• 제목/요약/키워드: Hospital ward

검색결과 673건 처리시간 0.03초

분만시 무균처치와 산후감염의 이환율과의 관계에 대한 연구 (Study on the Aseptic Care during Labor and Delivery, and their Effects to Peripheral Morbidity)

  • 이경혜
    • 대한간호학회지
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    • 제2권1호
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    • pp.141-157
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    • 1971
  • The peripheral infection is one of the major causes of maternal death, and although it is preventable through an effective prenatal as well as postnatal care its morbidity is increasing due to bacterial resistant to an effective antibiotics. The primary purpose of this study was to investigate the peripheral morbidity of 949 parturients who were admitted to the Obstetrics and Gynecologic department of Ewha Woman's University Hospital from January 1971 to September 1971. Among the 949 parturients, especially 40 normal parturients were selected (20, control soup was given complete aseptic care during labor and delivery and post delivery: 20, compare group was given the ordinary care practiced during labor and delivery and maternal ward of Ewha Woman's University Hospital) for bacteriologic test on vaginal flora twice, on admission and on complete cervical dilatation of each parturient. The results obtained from this study were as follows; 1. Majority of parturients age were 21 to 35 years old(90.83%), and educational level of 949 parturients was above high school. A large number of parturients socioeconomic level (according to their husbands' job) were moderate. 2, Among the 949 parturients, multipara (55.9%) were a little more than primipara (44. 1%) and 38.84% of parturients had experienced aborition. 3. In deliverty types, normal deliveries (804 cases) were more than cesarean section deliveries (145 cases) The peripheral morbidity after normal deliveries was 0.5%, and cesarean section deliveries, 23.45%. 4. Among 949 parturients incidence of hemorrhage eases (500cc or more bleeding) showed the higher peripheral morbidity (24.86%) than other cases (bleeding less than 500cc, 7.83%). 5. The majority of parturients (81.03%) had teen taking antenatal care, but most of them were taken irregular antenatal care. On the other hand, on admission, the parturients with complication were 30.32%, and their peripheral morbidity showed much higher (7.02%) than those with no complication (2.71%). 6. The incidence of peripheral morbidity in premature ruptured membrane was higher (10.91%) than normal parturienta (1.73%). 7. In the result of aseptic care during labor and delivery and post delivery, the number of cultured bacteria was legs in control group than Compare group (in control group, on admission 17, on complete cervical dilatation 12: in compare group, on admission 21 on complete cervical dilatation 21) . The most common bacteria were Staphylococcus (control group 14 on admission, compare group 16 on admission), and next Streptococcus, E- Coil, Bacillus Subtilis, in order. Also in control group the number. of colony were reduced (43%) more than in Compare group. Transient temperature elevation from 37℃ to 37.4℃ were noted in compare group (50%) than in control group (30%), and there was no one indicated above 38℃. In conclusion, the aseptic care is the test way of preventing peripheral infection as well as decreasing the puerperal morbidity. Therefore the most important nursing care is the aseptic care for each parturient during labor and delivery and peat delivery and also all the instruments must be cleaned and sterilized.

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임상간호교육의 일실험방법의 효과측정 (Experimental Study of. Clinical Obstetric Nursing Education)

  • 최연순
    • 대한간호학회지
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    • 제2권1호
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    • pp.217-236
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    • 1971
  • Introduction: The integration of theoretical material in the classroom with clinical practice in the field is an important concept in nursing education. nursing students at all levels need to acquire individual patient's needs, and applying creativity in the comprehensive nursing care. Problem solving and observation skills are important aspects in the development of nursing skills. Nursing students during their clinical work in maternal and child health observed that the major difficulties experienced by new mothers centered around psychological and physiological changes. Breast engagement and throbbing breast pain were the most frequent complaints by primiparas during the postpartum phase. In order to understand the factors affecting the discomfort, and to devise appropriate nursing care, these complaints were experimented. resent study represents an attempt to evaluate the impact of antepartal care (including breast care) on the subsequent of breast feeding difficulties. For the research purposes, hypotheses were made as follows: 1. There is a relationship between breast care and anthemata care attendance. 2. If primiparas practice treat care during their anthemata relied, they will have less throbbing breast pain during the postpartum phase. 3. If primiparas practice breast care during their antenatal period, they will have less breast engagement during the postpartum phase. Method: The researcher selected two highly specialized nurses in maternity clinical ward. They checked mother's chest circumference on the top line of breast every morning including mother's fever, caked breast, and lymphnodes on axillae. These nurses checked mother's breast while they staying hospital for four days. The total number of primiparas were 62 during June 5th to July 15th in 1971 at the Severance Hospital. For 40 days among 62 members of new mothers, 28 of them had breast care during antenatal period. Rest of them did not have breast care during antenstal period. Result: The result of this research revealed that the first hypothesis was accepted that the group which had breast care during antenatal period, had positive relationship with antenatal care. If the mothers were more educated, the more anticipated to antenatal care including breast care. For the second hypothesis, on the delivery day, there was no change on breast between two groups. On the first day of delivery, there were breast throbbing pains to the group who did not receive breast care, than the group who received the breast care. Therefore, second hypothesis was also accepted. For the third hypothesis, there was no breast engagement difference between two groups for the entire period. The third hypothesis was rejected.

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일반간호사의 조직 내 의사소통 유형과 직무만족 및 간호업무성과의 관계 (Relations Between the Types of Communication and, Job Satisfaction and Nursing Performance in Staff Nurses)

  • 서이아;박경민;이병숙
    • 한국보건간호학회지
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    • 제17권2호
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    • pp.317-332
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    • 2003
  • This study attempts to investigate the relations between the types of communication, the job satisfaction. and the nursing performance of the staff nurses. The subjects of this study were the 114 nurses working in general wards, intensive care units, and the emergency rooms of the general hospital in Kyongbuk province. They were asked to answer the questionnaires as regards the types of communication and job satisfaction, and their performance of nursing, and these were evaluated by the head nurses, and their direct seniors. The data were collected for 10 days from the September 17 to 26, 2002. According to the purpose of the study, descriptive analysis, ANOVA. Pearson correlation coefficient, and stepwise multiple regression were applied for the data analysis using SPSS 10.0. The results are as follows : 1. The types of communication of staff nurses showed that the upward communication was $3.12\pm0.56$. the downward communication was $3.56\pm0.42$. the horizontal communication was $2.98\pm0.44$. and the informal communication was $2.59\pm0.49$. It showed that the most frequent communication was the downward communication. 2. In terms of the job satisfaction, there was significant difference according to the length of the period working for one ward (F=5.95, p=0.003), 3. The performance of nursing was significantly different according to the age (F=23.52, p=0.000), the working duration as a nurses (F=21.9, p=0.000), the types of nursing unit (F=5.33, p=0.002), and the working duration in present nursing unit (F=15.87, p=0.000). 4. In terms of communication type, the job satisfaction was associated with quality of the upward communication (F=6.23, p=0.003), the downward communication (F=5.78, p=0.004), and the horizontal communication (F=11.73, p=0.000) There were no association between the types of communication and the performance of nursing. 5. There was a positive correlation between the communication and the job satisfaction. And the downward communication (r=0.398) showed the greatest correlation with the job satisfaction. There was no statistically significant correlation between the communication and the performance of nursing. And the upward communication (r=-0.058) showed a negative, though not significant correlation with performance of nursing. 5. There was a positive correlation between the communication and the job satisfaction. And the downward communication (r=0.398) showed the greatest correlation with the job satisfaction. There was no statistically significant correlation between the communication and the performance of nursing. And the upward communication (r=-0.058) showed a negative. though not significant correlation with performance of nursing. 6. The stepwise multiple regression result showed that the downward communication accounts for $15.8\%$ (p=0,000) of the job satisfaction.

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뇌혈관 질환 환자 사정에 대한 의료인간의 일치도 및 가정간호사업 대상자 선정에 관한 연구 (A Study on Client Selection Criteria for Home Health Care in Patients with Cerebral Vascular Disease)

  • 추수경;정복례
    • 한국보건간호학회지
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    • 제7권2호
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    • pp.39-52
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    • 1993
  • The primary purpose of this study is to promote and establish the development of home health care in Korea. It focuses on identifying and classifying the nursing activities that were provided by health professionals for patients who were admitted to two hospitals with cerebral vascular disease. And also. the study was conducted for comparison of client selection criteria between health professionals, and identifying patients who needed home health care The subjects of this study were 38 patients with cerebral vascular disease who were admitted to neuro-surgery wards at 2 hospitals with more than 500 beds in Daegu from November 1. through 30. 1991. Survey instruments were questionnaires to identify nursing activities and classify patients who needed home health care. Data was collelected by 1 doctor and 2 nurses per patient independently. They checked the same patient with the questionnaire on the same day and never communicated their information about patients with each other. All the questionnaires checked by doctor and nurses completely were 90. Statistical methods for analyzing data were non-parametric tests (Kruskal Wallice test and sign test). Correlation and percentages were used for further analysis. From this study. the following summarized conclusions have been drawn. 1. 10. 2 kinds of treatment and nursing activities were provided by health professionals for patients with cerebral vascular disease in hospital. 2. The points of nursing needs were between 32-37 out of a total of 500 as a result of the assessment about the health status of patients who were admitted to neuro-surgery ward with cerebral vascular disease. The points of Barthel Index of Functional Status Assessing Devices were between 24-34. Client Selection Criteria for Home Health Care was congruent between the Health professionals because the difference were not found to be statistically significant. 3. Patients classfied as home health care clients were $70-80\%$ of all patients who were admitted in hospital. There was not significant difference in patient selection criteria for home health care between health professionals statistically. As a result. the validity of different tools used in classifying home health care client were found to be congruent. 4. $80-85\%$ patients who could be discharged and sent to their homes early were identified as home health care clients. This study using client selection criteria. for home health care contributed to tool development because the validity of tools was verified. And also, this research represented that there was congruency in patient selection criteria for home health care between different health professionals. As a result, this study represented that many patients who were admitted to hospitals could be classified as a home health care clients. On the basis of the findings. further studies are required to develop client selection criteria using universal tools for classifying home health care clients in other chronic diseases. It is also recommended that comparative studies for client selection criteria between health professionals treating in other chronic diseases are necessary.

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간호·간병통합서비스병동간호사의 환자안전문화인식, 비판적 사고성향과 환자안전간호활동의 관계 (The Relationships among Awareness of Patient Safety Culture, Critical Thinking Disposition and Patient Safety Nursing Activities of Nurses among Comprehensive Nursing Care Service Ward)

  • 천고운;김지영
    • 한국산학기술학회논문지
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    • 제19권6호
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    • pp.345-354
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    • 2018
  • 본 논문은 간호 간병통합서비스병동간호사의 환자안전문화인식, 비판적 사고성향과 환자안전간호활동을 파악하고, 환자안전간호활동에 영향을 미치는 요인을 규명하고자 하였다. B시 3개 종합병원에서 간호 간병통합서비스병동간호사 150명을 대상으로 2017년 8월 20일부터 9월 10일까지 자료를 수집하였고, SPSS WIN 21.0을 이용하여 분석하였다. 간호 간병통합서비스병동간호사의 환자안전문화인식은 $3.32{\pm}0.32$점, 비판적 사고성향은 $3.50{\pm}0.31$점, 환자안전간호활동은 $4.28{\pm}0.46$점으로 나타났다. 환자안전문화인식은 간호 간병통합서비스병동 근무경력(F=4.79, p=.001)에 따라 유의한 차이를 보였다. 비판적 사고성향은 연령(F=3.89, p=.010), 직위(F=6.40, p=.002)에 따라 유의한 차이를 보였다. 환자안전간호활동은 직위(F=3.19, p=.044)에 따라 유의한 차이가 있었다. 간호 간병통합서비스병동간호사의의 환자안전간호활동 영향요인은 병원의 환자안전문화(${\beta}=.25$, p=.014), 상관/관리자의 태도(${\beta}=.20$, p=.046), 직위 ${\beta}=.14$, p=.040)였고, 설명력은 44.4%이었다. 간호 간병통합서비스간호사의 환자안전간호활동을 증진시키기 위해서는 병원의 환자안전문화에 대한 긍정적 인식 조성과 상관/관리자의 지지가 요구된다.

모의 상황을 활용한 환자안전 교육 프로그램 개발 및 효과 (The Development and Effect of the Patient Safety Education Program Using Simulated situation)

  • 정효선;김성희
    • 한국산학기술학회논문지
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    • 제20권12호
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    • pp.398-409
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    • 2019
  • 최근 의료기관평가 인증에서 환자안전사고에 대한 예방이 강화 되면서 환자안전은 환자를 중심으로 발생하는 의료사고를 관리하여 환자의 안전을 유지하는 것이다. 따라서 본 연구는 모의상황을 활용한 환자안전 교육프로그램을 개발하고, 입원환자에게 적용하여 교육 전, 후에 따른 환자안전에 대한 지식, 수행, 인식도에 미치는 효과를 파악하고자 시도되었다. 또한 프로그램 적용 후 환자안전 교육에 대한 만족도를 파악한다. 연구의 대상자는 서울 소재 D종합병원 병동에 입원한 환자 30명이다. 2019년 4월 15일부터 4월 30일까지 자료수집 하였으며 자료처리 및 분석방법은 SPSS 23.0을 이용하여 빈도, 백분율, paired t-test 로 분석 하였다. 연구 결과, 모의상황을 활용한 환자안전 교육 프로그램이 입원환자의 환자안전에 대한 지식, 수행, 인식도 향상에 모두가 유의하게 나타났다. 임상환경에서 실제상황과 유사한 모의상황을 경험해봄으로써 입원환자에게 환자 안전에 효과적인 교육 방법임이 확인되었다. 따라서 환자안전 교육 프로그램은 환자의 지식 및 수행, 인식도 향상에 긍정적인 영향을 주며, 임상에서 입원 환자의 환자안전 교육 시 교육 프로그램의 기초로 활용될 수 있을 것이라 기대된다.

아동간호사의 간호전문직관, 자기효능감과 환아부모와의 파트너십 (Nursing Professionalism, Self-Efficacy and Nurse Parent Partnership in Pediatric Nurses)

  • 조은주;방경숙
    • Child Health Nursing Research
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    • 제19권2호
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    • pp.94-101
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    • 2013
  • 목적 본 연구는 아동간호사가 스스로 지각하고 있는 간호전문직관, 자기효능감을 파악하고 이러한 인식이 실무영역의 중요 인자인 아동간호사-부모 파트너십과 관련이 있는지 파악하여 아동간호사의 실무환경개선을 위한 기초자료를 제공하는데 그 목적이 있다. 방법 본 연구의 대상자는 서울 소재 1개 대학병원 어린이병원에 근무하는 간호사로서, 해당병동에서 6개월 이상 근무한 간호사를 표적모집단으로 하여, 그 중 연구의 목적을 이해하고 참여에 동의한 간호사 165명을 대상으로 하였다. 자료수집 기간은 2012년 4월 9일부터 18일까지였으며 설문지를 이용한 자가보고방식으로 실시하였다. 결과 간호전문직관과 자기효능감, 환아부모와의 파트너십은 모두 통계적으로 유의한 양의 상관관계를 나타냈다. 본 연구를 통해 간호전문직관, 자기효능감이 높을수록 아동간호사-환아부모 파트너십이 높다는 것을 확인하였으며, 간호전문직관, 자기효능감, 아동간호사-환아부모 파트너십에 각각 영향을 주는 아동간호사의 일반적 특성도 확인하였다. 결론 본 연구의 의의는 아동간호실무의 효율성에 영향을 미치고 있지만 외국의 경우에도 연구된 바가 거의 없는 아동간호사의 간호전문직관과 자기효능감에 대하여 조사한 것, 이들과 아동간호사-환아부모 파트너십과의 관계를 밝힌 것이다. 본 연구의 결과는 아동간호사의 실무환경 개선을 위한 기초자료로 활용될 수 있을 것이며, 향후 아동간호 실무현상영역에 대한 연구가 더욱 활발히 진행되기를 기대한다.

동종 조혈모세포 이식환자의 이식 전 처치 형태에 따른 영양상태 (Nutritional Status of Recipients of Allogeneic Hemopoietic Stem Cell Transplantation by Types of Conditioning Regimen)

  • 김남초;김희승;최소은;박현정
    • 한국보건간호학회지
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    • 제14권2호
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    • pp.191-202
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    • 2000
  • This study was conducted for 39 patients who are recipients of allogeneic hemopoietic stem cell transplantation at BMT ward of St. Mary's hospital affiliated to Catholic University of Korea from April to September 1999. The subjects were devided into two groups; those who received both TEl and chemo therapy as conditioning regimen (TEl group). and those who used chemo agents as singular conditioning regimen (chemo group). The oral intake status of the two groups were compared through physical assessment and blood chemistry exam of the subjects, and factors influencing their nutritional change and oral intake were explored in each stage of the transplantation (six stages: admission, conditional stage, date of transplantation, one week after transplantation, two weeks after transplantation, and three weeks after transplantation). The prior aim of the study was to provide baseline data to minimize delayed treatment from nutritional deficiency of the subjects. The results were as follows: 1. TBI group was significantly decreased of oral calorie intake in two weeks after transplantation compared to admission and conditioning stage while that of chemo group was significantly decreased on the date of transplantation. 2. TBI group was significantly decreased of protein intake in two weeks after transplantation compared to admission and conditioning stage. In chemo group, protein intake was significantly decreased on the date of transplantation compared to admission. It was remarkable that TBI group showed lesser protein intake than chemo group. 3. Both group were significantly decreased of BMI in one week and three weeks after transplantation compared to admission. TBI group showed significantly higher BMI than chemo group. 4. Both group were significantly decreased of Triceps Skinfold Thickness (TST)on the date of transplantation compared to admission stage. 5. TBI group was significantly decreased of mid-arm muscle circumference (MAMC) in two weeks after transplantation compared to admission, conditioning, date of transplantation. 6. TBI group was significantly decreased of albumin level in two weeks after transplantation compared admission stage. In chemo group, it was significantly decreased on the date of transplantation compared to admission, three weeks after the transplantation. 7. TBI group was significantly decreased of transferrin level in two weeks after transplantation compared admission, conditioning, date of transplantation and one week after transplantation. In chemo group, it was decreased of transferrin level in 3 weeks after transplantation. 8. Oral intake of TEl group was impacted by vomiting before transplantation and gingivitis after transplantation. In chemo group, it was impacted by vomiting before transplantation and by two factors, gingivitis and nausea, after transplantation. The results showed oral calorie intake was not different between the two groups while protein intake was significantly lower in TBI group than chemo group. Oral intake was significantly impacted by vomiting before transplantation in both groups, but affected by oral gingivitis in TBI group and gingivitis and nausea in chemo group after transplantation. This findings present that standardized strategies to manage nutrition and gingivitis more effectively are desperately needed to enhance oral intake and protein intake of patients who receive TBI as conditioning regimen.

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부산지역 환자로부터 분리된 Methicillin Resistant Staphylococcus aureus(MRSA)의 응고효소형 및 항균제 내성에 관한 연구 (Coagulase Thping and Antibiotic Resistance of Methicillin Resistant Staphylococcus aureus (MRSA) Isolated form Patients in Pusan)

  • 류지한;이훈구
    • 미생물학회지
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    • 제36권3호
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    • pp.216-220
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    • 2000
  • 부산시 동아대학병원으로 내원한 83명의 환자 가건물로부터 methcillin 내성 Stphylococcus aureus(MRSA) 88 균주를 분리하고 응고 효소의 유형별 분석과 다약제 내성의 상호 관계를 연구하였다. 농(64.7%), 객담(26.2%), 기타 혈액, 장액 및 뇨로부터 균주가 분리되었고 mec A 유전자에 특이적인 primer 5'-AAAATCGATGGTAAAGGTT-GGC-3'와 5'-AGTTCTGCAGTACCGGATTTGC3'를 사용하여 PCR을 한결과 86균주에서 mec 유전자가 확인되었다. 응고효소형은 제 III형이 50%m IV형이 12.5%, III형이 6.8%, I, VII, VIII형이 4.5%로 제 II형이 가장 많았으며 제 V형은 전혀 분리되지 않았다. 응고효소형의 병동별 분포는 일반외과에서 제 II형이, 이비인후과 외래에서는 제 IV형이 우점종으로 분리되었다. 항균제 감수성 시험결과, vancomycin과 teicoplanin에서 전균주가 감수성을 나타내었었고 penionillin, cephalothin, erythromycin, gentamycin, imipenem, clindamycin, ciprofloxacin과 oxacillin등 8가지의 항균제에 대하여 동시내성을 나타낸 균주가 71주 (81%)였다. 항균제 내성과 응고효소형과의 상관관계는 없었다.

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장 천공을 동반한 혈역학적으로 불안정한 골반골 골절에서 전산화 단층촬영 전 시행한 혈관색전술의 지혈효과: 증례보고 (Emergency preoperative angioembolization without computed tomography to treat unstable pelvic fractures with bowel perforation)

  • 박찬용;강우성
    • 한국산학기술학회논문지
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    • 제20권3호
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    • pp.417-422
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    • 2019
  • 혈역학적으로 불안정한 골반골 골절 환자의 사망율은 40-60%에 이를 정도로 매우 높다. 하지만 이러한 환자들을 어떻게 치료해야 하는지에 대해서는 아직 논란의 여지가 많다. 저자들은 혈역학적으로 불안정한 골반골 골절 환자에서 빠른 응급 혈관조영술을 통해 효과적으로 지혈을 시행한 증례를 보고하고자 한다. 78세 여자가 넘어져서 발생한 골반 통증을 주소로 응급실을 통해 내원하였다. 내원 후 시행한 단순골반촬영에서 골반골 골절이 관찰되었으며, 혈압은 60/40 mmHg였다. 혈역학적으로 불안정하여 전산화단층촬영을 시행하지 않고 곧바로 혈관조영술을 시행하였으며, 빠른 지혈을 위해 세부적인 출혈 혈관을 선택하지 않고 양측 내장골동맥에 대해 색전술을 시행하였다. 색전술 시행 후 혈압이 안정화되고 나서 전산화단층촬영을 시행하였으며, 이 검사에서 장천공을 의심할 수 있는 다수의 복강내 공기 음영이 관찰되었다. 응급 개복술을 시행하였으며, 수술 소견상 소장에 약 1 cm 크기의 천공이 관찰되어 봉합을 시행하였고, 골반 주변 후복막강에 혈종이 있었으나 더 이상 팽창하지 않고 출혈 소견이 보이지 않아 그대로 두고 수술을 종료하였다. 환자는 중환자실로 입원하여 집중치료 시행하였고, 수술 3일째 일반병실로 전실하였다. 저자들은 이 증례에서 출혈을 동반한 골반골 골절과 소장천공 대해 전산화 단층촬영을 생략하고 빠른 혈관 조영술을 시행하여 효과적으로 치료할 수 있었다.