• Journal of Home Health Care Nursing
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• v.6
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• Journal of Korean Biological Nursing Science
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• v.22 no.4
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• pp.260-270
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• 2020

Purposes: Sepsis is a critical condition in which nurses should detect clinical manifestations and provide early intervention to prevent unwanted serious conditions in the patients. The initial occurrence and management of sepsis take place in general units, but there is a lack of knowledge in nurses. The purpose of this study was to examine the effects of a case-based sepsis education program and compare the case-based education program with and without smartphone applications. Methods: A quasi-experimental pre-test-post-test design with a control group was used. We provided a case-based education program with and without smartphone applications to the nurses and tested the effects of the program on knowledge, the accuracy of sepsis assessment, and self-efficacy as outcome variables. A total of 60 nurses in general units participated. To test differences in knowledge, the accuracy of sepsis assessment, and self-efficacy regarding sepsis between the groups over time, a mixed-design ANCOVA was used for parametric analysis, and generalized estimating equations (GEE) were used for nonparametric analysis. Results: There were significant differences in knowledge, the accuracy of sepsis assessment, and self-efficacy between the groups and within the groups over time. The intervention groups treated with the case-based education program showed improved outcome variables compared to the control group. There was no difference between case-based education with the smartphone application or without the application. Conclusions: The case-based education improved knowledge, the accuracy of sepsis assessment, and self-efficacy in the care of sepsis by nurses working in the general wards. The results suggest that the case-based education program for nurses was effective and eventually improved patient health outcomes.

• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.418-430
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• 2000

Nurses in today's challenging health care settings need to be skilled critical thinkers and clinical experts. The nurse must be able to use a broad knowledge base to mobilize resources, coordinate actions and evaluate outcomes in complex new situations. So the national licensing examination for registered nurses is change to improve the quality of professional competency of nurses in Korea. Prior to this, learning objectives should be developed and improved periodically. The purpose of this study is to describe the nursing competency to provide base line data for developing learning objectives in adult health nursing. This study was conducted by means of a questionnaire which was developed by the researcher after reviewing the literature. The questionnaire was based on learning objectives which were developed by a nation-wide nursing faculty majoring in adult health nursing. The subjects were 45 nurses in a middle level hospital. The collected data were treated using SPSS Win 7.5 Statistical Package so as to obtain such descriptive statistics as mean score, frequency, and to test reliability test, nonpar-Friedman test. To summarize the major findings in this study, it showed the scope of nursing competency and can guide the direction of study and methodological criteria to develop learning objectives. Recommendations for further research are: firstly, it is necessary to state learning objectives with learners' behavioral terminology; secondly, to overcome locality in scope of this study, there is a need to analyze with nation-wide sampling by an in-depth statistical analysis; thirdly, because the subjects of this study are mostly three-year graduate nurses, there is a need to compare this study with other studies of different subjects.

• Journal of Korean Biological Nursing Science
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• v.22 no.3
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• pp.213-221
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• 2020

Purpose: The purpose of this study was to explore the role performance and related factors of clinical research nurses (CRN) in the process of clinical trials of new drug development. Methods: Study participants were CRN whose affiliation was in non-capital areas and who had been working longer than three months at the time of the data collection. The data collection was conducted with a semi-structured questionnaire development by Hwang & Go, 2011 comprising 16 items of participants' characteristics and 60 items of role performance via in-person and online. Additionally, opinions which would be necessary to establish the CRN role were questioned for the future. A total of 141 questionnaires of 151 questionnaires responses were analyzed using descriptive statistics, t-test, and ANOVA for data analysis as appropriate. Results: The level of overall role performance was above average (5.61±0.90) with the highest in subject care (6.04 ± 0.96) and management and the lowest in self-development (4.39 ± 1.52). The only factor affecting overall role performance was employment status and the only sub-category affected by factors of employment status, and some general characteristics was self-development. Conclusion: From study results, it can be concluded that the CRN seem to perform their proper role. Nonetheless, self-development should be considered as critical aspect for better CRN competency, which is an important aspect toward improving the CRN role performance. Additionally, efforts to improve the level of role performance must be established through stable employment and concrete departmental placement as suggested in this study.

• Safety and Health at Work
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• v.12 no.2
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• pp.268-271
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• 2021

Lung granulomas are uncommon in Thailand. The disease typically develops from an occupational environment and is mostly caused by infection. Herein is a case report of a female patient, aged 48, working as a nurse in an Accident and Emergency Department at a hospital. Eighteen years prior to admission the patient was diagnosed with myasthenia gravis and pulmonary tuberculosis. The chest X-ray and CT scans showed a solitary pulmonary nodule in the lower left lung. The patient received an open thoracotomy with a left lobectomy. Granulomatous and nonseptate hyphae were found in the pathology diagnosis. The patient was thus diagnosed as having a lung granuloma. The galactomannan antigen test was positive. The solitary pulmonary nodule-found from the use of a Polymerase Chain Reaction (PCR) test-was an Aspergillus spp. The fungus culture was collected from air samples. The air samples were collected by the impaction technique using a microbial air sampler. Three types of Aspergillus spp. were found as well as Penicillium spp. and Monilia sitophila. The Aspergillus spp. was a match for the patient's disease. The patient was diagnosed as having a lung granuloma possibly Aspergillus nodule which was caused by airborne Aspergillus spp. from the occupational environment.

• Child Health Nursing Research
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• v.20 no.1
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• pp.58-66
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• 2014

Purpose: The purpose of this paper was to describe the attributes of nursing with humor based on an integrative review and to present basic information for developing humor intervention programs for children. Methods: Using combinations of the terms 'nursing' and 'humor' as key words, the researchers searched four electronic databases to relevant identify studies. Thirteen studies were selected through full text screening of related research published in academic journals from January 1993 to April 2013. Results: Through in-depth discussion and investigation of the relevant literature, three components emerged; 1) using instruments of coping for stress relief, 2) symptoms relief through pleasant feeling, and 3) job satisfaction and work improvement of nurse using humor. Conclusion: The results of this study suggest that humor is valuable as a nursing intervention for children and the possibility of bringing about positive results in nursing care if nurses utilize the sense of humor as fully as they can. Therefore, it is critical for nurses to develop a diversity of humor interventions for children as well as measurements to test quality and quantity of humor used in clinical pediatric settings.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.35-56
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• 1996

Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.