• Title/Summary/Keyword: Clinical Nursing Performance

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Analysis of Risk Factors for Patient Safety Management (환자안전 관리를 위한 위험요인 분석)

  • Ahn, Sung-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.3
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    • pp.373-384
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    • 2006
  • Purpose: This is a pilot study to identify patient safety risk factors and strategies for patient safety management perceived by nurses. Methods: Data were collected and analyzed with an open questionnaire from April to May 2005, targeted on 100 nurses working in two hospitals. The issues were 'what are risk factors for patients, nurses, and other medical practitioners? How do they prevent with the aftermath of risk factors, causes of incidents?' For data analysis, types and frequency of risk factors were worked out, using the Australian Incident Monitoring System Taxonomy. Results: The types of patient safety risk factor perceived by nurses were as follows ; therapeutic devices or equipment, infrastructure and services (29.5%), nosocomial infections (16.3%), clinical processes or procedures (15.4%), behavior, human performance, violence, aggression, security and safety (12.2%), therapeutic agents (9.7%), injuries and pressure ulcers (8.7%), logistics, organization, documentation, and infrastructure technology (5.6%). Strategies for patient safety included training of prevention of infection, education about safety management for patients and medical professionals, establishment of reporting system, culture of care, pre-elimination of risk factors, cooperative system among employees, and sharing information. Conclusion: These results will be used to provide evidences for patient safety management and educational program.

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End-of-Life Assessments and Communication for Dying Patients and Their Families

  • Lee, Eun Kyung;Jeong, Hyae Yeong;Kim, Kyung Won
    • Journal of Hospice and Palliative Care
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    • v.24 no.3
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    • pp.194-197
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    • 2021
  • End-of-life assessments aim to help dying patients and their families plan clinical interventions in advance and prepare them for a peaceful end of life, in which the patient accepts life and death, and the family accepts the patient's departure. It is important to assess whether death is imminent within a few days, because critical hospice care is provided intensively during that period. The following five changes constitute objective evidence of the end of life: diminished daily living performance, decreased food intake, changes in consciousness and increased sleep quantity, worsening of respiratory distress, and end-stage delirium. As subjective evidence, it is suggested that sensitive perceptions of experienced nurses and the feelings of family members caring for patients should also be considered. When notifying a patient or family members that the end of life is approaching, the members of the multidisciplinary hospice team must communicate with each other, share accurate information, and provide consistent explanations. They must also listen to non-verbal communication in an empathic and supportive manner.

Structural Equation Model of Clinical Nurses' Willingness to Perform Basic Life Support (BLS) in South Korea (임상간호사의 기본소생술 수행의지에 관한 구조방정식 모형 분석)

  • Uhm, Dong-Choon;Hwang, Ji-Young;Jun, Myung-he;Kim, Dong-ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.290-298
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    • 2016
  • This study was conducted to develop a model that explains the factors influencing the clinical nurses' willingness to perform Basic Life Support and to verify the appropriateness of the model. The participants were 550 clinical nurses working at a university hospital in Korea. The data were collected from self-reported questionnaires from October 2012 to February 2013. A total of 520 questionnaires were analyzed using the SPSS/WIN 20.0 and Amos version 18.0 software packages. The results indicated that the clinical nurses' knowledge of basic life support had a direct impact and their clinical experience had an indirect impact on their willingness to perform basic life support at the scene. These variables together explained 19.5% of the variance in the nurses' willingness to perform Basic Life Support. The clinical experience was correlated significantly with knowledge (r=.61, p<.001). To increase the clinical nurses' performance of Basic Life Support, knowledge and clinical experience should be reinforced by continuous in-service education on Basic Life Support, considering the disease status of hospitalized patients.

Knowledge and Performance of Universal Precautions by Nursing Students (일부 간호대학생의 혈액매개질환 예방 지침에 대한 지식과 실천 정도)

  • 김경미;김민아;정여숙;김남초
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.929-939
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    • 1999
  • The purpose of this study was to identify knowledge of universal precautions and its performance in practice. The research was conducted from November 2 to 30, 1998. A total 515 student nurses ; 249 from a baccalaureate nursing college and 266 from second and third year of a 3-year community nursing college were surveyed. The results are as following : 1. The average score for universal precautions knowledge was 270.41$\pm$19.43/300(range 150-300). The results showed that 99.2% of students avoid injury from used needles, 98.6% answered that they always wash their hands if they had contact with the patient's blood and they always dispose of used needles in special collectors (97.7%) for needles. But, 39.2% responsed that they dispose of used needles after recapping them. 2. The average score for universal precautions knowledge of the senior students in the 4-year college was the highest (277.65$\pm$13.99). 3. The average score for the performance of universal precautions knowledge was 53.18 $\pm$5.91(range 14-70). The items : ‘I cautiously avoid injury from the used needles’(4.92$\pm$0.33), ‘I always wash my hands if there has been contact with the patient's blood’(4.91$\pm$0.34), and ‘I always disposed of used needles in the appropriate collector’(4.89$\pm$0.42) showed the highest performance. However ‘I always dispose of used needles after recapping them’(2.19$\pm$1.39) and ‘I always use protection goggles when in danger of contamination’(2.19$\pm$1.20) showed low performance level. 4. The highest average score for universal precautions performance was shown among the second year students in 3-year nursing college (54.19$\pm$6.92) between the groups. It showed that the level of the universal precautions performance was higher for those who had education on university precautions prior to performance of the universal precautions than for those without any prior education. 5. The percentage of students who reported the experience of direct contact with patients' blood and/or body fluids was 42.30%. The experience of direct contact with blood and/or body fluids of the educational group was significantly higher than those were not educated. 6. The most frequent cause of the direct contact was ‘needle pricking and/or skin cut’(63.04%). The most frequent substance with which the students contact was ‘blood’(59.85%). The majority of the sample had answered that the mode of contamination was ‘unknown’(63.54%). The majority of the sample answered that strategies used after contamination included ‘washing with soap’(33.61%). Reviewing the chart of patients or asking other health professionals(28.85%). 7. The number of students who had the experience of a needle stick and/or skin cut was 145(28.16%). The clinical practice places where the incidents occurred were mainly in the internal medicine unit (45.07%) and the surgical unit (31.92%) followed by the intensive care unit and the emergency unit in order. The experience of a needle stick and/or skin cut happened during on intra-muscular injection 47.34% and intravenous injection 21.81%. The causes of the needle stick and/or skin cut were ‘putting the needle cap back on 77(35.81%)’. The number of students who took an appropriate post management blood test and/or vaccination was 27(18.62%). 8. The Pearson Correlation Coefficient between the knowledge of universal precautions and performance of universal precautions in practice showed a positive correlation.

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Influencing factors on health education performance of nurse in health promoting hospitals (건강증진병원 간호사의 건강교육수행 영향요인)

  • Lee, Jinsook;Kwon, Sohi
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.2
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    • pp.455-464
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    • 2015
  • This study aimed to identify the factors influencing health education performance of health promoting hospital nurses. The study was conducted with 231 nurses from four health promoting hospitals. Data were collected from May to June, 2013. Health education performance was positively correlated with education level, years of clinical experience, health promotion role recognition, and self efficacy for health education. Health promotion role recognition (${\beta}=.246$, p=.001), self-efficacy for health education (${\beta}=.282$, p <.001), and clinical experiences (${\beta}=.170$, p=.007) were significant predictors of health promoting hospital nurses' health education performance and explained 27.8% of the variance. The strategies to improve health promotion role recognition and self-efficacy for health education should be developed to improve health education performance of health promoting hospital nurses.

Teamwork Competency and Team Activity Experiences in Capstone Design Nursing Research Course (캡스톤 디자인 간호연구 수업의 팀워크역량과 팀활동 경험)

  • Min, Hae Young;Kim, Jiyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.1
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    • pp.705-716
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    • 2020
  • This triangulation study was performed in order to analyze the team competency effect of a capstone design nursing research course, and to appraise the content of team activity experiences. Subjects were 99 nursing students who were educated in the capstone design nursing research at D university. The teamwork competency of nursing students was compared before and after class, and the team activity experiences in the capstone design nursing research class was analyzed through narrative data. Our results show significant increases after class in task performance competency (t=-2.166, p=0.033), which includes goal execution competency (t=-2,224, p=0.028). In the interpersonal competency category, leadership was significantly increased after class (t=-2.085, p=0.040). The 5 categories evaluated were 'difficulties in managing resources', 'aware of the importance of personal effort and competency', 'efforts to effectively distribute roles', 'to realize the importance of communication', and 'strengthen the competency needed for clinical practice'. Through this research, we confirm that the capstone design nursing research course is effective for improving teamwork competency, and it provides a positive team activity experience to nursing students. Taken together, our findings indicate that the capstone design nursing research course can be applied to improve the nursing research competency by strengthening teamwork competency.

Evaluation of the Validity of Risk-Adjustment Model of Acute Stroke Mortality for Comparing Hospital Performance (병원 성과 비교를 위한 급성기 뇌졸중 사망률 위험보정모형의 타당도 평가)

  • Choi, Eun Young;Kim, Seon-Ha;Ock, Minsu;Lee, Hyeon-Jeong;Son, Woo-Seung;Jo, Min-Woo;Lee, Sang-il
    • Health Policy and Management
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    • v.26 no.4
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    • pp.359-372
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    • 2016
  • Background: The purpose of this study was to develop risk-adjustment models for acute stroke mortality that were based on data from Health Insurance Review and Assessment Service (HIRA) dataset and to evaluate the validity of these models for comparing hospital performance. Methods: We identified prognostic factors of acute stroke mortality through literature review. On the basis of the avaliable data, the following factors was included in risk adjustment models: age, sex, stroke subtype, stroke severity, and comorbid conditions. Survey data in 2014 was used for development and 2012 dataset was analysed for validation. Prediction models of acute stroke mortality by stroke type were developed using logistic regression. Model performance was evaluated using C-statistics, $R^2$ values, and Hosmer-Lemeshow goodness-of-fit statistics. Results: We excluded some of the clinical factors such as mental status, vital sign, and lab finding from risk adjustment model because there is no avaliable data. The ischemic stroke model with age, sex, and stroke severity (categorical) showed good performance (C-statistic=0.881, Hosmer-Lemeshow test p=0.371). The hemorrhagic stroke model with age, sex, stroke subtype, and stroke severity (categorical) also showed good performance (C-statistic=0.867, Hosmer-Lemeshow test p=0.850). Conclusion: Among risk adjustment models we recommend the model including age, sex, stroke severity, and stroke subtype for HIRA assessment. However, this model may be inappropriate for comparing hospital performance due to several methodological weaknesses such as lack of clinical information, variations across hospitals in the coding of comorbidities, inability to discriminate between comorbidity and complication, missing of stroke severity, and small case number of hospitals. Therefore, further studies are needed to enhance the validity of the risk adjustment model of acute stroke mortality.

Current Status of Patient Safety Regulations, Guidelines and Support Mechanisms in Korean Hospitals

  • Lee, Jae Ho;Kim, Jeong Eun;Kim, Suk Wha;Lee, Sang Il;Jung, Yoen Yi;Kim, Moon Sook;Jang, Seon Mi
    • Perspectives in Nursing Science
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    • v.10 no.2
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    • pp.158-166
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    • 2013
  • Purpose: This study was conducted to investigate patient safety regulations and guidelines in order to understand their current status, and to examine support measures to improve patient safety in Korean hospitals. Methods: The participants were the safety officers from hospitals with 200 or more beds and 112 hospitals responded to the online survey. The questions covered patient safety regulations, the performance level of patient safety activities, patient safety incident reporting systems, the dedicated professional, training, support mechanisms, and expectations of reporting systems. Results: Among preventative measures, fall prevention and hand hygiene were reported to be most widely practiced (92% and 91%, respectively). Time-out for invasive procedures showed a relatively low practice rate at 70%. Among patient care activities, transfusion, surgery and sedation, medication, and infection management were performed by 84, 74, 93 and 93% of the hospitals, respectively. Patient safety activities included patient safety committee, patient safety cooperation between decision-making bodies, patient safety workshops, seminars, lectures, and training for employees. Conclusion: Patient safety regulations and guidelines have not yet been sufficiently prepared, and a public institution such as a certification authority is of crucial importance to enforce these guidelines.

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Development of a Pain Assessment Tool for Critically Ill Patients (중환자 통증사정 도구 개발)

  • Choi, Eun Hee;Kim, Jin Hee;Choi, Kyung Ok;Yoo, Jung Sook;Kim, Mi Soon;Kim, Pil Ja;Jang, In Sun
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.136-148
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    • 2012
  • Purpose: The purpose of this study was to develop a reliable and valid pain assessment tool suitable for critically ill patients with communication problem in Korean intensive care unit. Methods: This pain assessment tool, Critical Care Non-verbal Pain Scale (CNPS), was developed based on review of national and international researches. Data were collected from ten intensive care units at five major general hospitals in Seoul. Reliability and validity were tested during performance of position change and endotracheal suctioning. Pain was measured before, during, and 20 minutes after the two procedures. Results: Interrater reliability of the CNPS was analyzed by ICC (Intraclass correlation coefficients). ICC values were significant from .833 to .883. Significant correlation between the FPS (Face Pain Scale) scores and the CNPS scores verified concurrent validity of the CNPS. For position change, CNPS scores increased significantly between before and during (t=-23.399, p<.001) and decreased significantly between during and 20 minutes after (t=22.760, p<.001). For endotracheal suctioning, CNPS scores increased significantly between before and during (t=-29.064, p<.001) and significantly decreased between during and 20 minutes after (t=28.194, p<.001), verifying construct validity of the CNPS. Conclusion: Results indicate that the CNPS can be used to assess pain of critically ill patients who have communication problem.

Factors related to the Performance of Mammography Screening among Women with a Family History of Breast Cancer in Korea

  • Oh, Jin-A;Kim, Tae-Hyun;Park, Young-Ok
    • Women's Health Nursing
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    • v.17 no.5
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    • pp.439-446
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    • 2011
  • Purpose: Early diagnosis is the primary method aimed at controlling breast cancer. The purpose of this study was to analyze some factors affecting the performance of mammography screening among women with a family history of breast cancer in Korea. Methods: This study applied a descriptive design method through structured self-report questionnaires. The Care Seeking Behavior Theory provided a theoretical framework for the study. Factors measured in this study represent demographic, clinical, and psychosocial variables including anxiety, barriers, utility, habits, perception, and facilitators. A total of 212 participants, of at least 20 years old, were sampled from April 8, 2010 to March 31, 2011. The data was analyzed by logistic regression method using the Statistical Package for the Social Science 18.0 software. Results: Of the 212 participants, 122 women (57.5%) went through mammography screening. The results of the analysis showed that (a) age (Odds Ratio [OR] =1.10, p<.001), (b) facilitating influences (OR=1.83, p=.008), (c) perception of mammography importance (OR=1.92, p=.011), (d) barriers to mammography (OR=0.60, p=.031), and (e) utility of mammography (OR=2.01, p=.050) significantly affect mammography screening. Conclusion: The results underscore the impact that psychosocial variables in obtaining mammography have on adherence to screening. Women with a family history of breast cancer should be given accurate information and recommendation about mammography by healthcare provider and a regular source of healthcare.