• Title/Summary/Keyword: Ambulatory care nurses

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Emotional Labor Experienced by Ambulatory Care Nurses (외래간호사의 감정노동 경험)

  • Song, Mi-Ra;Park, Kuem-Ju
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.4
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    • pp.451-461
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    • 2011
  • Purpose: The purpose of this study was to explore emotional labor experienced by nurses in ambulatory care setting. Method: The phenomenological method developed by Giorgi was used for this study. The participants were 9 nurses who had experienced emotional labor. Data were collected between May and August 2010 by face-to-face interviews. The interview was recorded and then transcribed. Results: The constituents associated with the meaning of the nurses' experiences of emotional labor in ambulatory care setting were as followings: bearing down of suffering emotions coming up from the bottom, feeling loneliness when having to undertake care alone by oneself, having conflict between nursing professional and services, managing mind by means of both internal and external resources, getting ridding oneself of conflict with forced emotions over time. Conclusions: The results of this study should contribute to a deeper understanding of the meaning of emotional labor experienced by nurses in ambulatory care. The results also highlight the need to develop programs for nurses in ambulatory care setting to help them express their real action.

Developing of a Tool for Ambulatory Care Nurse Competencies (외래간호사 역량 증진을 위한 간호역량 평가도구 개발)

  • Min, Myoungjin;Yu, Soyoung
    • Journal of Korean Academy of Nursing Administration
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    • v.23 no.1
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    • pp.90-100
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    • 2017
  • Purpose: The purpose of this study was to develop a tool to evaluate the nursing competency of ambulatory nurses and to verify the reliability and validity of the developed tool for use in general hospitals. Methods: The evaluation tool for ambulatory nursing competency was developed through a literature review and tests for validity and reliability. Results: Subsequent to a review of the literature on nursing performance of ambulatory nurses, a 12 item questionnaire was developed. Through factor analysis, 12 items in a 2 factor solution were derived. Cronbach's ${\alpha}$ coefficient of the final instrument was .86. Conclusion: The assessment tool developed in this study allows for objective assessments of nursing competencies in relation to the competencies expected of ambulatory care nurses. It is hoped that the assessment tool can be used for empirical verification and to provide basic data for establishing the necessary policies to secure outstanding human resources.

Exposure to Formaldehyde of Ambulatory Care Nurses in University Hospital (대학병원 내 외래간호사의 포름알데히드 노출 평가)

  • Gu, Dongchul;Lee, Chaekwan;Lee, Jaewan;Lee, Suyeon;Yun, Soonyoung;Han, Areum;Kim, Hyunju;Park, Yeongbeom;Jeong, Seongwook;Moon, Chanseok
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.24 no.4
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    • pp.446-452
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    • 2014
  • Objective: This study aimed to evaluate the exposure status of formaldehyde(FA) among the nurses in ambulatory care departments of university hospital. Methods: Two university hospitals were surveyed. The FA concentration in air were measured to target 62 nurses in 8 ambulatory care departments(89 samples). Air sampling and analysis of FA were carried out according to the OSHA Method ID-205. The survey was conducted with questionnaire asking about how to control FA and whether the nurses use the formaldehyde protectors or not. Results: FA was detected in all samples. The maximum concentration of FA was 0.258 ppm and the geometric mean was 0.023 ppm. There was no sample that exceeded any of exposure standards by OSHA-TWA whereas there were 54 samples(60.7%) that exceeded the standards by NOISH-TWA. Among 62 nurses handling FA, 13 nurses(21.0%) used the protective gloves while nobody used a gas mask. It was assessed that any of 8 common ambulatory care departments did not use a safety cabinet for FA in which local exhaust ventilation was fixed. Conclusions: Nurses in ambulatory care departments were exposed to FA. Therefore, the environment management of a workplace, the health management of a nurses, FA handling education and installing a FA cabinet with a local exhaust ventilation were needed because FA as a carcinogen was able to cause any cancer to a human body if it was emitted in air for long time.

A Study on the Performance and the Importance of Ambulatory Nursing Activities (외래 간호인력 업무활동 수행도와 중요도 분석;종합병원${\cdot}$종합전문요양기관 중심으로)

  • Hwang, Hye-Young;Park, Jeong-Hye;Kim, Ji-Soo;Chen, In-Sug;Bae, Kyung-Ok;Seo, Mi-Sook;Yang, Woo-Jeong;Jung, Moon-Young;Chae, Ji-Sun;Hong, Ji-Yeon;Kim, Moon-Sil
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.1
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    • pp.109-117
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    • 2007
  • Purpose: This study focused on analysing the performance and the perception of importance about workload of ambulatory nurses and nurse-aides for quality of nursing. Method: The subjects of this study were 126 ambulatory nurses and 117 nurse-aides in 6 secondary and 4 tertiary hospitals. The method of data collection was used the questionnaire. Result: As a result, First, nurses' activities that the performance score is above 3.0 are reception, guidance, reservation, confirm, checking medical record, operating report, explanation of disease, explanation of examination discuss with medical part, discuss with supporting part, solving patient problem environment management, and paper work. And the other side, those of nurse-aides are reception, guidance, reservation, preparation for clinic, assistant for clinic, preparation for examination, material transfer & receipt, confirm, checking medical record, and arrangement. Second, nurses-aids perceive above 3.0 performance score activities to be important for themselves. Finally, nurses perceive three categories of patient education/counselling, patient advocacy and quality improvement to be more important and higher performance when compared with nurse-aides. Conclusions: Ambulatory nurse's important nursing activities are therapeutic care, patient education/counselling, patient advocacy, communication, personal management, quality improvement.

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Prescription, Transcription and Administration Errors in Out-Patient Day Care Unit of a Regional Cancer Centre in South India

  • Mathaiyan, Jayanthi;Jain, Tanvi;Dubashi, Biswajit;Batmanabane, Gitanjali
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2611-2617
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    • 2016
  • Background: Medication errors are common but most often preventable events in any health care setup. Studies on medication errors involving chemotherapeutic drugs are limited. Objective: We studied three aspects of medication errors - prescription, transcription and administration errors in 500 cancer patients who received ambulatory cancer chemotherapy at a resource limited setting government hospital attached cancer centre in South India. The frequency of medication errors, their types and the possible reasons for their occurrence were analysed. Design and Methods: Cross-sectional study using direct observation and chart review in anmbulatory day care unit of a Regional Cancer Centre in South India. Prescription charts of 500 patients during a three month time period were studied and errors analysed. Transcription errors were estimated from the nurses records for these 500 patients who were prescribed anticancer medications or premedication to be administered in the day care centre, direct observations were made during drug administration and administration errors analysed. Medical oncologists prescribing anticancer medications and nurses administering medications also participated. Results: A total of 500 patient observations were made and 41.6% medication errors were detected. Among the total observed errors, 114 (54.8%) were prescription errors, 51(24.5%) were transcribing errors and 43 (20.7%) were administration errors. The majority of the prescription errors were due to missing information (45.5%) and administration errors were mainly due to errors in drug reconstitution (55.8%). There were no life threatening events during the observation period since most of the errors were either intercepted before reaching the patient or were trivial. Conclusions: A high rate of potentially harmful medication errors were intercepted at the ambulatory day care unit of our regional cancer centre. Suggestions have been made to reduce errors in the future by adoption of computerised prescriptions and periodic sensitisation of the responsible health personnel.

Job Description of the Nurses Working in Outpatient Department by DACUM Technique (DACUM 직무분석 기법을 이용한 외래간호사의 직무분석)

  • Cho, Kyung Sook;Kang, Hyun Sook;Kim, Joo Hyun;Son, Haeng Mi;Han, Hye Ja;Sung, Young Hee;Park, Jung Won;Song, Mal Soon
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.2
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    • pp.31-45
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    • 2008
  • Purpose: The purposes of this study were: (a) to identify role definition, tasks, and duties of the nurses who work in outpatient department (OPD), (b) to do Development a Curriculum(DACUM) chart, and (c) to compare duties and tasks among nurses, nurse's assistants, and doctors. Method: The DACUM committee was organized with 10 nurses who worked in OPD. The committee derived the duties and tasks of OPD nurses from what they had done at workplace. Validity of the derived duties and tasks was tested by 23 nurses at 15 university hospitals. Results: Eleven kinds of duties were identified: preparation for outpatient's medical examination; support for outpatient's medical examination; management of outpatients; outpatient education; outpatient counseling; special examination of outpatient; OPD administration; management of OPD supplies; management of facilities and environments of OPD; management of OPD personnel, and self-improvement. Ninety-two tasks were classified. Conclusion: The abilities for education and emergency care of OPD nurses should be empowered. The results of this study would not only contribute to the effective OPD nursing care, but also be useful as basic data in hospital management.

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Estimation of nursing cost for selected special nursing services;operative nursing, emergency nursing, and ambulatory nursing (임상특수분야 간호원가 산정;응급실, 수술실, 외래를 중심으로)

  • Park, Jung-Ho;Sung, Young-Hee;Kim, Eul-Soon;Park, Kwang-Ok;Park, Jung-Sook;Sung, Il-Soon;Song, Mi-Sook;Cho, Moon-Soo
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.2
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    • pp.309-321
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    • 2002
  • Purpose: A cost analysis for nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing unit was performed using patient classification system by nursing intensity in order to determine an appropriate nursing fee schedule. Method: The data were collected from 4 secondary hospitals and 5 tertiary hospitals from November 14th 2000 to January 15th 2001. The study was conducted through four phases as follows: 1) Nursing hours of each nursing service in special nursing units were measured using three kinds of patient classification systems by nursing intensity. 2) The nursing cost of nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing units was estimated based on patient classification system by nursing intensity. Results: As a result, nursing hours by nursing intensity of each special nursing unit were measured, and every nursing cost by nursing intensity in operation room and emergency room was estimated, meanwhile, the cost of nursing services in ambulatory care units was estimated only per visit as shown in chapter 4. Conclusion: Future research on nursing cost should be extended to other special nursing units such as various intensive nursing care units, delivery room, and so on. In addition, the patient classification system should be refined for its appropriateness to apply all levels of medical institutions.

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Computerization of Nurse Staffing and Scheduling according to Patient Classification (환자분류에 의한 간호인력 산정 및 배치과정 전산화)

  • Park, Jung-Ho;Park, Hyeoun-Ae;Cho, Hyon;Choi, Yong-Sun
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.399-412
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    • 1996
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current nursing productivity of nurses is not desirable unless the quality of care considered. Moreover. nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. As for the nurse scheduling, the critical problem of it in the hospital is determining the day-to-day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. Nurse scheduling, however, involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. Under these backgrounds, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. This study was performed to develop a system computerizing nurse staffing and scheduling based on the patient classification. As a preliminary step for the system development, nursing workload in a secondary hospital was measured from Sep. to Oct. 1994. On the grounds of this result, computerization of nurse staffing and scheduling was proceeded with three options. First one is based on the current medical law. Second one is based on the assigned number of nursing staff. And the last is based on the request by patient classification. Computer languages used in this study were MS Visual Basic 3.0 for the staffing and Access 2.0 for the scheduling, respectively. Prospective users may operate this system easily because icons and mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurse administrators manage nursing manpower efficiently and nurses develop quick and easy schedule generation and allow more time for the patient care.

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A Study on Self Care Compliance Related to Infection Management for Continuous Ambulatory Peritoneal Dialysis Patients (복막투석환자의 감염예방과 관련된 자가간호 이행에 관한 연구)

  • Lee Eun-Young;Kim Jung-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.5 no.2
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    • pp.313-323
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    • 1998
  • This study was a descriptive research on the level of self-care available to continous ambulatory peritoneal dialysis patients (hereinafter referred to as 'CAPD patient') related to the specific area of infection management. The method employed for the collection of data was a modified instrument of the self-care survey essentially based on Young Sook Choi's instrument. The relevant data was collected from september 1, 1996 to september 30, 1996. The subjects were provided with an open-ended question regarding the reasons behind why they did not seek self-care. The answers provided about self-care compliance were analyzed by SPSS for frequency, percentage, mean, t-test, ANOVA. Reasons for non-compliance were analyzed by content analysis. The results of the study were as follows : 1. The percentage of patients engaging in self-care were according to the following self performed tasks : preparation of dialysis : 30.58 points Dialysate exchange procedures : 49.40 points - Two bag type : 50.50 points - Spike type : 48.80 points - Neo type : 48.90 points Catheter exit site care : 25.13 points More specifically, in relation to the preparation of dialysis as referred to above, those patients engaging in self care was relatively high with respect to the cleaning of the dialysis before use and for the preservation of peritosol. However, in dialysate exchange procedures, data revealed that those patients engaging in self-care are relatively low with respect to putting on a mask during the performance of peritosol exchange. Similary in peritosol exchange procedure and catheter exit care, low levels of self-care performance were found in the area of putting on a mask during the peritosol exchange procedures and catheter line testing procedures, respectively. 2. In general characteristics, there appeared to be no distinction in self-care compliance among CAPD patients. 3. The main reasons for non-compliance were based in the following factor : intellectual, attitude, enviromental surrounding and physical. As a result of the foregoing finding, nurses should provide adequate assistance to promote self-care compliance by CAPD patients by checking the preparation of dialysis, dialysate exchange procedure, and catheter exit site care which recieved low point in this research.

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Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic (여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 -)

  • Park, Yeong-Suk
    • Women's Health Nursing
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    • v.5 no.1
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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.

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