• 제목/요약/키워드: CARE guidelines

검색결과 908건 처리시간 0.033초

재가노인 방문요양보호사의 낙상관련 대처 경험에 관한 연구 (A Case Study on Care Workers' Experiences of Coping with Falls among Community-Dwelling Elders)

  • 임선영;박혜선;마예원
    • 대한통합의학회지
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    • 제9권3호
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    • pp.99-110
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    • 2021
  • Purpose: The purpose of this study was to understand the experience and meaning of falls among care workers caring for the elderly. Methods: The participants comprised 10 care workers in Seoul and Gyeonggi Province, South Korea. The data collection period was from September to November 2020, and the data were obtained through individual in-depth interviews. The collected data were analyzed using the content analysis method of qualitative research. The main interview questions were as follows: First, in the event of a fall, "can you tell us about your experience and how you dealt with the fall?; second, "can you tell us about your role and the role of family members or the center that manages falls that occur outside of nursing visits.", third, "can you tell us about the difficulties in managing falls based on your experience?", and fourth, "how are falls that occur during nursing visits managed?" Results: As a result of analyzing the experiences of nursing care workers of falls while caring for elders in their homes, five main themes were derived. These were understanding the characteristics of the elderly at home, understanding possible emergency situations, providing caring services, minimizing physical harm, and delivering clear information. Conclusion: A significant finding of this study was that care workers who visit and provide care to elders at home confirmed the need for standard guidelines on appropriate responses in the event of a fall at home and the importance of managing emergencies arising from falls among elders at home. These results highlight the need for the development of emergency response education programs, such as programs on fall care among nurses and care workers who provide care to the elderly, and for enhanced understanding of the fall risk of elders who live at home.

의료과오시(醫療過誤時) 간호사의(看護師)의 주의의무(注意義務)에 관한 연구(硏究) (A Study on the Nurse's Due Care in Medical Malpractice)

  • 강선주
    • 간호행정학회지
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    • 제5권1호
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    • pp.113-136
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    • 1999
  • There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.

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Development of supplemental nutrition care program for women, infants and children in Korea: $NutriPlus^+$

  • Kim, Cho-Il;Lee, Yoon-Na;Kim, Bok-Hee;Lee, Haeng-Shin;Jang, Young-Ai
    • Nutrition Research and Practice
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    • 제3권3호
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    • pp.171-179
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    • 2009
  • Onto the world-fastest ageing of society, the world-lowest fertility rate prompted a development of various policies and programs for a betterment of the population in Korea. Since the vulnerability of young children of low socio-economic class to malnutrition was clearly shown at the in-depth analysis of the 2001 Korea National Health and Nutrition Examination Survey data, an effort to devise supplemental nutrition care program for pregnant/breastfeeding women, infants and preschool children was initiated. The program was designed to offer nutrition education tailored to fit the needs of the participants and special supplementary foods, using USDA WIC program as a benchmark. Based on the dietary intake of those age groups, target nutrients were selected and their major food sources were searched through nutrient content of foods and dietary pattern analysis. As a result, we developed 6 kinds of food packages using combinations of 11 different food items. The amount of each item in a food package was determined to supplement the intake deficit in target nutrients. Nutrition education in $NutriPlus^+$ aims to improve the nutrition knowledge, attitude, and dietary behaviors of the participants, and is provided through group lessons, individual counseling sessions and home visits. Breastfeeding is promoted with top priority in education for the health of both mother and baby. The eligibility guidelines were set for residency, household income, age, pregnancy/breastfeeding and nutritional risk such as anemia, stunting, underweight, and/or inadequate nutrient intake. Income eligibility was defined as household income less than 200 percent of the Korean poverty guidelines. A pilot study to examine the feasibility of program implementation was run in 3 public health centers in 2005 and expanded to 15 and 20 in the following 2 years. The result of 3-year pilot study will be reported separately along with the ultimate nationwide implementation of the $NutriPlus^+$ in 2008.

임상가를 위한 특집 4 - CBCT 검사법의 정도관리 및 선량 (Radiation Doses and Quality Assurance in Cone Beam CT(CBCT))

  • 최용석;김규태;황의환
    • 대한치과의사협회지
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    • 제52권3호
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    • pp.153-163
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    • 2014
  • 3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

전통적 출산법에 대한 문헌적 고찰 (Study of the oriental medical literature for traditional childbirth)

  • 윤성민;강한주;정우석;장명준
    • 대한의료기공학회지
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    • 제11권1호
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    • pp.117-143
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    • 2009
  • The community of women into society in various fields is expanding, and married late, and accordingly, the first child birth is increasing age. Accordingly, dystocia has also increased. Listed in the literature that the traditional method of birth seemed to oriental medical interpretation of one of the ancient wisdom of the predecessors to explore. The result of this study is summarized as follows. 1. Child birth custom divide into childbirth preparation, childbirth and postpartum care. Postpartum care divide into preparation of the birthplace, food for pregnant woman and birth preparation of the necessary things. 2. Preparation of the birthplace of the court case and that qeen is three months, one month before that in the case of concubines were installed. The difference in manners, and actual number but the configuration of the same item was prepared. In the private, birthplace is installed husband's home or parent's home. 3. Rice and seaweed is food for pregnant woman. San Miguel (产 米), sangwak (山 藿) specifically called was selected by Keep elaborate. 4. 1 month before birth to baby clothing is usually prepared. For the safe of a paturient woman and a baby, magical prescription was practiced in so-guk-so(昭格署) in early chosun dynasty. After so-guk-so(昭格署) abolished magical practice was stopped. Then Wore old clothes based on dong-ui-bo-gam(東醫寶鑑) 5. Im-san-ye-zi-bub(臨产豫智法) specifically to instruct the royal birth is the birth of guidelines. Im-san-ye-zi-bub(臨产豫智法) cosist of birth place, abdominal pain Precautions, food, care after childbirth, remove the plecenta posion, method of cut navel, bath, protection. Through various court records of the situation, according to the guidelines are properly applied based on dong-ui-bo-gam(東醫寶鑑).

Treatment of Latent Tuberculosis Infection and Its Clinical Efficacy

  • Kim, Hyung Woo;Kim, Ju Sang
    • Tuberculosis and Respiratory Diseases
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    • 제81권1호
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    • pp.6-12
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    • 2018
  • The role of the treatment for latent tuberculosis infection (LTBI) has been underscored in the intermediate tuberculosis (TB) burden countries like South Korea. LTBI treatment is recommended only for patients at risk for progression to active TB-those with frequent exposure to active TB cases, and those with clinical risk factors (e.g., immunocompromised patients). Recently revised National Institute for Health and Care Excellence (NICE) guideline recommended that close contacts of individuals with active pulmonary or laryngeal TB, aged between 18 and 65 years, should undergo LTBI treatment. Various regimens for LTBI treatment were recommended in NICE, World Health Organization (WHO), and Centers for Disease Control and Prevention guidelines, and superiority of one recommended regimen over another was not yet established. Traditional 6 to 9 months of isoniazid (6H or 9H) regimen has an advantage of the most abundant evidence for clinical efficacy-60%-90% of estimated protective effect. However, 6H or 9H regimen is related with hepatotoxicity and low compliance. Four months of rifampin regimen is characterized by less hepatotoxicity and better compliance than 9H, but has few evidence of clinical efficacy. Three months of isoniazid plus rifampin was proved equivalence with 6H or 9H regimen in terms of efficacy and safety, which was recommended in NICE and WHO guidelines. The clinical efficacy of isoniazid plus rifapentine once-weekly regimen for 3 months was demonstrated recently, which is not yet introduced into South Korea.

암환자에게 제공된 다빈도 간호중재 분석 - 5개 종합병원을 중심으로 - (Analysis of Nursing Interventions Frequently Used with Cancer Patients)

  • 문경희;안미정;김필자;박정연;김명애;박인숙;배수현;이소정;권인각;김소선
    • 임상간호연구
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    • 제15권1호
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    • pp.107-122
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    • 2009
  • Purpose: The purpose of this study was to identify nursing interventions frequently used with cancer patients. Nursing records from 5 general hospitals for patients with stomach, liver, lung or colon cancer were analyzed. Method: A descriptive study methodology was used and nursing records for 15 patients in each disease category at each hospital, who were admitted and discharged during June 2007 were analyzed. Results: Five domains of NIC were found and the physiological(basic) domain was most frequent (31.52%). Twenty two classes of NIC were identified with risk management for safety being most frequent (22.49%). For the 119 nursing interventions identified, the most frequent was pain management with 7,827 (12.31%), followed by prevention of falls (11.76%), surveillance (6.79%) and wound care (5.12%). Nursing activities of pain management and prevention of falls were comparable to activities listed in literature on guidelines for evidence based and best practices in nursing care. Eight of the 17 nursing activities for pain management, and 9 of 14 for fall prevention were consistent with these guidelines. Conclusion: In this study, nursing interventions were found to be focused on physical care, monitoring patients' condition and education. We have to develop diverse nursing interventions and a convenient recording process.

신생아중환자실에서의 가족중심돌봄 기반 가족중재연구에 대한 통합적 문헌고찰 (An Integrative Review of Family Interventions based on a Philosophy of Family-Centered Care in Neonatal Intensive Care Units)

  • 정나리;김예슬;박은영;여리사;황지원
    • Perspectives in Nursing Science
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    • 제16권1호
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    • pp.35-44
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    • 2019
  • Purpose: The aim of this study is to analyze the characteristics of family interventions based on a philosophy of family-centered care conducted in neonatal intensive care units through an integrative literature review. Methods: We searched the PubMed, CINAHL, RISS, KISS, and DBpia databases; a total of 20 studies, published between January 2013 and May 2018, was selected according to our criteria. Results: Mothers accounted for a greater proportion of participants in family interventions than did fathers. Family interventions described in the studies were categorized into four educational and sixteen non-educational interventions. Among non-educational interventions, skin-to-skin-contact interventions, such as kangaroo care, accounted for the highest proportion. Only one paper employed a theoretical framework. Conclusion: More family interventions based on theoretical frameworks should be conducted as these frameworks serve as guidelines for nursing research. As the stress patterns experienced by parents in neonatal intensive care units showed gender differences, more programs tailored for fathers are needed. Moreover, further research should be conducted to evaluate feasibility as an outcome variable, and studies of family interventions based on a philosophy of family-centered care should be performed more actively in the neonatal intensive care units in Korea.

병동 간호사의 가정용 인공호흡기 적용 환자 간호 스트레스 영향요인 (Factors Influencing Stress of Nurse who care for patients using a Home Mechanical Ventilator in General Ward)

  • 민현주;권희영;신채원;하영진;김현정
    • 가정∙방문간호학회지
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    • 제26권1호
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    • pp.91-101
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    • 2019
  • Purpose: The purpose of this study was to identify factors associated with stress related to home mechanical ventilator (HMV) care in general ward nurses. Methods: The study participants were 110 general ward nurses. Data on participant characteristics, level of knowledge, education needs, coping ability in emergency situations, confidence, and stress were collected from August 1 to 30, 2018 using a structured questionnaire by web-based surveys. Data were analyzed using SPSS/WIN 20.0 for descriptive statistics and independent t-test, one-way analysis of variance, Pearson's correlation coefficient, and multiple regression analysis. Results: Significant factors associated with stress related to HMV care were ward career, intensive care unit (ICU) career, intensive care room (ICR) career, education experience, and satisfaction level of HMV education. Stress had negative correlations with confidence and positive correlations with education needs. The determining factors affecting stress related to HMV care in the general ward were confidence (${\beta}=-.31$, p=.004), ICR career (${\beta}=-.27$, p<.001), education needs (${\beta}=.24$, p=.005), education frequency (${\beta}=-.18$, p=.040), and ICU career (${\beta}=-.18$, p=.025); their explanation power was about 41.8%. Conclusions: It is necessary to develop HMV care training manuals and guidelines and consider ICU or ICR careers for patient safety.

Patterns of Care 연구 개발을 위한 직장암의 수술 후 방사선치료 시 적정 방사선치료 조사영역 제안 (Suggestion of Optimal Radiation Fields in Rectal Cancer Patients after Surgical Resection for the Development of the Patterns of Care Study)

  • 김종훈;박진홍;김대용;김우철;성진실;안용찬;유미령;전미선;홍성언;오도훈;김일환
    • Radiation Oncology Journal
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    • 제21권3호
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    • pp.183-191
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    • 2003
  • 목적: 전국의 각 병원 방사선종양학과 전문의들이 시행하고 있는 직장암의 수술 후 방사선치료 조사영역 결정 원칙들을 취합하여 이를 바탕으로 표준적인 조사영역을 제시하고 향후 Patterns of Care 연구를 위한 기본 자료로 삼고자 한다. 대상 및 방법: 경인지역 소재 18개 병원의 방사선종양학과 전문의들이 모인 합의도출 위원회에서 직장암의 수술 후 방사선치료 조사영역 결정 원칙을 파악하기 위해 개발한 항목들을 이용하여 직장암의 방사선치료를 담당하고 있는 전국의 48개 병원 방사선종양학과 전문의들을 대상으로 설문조사를 시행하였다. 전문의 별 치료원칙의 파악에 사용된 설문 항목들은 모의치료 시 조사영역 결정 19개 항목으로서 전후방 치료 시의 상연, 하연 및 측연과 측면 치료 시 전연, 후연 및 차폐물의 적용 범위 등을 묻는 내용이었고, 45개 병원 중 33개 병원의 전문의들로부터 회신된 내용과 해부학적, 임상적 결과들을 바탕으로 일반적으로 권장할 만한 적절한 방사선조사영역을 도출하였다. 결과: 직장암의 수술 후 방사선치료 조사영역 결정에 있어 권고할 만한 일반적인 원칙으로 다음의 사항들을 개발하였다. 상연은 제5요추 하단이나 중간부위, 또는 천장골관절 상단, 하연은 전하방 절제수술 시에는 문합부로부터 일정거리 하방, 복회음부 절제수술 시는 회음부 봉합부로부터 일정거리 하방, 전후방 치료 시의 측연은 골반강 내벽면으로부터 일정거리 외측, 측면 치료 시의 전연은 치골결합부 후단, 그리고 후연은 천골 전면 또는 후면으로부터 일정거리 후방으로 정하여 천골 전면부의 공간을 충분히 포함시키는 것이 합리적인 것으로 나타났다. 권고안과 비교할 때, 상연의 경우 23건($70\%$), 하연의 경우 전하방절제수술 시 13건($39\%$), 복회음부 절제수술시 32건($97\%$), 측연의 경우 32건($97\%$), 후연의 경우 32건($97\%$), 그리고 전연의 경우 16건($45\%$)에서 부합되는 것으로 나타났다. 결론: 직장암의 수술 후 방사선치료 시 적절한 방사선치료 조사영역의 결정을 위하여 표준적인 조사영역을 제시 하였으나 개별 환자의 병변 위치와 진행상태, 수술 소견 등에 따라 적절한 변형은 필수적이라 하겠다. 이 권고안의 임상적 타당성은 향후 시행될 Patterns of Care 연구를 통하여 증명하는 것이 필요하겠다.