• Title/Summary/Keyword: Critical care nurse

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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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Post-traumatic Growth and it's associations with Deliberate Rumination, Self-disclosure, and Social Support among Intensive Care Unit Nurses (중환자실 간호사의 의도적 반추, 자기 노출, 사회적 지지가 외상 후 성장에 미치는 영향)

  • Min, Sae Mi;Kim, Hee Jun;Kim, Chun-Ja;Ahn, Jeong-Ah
    • Journal of Korean Critical Care Nursing
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    • v.15 no.2
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    • pp.50-63
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    • 2022
  • Purpose : This study aimed to identify intensive care units (ICU) nurses' experience of traumatic events, deliberate rumination, self-disclosure, social support, and post-traumatic growth (PTG), and to explore relationships among the variables. Methods : Participants were 157 nurses who have provided direct patient care for six months or more in ICUs at a university hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVAs, Pearson correlations, and multiple linear regressions using the SPSS/WIN version 23.0. Results : The PTG was found to be significantly associated with deliberate rumination (r=0.36, p<.001), self-disclosure (r=0.39, p<.001), and social support (r=0.54, p<.001). Factors that affect PTG significantly were found in the order of social support (𝛽=0.40, p<.001), self-disclosure (𝛽=0.25, p<.001), and deliberate rumination (𝛽=0.24, p<.001). The final regression model explained 40.1% of the variance of PTG (F=26.33, p<.001). Conclusion : The influencing factors identified in this study on PTG, including social support, self-disclosure, and deliberate rumination should be included in programs to promote PTG for ICU nurses who may experience traumatic events repeatedly.

Task Analysis of Emergency Nurse Practitioners: Frequency, Importance, Autonomy, and Perceived Competence to Perform (국내 응급전문간호사의 업무 수행빈도, 중요성, 자율성 및 지각된 수행능력)

  • Ahn, Suk Hee;Lee, Eun Nam;Song, Rhayun;Park, Jin-Hee;Kim, Bok-Ja;Sung, Mi Hae;Lee, Eun Ja;Kim, Minju;Kim, Sung Sook
    • Journal of Korean Critical Care Nursing
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    • v.8 no.1
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    • pp.25-40
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    • 2015
  • Purpose: The purpose of the study was to identify the frequency and importance of task performance and the perceived competence to perform of the emergency nurse practitioners (ENPs) certified in Korea. Method: This cross-sectional study was conducted with 41 ENPs certified by March 2012. The questionnaire to identify frequency, importance, autonomy, and perceived competence to perform 131 typical ENP task elements was developed on the basis of the standardized role of an ENP defined by the Korean Accreditation Board of Nursing Education. The data were analyzed using descriptive statistics. Results: The professional nursing practice showed the highest scores for performance frequency, task importance, autonomy, and perceived competence to perform as compared to other job categories. Clinical decision making was the most frequently performed duty. Data collection was the duty with highest levels of importance, autonomy, and perceived competence for the ENPs. However, the ENPs reported that research was the duty with the lowest levels of frequency, importance, autonomy, and perceived competence Conclusion: ENPs in Korea perform various tasks. In order to improve their position in the field, it is necessary to clarify their job description and enhance their competence to perform evidencebased professional nursing practices.

Relationships between Sedation Knowledge and Nurse Practice Competences in Intensive Care Unit (집중치료실 간호사의 진정요법 지식과 간호실무 역량요인의 상관성 분석)

  • Jang, Hyejoo;Lee, JuHee;Nam, Ae-Ri-Na;Kim, Heejung
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.1
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    • pp.74-84
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    • 2018
  • Purpose: For this study an examination was done of relationships between intensive care unit (ICU) nurses' knowledge related to sedation and their clinical competencies in sedation practice. Methods: Ninety one ICU nurses were recruited from two tertiary hospitals in South Korea. A self-report questionnaire was used to examine the levels of knowledge related to sedation and nursing practice competence based on Ajzen's theory of planned behavior. Descriptive statistics, independent t-tests, one-way ANOVA, and Pearson correlations were performed using the IBM SPSS 21.0 Results: ICU nurses are more knowledgeable about general information on sedation rather than up-to-date information. Continuing education on sedation was related to difference in knowledge levels. However, the levels of knowledge were not related to competence in sedation practice. Instead, a positive attitude toward sedation practice was significantly related to the subjective norms; orders and goals, perceived behavioral control, practice of sedation, and intention to use. Conclusion: The results of this study provide fundamental information on levels of knowledge related to sedation practices of Korean ICU nurses. Continuing education should emphasize up-to-date information on sedation practice and need for positive attitudes which influence all other competencies towards sedation practices to achieve optical care of sedation in the ICU.

A Reconsidering on Setting for Philosophy and Curriculum Development in Nursing Education (간호교육과정틀에 관한 소고 -돌봄과학과 보건정책 중심으로-)

  • Kim Myung-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.1
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    • pp.55-66
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    • 1995
  • The goals of nursing education, and the bases for evaluating them depend on the goals of nursing practice. In order to prepare for the coming twenty first century and the meet changing societal demands and health needs, it is necessary to develop a new conceptual framework for future nursing education. While hospitals will still be in significant components of the health care system, will no longer be central focus or dominant influence. Health care services will be more usually delivered at community base. The nursing education required by that new approach must provide for reconsidered about a concept of caring as nursing curriculum. The changes in health care delivery that have occured, now being proposed, for nursing education undergoing its own changes. So the philosophy and objectives of education meed to reconsidering about the caring concept and general nursing. Nurse educators must prepare students to practic in condition of constant change. At the same time nurse educators must emphasize preparation about that. The practice of science of caring in nursing draws on a basic knowledge of the behavioral knowledge, biophysical processes, pathological processes, nursing skills and procedures and various treatment regimes and problem solving to help decision making in nursing situations. The concept of care is probably one of the least understood ideas used by professional and nonprofessional people, yet it is probably one of the most improtant concepts to be understood by nursing. Human caring and human relationships are closely interrelated. Humn caring remains an essential dimension of professional work and the science of caring as essental to the discipline of nursing. It is expected that the objectives of nursing education will be accomplished when the course and content of the curriculum are based on this conceptual framework. One recurrent education goal with some consistency is that of equipping the student with the necessary skills to live effectively and productivly in the world of tomorrow. In the new vision we are developing, professional education must also include exposure to liberal arts, encouragement of critical thinking, and a moral context for advanced professional education that is based upon a contextual health policy and caring science educational model.

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Thinking Strategies of Triage Nurses' Decision Making in the Emergency Department: Think Aloud Study (응급실 중증도 분류 간호사의 의사결정과정에 나타난 사고전략: 소리내어 생각하기)

  • Moon, Sun Hee;Park, Yeon Hwan
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.15-26
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    • 2016
  • Purpose: The aim of this study was to identify thinking strategies in the complicated decision-making process based on real patient-based data of triage nurses in the emergency department (ED). Methods: This study used the 'think aloud' method to collect data from 8 triage nurses from one general hospital ED in South Korea. The data were analyzed with protocol analysis using thinking strategies. Results: The triage process was divided into three stages. The first stage consisted of 8 thinking strategies, including searching for information. They used intuition based on directly observed concepts for identifying a crisis. The second stage consisted of 17 thinking strategies related to the decision-making process. They assessed patients and generated a hypothesis to try to understand their health problems through analytic thinking. The third stage consisted of 10 thinking strategies, including qualifying. They considered the situation of the ED and properly triaged the patients. During the triage process, they frequently used judging the value and searching for information on 17 thinking strategies. Conclusions: Triage nurses demonstrated various connected thinking strategies for each stage. Based on our results, further studies should be done to develop a triage education program.

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Development and Psychometric Evaluation of the Korean Nursing Work Environment Scale (한국형 간호사 근무환경 측정도구 개발 및 평가)

  • Park, So-Hee;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
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    • v.8 no.1
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    • pp.50-61
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    • 2015
  • Purpose: The purpose of this study was to develop a valid tool for measuring the work environment of Korean nurses and test the validity and reliability of the instrument. Methods: This is a methodological study for developing and testing a measurement tool. The conceptual framework for the tool was formed through a literature review and in-depth interviews with clinical nurses. 260 meaningful statements were derived through this process, and 59 of the primary items were generated out of these statements. On the basis of the content validity test, 41 items were selected for the preliminary tool. A total of 350 nurses from 7 hospitals responded to the preliminary questionnaire in October 2011. Results: After the item analysis and the principal component analysis using varimax rotation methods, 11 items were deleted. Considering the conceptual framework and the scree plot, we extracted 4 factors from the final 30 items. These factors were organizational support, head nurse's leadership, support system, and relationship with coworkers, and their total variance was 54.4%. The value of Cronbach's ${\alpha}$ of the final tool was 0.92. Conclusion: The above findings revealed that the Korean Nursing Work Environment Scale (K-NWES) is an appropriate, valid, and reliable tool for evaluating the work environment of Korean nurses. Further research to perform a criterion validity test of the K-NWES is needed.

The Effects of Discharge Planning for the Elderly with Pulmonary Disease in the Emergency Room (퇴원계획중재가 응급실 내원 호흡기 질환 노인의 퇴원준비도, 간호서비스 만족도, 재입원율에 미치는 효과)

  • Kim, Hyeon-Ju;Park, Yeon-Hwan
    • Journal of Korean Critical Care Nursing
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    • v.7 no.1
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    • pp.24-32
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    • 2014
  • Purpose: The purpose of this study was to examine the effects of discharge planning on patient satisfaction, the readmission rate and preparedness for discharge in the elderly admitted to the emergency room (ER) for pulmonary disease. Methods: A quasi-experimental intervention study design was used. Older adults with pulmonary health problems in the ER in one general hospital were randomly allocated to either an experimental (n=21, 74.2 years) or control group (n=19, 70.7 years). The experimental group participated in a discharge planning program by a geriatric nurse practitioner. Data were collected from medical records, physical measurements and structured questionnaires including information on demographics, patient satisfaction, readmission, and preparedness for discharge. Results: Participants in the experimental group had significantly better outcomes with regard to patient satisfaction with nursing services (p=.003) and preparedness for discharge (p=.034). However, there was no significant effect on the readmission rate (p=.392) Conclusion: The results suggested that a discharge planning program could bolster nursing service satisfaction and preparedness for discharge in older patients admitted to the ER for pulmonary health problems. To clarify the effects of discharge planning on older patients admitted to the ER, a larger sample population, better instruments for various measures, a new manual on discharge planning and frequent follow-up will be necessary.

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A Study on the Incidence of Diarrhea According to the Density of Nutrients Formulations in Nasogastric Tube-feeding Patients (비위관영양환자의 영양물 농도가 설사유발정도에 미치는 효과)

  • Park, Mi-Suk;Kim, Joo-Hyun;Kwak, Chan-Yeong
    • Journal of Korean Biological Nursing Science
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    • v.10 no.2
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    • pp.105-112
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    • 2008
  • Purpose: The purpose of this study was to investigate the difference in the incidence of diarrhea among the subjects given hypertonic and isotonic nutrients to the nasogastric tube feeding patients in the a critical care setting. Methods: This study is aquasi-experimental study with a pre & post-test design. The sample size of 40 was calculated based on Cohen's formula (1988). The total of 40 subjects who signed the informed consent were randomly selected and divided evenly into two groups, experimental and control group. Results: There are no significant differences between the two groups in homogeneity test (sex, age, albumin level, the use of antibiotics, antacid, and $H_2$ blocker). However, the frequencies of occurrence in diarrhea according to the density of nutrients formulation indicated a statistical difference at the level of .005 (p=.001): diarrhea occurred in four of 20 (20%) of the experiment group, but 14 (70%) of the control group. Also the onset date of diarrhea in the experiment group is later than that of the control group. Conclusion: The research findings suggest that we should begin with low density nutrients for nasogastric tube feeding, and increase its density gradually to decrease diarrhea incidence in the critical care setting.

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Development of Nursing Intervention List - Caregiver Support : Soobal - (돌봄제공자 지원 : 수발발간호중재 목록 개발 - 뇌졸중을 중심으로 -)

  • 안수연;염영희
    • Journal of Korean Academy of Nursing
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    • v.29 no.3
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    • pp.518-529
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    • 1999
  • The purpose of this research was to develop a nursing intervention list for family caregivers. The specific steps were as follows : 1. Analyze the concept, Soobal, based on literature review and case observation. 2. Generate an initial list of defining activities for ‘Caregiver Support : Soobal’. 3. Validate the defining activities. 4. Complete the final list of defining activities. A two-round Delphi questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of intervention, Caregiver Support : Soobal. The definition of ‘Caregiver Support : Soobal’ was provision of the necessary information, advocacy, and support to facilitate primary patient care by someone other than a health care professional in Korean traditional manners. Ten nurse experts participated in Round I and II of this study. They were asked to rate activities that examplified the interventions on a scale of 1 (activity is not at all characteristic) to 5 (activity is very characteristic). Round I contained 15 ‘critical’ activities and 10 ‘supporting’ activities, while round II contained 16 ‘critical’ activities and 6 ‘supporting’ activities. No activities were considered to be ‘nonsupporting’ in both round I and II. Finally, the definition and 25 defining activities were developed. Intervention, Caregiver Support : Soobal, attained an ICV score of .82. This study provides a protocol model to develop Korean nursing interventions.

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