• 융합정보논문지
• /
• 제7권6호
• /
• pp.25-33
• /
• 2017

본 연구의 목적은 간호 간병통합서비스병동의 간호사와 일반병동 간호사의 직무만족, 간호전문직관, 간호근무환경을 비교분석하여 기초융합자료를 제공하기 위함이다. 연구는 2016년 5월 1일부터 7월 30일까지 서울 경기지역 임상간호사를 대상으로 실시하였다. 자료는 SPSS WIN 23.0으로 분석하였다. 연구결과는 일반병동 간호사 100명과 간호 간병통합서비스병동 간호사 92명을 비교하였을 때, 일반병동에서 간호근무환경 점수(t=3.027, p=.003)와 직무만족 점수(t=2.451, p=.015)가 통계적으로 높게 나타났다. 일반병동간호사는 간호전문직관이 높을수록 직무만족(r=.605, p<.001)에 정적인 상관이 있는 것으로, 간호간병통합서비스병동 간호사 또한 간호전문직관이 높을수록 직무만족 (r=.642, p<.001)에 정적인 상관이 있는 것으로 나타났다. 향후 간호 간병통합서비스의 질적 보장을 위해서는 간호 간병통합서비스병동의 간호근무환경과 간호전문직관의 확립을 위한 전략이 필요하다.

• 간호행정학회지
• /
• 제9권4호
• /
• pp.559-569
• /
• 2003

Purpose: The purpose was to investigate nurse staffing levels and patient outcomes(nosocomial infection, patient fall, pressure ulcer). Method: The subjects of this study were 305 nurses from 20 general hospitals who worked at 39 medical and surgical wards. Self-reporting questionnaire which was developed by the writer through preceding study was used. In data analysis, SPSS WIN 10.0. program was utilized for descriptive statistics, ANOVA. Result: The mean of patient-to-nurse ration was 5.2:1. 65% among 20 hospitals was over 300 beds, 90 was located in urban area and 55 was private hospitals. Patient-to-nurse ration of hospitals in under 300 beds or rural area or private ownership was lower than hospitals in 300 beds or urban area or public ownership. 89.9 among 39 wards was medical or surgical wards. The mean of length of stay, 8-14 days got a majority and showed higher patient-to-nurse ration. Of the general characteristics, rural was significantly hight to patient fall(F=3.205, p<.05), medical unit was significantly high to patient fall, pressure ulcer(patient fall: F=8.890, p<.001, pressure ulcer: F=3.399, p<.05) and over 15 days was significantly higher than under 14 days of the mean of length of stay. And there was significant relationship between over 6.0:1 and over 4.0:1 to less than 5.0:1(F=4.817,p<.01). Conclusion: This study has shown a relationship between patient-to-nurse ration and patient fall using not objective research tool but self-reporting questionnaire. Therefore further research is needed to study using objective research tool. Based on this study, the effect of nurse staffing levels on patient outcome also has to be studied.

• 대한간호학회지
• /
• 제51권1호
• /
• pp.27-39
• /
• 2021

Purpose: This study aimed to identify the degree of non-nursing tasks and nursing care left undone in integrated nursing care wards, and examine their relationships with nurses' burnout, job satisfaction, turnover intentions, and medical errors. Methods: A cross-sectional questionnaire survey was conducted. Data were collected using self-report questionnaires from 346 nurses working in 20 wards of seven small and medium-sized general hospitals, and analyzed using multiple regression and multiple logistic regression analysis with the SPSS WIN 25.0 program. Results: The mean score for non-nursing tasks was 7.32±1.71, and that for nursing care left undone was 4.42 ± 3.67. An increase in non-nursing tasks (β = .12, p = .021) and nursing care left undone (β = .18, p < .001) led to an increase in nurses' burnout (F = 6.26, p < .001). As nursing care left undone (β = .13, p = .018) increased, their turnover intentions also (F = 3.96, p < .001) increased, and more medical errors occurred (odds ratio 1.08, 95% confidence interval 1.02~1.15). Conclusion: Non-nursing tasks and nursing care left undone are positively associated with nurses' burnout, turnover intentions, and the occurrence of medical errors. Therefore, it is important to reduce non-nursing tasks and nursing care left undone in order to deliver high quality nursing care and in turn increase patient safety.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권1호
• /
• pp.69-73
• /
• 2013

Background: An increasing trend of cytotoxic drug use, mainly in cancer treatment, has increased the occupational exposure among the nurses. This study aimed to assess the change of nurses' safety-related knowledge as well as attitude levels and subsequently to assess the change of cytotoxic drug handling practices in wards after a series of pharmacist-based interventions. Materials and Methods: This prospective interventional study with a before and after design requested a single group of 96 nurses in 15 wards actively providing chemotherapy to answer a self-administered questionnaire. A performance checklist was then used to determine the compliance of all these wards with the recommended safety measures. The first and second assessments took 2 months respectively with a 9-month intervention period. Pharmacist-based interventions included a series of technical, educational and administrative support measures consisting of the initiation of closed-system cytotoxic drug reconstitution (CDR) services, courses, training workshops and guideline updates. Results: The mean age of nurses was $32.2{\pm}6.19$ years. Most of them were female (93.8%) and married (72.9%). The mean knowledge score of nurses was significantly increased from $45.5{\pm}10.52$ to $73.4{\pm}8.88$ out of 100 (p<0.001) at the end of the second assessment. Overall, the mean practice score among the wards was improved from $7.6{\pm}5.51$ to $15.3{\pm}2.55$ out of 20 (p<0.001). Conclusions: The pharmacist-based interventions improved the knowledge, attitude and safe practices of nurses in cytotoxic drug handling. Further assessment may help to confirm the sustainability of the improved practices.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제29권3호
• /
• pp.17-28
• /
• 2023

Purpose: This study aims to provide basic data for the future construction plans of the Infectious Disease Hospitals by analyzing the area composition and required room ratios in the wards and ICU of currently under-construction infectious disease hospitals. Methods: 3 Methods have been used in this paper. 1) This study conducted a literature review on major considerations and related guidelines for hospitals specializing in infectious diseases using existing data. 2) Based on the objects and activities of the hospital space, zones and areas were set for each department according to infection control. 3) Based on the established zones and areas, basic plan drawings of three hospitals specializing in infectious diseases currently under construction were collected and architectural drawing analysis was performed. Results: 1) Infectious Diseases Hospital must have a spatial organization that can accommodate patient isolation, infection control, efficiency of medical service, and changes. 2) Zones for infection control are divided into negative pressure and non-negative pressure zones based on airborne precaution isolation. It is divided into clean and contaminated zone according to class of cleanliness by Aseptic technique. Areas are classified by objects (patients, healthcare workers, supplies) and activities (access, medical treatment, support), and a system for organizing space is established based on this. 3) By analyzing the area composition of each departmental area, each required room, and each required space in the wards and intensive care units, it provides basic data for the spatial organization for architectural planning of the infectious disease hospital. Implication: It can be used as basic data when planning related facilities by analyzing the characteristics of the space plan of the required room according to the relationship between activities, movement lines, and operation plans based on user behavior.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제29권4호
• /
• pp.29-35
• /
• 2023

Purpose: The 2015 Middle East Respiratory Syndrome (MERS) outbreak and the recent COVID-19 pandemic have highlighted the lack of negative pressure isolation rooms and the fragility of the healthcare system. The need for healthcare facility transformation for respiratory infectious diseases has become more prominent due to COVID-19, and the purpose of this study is to provide a foundation for the rapid, economical, and safe construction of negative pressure isolation wards. Methods: This study analyzes the current status of hospitals that have been converted to negative pressure isolation rooms, and provides architectural plans and examples to provide a reference for bedroom change. Research data of this study have been obtained by analyzing the drawings of negative pressure isolation wards of nationally designated inpatient treatment beds and urgent isolation beds. In addition, the relevant literature of urgent isolation beds has been analyzed to derive bedroom change type. Result: In this study, a total of 21 isolation bed conversion methods have been presented. Implications: In order to change efficiently from a general ward to an isolation ward, it is necessary to consider the actual hospital's infectious disease transmission patterns and facility conditions.

• 가정∙방문간호학회지
• /
• 제31권1호
• /
• pp.44-55
• /
• 2024

Purpose: This is a retrospective secondary data analysis study based on real-world data to analyze the level of nursing care needs of patients in a comprehensive nursing care service ward, and identify factors influencing nursing needs. Methods: Study participants included patients admitted to two comprehensive nursing care service wards at a tertiary general hospital located in Gyeonggi-do, Korea. After obtaining permission from the health and medical information team of the target hospital, data were collected from their electronic medical records. Nursing care needs were measured using seven items on nursing activity and four items on daily living activities developed by the National Health Insurance Service (NHIS). The collected data were analyzed using the SPSS version 29.0 with frequency and percentage, mean and standard deviation, minimum and maximum values, t-test, ANOVA, Pearson's correlation coefficients, and multiple linear regression. Results: The level of nursing care needs of patients in comprehensive nursing care service wards was found to be higher for patients with pressure sores (β=.33), older patients (β=.26), patients who underwent procedures (β=.15), patients with present guardians (β=.15), and patients with more comorbidities (β=.10). The total explanatory power was 51.0%. Conclusion: It is necessary to accurately identify patients' nursing care needs and provide nursing care according to priority by considering the characteristics of patients in comprehensive nursing care service wards.

• Journal of Hospice and Palliative Care
• /
• 제25권4호
• /
• pp.159-168
• /
• 2022

Purpose: This study aimed to investigate the impacts of end-of-life care competency and ethical dilemmas on psychological burnout in nurses who care for terminal cancer patients. Methods: A cross-sectional study of 160 nurses who cared for terminal cancer patients was conducted. The participants were recruited from the hospice-palliative care wards, hematology or oncology wards, or intensive care units of three general hospitals in a single metropolitan area. Data were collected using a self-administered survey to assess end-oflife care competency, ethical dilemmas, psychological burnout, and general sociodemographic characteristics. Data were analyzed using descriptive statistics, the independent ttest, analysis of variance, Pearson correlation coefficients, and hierarchical linear regression analysis using SPSS for Windows (version 26.0). Results: Psychological burnout was significantly correlated with end-of-life care competency (r=-0.23, P=0.003) but not with ethical dilemmas. The results of the hierarchical linear regression analysis indicated that endof-life care competency (β=-0.280, P=0.010) and ethical dilemmas (β=0.275, P=0.037) were significant predictors of psychological burnout, after adjusting for age, religious status, clinical experience, and unit type. Conclusion: The current study's findings demonstrate that end-of-life care competency and ethical dilemmas are crucial factors that affect psychological burnout in nurses who care for terminal cancer patients. Substantive education programs must be developed to improve nurses' competencies in end-of-life care and ethical dilemmas to decrease psychological burnout.

• 대한간호학회지
• /
• 제44권2호
• /
• pp.219-227
• /
• 2014

Purpose: To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards. Methods: A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program. Results: Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22-2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer. Conclusion: MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.

• 한국산학기술학회논문지
• /
• 제16권5호
• /
• pp.3293-3302
• /
• 2015

본 연구는 신경계병동에서 억제대를 적용 중인 환자의 가족을 대상으로 억제대 적용에 대한 인식과 태도를 파악할 목적으로 시행된 서술적 조사연구이다. 2014년 6월 1일부터 2014년 9월 30일까지 부산시 소재 일개상급종합병원의 신경계병동에서 억제대를 적용 중인 환자의 가족 70명을 대상으로 설문조사했고 환자자료는 의무기록으로 조사했으며 수집된 자료는 서술통계, t-test, ANOVA, $Scheff\acute{e}$ tests로 분석했다. 환자가족은 여자가 68.6%, 평균 47.9세, 환자의 배우자나 자녀가 70% 이상이었고 일일 평균 15.4시간 동안 환자를 돌보고 있었다. 억제대 적용에 대한 인식의 평균점수는 4.2/5점이었고, 치료장치 유지와 관련된 인식점수가 높았고(평균 4.6-4.9/5점) 억제대 적용부위에 따라 양손이 한손보다 더 중요하다고 인식했다. 억제대 적용태도에 있어서는 환자와 가족에게 적용과 제거에 대한 결정권이 있다와 관련된 문항에 동의하는 가족이 많았다. 본 연구의 결과를 토대로 환자가족에게 억제대 관련 정보제공과 지속적인 교육을 통한 지원이 요구된다.