in therapeutic procedure' 'health status'. 'familial relationship'. 'Health Status' of the rural olderly were explained by 'exercise'. 'drinking'. 'familial relationship'. 'activities of daily living'. Thus, health behaviors practice mutually interact with health status. In conclusion. the health promotion and care program component are recommended to include ation on the necessity of positive health promotion active social acitivities. pleasant life style, adaption into changes on the elderly, safety in residential area. community acitivity and resource utilization. etc .. in addition to the elderly's disability and sickness caring services.

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간호사의 정맥주사 관리에 대한 인식과 수행에 관한 연구 (A Study on the Nurse's Recognition and Performance in Intravenous Therapy Management)

  • 김명희;김윤화
    • 기본간호학회지
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    • 제5권2호
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    • pp.207-224
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    • 1998
  • The purposes of this study were to identify nurse's recognition and performance and to represent the factors of hindrance in the IV therapy management. The subjects were 420 nurses who worked at five general hospitals in Pusan. Tha data were collected using a questionnaire and the period of data collection was from January 1 to January 31, 1998. The instrument for this study was made by author oneself on the basis of guidelines Simmons et al', CDC' Stanley' and Kurdi' guideline, Cllinical Nurse's Association' that consist of 68 items for 5 fields ; pre-injection, just before-injection, needle-injection, during injection, post-injection field. Cron-bach Alpha coefficient of recognition and performance in the IV therapy management was .93 and .87. The datas were analized by a SPSS program using frequency, percent, paired t-test, t-test and oneway ANOVA. The results obtained were as follows : 1. The mean score of recognition in IV therapy management was significantly higher than that of performance(t=5.86, P<.001). 2. The items of lower than mean score of each fields in performance were the identification of drugs, hands washing, patient teaching about medication, disinfectional methods of the injection site and the rubber stopper in bottle, the use of disposable gloves, mask and eye goggles at the chemotherapy preparation, use of tape and armboard, changing the IV tubing, labeling the dressing over the injection site, observation and recordings of patient's condition after medication and confirmation of the needle length at the needle removal. 3. The factors of hindrance in IV therapy were 'having no time', 'insufficiency of goods', 'unknowing of methods', 'no disadvantage', and 'factors of doctor's doing'. The most important factor was 'have no time', especially item of hands washing. The other factors of hindrance showed high frequency in the following items ; 'insufficiency of goods' in the use of disposable gloves, mask and eye goggles at the chemotherapy preparation, 'unknowing of methods' in the certification of drugs compatibility, 'no disadvantage' in the labeling the dressing over the injection site, and 'factors of doctor's doing' in the changing the subclavian catheter dressing and checking the glucose level during the TPN infusion. In conclusion, there is necessity of educational program which can improve the nurse's knowledge of drugs, disinfection methods, comfort of patient and recordings in IV therapy management and alternative plan which are political and financial aids such as setting up the sink, giving of paper towels and necessary goods in the IV therapy for reducing the factors of hindrance for IV therapy management.

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