Continuous measurement of quality indicators (QIs) should be a routine part of colonoscopy, as a wide variation still exists in the performance and quality levels of colonoscopy in Korea. Among the many QIs of colonoscopy, the adenoma detection rate, average withdrawal time, bowel preparation adequacy, and cecal intubation rate should be monitored in daily clinical practice to improve the quality of the procedure. The adenoma detection rate is the best indicator of the quality of colonoscopy; however, it has many limitations for universal use in daily practice. With the development of natural language processing, the adenoma detection rate is expected to become more effective and useful. It is important that colonoscopists do not strictly and mechanically maintain an average withdrawal time of 6 minutes but instead perform careful colonoscopy to maximally expose the colonic mucosa with a withdrawal time of at least 6 minutes. To achieve adequate bowel preparation, documentation of bowel preparation with the Boston Bowel Preparation Scale (BBPS) should be a routine part of colonoscopy. When colonoscopists routinely followed the bowel preparation protocols, ≥85% of outpatient screening colonoscopies had a BBPS score of ≥6. In addition, the cecal intubation rate should be ≥95% of all screening colonoscopies. The first step in improving colonoscopy quality in Korea is to apply these key performance measurements in clinical practice.
The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed include confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient /family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who have had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.
Cho, Myung Sook;Cho, Yong Ae;Song, Mi Ra;Kim, Mi Kyung;Cha, Sun Kyung
Korean Journal of Adult Nursing
/
v.25
no.2
/
pp.136-147
/
2013
Purpose: This study developed a program to facilitate evidence-based practice (EBP) in one nursing organization, and identifies the effects of the program on the nurses' EBP facilitators. Methods: The program was based on the Transtheoretical Model of stages of organizational change, a literature review, the cases of hospitals overseas, and a prior study. To identify the effects of the program, a one-group pretest-posttest study was conducted with 45 nurses who participated in the EBP implementation. Results: The program consisted of EBP educational sessions, consultations with academic nursing faculty and clinical EBP mentors, and support from the administration and relevant departments. After the EBP program, there was a statistically significant difference in belief in the value of EBP between the pretest and the posttest (t=2.31, p=.026). However, no significant differences were found between the pretest and the posttest for organizational support to develop EBP (t=0.62, p=.537), skills in locating and evaluating research reports (s=-1.00, p=.987), knowledge of research language and skills (s=-1.00, p=.986), and time to devote to EBP (s=-23.00, p=.711). Conclusion: The findings provide important data that can be used to develop and implement strategies for enhancing EBP in clinical settings in Korea.
The purpose of this study was to survey the cause factor and degree of stress experienced by second and third grade students of dental hygiene department in Gyeong-nam province and Ulsan Metropolitan city who were finished two weeks public health center training and four weeks dental hospital and local dental clinical training. It was to provide basic data and improve the problem of clinical training program. 1. In respect of their motives of choosing the hygiene department, 64.8% in second grade and 62.2% in third grade of those respondents cite guarantee of getting a job as main reason. In respect of the satisfaction for major field, 29.6% of second grade and 73.3% of third grade respondents were satisfied. 2. In the satisfaction for clinical training in public health center, 46.3% of second grade and 46.7% of third grade respondents were satisfied. In the satisfaction for clinical training in local dental clinic and hospital, 50.9% of second grade and 66.7% of third grade respondents were satisfied. 3. In the respect of major factor to feel stress in clinical training in public health center, the relation of school practice program and clinical training in public health center, 50.5% of respondents was felt stress because of the difference between school practice program and field condition was exist. 4. In the respect of major factor to feel stress in local dental clinic and hospital training, the relation of school practice program and clinical practice in public health center, 54.5% of respondents were felt stress. 62.1% of respondents were felt stress because of the difference between knowledge and practice. 58.1% of respondents were felt stress because of the difference between school practice program and field condition was exist. 50.5% of respondents were felt stress because of the lack of knowledge in related fields. As the above results, it is necessary to develop clinical practice program that is to increase satisfaction and provide motivation in oder to reduce the stress during clinical training.
The purpose of this study was to understand the comprehensive relationship among sense of coherence, clinical practice stress, and major satisfaction of students in the department of dental hygiene. From four local universities, departments of dental hygiene were selected: two departments represented a three-year curriculum system and two represented a four-year curriculum system. Data from the final questionnaires of 319 students were analyzed. Differences between variables were analyzed using t-tests and ANOVAs, and correlations were checked using Pearson's correlation coefficients. Path analysis was conducted to analyze the relationship among clinical practice stress, sense of coherence, and major satisfaction. The results indicated that clinical practice stress had a negative influential relationship with both sense of coherence, and major satisfaction. In addition, sense of coherence had a positive influential relationship with major satisfaction. The direct and indirect effects among factors displayed significant differences, indicating that clinical practice stress has a partial mediation effect on sense of coherence and major satisfaction. Therefore, major satisfaction can be increased by developing and implementing programs to improve sense of coherence.
Purpose: The purpose of this study was to try to understand the essence of the experience early turnover of the new nurse by applying the phenomenological method and to provide basic data for a community-based management program. Method: Phenomenological approach was used to identify subjects experience. Subjects were five new nurses, with less than one year of clinical experience in clinical practice. This study used in-depth interview. Results: there were 104 meaningful sentences or phrases, with 41 generally comprehensive thema. Finally, thema were classified into 12 thema clusters. Conclusion: Finally, based on the results, some suggestions regarding management of early turnover of new nurses are needed. First, we proposed a new characterized of hospital selection method for each hospital. Second, practical training in clinical practice in the school and the community is necessary in order to reduce the real impact of new nurses. New nurses require various support elements in order to mitigate the real shock the first time they encounter clinical practice. Third, addition of work-related training and promotion of a self-esteem program will be needed. Fourth, interview opportunities with seniors who adapted successfully in clinical should be provided for new nurses. In addition, continuous communication should be provided for new nurses.
Recently, there has been an increasing interchange between South Korea and North Korea. Accordingly, there has been active research to understand the society and culture of North Korea, it has been attempted to have comparative study about nursing education to increase understanding between South and North Korea. In the current educational system, 12 years of education is required for entering a nursing college or university in South Korea, but there are only 10 years for entering nursing college in North Korea. After finishing undergraduate studies one can enter graduate school for a masters degree and or a doctoral degree, but there is a longitudinal relation to medical education in North Korea. Regarding the number of nursing educational institutions, there are 50 BSN programs & 61 Diploma programs in South Korea and 11 Diploma programs in North Korea. In regards to curriculum, South Korea has diverse subjects for general education for freshmen, then is subjects to basic specialities sophomore year, and speciality subject and clinical practices from junior year corresponding to the student's intentions. North Korea has minor subjects for general education and basic specialities in freshmen, speciality subjects sophomore year, speciality subjects and clinical practice in the junior year that may not correspond with the student's intentions. The most outstanding difference in the curriculum is North Korea has various subjects for oriental medicine with clinical application. North Korea also does not teach computer science and English is at a very low level. In clinical practice, South Korea has various settings for clinical practice including community health institutions under the nursing professor or clinical instructor. However, North Korea has limited settings for clinical practice (general hospitals) under a doctor's instruction. Also both South and North Korea have a similar licensing system. Therefore, there must be many more studies regarding North Korea, especially in nursing and nursing education in order to decrease differences and confusion between the Koreas and to prepare for a future unification.
The author recommends the creation of a nationwide career guidance program at the national level through the establishment of a long-term cohort, involving collaboration among medical schools nationwide. This cohort would be constructed for the purpose of analyzing correlations from admission to medical school to post-graduate education, facilitating the development of a career guidance program. This will aid in career development through students' self-analysis and competency building. Each medical school should operate a systematic career guidance program. Career guidance for post-graduate major selection should be included in the regular curriculum. Schools are advised to operate student counseling rooms for various career guidance services. For example, medical schools can operate 1:1 career counseling, academic counseling, career guidance surveys, psychological tests, and counseling. It is advisable to establish a mentor-professor system, connect mentor professors, and build a network of experts related to majors to provide immediate support according to students' needs. Professional mentor training should be provided to mentor professors. To provide opportunities for students to experience their career paths in advance, early clinical exposure, long-term integrated clinical practice, community-based clinical practice, participation in student research programs, career fairs, and student internship programs are recommended. In South Korea, it is necessary to systematically operate the internship system and make improvements to facilitate optical career choices. Additionally, considering the significant influence of social factors on students' career choices in South Korea, efforts should be made to identify and address the issues related to these social factors.
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