• Title/Summary/Keyword: Clinical rounds

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A Delphi Study to Elicit Policies for Nurse Workforce based on Patient Safety (환자안전 중심 간호인력 정책 도출을 위한 델파이 연구)

  • Chang, Sung Ok;Lee, Byoung Sook;Kim, Jong Im;Shin, Sung Rae
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.2
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    • pp.215-226
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    • 2014
  • Purpose: This study was done to suggest policies for nurse workforce based on patient safety. Methods: The two steps in developing the items were items related to what would be desirable policies and items on how the policies should be developed for patient safety regarding nurse workforce. A literature review was done and suggestions from experts through two rounds using the Delphi technique were outlined. The fifteen experts who participated in this study were six representatives of service consumers and nine representatives of service providers (four medical doctors and fives nurses). Results: To guarantee patient safety, accreditation of nursing practice and nursing education were found to be necessary, and to prevent medical and nursing accidents in clinical practice, the professional judgement of the nurses was found to be pivotal to the provision of safe nursing services. Conclusion: Polices on nursing for the nurse workforce based on patient safety in clinical settings should be established to ensure that nursing care is provided according to the nurses' clinical judgements based on their professional knowledge and assessment skills.

Development of Core Competency Scale for clinical nursing student educators (간호학 임상실습 현장지도자 핵심역량 측정도구 개발)

  • Park, Hyun Sook;Choi, Eun Hee;Kim, Gyung Duck;Kim, Young Hee;Jeon, Mi Yang;Hwang, Hyenam
    • The Journal of Korean Academic Society of Nursing Education
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    • v.28 no.4
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    • pp.345-356
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    • 2022
  • Purpose: This study aimed to develop a Core Competency Scale for clinical nursing student educators. Methods: In this study, we constructed a conceptual framework, selected initial items, verified the content validity, conducted two rounds of Delphi expert consultation, selected secondary and tertiary items, and extracted the final items. The study included 242 clinical educators for nursing students. Item analysis, factor analysis, criterion validity, and internal consistency were used for the data analyses. Results: For the final scale, 35 items were selected and 5 factors were categorized, which together explain 61.7% of the total variance. The factors were education and evaluation, research and cooperation, ethical/legal principles, presenting leadership, and clinical practice. The scores for the scale significantly correlated with the teaching efficacy scale for clinical nursing instructors. The Cronbach's alpha coefficient for the 35 items was .96. Conclusion: The findings of this study demonstrated that the core competency scale has good validity and reliability. This scale can be used to assess the competency of clinical educators for nursing students; hence, it will help in evaluating the relationship between the skills of clinical educators for nursing students and the self-efficacy of those students.

Analysis of Nursing Care Activities of Nursing Students in Clinical Experience (간호학생의 임상실습 간호활동시간 분석)

  • Lee Chung-Hee;Sung Young-Hee;Jung Yoen-Yi;Kim Jung-Suk
    • The Journal of Korean Academic Society of Nursing Education
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    • v.4 no.2
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    • pp.249-263
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    • 1998
  • The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

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Activities to Improve the Accessibility to clinical social work for Patients from Vulnerable/Disadvantaged/Marginalized Social Groups (취약계층 환자의 의료사회 복지서비스 접근성 증진 활동)

  • Hur, Lib;Lee, Young-Sook
    • Quality Improvement in Health Care
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    • v.19 no.2
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    • pp.80-88
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    • 2013
  • Objectives: With the increase in the number of people who are marginalized in receiving medical services, the role of Seoul National University Hospital as a public hospital is being emphasized. However, many patients are either experiencing delays in receiving medical services or simply being left out as a result of the inaccessibility to the department of social work on part of both the patients and the medical staff. Methods: In order to increase consultation from other departments and the accessibility to the department of social work for the socially marginalized group through early consultation from other departments, the following steps were taken. First, an orientation program for novice medical residents led by clinical social worker was introduced/implemented. Second, posters and brochures on various financial aids programs were produced and distributed. Third, a system of early screening was built/constructed, and once a week rounds and early screening meeting were executed/carried out. Result: The department of social work's rate of consultation from other departments increased by 4.4% compared to last year, while it showed 61% increase for those wards that had an early screening meeting. In addition, the average time of consultation from other departments was reduced by 3.1 days, securing sufficient amount of time for clinical social work services, both in terms of quality and quantity. Conclusion: It is believed that the various promotional activities, along with the strengthening of accessibility to clinical social work services and early consultation on part of social disadvantaged/marginalized group, would undoubtedly help provide quality services to patients and increase their level of satisfaction. In this way, the wards can effectively reduce the number of unnecessary hospital stay days while the hospital can prevent the accumulation of outstanding bills/fees as well as contribute to the publicness of hospitals. The promotion of clinical social work programs in various ways are crucial to ensuring the satisfaction of patients and hospital staff.

A case report on a patient with Dupuytren's contracture improved by acupuncture, moxibustion and bee venom pharmacopuncture (침, 뜸, 봉약침으로 호전된 듀피트렌 구축 환자 증례 보고)

  • Bang, Chan Hyuck;Sohn, Soo Ah;Lee, Kyung Yun;Ok, So Yoon;Choi, Yu Na
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.173-180
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    • 2016
  • Objectives : To treat the progression of fibroproliferative disease that affects the flexion contracture of the fingers for patients with Dupuytren's contracture, the purpose of this study is to report a case of a patient with Dupuytren's contracture after complex Korean medical treatment. Methods : A patient was treated with acupuncture, moxibustion and bee venom pharmacopuncture on their left palmar aponeurosis. Six rounds of acupuncture and moxibustion were administered from November 30, 2015 through to January 2, 2016. Three rounds of bee venom pharmacopuncture was administered from December 14, 2015 through to January 2, 2016. The degree of flexion contracture and the Tubiana's stage were measured to evaluate the clinical improvement. Results : After 30 treatment sessions the flexion contracture degrees of the 4th finger's metacarpophalangeal joint and proximal interphalangeal joint improved as much as $25^{\circ}$, $15^{\circ}$, respectively. And the flexion contracture degrees of the 5th finger's metacarpophalangeal joint, proximal interphalangeal joint and distal interphalangeal joint improved as much as $15^{\circ}$, $10^{\circ}$, $5^{\circ}$, respectively. The Tubiana's stage of each finger decreased from 4 to 3. Conclusion : This study suggests that acupuncture, moxibustion and bee venom pharmacopuncture could be effective for patients with Dupuytren's contracture.

Cohort profile: National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008)

  • Kim, Ju Hee;Lee, Jung Eun;Shim, So Min;Ha, Eun Kyo;Yon, Dong Keon;Kim, Ok Hyang;Baek, Ji Hyeon;Koh, Hyun Yong;Chae, Kyu Young;Lee, Seung Won;Han, Man Yong
    • Clinical and Experimental Pediatrics
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    • v.64 no.9
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    • pp.480-488
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    • 2021
  • Background: An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea. Purpose: This study established the National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008) based on data from a nationwide population-based health screening program and data on healthcare utilization for children. Methods: The NICKs-2008 study consisted of the Korean National Health Insurance System (NHIS) and the National Health Screening Program for Infants and Children (NHSPIC) databases comprising children born in 2008 (n=469,248) and 2009 (n=448,459) in the Republic of Korea. The NHIS database contains data on age, sex, residential area, income, healthcare utilization (International Classification of Diseases10 codes, procedure codes, and drug classification codes), and healthcare providers. The NHSPIC consists of 7 screening rounds. These screening sessions comprised physical examination, developmental screening (rounds 2-7), a general health questionnaire, and age-specific anticipatory guidance. Results: During the 10-year follow-up, 2,718 children (0.3%) died, including more boys than girls (hazard ratio, 1.145; P<0.001). A total of 848,048 children participated in at least 1 of the 7 rounds of the NHSPIC, while 96,046 participated in all 7 screening programs. A total of 823 infants (0.1%) weighed less than 1,000 g, 3,177 (0.4%) weighed 1,000-1,499 g, 37,166 (4.4%) weighed 1,500-2,499 g, 773,081 (91.4%) weighed 2,500-4,000 g, and 32,016 (5.1%) weighed over 4,000 g. There were 23,404 premature babies (5.5%) in 2008 compared to 23,368 (5.6%) in 2009. The developmental screening test indicated appropriate development in 95%-98% of children, follow-up requirements for 1%-4% of children, and recommendations for further evaluation for 1% of children. Conclusion: The NICKs-2008, which integrates data from the NHIS and NHSPIC databases, can be used to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors.

Development of Korean Nurse Residency Program for Tertiary Hospitals (국내 상급종합병원 신규간호사의 실무적응지원 프로그램 개발)

  • Kwon, In Gak;Cho, Yong Ae;Kim, Kyeong Sug;Kim, Mi Soon;Cho, Myung Sook
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.2
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    • pp.149-164
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    • 2021
  • Purpose: The purpose of this study was to develop a Korean Nurse Residency Program (KNRP) in order to facilitate new nurses' transition to clinical practice working at tertiary hospitals in Korea. Methods: The KNRP was developed through a literature review, investigation of NRP cases in United States, two rounds of expert consultation, and appropriateness survey. For appropriateness survey of the program, a questionnaire with 118 items and 14 subcategories including overview and operation of KNRP, education programs, staffing criteria for new nurses' education, preceptor supporting strategies, evaluation standards for new nurse's education, infrastructure, and KNRP benefits was used. Data were collected from 369 nurses including nurse educators, nurse managers, preceptors, and new nurses working at 43 tertiary hospitals in Korea from February 16, 2021 to March 22, 2021. Data were analyzed with descriptive statistics. Results: Appropriateness score of KNRP was 3.42±0.31 (out of 4) and those of 14 subcategories ranged from 3.18±0.47 to 3.58±0.46. The final version of the KNRP postulated is a one-year program, which is composed of off-job training and on-site training including preceptorship over 3 months, and competency reinforcement and adaptation supporting programs. Conclusion: The application of the one-year KNRP will facilitate new graduate nurses' transition to clinical practice. In order for effective application of the KNRP, cooperative efforts of the government, professional associations, and hospitals are needed.

Development and Effect of Pain Management Protocol for Nursing Home Patients with Dementia (노인 간호 요양시설에서의 치매환자 통증관리 프로토콜 개발 및 효과)

  • Chang, Sung-Ok
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.1
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    • pp.29-43
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    • 2007
  • Purpose: This study was done to develop a pain management protocol for nursing home patients with dementia and to examine effects of the protocol on pain assessments and interventions by the nurses and on pain relief signs in the patients. Method: The six steps in the protocol development and the examination of effect are outlined. Three rounds using the Delphi technique and one group pretest-posttest design experiment were developed. Design issues, such as sample selection and sample size, are addressed in relation to the study protocol. Results: After implementation of the pain management protocol, there were significant changes nursing actions including frequency of number of physical examinations, utilization of pain assessment tools, and request to doctors for discomfort management and there were significant changes in frequency in the number of verbal and physical expressions of pain, and emotional patterns. Conclusion: This is the first pain management protocol for patients with dementia in Korea. However, more study will be needed to determine the methodological strength and necessary revisions for the protocol.

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A Clinical Case of Lymphadenopathy and Hearing Loss after Covid-19 Vaccination (COVID-19 백신 접종 후 발생한 라력(瘰癧)과 이롱(耳聾)에 대한 치험 1례)

  • Kim, Kyung-Jun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.3
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    • pp.95-106
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    • 2022
  • Objectives: The purpose of this study is to report a case of lymphadenopathy and hearing loss in a patient after coronavirus disease 2019(COVID-19) vaccination. Methods: The patient diagnosed as lymphadenopathy and hearing loss(sensorineural hearing loss) after the first and second rounds of the Pfizer COVID-19 vaccination. We applied Korean medical treatment including herbal medicine and acupuncture for lymphadenopathy and SSNHL. We used VAS(Visual Analog Scale), CT-scan and Pure Tone Audiometry to estimate they symptoms. Results: After the treatment, general symptoms of lymphadenopathy and hearing loss including aural fullness showed big improvement. Conclusions: This case report shows effect of Korean medicine on lymphadenopathy and SSNHL and suggests a possibility of Korean medicine to treat adverse events following COVID-19 vaccination.

A Relationship between Burden of Clinical Nursing Instructor and Teaching Effectiveness (임상실습 지도자의 부담감과 교수 효율성과의 관계)

  • Son Haeng-Mi;Kim Sook-Young;Lee Hwa-In;Jun Eun-Mi;Han Shin-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.4 no.2
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    • pp.187-203
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    • 1998
  • The purpose of this study was to identify the correlation between burden and teaching effectiveness on clinical nursing practice. The subjects were collected 135 clinical nurses who have taught nursing students and worked at hospitals which have over 400 beds in Seoul, Inchon, and Kyoung-gi Do. The instruments used in this study were : the burden on clinical nursing education was measured by Montgomery (1985) developed and visual analogue scale, and effectiveness of clinical instruction was measured by Reeve (1994) developed. The results of this study were as follows. 1) Seeing that the general characteristics of participants : average ages we 32.8 years old, 29.6% of them have Catholics in religions. 75.6% of them were graduated from 3-year nursing college. 20.7% of nurses are working at the surgery ward and I.C.U in each. Clinical nursing career is average 10.03 years, clinical instructional career is 5.22 years, and clinical teaching time is 5.26 hours in a day. Contents of clinical teaching were composed of basic nursing skills 80.7%, orientation 78.5%, inspection(making rounds) 71.9%. 2) The mean score of the burden on clinical nursing instructor was 2.42 by Montgomery's scale and 4.69 by the visual analogue scale. Theses scores represented that subjects were not affected burden highly. The mean score of leaching effectiveness on clinical nursing education was 3.47 and the almost items were found to have higher level. 3) There is no statistically significant differences in the burden according to general characteristics. And the teaching effective ness on clinical nursing education according to general characteristics regarding the age, job position, clinical career and clinical educational time were shown statistically significant differences. 4) There is a negative correlation between the burden and teachin effectiveness on clinical nursing education with a correlation efficient(r=-0.396, p<0.01). Further study is recommended to explore the meaning of burden experiences of clinical instructor deeply and to identify the correlation between the burden of clinical instructor and teaching effectiveness as the job position, and to analysis differences in teaching effectiveness as subcategories.

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