• Title/Summary/Keyword: 억제대

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Decreasing the application rate of unnecessary physical restraint through the establishment of a guideline for restraint application (억제대 적용지침 개발을 통한 불필요한 억제대 적용율 감소 활동)

  • Kwak, Kyung-Sun;Kim, Sung-Eun;Bae, Eun-Kyoung;Lee, Eun-Sook;Lee, Eun-Hye;Choi, Yun-Jeong;Lee, Yun-Kyung
    • Quality Improvement in Health Care
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    • v.15 no.2
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    • pp.93-103
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    • 2009
  • 문제: 억제대 적용에 대한 구체적 적용 지침 없이 의례적으로 억제대를 사용함으로 인해 환자들의 신체적 또는 정신적 안전을 위협할 수 있다. 목적: 완전 진정 상태 이거나 근력이 약하여 발관 능력이 없는 환자에 대한 예방적 적용, 바빠서 환자를 볼 수 없는 경우, 간호사 본인의 판단이 없이 타인의 요구에 따르는 등의 불필요한 억제대 적용이 증가하는 원인을 파악하여 중환자실의 특수성에 맞는 억제대 적용 및 제거 지침을 마련하고자한다. 의료기관: 인천광역시에 소재한 의과대학 소속병원의 집중치료실 질 향상 활동: 불필요한 억제대 적용에 영향을 미치는 요인을 선정하여 개선활동 수행. 개선효과: 억제대 적용에 대한 중환자실 간호사에게 미치는 영향을 보면 태도 정도 p=0.09(p<0.1), 올바른 수행 능력은 p=0.005(p<0.05)로 통계적으로 유의한 것으로 나타났다. 지식 정도 p=0.172(p<0.05) 통계적으로 유의 하지는 않지만 모든 항목이 개선 활동 전 에 비해 2,3차 개선 활동 후에 향상 한 것으로 나타났다. 개선 활동 전에 8.1%였던 간호 기록, 0.7%였던 간호 중재, 0%였던 의사 처방율이 3차 개선 활동 후 3가지 모두 100% 달성되었다. 이는 억제대 적용율 감소 및 부적절한 억제대 적용율은 유의하게 감소 하였다. 교훈: 중환자실 간호사의 억제대 적용에 대한 태도, 지식, 올바른 간호 수행 능력은 지속적으로 재평가 되어지고, 교육내용은 좀 더 나은 간호 제공을 위하여 개발되어져야 할 것이다. 억제대 적용 기준과 제거 기준을 Check List 하여 객관성의 유지를 위한 개선 활동은 계속적으로 Feedback 되어야 할 것이다.

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A Study on Caregiver's Perception of Restraints (요양보호사의 억제대 사용에 대한 인식)

  • Kang, Hye-kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.5
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    • pp.452-458
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    • 2016
  • This is a descriptive study on visiting caregivers' perception of restraint use. Data were collected from 113 caregivers working at long-term facilities using a structured questionnaire from Feb to March 2016. The caregivers' perception of restraint use was the medium score. The items they considered the most important reasons for the restraints was "Protecting an older person from falling out of bed", which was primarily intended to prevent accidents of the elderly. The score of the knowledge of restraint use was 11.23 points out of 18 and those affected were more than 50 years of age. The attitude score to the use restraints was 9.19, and caregivers thought it should be possible to refrain from using restraints. Work experience of 3 years or less were higher. The perception of using restraints is affected by the knowledge and attitudes of restraint use. This is very important for the elderly in long-term care facilities and is related to health and human rights. Therefore, it is important to provide continuous education related to the use of restraints and regulations on their management.

Families' Perception and Attitude toward Applied Physical Restraints in General Neurological Wards (신경계 병동에서 억제대를 적용 중인 환자가족의 억제대 적용에 대한 인식과 태도)

  • Ha, So-Yeon;Ha, Yi-Kyung;Kim, Myung-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.5
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    • pp.3293-3302
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    • 2015
  • This study was conducted to identify families' perception and attitude toward application of physical restraint(PR) in general neurological wards. The study is based on subjects from 70 family members who have cared patients applying PR. Data was collected using self-report questionnaires and reviewing of patients' medical records. 68.6% of subjects were female and the mean age was 47.9 years old. Family members were either sons, daughters or spouses. The questionnaires analyzed families' perceptions based on a score of 5, the results showed a mean score of 4.2, and items related to maintaining therapeutic tools scored the highest. The application of PR with two hands was perceived by families as more important than PR applied with one hand. In families' attitude toward PR, there was general agreement that families had the right to decide to apply and remove PR. Continuous education and information regarding PR is required to support families.

A Study on perceptions about physical restraint use of nurse in small and medium sized hospitals (중소병원 간호사의 신체 억제대 사용에 대한 인식)

  • Kim, NamSuk
    • Journal of Digital Convergence
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    • v.15 no.12
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    • pp.581-590
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    • 2017
  • This study was conducted to investigate the perception of nurse's use of physical restraints. This study is a descriptive research study for 138 nurses who work at the small hospitals under 300 beds. Statistical analysis was performed using descriptive statistics, t-test, ANOVA, and factor analysis using the SPSS statistical program. The results of this study were as follows: The overall average of the nurses' perception of physical restraint was $3.91{\pm}0.54$, and the most important reason for using a physical restraint was to protect the patient from falling out of bed($4.37{\pm}0.68$). The factor analysis showed that 'behavior, psychological symptom management($3.81{\pm}0.67$)', 'maintain medical treatment($4.11{\pm}0.60$)' and 'patient safety($4.13{\pm}0.63$)'. It is necessary to understand the characteristics and factors of nurse's use of physical restraint in small and medium hospitals. Moreover, it is also required to use minimum physical restraints for patient's safeties and rights based on accurate understanding of physical restraint's use. Therefore, it is needed to provide job training for the physical restraint that is used in various situations and to develop education and intervention program to adjust in nurses' situation.

Factors Influencing Nursing Practices of Physical Restraints Use by nursing students (간호대학생의 신체적 억제대 사용 관련 간호실무 예측 요인)

  • Ha, Sun-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.4
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    • pp.529-537
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    • 2021
  • Although the use of physical restraints is controversial, it is still commonly used in hospitalized patients to prevent patient accidents in clinical practice. It is, therefore, necessary to evaluate the knowledge, attitude, perception, and nursing practices related to the use of physical restraints. This was a cross-sectional descriptive study in which self-administered questionnaires were collected from 144 nursing students at two Universities. Descriptive statistics, including t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression, were applied to analyze the data collected. Our results reveal that the mean knowledge score of nursing students regarding the use of physical restraints was 11.55±2.81, the mean attitude score was 60.01±7.24, the mean perception score was 59.97±10.68, and the mean nursing practice score was 38.04±4.15. Significant positive correlations were observed between nursing practice and knowledge, attitude, and perception. Multiple regression analysis showed that the factors significantly related to nursing practice and the use of physical restraints were perception (β=.23, p=.005) and attitude (β=.21, p=.009), having a total explained variance of 13.0%. The findings from this study suggest that perception is the strongest predictor of the use of physical restraints in nursing practice. Thus, it is necessary to develop and apply an evidence-based educational intervention program to ensure that nursing students correctly understand the need for physical restraints and later use them appropriately in clinical practice.

Physical Restraints Use and Associated Factors Among Elderly Patients in Long-term Care Hospitals (요양병원 재원 노인의 신체적 억제대 사용과 관련 요인)

  • Ko, Yeong Ju;Ha, Sun-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.9
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    • pp.167-174
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    • 2019
  • The propose od this study was to examine the extent of using physical restraint on elderly patients (over 65 years old) and who were patients in long-term care hospitals. The data was collected, from March 3 2018 to March 29 2018, from the electronic nursing records by using a recording tool, and clinical observation was also used for assessing the use of physical restraint and the related factors. Descriptive statistics, Pearson correlation coefficients and logistic regression were then performed. The usage rate for physical restraints in long-term care hospital was 83.7%, and the most common type of physical restraint was side rails. The use of physical restraints showed a positive correlation with the fall risk scores and a negative correlation with the MMSE. Logistic regression analysis showed that the Fall Risk Score (OR=1.02, 95% CI=1.01~1.03), MMSE (OR=0.94, CI=0.88~0.99) and the use of medical devices (OR=0.80, 95% CI=0.65~0.98) were related with using physical restraints. Therefore, it was confirmed that physical restraint was used in cases of a high risk of falling, severe cognitive impairment and the use of complex and fragile medical devices to treat the patient. Clinical nursing practice should be changed so that treatment alternatives can be applied for elderly patients rather than using too many physical restraints.

Factors Influencing Nursing Practices of Physical Restraint Use among Nurses working in Long-term Care Hospitals (요양병원 간호사의 신체적 억제대 사용과 관련된 간호실무에 영향을 미치는 요인)

  • Ha, Sun-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.526-534
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    • 2019
  • This study was undertaken to identify knowledge, attitude, perception and nursing practice toward use of physical restraints, among nurses in long-term care hospitals. We further explored the impact of factors associated with nursing practice toward use of physical restraints. This was a cross-sectional descriptive study in which self-administered questionnaires were collected from 128 nurses working at 11 long-term care hospitals. Descriptive statistics, including t-test, one-way ANOVA, Welch's test, Pearson correlation coefficients and multiple regression, were applied to analyze the data collected. Our results reveal that the participants possess moderate levels of knowledge, attitude, perception and nursing practice toward use of physical restraints. Significant positive correlations were observed between nursing practice and knowledge. Multiple regression analysis showed that the factors significantly related to nursing practice and use of physical restraint were knowledge (${\beta}=0.27$, p=0.002) and attitude (${\beta}=-0.17$, p=0.044), having a total explained variance of 9.0%. The findings from this study suggest that knowledge is the strongest predictor on nursing practice toward use of physical restraints. Thus, we propose that developing and applying evidence-based educational intervention programs to reduce the use of physical restraints in long-term care hospitals are required.

Evidence-based Clinical Practice Protocol of Physical Restraints by Adaptation Process for Patients in a Geriatric Hospital (요양병원 입원 노인을 위한 신체 억제대 프로토콜의 수용개작)

  • Park, Mi Hwa;Sohng, Kyeong-Yae
    • The Korean Journal of Rehabilitation Nursing
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    • v.19 no.2
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    • pp.118-127
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    • 2016
  • Purpose: This study was to develop an evidence-based clinical practice protocol of physical restraints by adaptation process for patients with a geriatric hospital. Methods: Protocol adaptation process was conducted in accordance with manual for guideline adaptation version 1.0 by ADAPTE collaboration. Results: The adapted physical restraint protocol was consisted of 3 domains and 37 recommendations. The number of recommendations in each domain were: 7 nursing assessment, 19 nursing intervention, and 11 nursing evaluation. More than half (56.8%) of the recommendations were rated as grade B, 37.8% as grade C, and 5.4% were rated as grade D. Conclusion: The adapted physical restraint protocol is expected to contribute as an evidence-based clinical practice protocol for healthcare workers in geriatric hospitals for reducing and improving efficiency of appropriate physical restraints use.

Determination of Antifungal Activity on Pepper Anthracnose and Plant Growth Promoting Activity of Pleurospermum camtschaticum Root Extract (누리대 뿌리 추출물의 고추 탄저병에 대한 항균 및 생장 촉진 활성 검정)

  • Inkyu Lee;Young Sun Baek;Youn Su Lee
    • Research in Plant Disease
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    • v.29 no.3
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    • pp.268-275
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    • 2023
  • This study was conducted to confirm the utilization of Pleurospermum camtschaticum root extract as an organic agricultural material. Antioxidant activity of P. camtschaticum root extract, closely related to antibacterial activity, increased in a dose-dependent manner. In mycelial growth inhibitory activity, 100% P. camtschaticum root extract supressed over 70% for Colletotrichum coccodes and over 68% for Colletotrichum dematium. In the pepper fruit anthracnose development test, the size of the lesion decreased in a dose-dependent manner, which showed the same tendency as the previous results in inhibitory activity on mycelial growth. In the pepper seed germination and red pepper growth promotion test of P. camtschaticum root extract, oposite results was confirmed. The lower the concentration, the more the seed germination and growth promotion effects were shown. The phenol content of pepper leaves was also measured after pepper growth promotion test have been completed. The phenol content related to antibacterial activity increased in all treated groups compared to the untreated group. Therefore, the results of this study showed the possibility of development as an organic material.

Inhibitory Effects of Phyllostachys bambusoides on Melanin Synthesis and Tyrosinase Activity in Cultured Human Melanoma Cells (대잎 추출물의 멜라닌 합성과 타이로신 활성 저해 효과)

  • Huh, Man Kyu;Han, Min Ho;Park, Cheol;Choi, Yung Hyun
    • Journal of Life Science
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    • v.24 no.3
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    • pp.284-289
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    • 2014
  • Tyrosinase is a rate-limiting enzyme that controls the production of melanin. The effect of bamboo (Phyllostachys bambusoides) on tyrosinase activity and melanin synthesis has not been studied. We analyzed the effects of leaf and inner film fractions of bamboo extracts on the inhibition of tyrosinase activity and on melanin production. At a concentration of 5 mg/ml, the extracts of bamboo down-regulated the production of melanocytes. In addition, the extracts of bamboo reduced tyrosinase activity and the melanin content in vitro. Our results suggest that bamboo extract may constrain melanin synthesis by inhibition of the activity and expression of tyrosinase.