• International Journal of Advanced Culture Technology
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• 제7권3호
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• pp.70-78
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• 2019

This paper outlines an intervention protocol used to educate nurses in a project that implemented and evaluated a delirium educational program in one general hospital. It outlines an evaluation of the content of the education and processes used to deliver the intervention through an analysis of reflective notes. The educational protocol was designed for adult learners and grounded in the six assumptions of Knowles' learning theory. Results suggest the educational program positively impacted on participating nurses' knowledge, attitudes and family caregiver involvement in delirium care of hospitalized older adults with and without dementia. This paper also acknowledges the challenges involved in sustaining a practice change through an educational intervention.

• International Journal of Advanced Culture Technology
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• 제7권1호
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• pp.112-121
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• 2019

The purpose of the study was to determine whether a delirium educational program has a positive outcome on nurses' documentation in patient records of delirium care. A one group pre-post design was used. A convenient sample of 60 consecutive records that included documentation by participating nurses in four medical wards of one regional general hospital in South Korea was audited two months before and two months after a delirium educational program. Although an educational program in this study positively changed nurses' knowledge and attitudes, these positive effects did not translate to improvement in the documentations of delirium care. There was no significant increase in the frequency of nursing documentation of delirium assessment following participation in the educational program. Furthermore, there was no significant increase in the frequency of nursing documentation of the use of non-pharmacological management following the documentation of keywords associated with delirium after participation in the educational program. The findings indicate the need to develop, implement and record a systematic risk assessment for delirium and assessment and management of existing delirium based on evidence-based guidelines in clinical practice in South Korea.

• 종양간호연구
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• 제11권2호
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• pp.155-162
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• 2011

Purpose: The purpose of this study was to examine the actual care costs paid to Korean Oncology Advanced Practice Nurses (KOAPN). Methods: We collected data using a group discussion and questionnaire identified 115 tasks from job descriptions developed by the Korean Accreditation Board of Nursing. Forty-two KOAPN working at three university hospitals in Seoul were asked to evaluate each task as to type and whether the cost is paid or not. They were also asked to indicate the tasks in urgent need of development of a care cost with high priority. Results: Only five tasks (4.3%) related to treatment and complication related interventions or education were paid, and they were paid only once during the entire treatment period and were not covered by national health insurance. It was approved as a medical fee by health insurance review & assessment service. Furthermore, the names of the authority (doctor) and the actual provider (nurse) of the prescriptions were different for three of those tasks. Most of the suggested tasks needing development of care costs were actions specifically performed by nurses (physical-psychosocial-spiritual assessment, independent nursing interventions). Conclusion: KOAPN are currently paid for few tasks. To maximize the utilization of KOAPN, the establishment of a clear rational payment system directly related to their actual activities is needed.

• 임상간호연구
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• 제24권2호
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• pp.197-208
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• 2018

Purpose: This study aimed to investigate the current statistics of professional medical support staffs(PMSSs) working in general hospitals with less than 500 beds. Methods: This study was conducted on 35 general hospitals with less than 500 beds from September 11th to October 27th, 2017. Results: Four hundred fifty one PMSSs were currently providing medical support. The number of clinical nurse experts was the highest among the roles, followed by Physician Assistants(PA) and Advanced Practice Nurses. The mean job satisfaction score was 3.07 out of 5. In the case of PA group, most of the delegated prescriptions were performed, however the delegated roles were not much documented in written format. The paucity of documentation requires a development of a committee for PMSSs, including a development of selection criteria and a scope of practice in each institution. Conclusion: The results of this study suggested the composition of a committee for PMSSs in the medical institutions and renaming the specified titles of PMSSs.

• 한국직업건강간호학회지
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• 제12권1호
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• pp.59-70
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• 2003

Purpose: The purpose of this study was to project the workforce of occupational health nurse-specialist(OHN-S) in Korea. Method: Ratio model and expert opinion were used for projecting the number of OHNS. Result: 1) In 2002, there are 1,405 occupational health nurses in Korea. This represents 0.93% of total available nurses and 3 occupational health nurses per 100,000 population. 2) The number of OHN-S needed to meet the demands in 2002, 2005 and 2020 was estimated at 3,318, 3,351 and 3,515 respectively. The projected number of OHN-S of the year 2002 was 2.20% of total available nurses in Korea and 7 OHN-S per 100,000 population. Conclusion: In order to match the supply to the need, the professional organizations should direct their effort toward enacting legislation. Education systems should identify strategies in initialing advanced practice nursing programs in master's level as well as standardizing curriculums across the programs.

• 가정∙방문간호학회지
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• 제27권2호
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• pp.137-145
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• 2020

Purpose: This study aimed to identify the training system and current status of home health nurses and to examine ways to retain sufficient number of advanced practice nurses (APNs) in the home health nursing field. Methods: This study analyzed the adequacy of the supply of home health nurse by reviewing the existing research literature and statistical data. Results: Discussions on how to revitalize the home care business have been ongoing since the beginning of 2001. However, despite home health nurses being oversupplied, discussions on the adequacy of supply have always been excluded from the focus of revitalization. The recent expansion of the home care business has resulted in a shortage of workforce, which can be inked not only to the continuous reduction of the designated quota of programs but also to the regional imbalance of educational institutions. The serious imbalance between supply and demand has caused fears that the home care business would drastically reduce. Conclusion: It is necessary to not only increase designated quotas for APNs programs but also integrate those programs of the similar curricula, thus lowering supply shortages in home health nurses.

• 간호행정학회지
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• 제18권2호
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• pp.189-201
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• 2012

Purpose: The purpose of this study was to explore the use of outcome indicators and perception of outcome evaluation of oncology advanced practice nurses (APNs). Method: A total of 111 oncology APNs from hospitals which have over 400 beds were surveyed. The participants' use of outcome indicators and perception of outcome evaluation were collected using a questionnaire including 84 outcome indicators for APNs developed by Sung et al. and 13 items on APNs' contribution to the hospitals developed by Kleinpell (2005). Data were analyzed using descriptive statistics, t-test, and $x^2$ test. Result: Twelve items out of 84 outcome indicators were used over 50% of the time and 57 items could be used in the future by the participants. Seven of the 10 top-ranking outcome indicators in use were education related and were also expected to be used frequently in the future. The score for participants' perception of outcome evaluation was average-high, 3.82 out of 5. Conclusions: The results of the study show that the main outcome indicator for oncology APNs is education related, and thus the use of education related outcome indicators is recommended to make oncology APNs' activities be more visible.

• 여성건강간호학회지
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• 제5권1호
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• 대한간호학회지
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• 제24권2호
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• pp.190-205
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• 1994

Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

• 한국콘텐츠학회논문지
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• 제16권3호
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• pp.354-365
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• 2016

건강소비자의 고품질 간호요구가 증대됨에 따라 전문간호사 제도가 시행된 이후 전문간호사의 직무에 대한 임파워먼트, 직무만족, 조직몰입의 수준을 파악하고 일반간호사와 비교한 연구가 필요한 시점이다. 이에 본 연구는 서울과 인천지역의 6개 상급종합병원과 4개 종합병원의 전문간호사와 간호사를 대상으로 직접 배포하거나 이메일을 통해 설문지를 받아 분석하였다. SPSS 18.0을 사용하여 t 검정과 ANOVA 분석을 실시하였다. 임파워먼트 평균은 전문간호사($3.56{\pm}0.53$)와 간호사($3.50{\pm}0.54$)간에 유의한 차이가 없었다(t =-. 861, p = 0.390). 직무만족 평균도 전문간호사($3.36{\pm}0.53$)와 간호사($3.25{\pm}0.46$)간에 유의한 차이가 없었다(t =- 1.575, p = 0.117). 조직몰입 평균도 전문간호사($3.11{\pm}0.34$)와 간호사($3.05{\pm}0.36$)간에 유의한 차이가 없었다(t =- 1.301, p = 0.195). 임파워먼트, 직무만족, 조직몰입 모두 전문간호사와 일반간호사 집단간 유의한 차이가 없었다. 이는 한국에서 전문간호사 역할이 명확하게 정립되어 있지 않고 고용과 보상이 적절하지 않은 점과 전문간호사 제도의 운용과 효율이 부족한 실정에 기인한다고 생각된다.