• 제목/요약/키워드: Acute Care

검색결과 972건 처리시간 0.027초

일 대학병원 간호사의 다약제 내성균 감염관리지침에 대한 지식과 수행정도 (Hospital Nurses' Knowledge and Compliance on Multidrug-resistant Organism Infection Control Guideline)

  • 강지연;조진완;김유정;김동희;이지영;박혜경;정성희;이은남
    • 대한간호학회지
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    • 제39권2호
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    • pp.186-197
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    • 2009
  • Purpose: This study was done to investigate nurses' knowledge of, and compliance with the multidrug-resistant organism (MDRO) infection control guidelines. Methods: A survey questionnaire was developed based on the institutional and national guidelines and was administered to a convenience sample of 306 nurses in a university hospital. Results: The mean score for knowledge was 33.87 (percentage of correct answers: 82.61%). The percentages of correct answers for basic concepts, route of transmission, hand washing/protective devices and environment management were 74.27%, 94.29%, 92.90% and 75.54% respectively. The mean compliance score was 4.15 (range: 1-5). The compliance scores for education, communication, contact precaution, disinfection, surveillance culture, and hand washing were 3.29, 4.05, 4.20, 4.50, 4.40 and 4.48 respectively. Nurses indicated "lack of time (30.06%)", "lack of means (10.78%)" and "lack of knowledge (9.48%)" as reasons for noncompliance. Conclusion: While most educational programs have focused on hand washing or use of protective devices to prevent transmission of MDRO in acute care settings, hospital nurses' knowledge of the basic concepts of MDRO and environmental management has remained insufficient. Nurses are relatively non-compliant to the guidelines in the areas of education (staff, patient, family) and communication. Comprehensive educational programs are needed to decrease hospital infection rates and to improve the health of patients.

건강통제위 개념의 국내 간호연구 분석 (Health Locus of control : A Review of the Nursing Research in Korea)

  • 이은희;임숙빈;김인자;이은옥
    • 대한간호학회지
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    • 제23권4호
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    • pp.694-712
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    • 1993
  • A number of nursing researchers have used the concept of health locus of control over the past decade in Korea. This article reviewed 92 nursing research papers on health locus of control conducted since 1982, and examined type of subjects, design, measurement instruments, the scores of each dimension of the HLOC, and significant variables. Most of the research were correlational in design, used an 18-item 6-point score instrument and studied the relationship between HLOC, health re-lated variables, and cognitive-emotional variables, The health related variables included health behavior, health management, preventive health behavior, compliance to treatment regimen and self care behavior The cognitive-emotional variables included depression, anxiety, stress and self- esteem. Some consistent findings are beginning to emerge. The concept of internal HLOC was positively correlated with the health related variables. But few studies found any significant correlation between powerful others HLOC and health related variables. In the case of chance HLOC, few studies reported a significant relationship. Many of the articles reported significant relationships between internal HLOC and cognitive-emotional variables, but few reported a significant relationship between powerful others or chance HLOC and cognitive -emotional variables. all experimental studies but one found that only internal HLOC was significantly changed following experimental manipulation. When the different groups of subjects such as normal persons, chronic patients, acute patients were compared in terms of mean scores, it was found that the HLOC appeared to change depending on the status of the patients. Recommendations for future research include modification of the instrument to increase the reliability and validity, study about the pattern of response suggested by Wallston and Wallston(1982) and further experimental study on changing the belief of subjects to internal HLOC.

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병원간호사의 정보활용능력과 개인정보보호에 대한 인식이 윤리적 가치관에 미치는 영향 (Influence of Information Literacy and Perception of Patient Data Privacy on Ethical Values among Hospital Clinical Nurses)

  • 서형은;두은영;최수진;김미영
    • 간호행정학회지
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    • 제23권1호
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    • pp.52-62
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    • 2017
  • Purpose: The aim of this study was to elucidate clinical nurses' ethics germane to information literacy and perception of patient data privacy and thus help nurses to develop more positive and consolidated ethical values. Methods: For this study a descriptive survey design was used. Participants were 142 nurses who worked in a hospital and completed self-report questionnaires. Data were collected from August 1 to 5, 2016 and were analyzed using independent t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficients, and stepwise multiple regression with SPSS 22.0. Results: Ethical value had a positive correlation with information needs (r=.25, p=.002) in information literacy as well as in direct patient care (r=.27, p=.001), shift work (r=.20, p=.016), patient information management (r=.39, p<.001), and communication (r=.24, p=.004) in perception of patient data privacy. Patient information management, educational background, and age were significant variables predicting the level of ethical values and accounted for 21% of the variance. Conclusion: Ethical values education with particular emphasize on managing patient information should be encouraged for nurses who are younger and have a lower education level. Findings indicate a need for education programs to guide clinical nurses to utilize appropriate information when solving ethical challenges in every day nursing practice.

다문화가족 방문교육지도사의 자존감 및 낙관성이 셀프리더십에 미치는 영향 (The Influence of Self-esteem and Optimism on the Self-leadership of Multicultural Family Home-visit Instructors)

  • 권기남;황혜신;채진영;김헤라;강복정;서주현
    • 가정과삶의질연구
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    • 제35권2호
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    • pp.63-75
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    • 2017
  • The purpose of this study was to investigate the differences in optimism, self-esteem and self-leadership according to age, monthly income, and teaching experiences of multicultural family home-visit instructors and the influence of optimism and self-esteem on self-leadership. 668 home-visit instructors participated in the online survey from 140 multicultural family support centers in Seoul, 6 metropolitan cities, 9 provinces, and other cities and counties. Data were analyzed through frequence, percentages, Pearson's correlations, One-way ANOVA, $Scheff{\acute{e}}$ post-hoc test, and stepwise multi-regression using SPSS 21.0. The main findings are as follows. First, there were significant differences in optimism and self-esteem according to age and monthly income. Second, there were significant differences in self-leadership according to age and home-visit teaching experiences. Third, the stepwise multiple regression model showed that optimism, self-esteem and the individual variables had an influence on the self-leadership of home-visit instructor's self-expectation. These results suggest that self-esteem and optimism are important precursors of self-leadership and self-leadership training based on self-esteem and optimism is necessary for self-leadership enhancement of home-visit instructors.

뇌졸중 환자의 낙상 예측을 위한 평가도구 비교 (A Comparison of Assessment Tools for Prediction of Falls in Patients With Stroke)

  • 원종임
    • 한국전문물리치료학회지
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    • 제21권2호
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    • pp.37-47
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    • 2014
  • Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

Assessing Reliability of Medical Record Reviews for the Detection of Hospital Adverse Events

  • Ock, Minsu;Lee, Sang-il;Jo, Min-Woo;Lee, Jin Yong;Kim, Seon-Ha
    • Journal of Preventive Medicine and Public Health
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    • 제48권5호
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    • pp.239-248
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    • 2015
  • Objectives: The purpose of this study was to assess the inter-rater reliability and intra-rater reliability of medical record review for the detection of hospital adverse events. Methods: We conducted two stages retrospective medical records review of a random sample of 96 patients from one acute-care general hospital. The first stage was an explicit patient record review by two nurses to detect the presence of 41 screening criteria (SC). The second stage was an implicit structured review by two physicians to identify the occurrence of adverse events from the positive cases on the SC. The inter-rater reliability of two nurses and that of two physicians were assessed. The intra-rater reliability was also evaluated by using test-retest method at approximately two weeks later. Results: In 84.2% of the patient medical records, the nurses agreed as to the necessity for the second stage review (kappa, 0.68; 95% confidence interval [CI], 0.54 to 0.83). In 93.0% of the patient medical records screened by nurses, the physicians agreed about the absence or presence of adverse events (kappa, 0.71; 95% CI, 0.44 to 0.97). When assessing intra-rater reliability, the kappa indices of two nurses were 0.54 (95% CI, 0.31 to 0.77) and 0.67 (95% CI, 0.47 to 0.87), whereas those of two physicians were 0.87 (95% CI, 0.62 to 1.00) and 0.37 (95% CI, -0.16 to 0.89). Conclusions: In this study, the medical record review for detecting adverse events showed intermediate to good level of inter-rater and intra-rater reliability. Well organized training program for reviewers and clearly defining SC are required to get more reliable results in the hospital adverse event study.

유아교사의 수업설계요소에 대한 인식과 실행간 차이연구 (A Survey Study on the Difference between Recognition and Implementation in Early Childhood Teachers on Instructional Planning Elements)

  • 김재환;금미숙
    • 한국보육지원학회지
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    • 제8권4호
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    • pp.159-183
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    • 2012
  • 본 연구는 유아교사의 수업설계 요소들의 인식과 실행에 대한 차이를 알고, 설립유형과 담당 유아연령에 따른 차이도 분석 연구하고자 한다. 이를 위해 강원도에 근무하는 유아교사 341명을 대상으로 설문조사하였다. 측정도구의 Cronbach ${\alpha}$는 수업설계요소 인식도 0.92, 실행도 0.94로 모두 신뢰도가 높았으며, 영역은 3가지 영역으로 구분하였다. 자료분석은 paired t-test(검증), 일원변량분석, Scheff$\acute{e}$ 분석을 사용하였으며, 연구결과 첫째, 인식도와 실행도의 4점 척도에서 각 각 높은 점수로 나타났으며, 인식이 높을수록 실행도가 높았다. 그리고 실행도는 인식도보다 낮게 나타났으며, 통계적으로 유의하였다. 둘째, 기관유형에 대한 인식도와 실행도는 국 공립유치원에서 가장 높았고, 민간어린이집에서 가장 낮았다. 셋째, 유아교사의 담당연령에 대한 차이는 만 5세에게서 가장 높았고, 만3세에게서 가장 낮았다. 연구결과를 통하여 유아교사들의 수업설계요소에 대 한 인식과 실천을 높일 수 있는 다양한 강화체제의 필요성을 제언하였다.

상호목표설정 간호중재가 유방절제술 환자의 수술 후 회복에 미치는 효과 (Effect of Nursing Intervention of Mutual Goal Setting on Recovery of Mastectomy Patient)

  • 장은희
    • 기본간호학회지
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    • 제8권2호
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    • pp.172-188
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    • 2001
  • Purpose: The purpose of this research was to test the effectiveness of the nursing intervention, mutual goal setting, for patients who have had a mastectomy. Special reference was given to King's goal attainment theory and a theoretical framework for establishing an effective nursing strategy to enhance patient recovery is suggested. Method: This research employed a quasi-experimental design which consisted of pretest-posttest non-equivalent control and experimental groups. Data were collected from 37 patients who had a mastectomy and were hospitalized in the Department of Surgery of Y Medical Center from January 2001 to May 2001. The experimental group received the nursing intervention, mutual goal setting four times from the day before the operation to the fifth day after the operation while the control group received only routine nursing care. As postoperative recovery indicators, ROM of arm joints, arm circumference, pain, physical symptoms, oxygen saturation stress, anxiety and body image were measured. Result: The test results are as follows : 1) there were statistically significant differences between the experimental and control groups in extension and internal rotation of the shoulder Joint and flexion of the wrist joint. 2) there was no significant difference between the two groups in arm circumference. 3) there were no significant differences between the two groups in pain, physical symptoms, or oxygen saturation. 4) there were no significant differences between the two groups in stress, anxiety, or body Image. On the basis of research results, the following are recommended : 1) The effectiveness of nursing intervention in the acute recovery period as well as long term effects need to be investigated. 2) There is a need to develop an instrument to measure perception which facilitates goal attainment in the interactive setting between patients and nurses.

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Gemcitabine And Cisplatin Followed by Chemo-Radiation for Advanced Nasopharyngeal Carcinoma

  • Jamshed, Arif;Hussain, Raza;Iqbal, Hassan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권2호
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    • pp.899-904
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    • 2014
  • Concurrent chemo-radiation (CRT) has been established as the standard of care for non-metastatic loco-regionally advanced nasopharyngeal carcinoma (NPC) but recently the addition of induction chemotherapy in the already established regimen has presented an attractive multidisciplinary approach. This retrospective study was carried out to evaluate the efficacy of induction chemotherapy (IC) followed by CRT for the management of loco-regionally advanced NPC. Between July 2005 and September 2010, 99 patients were treated with cisplatin based IC followed by CRT. Induction chemotherapy included a 2 drug combination; intravenous gemcitabine $1000mg/m^2$ on day 1 and 8 and cisplatin $75mg/m^2$ on day 1 only. Radiotherapy (RT) was given as a phase treatment to a total dose of 70 Gy in 35 fractions. Concurrent cisplatin ($75mg/m^2$) was administered to all patients on days 1, 22 and 43. All patients were evaluated for tumor response and adverse effects after IC and 6 weeks after the completion of the treatment protocol. Statistical analysis was performed using SPSS version 17 and Kaplan Meier estimates were applied to project survival. Median follow-up duration was 20 months. The 5-year overall survival (OS), loco regional control (LRC) and relapse free survival (RFS) rates were 71%, 73% and 50%respectively. Acute grade 4 toxicity related to induction chemotherapy and concurrent chemo-radiation was 4% and 2% respectively, with only 3 toxicity-related hospital admissions. We conclude that induction gemcitabine and cisplatin followed by chemo-radiation is a safe and effective regimen in management of nasopharyngeal carcinoma, meriting further investigation in randomized clinical trials.

Prevalent Signs and Symptoms in Patients with Skin Cancer and Nursing Diagnoses

  • Lisboa, Isabel Neves Duarte;de Azevedo Macena, Monica Suela;da Conceicao Dias Fernandes, Maria Isabel;de Almeida Medeiros, Ana Beatriz;de Lima, Cyndi Fernandes;de Carvalho Lira, Ana Luisa Brandao
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3207-3211
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    • 2016
  • Background: Skin cancer has a remarkable importance given the high incidence in the population. In Brazil, it is estimated that there were 98,420 new cases of non-melanoma skin cancer among men and 83,710 new cases among women in 2014. Objectives: To verify signs and symptoms present in patients with skin neoplasms according to the literature and relate them to the nursing diagnoses of NANDA International. Materials and Methods: Integrative literature review carried out from March to May 2015 in the databases: Cumulative Index to Nursing and Allied Health Literature, SCOPUS, National Library of Medicine and Nattional Institutes of Health, Latin American and Caribbean Sciences of Health and Web of Science. The descriptors used were: 'Signs and Symptoms' and 'Skin Neoplasms'. Sixteen articles were identified as the final sample. After review, the signs and symptoms of skin cancer identified in the literature were related to the defining characteristics present in NANDA International, with the aim to trace possible nursing diagnoses. Results: The most prevalent signs and symptoms were: asymmetric and well circumscribed nodules with irregular borders; speckles with modified color aspect; ulcerations; blisters; pain; itching; and bleeding. The principal nursing diagnoses outlined were: risk for impaired skin integrity; impaired skin integrity; acute pain; risk of shock; and impaired comfort. Conclusions: The identification of signs and symptoms present in patients with skin cancer and the relationships of these with the nursing diagnoses of NANDA International provide a basis for qualified and systematized nursing care to this clientele.