Cardiac cathererization has become a routine diagnostic procedure indicated for evaluation of a wide varity of cardiac conditions. Patients are admitted to the coronary care unit after cardiac catheterization. These conscious patients report feeling uncomfortable in the CCU, but no studies have been done on the effects of bed rest, sand bags on the femoral puncture site and restricted mobility for 4 to 12 hours or longer postprocedure. The main objective of this thesis is to provide basic data to nursing on interventions which de-crease the uncomfortableness experienced by patients in the CCU following cardiac catheterization. In this phenomenological study, the various discomforts felt by the patients were collected and classified. The study subjects were a convenience sample of 29 patients who were admitted to the CCU of a general hospital in Inchon following cardiac catheterization. They were conscious, so they were able to communicate without difficulty. The data were collected over an U days period from July 21, to October 14, 1994. The subjects were interviewed using unstructured open questions and the interviews were tape recorded with the patient's permission The data were analyzed using the Van Kaams phenomenological method. Reliability and validity were exammed by two professor of nursing science, one head nurse, one staff nurse and one cardiologist. The results of the study are summarized as follows ; 1. The 129 descriptive statements by the postcardiac catheterization patients of discomfort were organized into 19 themes. 2. The 19 themes were divided into 3 categories ; physical, psychological, and environmental aspects. 3. The problems concerning the physical aspect were the discomfort of restriction of movement, dysuria, medical devices, pain in the puncture site, symptom is related to the procedure of cardiac catheterization, headache and dizziness, leg painand tingling sensation, and chest pain. The problems concerning the psychological aspect were regret resulting from dependency, economic burden, dissatisfaction with medical personnel, dissatisfaction with medical service system, anxiety about the result of the procedure, concern about the prognosis, loneliness, and concern over treatment procedure. The problems concerning the environmental aspect were influence from neighboring patients, noise, and maladaptation to environmental change. The necessity for holistic care which satisfies physical, psychological, and environmental need must be emphasized in order to solve these discomforts.
Kim, Joo-hyun;Lee, Eun-hee;Hyun, Hae-Jin;Gil, Jung-Hee;Kim, Jin-Soon;Park, Yang-Sook;Park, Jin-Sook;Lee, Ho-Youn
Journal of Korean Biological Nursing Science
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v.11
no.2
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pp.143-148
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2009
Purpose: The purpose of this study was to identify the affecting factors on the health promoting behaviors of the clinical nurses. Methods: This study was a trans-sectional survey research. The subjects of this study were 206 clinical nurses. The data were collected by questionnaires and medical records. Results: There were significant positive relationships between health promoting behavior and perceived health status, job satisfaction, familial support. There were significant negative relationships between health promoting behavior and depression. The significant affecting factors on the health promoting behaviors of the clinical nurses were depression, familial support and job satisfaction. These 3 factors explain 18.6% of the health promoting behaviors of the clinical nurses. Conclusion: This study provides the empirical evidence that health promoting behaviors of the clinical nurses are closely related to depression, familial support, and job satisfaction. This results can be used to develop health promoting program for clinical staff nurses.
Journal of The Korea Institute of Healthcare Architecture
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v.28
no.4
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pp.61-69
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2022
Purpose: In response to the rapid spread of COVID-19 in 2020, the government supported facilities and equipment through the 'Urgent Isolation Ward Expansion Project'. Design and remodeling of efficient negative pressure isolation facilities had to be done in a short period of time, and the performance gap between facilities was very large because the types of hospitals and wards of existing medical facilities were diverse. In order to secure the stability of isolation wards between medical facilities and reduce the facility gap, guidelines for planning isolation wards considering the diversity of each hospital should be appropriately presented. In consideration of these points, this study aims to provide basic data for future remodeling guidelines for each plan type of the negative pressure isolation ward first. Methods: We analyzed the plans before and after the change of 13 case hospitals that performed the urgent care bed expansion project for COVID-19 confirmed patients. Before the remodeling, the current status of the facility was analyzed according to the type of corridor, the location of the nursing station, and the location of the elevator. After remodeling, the flow of medical staff and patients, the flow of entry and exit of clean and contaminated items, and the space of negative pressure and non-negative pressure areas. Results: The ward type was divided into three types according to the corridor type and room arrangement: double loaded corridor type with two side wards, race track type with one side ward, and race track type with two side wards. Based on these three types, the standard floor plan type of the isolation ward was proposed in terms of the location of the elevator bank and Nurse station. Implications: When the existing general ward is converted into a negative pressure isolation ward, this study can be a basic data to present customized guidelines for each ward type.
This study was performed to find out the differences between noise levels of hospital wards and the nurses efforts for noise management in some general hospitals. The hospital wards selected were the intensive care unit(ICU), the emergency room(ER), the nursery room(NR), the internal medicine(IM), the general surgery(GS) among the 5 general hospitals located in Seoul. The data were collected from August 3 to September 13, 1999 through questionnaire survey and noise measurement in each nursing station of hospital wards. Data analysis was done by SPSS 8.0 package among the 305 questionnaires and 24 hours monitored noise levels. Frequency, Chi-square and ANOVA test were used. The study results were as belows: 1. The noise level measured by 24 hours monitoring survey were exceeded on the standard limit in all the hospital wards. Data also showed that noise levels were significantly different in each ward among the three shifts working duties. 2. The subjects were all female nurses. They were mostly working in the ICU ward(28.9%). They were 26~30 years old (43.9%), junior college graduates(57.0%), working for 1~5 years(55.1%) as staff-nurse(85.6%). There were no significant differences between hospital wards and general characteristics of nurses. 3. The noise levels perceived by nurses were regarded as 'Highly noisy'(56.4%), especially during the 11:30 and 15:30 (30.2%) o'clock. Data also showed that noise education was not ever given to nurses(89.9%). Nurses also responded that they hardly put an effort to reduce noise level(54.8%). However, there were significant differences between wards and noisy working time, experience of noise education and level of effort for noise reduction. 4. Nurses also perceived the ventilator alarm and EKG-alarm as the most disturbing sounds in the ICU, human voice and telephone ringing in the ER, human voice and EKG-alarming in the NR, human voices and telephone ringing in IM and GS both wards respectively in order. There were significant differences between hospital wards and noise making factors. 5. Nurses were shown that they regarded highly 'Sound reduction of the human voice', 'Careful handling on medical instruments', and 'Immediate appliances on alarming materials' as the practical method for noise management. There were significant differences between hospital wards and behavioral practical efforts for noise management. According to that results, the statistical differences were shown in the 24 hour monitored noise levels in each ward. Also, nurses perceived the noise severity differently and they approached variously on the practical efforts for noise reduction in each ward. Thus, author thinks that concrete and systematic endeavor will be necessary for noise reduction and management in hospitals for better working and healing environment for both of patients and staffs.
Now, Korean health technology and health service is proud to be world class one at a level of not falling behind anywhere in the world. However, this health service has been provided, centering on hospital or medical staff, not patient so far. And there is a tendency to gradually change into patient-centered health service. According to the results of survey performed by Korea Institute for Health and Social Affairs, it was reported that, as of 2016, 30% or more of inpatients were not sufficiently given information relating to hospital rounds, and in particular, 50% or more of inpatients in their twenties to thirties expressed discontent, and approximately 17% of inpatients in their seventies and beyond expressed discontent. In the light of these data, especially inpatients in their twenties to thirties want information relating to hospital rounds and the like. And taking into consideration that they are characterized by being accustomed to using a smartphone, it is intended to design and implement a hospital rounds information smartphone application. Now, in some of medium and large hospitals, information about hospital is provided through smartphone application. However, the main purpose is hospital information or outpatient's appointment to see a doctor and so on. Even in case of providing information about hospital rounds, only information about approximate time to make rounds is provided. This paper is intended to design and implement hospital rounds information system making it possible to check their turn when rounds are made by utilizing NFC function in smart phone.
This study was done in order La provide basic data to a Fee System for hospital based Home Health Care services in Korea in the future. It was done by investigating activities provided to possible Home Health Care clients who could be discharged early from genera] hospitals and then estimating the nursing care fee according to each nursing activity based upon the time used for activity. The subjects of the study were selected by convenience sampling and consisted of 35 clients who might be clients for Home Nursing Care and were presently admitted to a medical- surgical ward of Y University Medical Center located in Seoul, Korea. The data collection period was from September 1, 1991 to September 30, 1991. The research in strum nets utilized for the study were a client selection criterial for Home Health Care developed by Choo(l991) and a check-list of nursing activity developed by researcher. The results of the study were as follows : 1. There were 44 different nursing activities provided in the seven days but the time was calculated for only 25 of the nursing activities. 2. Fees for the 25 different nursing activities were calculated by multipling the median of the average wage of a staff nurse having five years experience in an A grade general hospital to the Lime of the nursing activity. The results were compared with the insurance fee which the government recognized as an appropriate fee for that activity. The nursing activities with a lower calculated fee than the insurance fee were suction, catheterization, exercise education and dressing change. The nursing activities with a higher calculated fee than the government recognized fee were 1M injection and vital sign check. 3. There was a range of 1-15 nursing activities provided daily to the client. For the average number of nursing activities per day of 6.26 events the nursing care fee was calaulated at W 6136 per day. 4. Based upon the results of the study, a recommentdation for a Home Health Care fee per visit based on the nursing activities provided could be formulated for a Home Health Care fee system. It could be formulated as following: 1) Home health Care fee per visit $=[(direct{\;} nursing{\;}fee(direct{\;}nursing{\;}care{\;}time{\;}per{\;}activity{\;}{\times}{\;}average{\;}nursing{\;}wage)+indirect fee]{\times}average$ nursing activity per visit]+management fee+ materials fee+a travel fee In this way a nursing fee could be calculated based upon the result of the study of the nursing fees per visit. 2) Nursing activity fees per visit. = $([direct nursing{\;}care{\;}fee+indirect{\;}nursing{\;}fee]{\times}average$ number of nursing activities provided per visit] (W 6, 136) + travel fee(\ 5, 542) +management fee material $fee({\alpha})\{\;}16, 436+{\alpha}$ The nursing fee per visit as calculated in this research of $\{\;}15, 0000+{\alpha}$ could be adjusted according to the patient's condition or the use of high technology nursing care or according to the amount of time spent for travel. The nursing care fee per visit presented in this study can be validated through a Home Health Care demonstration project.
The purpose of this study was to investigate the performance of dental infection control. This survey was performed on 158 of the dental hygienist in certain areas. The research was performed using a self-reported questionnaire and interview method from June to July, 2014. The collected data was analyzed by PASW Statistics ver. 18.0. Guideline of infection management, infection controller, regular infection control training, Sterilization of the handpiece/per head resulted 57~74% for dental hospital. It was higher than 13~20% for dental clinics (p<0.05). Infection control guidelines and vaccination recognition of dental were more performed in dental hospital. Patient's hand hygiene performed, tooth brushing before treatment, cross infection educational experience was less than 20%, research cooperation of medical history was over 90% (p<0.05). Performing rate of the dental hospital workers were investigated higher in protective personal devices, infection control of treatment room. A correlation analysis about institutional support, infection control of dental hygienists, patients with infection control cooperation showed a positive correlation statistically significant. Infection control can be enhanced when the medical staff, the patient, the organization combined cognitive and practice. Dental hygienist is required to recognize and practice the infection control guidelines through continuing education.
Hospice and palliative care in Taiwan has been growing continuously. The 2015 Quality of Death index, as rated by the Economist Intelligence Unit, ranked Taiwan first among Asian countries and sixth in the world. In this review article, we highlight three particular areas that might have contributed to this success; the laws and regulations, spiritual care and research network. Finally, we discuss the future challenges and prospects for Taiwanese encounters. A systemic review was conducted with the keywords "hospice palliative care Taiwan" using PubMed. The passing of the "Natural Death Act" in 2000 set the example and established a landmark for patient autonomy in Asia; it guarantees the patient's right to request that medical staff do not resuscitate (DNR) them and to reject other futile medical treatments at the end of their life, thus reflecting the importance of palliative care from the policy perspective. In 2015, Taiwan passed another pioneering law entitled the "Patient Autonomy Act". This law states that a patient may decline medical treatment according to his/her own will. Taiwanese indigenous spiritual care was launched in 2000. It requires a Buddhist Chaplain to successfully complete a training program consisting of lectures, as well as bedside practicum before applying Buddhist practices to end-of-life care. The Japan-Korea-Taiwan research network was established for the purpose of enabling collaborative research for the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) cohort. With consensus from the government and society to make it a priority, hospice and palliative medicine in Taiwan has been growing steadily.
This study was conducted to provide the base line for the use of prophylactic antibiotics and the standard of antibiotic use and the evaluation based on analysis of current use, quality assessment and periodic changes of prophylactic antibiotics in a university hospital. We chose the year 2008, 2009, 2010, 2012, and 2014 as the study periods since the primary evaluation on the first year of implementation in 2007. For this study, healthcare benefit quality assessment data from the Health Insurance Review and Assessment Service was used. We analyzed the differences each year of treatment period; one category for initial treatment timing, three categories for selecting antibiotics, and two categories for the length of treatment from multiple evaluation indices of gastric surgeries, colorectal surgeries, and cholecystectomy. The analysis revealed the followings: Regarding length of antibiotics treatment, total days of treatment decreased down to 1.5, 1.5, and 0.6 days in the year 2014, from 13.5, 12.8, and 6.9 days in the year 2007, for gastric surgeries, colorectal surgeries, and cholecystectomy. Based on these outcomes, the efforts to devise efficient delivery and distribution of the recommendations or indices which medical staff could adhere for quality improvement of the prophylactic antibiotics would be necessary. Also implementing monitoring system to help the hospitals to acknowledge their own faults may be helpful.
Tama, Tika Dwi;Astutik, Erni;Katmawanti, Septa;Reuwpassa, Jauhari Oka
Journal of Preventive Medicine and Public Health
/
v.53
no.6
/
pp.465-475
/
2020
Objectives: This study was conducted to examine the association between birth patterns (defined in terms of birth order and interval) with delayed breastfeeding initiation in Indonesia. Methods: A cross-sectional study was carried out using data from the Indonesian Demographic and Health Survey 2017. The weighted number of respondents was 5693 women aged 15-49 years whose youngest living child was less than 2 years old. Multivariable logistic regression was conducted to evaluate associations between birth patterns and delayed breastfeeding initiation after adjusting for other covariates. Results: This study found that 40.2% of newborns in Indonesia did not receive timely breastfeeding initiation. Birth patterns were significantly associated with delayed breastfeeding initiation. Firstborn children had 77% higher odds of experiencing delayed breastfeeding initiation (adjusted odds ratio, 1.77; 95% confidence interval, 1.02 to 3.04; p<0.05) than children with a birth order of 4 or higher and a birth interval ≤ 2 years after adjusting for other variables. Conclusions: Firstborn children had higher odds of experiencing delayed breastfeeding initiation. Steps to provide a robust support system for mothers, especially first-time mothers, such as sufficient access to breastfeeding information, support from family and healthcare providers, and national policy enforcement, will be effective strategies to ensure better practices regarding breastfeeding initiation.
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