• 제목/요약/키워드: Evaluation of Quality of Nursing

검색결과 331건 처리시간 0.031초

연하 곤란이 동반된 급성 뇌졸중 환자를 위한 장관 영양 프로토콜 개발 및 효과 (Development and Evaluation of an Enteral Nutrition Protocol for Dysphagia in Patients with Acute Stroke)

  • 유성희;김소선
    • 대한간호학회지
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    • 제44권3호
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    • pp.280-293
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    • 2014
  • Purpose: The study was done to develop an evidence-based enteral nutrition (EN) protocol for effective nutritional support for dysphagia in patients with acute stroke, and to evaluate effects of this protocol on clinical outcomes. Methods: A methodological study was used to develop the EN protocol and a quasi-experimental study to verify the effectiveness of the protocol. The preliminary EN protocol was drawn by selecting recommendations from previous well-designed EN guidelines, and then developing additional recommendations based on high-quality evidence. Content validation was assessed by an expert group, and clinical applicability by care providers and patients. The scale-level content validity index of the final EN protocol was 0.99. Assessment was done of differences in percentage of caloric goals achieved and presence of undernutrition, aspiration pneumonia, and gastrointestinal (GI) complications after application of the EN protocol. Results: In the EN protocol group, the percentage of caloric goals achieved ($R^2=.24$, p=.001) and the reduction of GI complications (p=.045) were significantly improved, but the presence of undernutrition (p=.296) and aspiration pneumonia (p=.601) did not differ from the usual care group. Conclusion: Results indicate that the new EN protocol for dysphagia in patients with acute stroke significantly increased their nutritional intake and reduced GI complications.

Unit Dose Drug Distribution System의 도입을 통한 투약시스템의 질 향상 평가 (Evaluation of Quality Improvement in Inpatient's Medication System through the Implementation of Unit Dose Drug Distribution System)

  • 이인향;이순실;이병구;최원자;홍성선
    • 한국의료질향상학회지
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    • 제8권1호
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    • pp.22-42
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    • 2001
  • Background : A study comparing unit dose drug distribution system(UDS) versus traditional drug distribution system(TDS) was conducted in Seoul National University Hospital. The objectives of this study were to identify safer drug distribution system and to measure the efficiency of both systems in utilizing nursing and pharmacist's time. Methods : The study was designed to compare the data on medication errors, nursing time and pharmacists' time before and after implementation of the UDS in the internal medicine and otorhinolaryngology care units. The data on actual medications administered to patients were obtained by a disguised observer during the study period. The data collected were then compared with the physicians' orders to determine the rate of medication errors. In addition, using ten-minute interval work-sampling method nursing and pharmacists' time were measured. Results : About 6% of medications were administered incorrectly in the TDS, in comparison to 1.6% in the UDS. The rate of medication error decreased significantly in the UDS compared with the TDS. Mean times spent on medication-related activities by nurses were 34.1% in the TDS and 28.5% in the UDS. In the internal medicine care unit, nursing time associated with medications decreased significantly after the implementation of the UDS, but the reduction in medication-related nursing time in the otorhinolaryngology care unit was not significant. Pharmacist's medication-related work activities, increased from 2% in the TDS to 20% in the UDS. Pharmacist's time spent on therapy-related activities increased significantly. Conclusion : The rate of medication errors in the UDS decreased significantly compared with the TDS. Time spent on medication-related activities decreased for nurses while it increased for pharmacists. In summary, the UDS was estimated to be safer and to utilize of pharmacists' and nursing time more efficiently than the TDS.

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Systematic Review of Meaning-centered Interventions for Adolescents

  • Lim, Young Sook;Kang, Kyung A
    • Child Health Nursing Research
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    • 제24권3호
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    • pp.263-273
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    • 2018
  • Purpose: This study analyzes meaning-centered intervention studies conducted in Korea and abroad to compare and confirm their characteristics and results. Methods: A literature search using keywords in English and Korean was performed using nine electronic databases in December 2017. Search participants included adolescents, and interventions conducted in meaning-centered intervention studies were selected for evaluation. A Risk of Bias Assessment tool for non-randomized studies was used for quality assessment. Results: All studies were based on quasi-experimental designs. The semantic intervention included topics such as freedom, choice, responsibility, pain, death, finding value of life, purpose and meaning of life, and becoming a master of my life. All studies used logotherapy, and included meaningful interventions that influenced the meaning and purpose of the life of adolescents. The life satisfaction of adolescents changed significantly when there is a positive and open relationship with their parents. Therefore, an educational program for parents based on meaning therapy is desperately needed. Conclusion: Meaning-centered interventions were found to be effective interventions for exploring the meaning of life not only for adolescents with problems but also for healthy youth, and as such could be used as basic data for the development of an appropriate intervention for enhancing their life.

부모.자녀건강학회지 논문분석 (창간호-2009) (Analysis of Research Papers Published in the Korean Parent-Child Health Journal (1998-2009))

  • 박혜숙;오진아
    • 부모자녀건강학회지
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    • 제14권1호
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    • pp.1-8
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    • 2011
  • Purpose: This study was aimed to classify the major subjects and theme and to analyze the data collection and analysis method in research papers published in the Korean Parent-Child Health Journal of the Academic Society of Parent-Child Health since 1998. Methods: A total 152 studies published from the first edition to volume 12, number 2 were reviewed using structured analysis criteria developed by researchers; research type, research design, research subjects, research theme, data collection and analysis method. Research theme was founded 4 nursing domains. Data collection and analysis method of papers were limited to quantitative and qualitative researches. Results: One hundred papers conducted quantitative research; 79.0% used survey design. Most of the data collection and analysis method in quantitative research were self-reported questionnaire (69.4%) and parametric statistics respectively. The research subjects of sixty three papers were parent with well or child. The common domain studies was human related concepts such as raring. Conclusion: The findings of this study suggest that published studies have been improved and diversified, however, detailed and clear evaluation tool that assess study process and method should be developed as a way to further improve the quality of published papers in the Korean Parent-Child Health Journal.

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[논문철회]농촌 지역 주민맞춤 '우리마을 예쁜치매쉼터 프로그램' 사례 ([Retracted]"Our Village's Pretty Dementia Shelter Program" for Rural Residents: A Case Report)

  • 전열어
    • 한국농촌간호학회지
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    • 제18권2호
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    • pp.73-79
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    • 2023
  • Purpose: This study describes how public health officials running clinic-centered around "Our Village's Pretty Dementia Shelter" improved their ability to cope with dementia and health by implementing early dementia screening and cognitive intervention programs. Methods: This study targeted 11 hopeful seniors from 6 villages, who were residents of the area under the jurisdiction of Health Clinic B located in County A, were over 65 years of age, and had not experienced Our Village's Pretty dementia shelters. Results: The results of the Cognitive Screening Test (CIST) showed that scores improved on all evaluation items and depression decreased. Through the dementia prevention program, health improved, vitality increased through leisure activities and cultural experiences in daily life, and the quality of life improved. Aadditionally, participating with close neighbors has become an activity that can make dementia prevention activities a habit and widespread practice. Conclusion: This case demonstrate the need for continued implementation of dementia prevention and health promotion programs for rural residents. Accordingly, it is necessary to continuously operate dementia prevention programs by diversifying them and securing expertise from rural nurses.

소규모사업장 보건기술지원사업에서의 간호활동경험 : 포커스그룹 인터뷰 (The Experience of Nurses Who are working in the Government-Funded Subsidized Occupational Health Program for Small Scale Industries : Focus Group Interview)

  • 한영란;김수근;하은희
    • 한국직업건강간호학회지
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    • 제11권2호
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    • pp.132-149
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    • 2002
  • Purpose: This study was conducted to provide the fadamental information to prepare better Occupational Health Program for SSI based on the evaluation of the experience of nurse who were working in the Government-funded subsidized occupational health program for SSI. Method: The focus group method was used. Data was collected using focus group interviews and analyzed in the framework of the Grounded theory method as mapped by Strauss and Corbin(1990). The subjects were 14 nurses. Result: We identified 60 concepts, 30sub-categories and 6 categories(Table 1). Categories were Various services, Difficulties in implement Services, Successful strategies, Program Evaluation, Alternative Plans and Adaptation to new field. Conclusion: Nurses evaluated the effect of this program that autonomous health management ability has not changed although the possibility for the small scale industries to start the health management arose by acknowledging the importance of the health management of the workplace. In spite of many difficulties in implement services, nurses provided various health services using successful strategies. They suggest that various programs such as a model set-up suitable for the quality of workplaces and a role model set-up of the occupational health nurse for SSI as well as various efforts for the activated this program were needed. Nurses had a hard time in unfamiliar field when they began this program and overcame this difficulties with various strategies.

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가족-보건교사 간 학교건강관리 파트너십에 관한 통합적 문헌고찰 (An Integrative Review Regarding Family-School Nurse Partnership in School Health Care)

  • 엄주연
    • 한국보건간호학회지
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    • 제34권2호
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    • pp.165-181
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    • 2020
  • Purpose: This study is an integrative review of previous research conducted on family-school nurse partnership in school health care, as perceived by school nurses, children, and families. Method: The study was conducted according to the five stages of integrative review suggested by Whittemore and Knafl (2005), which involved problem identification, literature search, data evaluation, data analysis, and presentation of results. Suitable literature was found using portals such as PubMed, CINAHL, Embase, and Web of Science. Key words such as school nurses, family, parents, children, and partnership were used to narrow the search results. Studies published in peer-review journals between 2006-2018 were selected. The quality of studies was appraised using critical appraisal tools provided by the Joanna Briggs Institute (2020). Result: Thirteen studies (5 quantitative and 8 qualitative) were finalized for the final review process. After an extensive review, four key themes of school nurse-family partnership in school health care were identified: partnership components, partnership barriers, partnership facilitators, and strategies to promote partnership. Conclusion: Partnership and its components, barriers, and facilitators, along with strategies for its promotion should be considered in school health care. Further studies are needed on the perceptions held by parents and children regarding school health care partnership.

뇌졸중 환자의 가족 기능에 영향을 미치는 요인 분석 (A Study on the Influencing Factors in Family Functioning of Stroke Patients)

  • 조복희
    • 재활간호학회지
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    • 제1권1호
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    • pp.1-14
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    • 1998
  • The purpose of this study was to identify the factors affecting family functioning of stroke patients. A descriptive survey research was conducted in which 65 stroke patients and their primary caregivers were conveniently sampled. Data were collected from July to September, 1998 through interviewing using a structured questionnare. The measuring instruments used were Barthel Index by Mahoney and Barthel(15 items), Quality of Relationship Scale by Archbold and Stewart(15 Items), Role Stress of Caregiver Scale by Yang(14 items), Situational Definition Scale by Lee(9 items), Family Hardiness Index by McCubbin, McCubbin. and Thompson(20 items), and Family Adaptability Cohesion Evaluation Scale(FACES-III) by Olson, Portner, and Lavee(20 items). The obtained data were analyzed using percentage, t-test, ANOVA, Duncan test, and Pearson coefficients correlation by SAS/PC program. The results were as follows; 1. Role Stress of Caregiver was not severe and Quality of Relationship was moderate. The level of Situational Definition of primary caregivers was not high but Family Hardiness and Family Functioning were rather high. 2. The following relationships between research variables and demographic characteristics of the primary caregivers of stroke patients were significantly different; occupation of caregiver between Quality of Relationship, occupation of caregiver between Situational Definition, family type between Role Stress, caregiving duration between Family Hardiness, caregiving duration between Family Functioning, and hospitalization days between Family Functioning. 3. The correlations between research variables were as follows; There was positively correlated between patient's ADL and Quality of Relationship. The relationship of the patient's ADL between Role Stress was negatively correlated. Quality of Relationship between Situational Definition, Family Hardiness, and Family Functioning were significantly correlated. The correlation of Situational Definition between Family Hardiness, and Situational Definition between Family Functioning were very high. As a result of these findings, Quality of Relationship, Role Stress, Situational Definition. and Family Hardiness were useful variables for identifying Family Functioning of stroke patients. It is important for the rehabilitation nurse to be knowledgeable about family functioning of stroke patients to promote rehabilitation process.

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간호사 국가고시문제의 내용분석 (A Content Analysis of the test of the National Examination for Registration Nurses in Korea over 3 years)

  • 서문자;윤순녕;유지수;송지호;최경숙
    • 대한간호학회지
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    • 제26권1호
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    • pp.73-93
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    • 1996
  • This study aimed to analyse the test contents of the national examination for the registered nurses (NERN) over 3 years from 1991 to 1993 in Korea. In recent years in Korea, the MCQ(multiple choice question) has been showing to be a highly recognized method for assessing the qualification of registered nurses. Unfortunately, nursing faculties have found NERN had some bad MCQs through having evaluation workshop for Some MCQs often provide so many unwriting clues which become a bias of the results, and some items fell into the category of the lower level of educational taxonomy such as isolated recall a fact or data. Frequently the stems of the questions are ambigous, unclear, disputable, esoterical or trivial. Considering those fallacies of the national examination, it is very critical to review the test items to see whether it is of high quality, is more fair, reliable and objective in depth. Therefore, this study was done to provide data for the improvement of the test contents as well as the teachers's assessment skill. For this study, the ad hoc committee was composed of 16 members, including 5 education board members of Korean Academic Nurses Association and 11 nursing faculty members. This committee had one day panel discussion and filled the checklist for this study. The process of analysing data was held over 10 times during 1992-1994. The analysis focussed on educational taxonomy such as cognitive domain(knowledge), psychmotor domain (skill), affective domain(attitude) and the level of learning such as recall, understanding, problems solving, and learning area of theory and practice, and the learning content categorised by nursing process and disease process. The test analysed using difficulty index and the structure of the test items was analysed. The conclusions and suggestion as follows : 1. In learning area, the average ratio of the theory and practice was 1 : 1.1 which was less than 1 : 2 suggested by Korean National Health Institute, and the ratio was different by the 8 leaning subjects of nursing. 2. In category of the educational taxonomy, the knowledge domain was emphasized mostly(79. 7%), the skill domain was 14.9%, and the attitude domain was 5.4% only. 3. In the level of learning, generally, the test items of the level of recall(45.5%) and the understanding(46.3%) were covered almost and the problem solving was 8.1%. 4. In the learning contents, generally, the test items related to nursing process was 67.2% and that of disease process was 32.8%. However, this proportion was different by the 8 leaning subjects. Even though the nursing diagnosis has been emphasized in nursing curricula recently, the test items of this was identified very few. 5. In the structure of the test item, some were not clear, incorrect grammar, unclear description and some have clues to answer. 6. In the item analysis, the non-acceptable level of the difficulty index (means too easy) was 65.7%, and the acceptable level was 33.9%. Considering the results we would like to suggest the followings, 1. Since the test items of knowledge domain was dominant, the test items of the practice domain and attitude domain should be emphasized more. 2. The regular review and analysis of NERN should be arranged in order to improve the quality of the test items which will give influence to the nursing education positively.

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공공병원 직원들의 신포괄수가제 참여 전후 인식변화 (Changes in Public Hospital Employees' Perceptions Following the Introduction of the New Diagnosis-Related Groups (DRG)-Based Payment System in the Republic of Korea)

  • 김현주;이진용
    • 한국의료질향상학회지
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    • 제27권2호
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    • pp.30-44
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    • 2021
  • Purpose: The aim of this study was to investigate the changes in perception of the New Diagnosis-Related Group (DRG)-based payment system, make overall evaluation after participation, and examine opinions on further policy improvement among employees of a public hospital participating in the pilot project in Korea. Methods: We investigated changes in perception of the New DRG-based payment system before and after participation in the pilot project using a qualitative research method. We conducted individual in-depth interviews with the management and healthcare professionals and Focus Group Interviews (FGIs) with the staff in the nursing and administrative departments. Results: Before implementing the pilot project of the New DRG-based payment system, the management was in favor of participating in the pilot project, whereas the healthcare professionals were strongly opposed to participation in the pilot project, and the staff in the nursing and administrative departments were slightly opposed to participation. After implementing the pilot project, there were remarkable changes in the perception of the New DRG-based payment system among healthcare professionals and the administrative staff. Healthcare professionals' perception was altered in a positive way, while the administrative staff's perception of the system became negative. Conclusion: There were no restrictions on clinical practice or deterioration of quality of care observed in association with the participation in the New DRG-based payment system. However, certain unintended consequences of the New DRG-based payment system may arise as well. Therefore, the government needs to examine the problems identified in this study to reflect on and improve the New DRG-based payment system for stable expansion.