• Title/Summary/Keyword: Lack of nursing

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Role, Change, Job Satisfaction and Obstacles in Carrying out the Role of Public Health Nurses in Health Center (보건소 보건간호사의 역할변화, 역할수행의 장애요인과 만족도)

  • Ahn, Kyeong-Sook;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.1-13
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    • 1995
  • Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.

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A Study on the Sufficiency of Anticipated Effect of Order Communication System Introduced to Medium-Sized Hospitals (Focused on the case of S Hospital) (중소병원의 처방전달시스템 도입효과분석에 관한 연구 (S병원의 사례를 중심으로))

  • Hong, Suk-Won;Jung, Key-Sun;Choi, Sung-Woo
    • Korea Journal of Hospital Management
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    • v.7 no.4
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    • pp.172-192
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    • 2002
  • The purpose of this study is to ascertain whether the effect of introduction of OCS(Order Communication System) to the hospital is satisfied or not comparing the anticipated effect with the actual effect. For this purpose, a domestic hospital which has introduced and has been operating OCS for several years was chosen. Based on the internal data of S Hospital prepared before introducing OCS, researcher has analyzed the basic direction, design standard and status of operation after the introduction of OCS, etc. After analyzing the status of operations of several departments using OCS and interviewing with the chiefs of pertinent departments, a survey form was designed. Actual survey and interviews were conducted by the researcher for weeks to know whether doctors, nurses, medical technicians and clerks of the patient management dept. were satisfied with OCS and to find if they have any recommendations to improve OCS. Based on the analysis of survey, the effect of OCS was evaluated whether it has satisfied the anticipated effectiveness. For the question if they feel convenient in using OCS, doctors, nursing staffs in charge of ward and the staffs of billing dept. has answered that they were all satisfied(100%). The answers for the same question were relatively high in the case of nurses in charge of outpatient and staffs of radiography. Of course, there have been some nurses and staffs who complained for the inconvenience. However, overall satisfaction was high on the average. Some common problems occurred after the introduction of OCS were frequent errors due to instability of OCS system, paralysis of function of hardware on data back-up system and redundant investment due to erroneous choice of DB program in setting DB. It was also pointed out that lack of computer education and low participation of medical staffs has resulted in failure of developing effective software. As a result, it has lowered the efficiency of OCS. For example, some works have to be done by hands even after OCS. Based on the result of this research, recommendations to maximize the effect of OCS were presented as follows. First, strong leadership of CEO and active cooperation of doctors are mandatory. Second, all the process of hospital work should be analyzed and be redesigned in more efficient ways. Third, OCS should be designed to be user-based system which can be used efficiently by all staffs of the hospital. Forth, prior to the operation of OCS, proper tests of the program and trainings of the pertinent staff are required. Fifth, prior to the selection of hardware, BMT(Bench Marking Test) should be conducted. Sixth, before introducing OCS, staffs in charge of OCS should visit many hospitals operating the OCS system and take their cases into account.

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Perceptions of Hospital Health Information Managers Regarding Present on Admission Indicators in Korea: A Qualitative Study (입원 시 상병의 수집 및 활용에 관한 보건의료정보관리사의 관점: 질적 연구)

  • Pyo, Jee-Hee;Choi, Eun-Young;Oh, Hae-Mi;Lee, Won;Kim, Ju-Young;Ock, Min-Su;Kim, So-Yoon;Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.26 no.1
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    • pp.23-34
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    • 2020
  • Purpose: This qualitative study was conducted to examine the current status and problems concerning the collection of present on admission (POA) indicators and determine how to use these indicators for evaluating the quality of care and degree of patient safety. Methods: A total of 11 health information managers were divided into two groups according to the size of their hospitals. Two focus group discussions (FGDs) were conducted, one for each group, which followed a pre-developed semi-structured guideline. The verbatim transcriptions of the FGDs were analyzed. Results: The majority of participants were concerned about entering POA flags honestly because they did not know how future POA indicators would be used. In particular, for some participants, POA N was a burden that could imply a signal of mismanagement within the medical institution. In addition, the lack of awareness and indifference of physicians regarding POA indicators were some of the difficulties for POA flag entry. Although medical institutions are making efforts to improve the accuracy of POA flagging, many participants mentioned the need to develop real case-oriented POA entry guidelines to improve the accuracy of POA flagging. Conclusion: To increase the validity of POA indicators, it is necessary to increase the level of awareness of POA indicators in physicians and other medical professionals. Furthermore, efforts related to POA indicators by individual medical institutions need to be reflected in the process evaluation.

Discharge education reinforcement activities for mother of premature infants (미숙아 어머니의 퇴원교육 프로그램 강화활동)

  • Lee, Hui-Jeong;Soul, Hyun A;Lee, Kyeong-Nam;Seo, Gyeong-Ok;Moon, Su-Mi;Kim, Ki-Hwi
    • Quality Improvement in Health Care
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    • v.20 no.1
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    • pp.76-88
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    • 2014
  • Objectives: Parents of a premature baby feel a pressure on their baby's growth and they are highly in need for proper education. However, the lack of proper education can cause the difficulty of follow-up care and rehospitalization. Currently, methods of education among each nurse are based on verbal explanation and can be often different. Therfore, it is true that the psychological burden is great during education. Hence, by enforcing discharge education activities, we intend to provide information; induce participation of parents; promote the level of performance; standardize education program; and increase the job satisfaction of nurses. Methods: NICU conducted a questionnaire survey of the demand and satisfaction for discharge education among mothers that left hospital. And before and after the improvement activity, the satisfaction level of mothers and nurses were studied, and rehospitalization rate were analyzed. Results 1)The survey results of the satisfaction level of mothers towards education program as followes: The level of understanding of content, general babysitting, special situation, education method, and educator attitude showed statistically significant increase. 2)The survey results of the satisfaction level of nurses towards education program as followes: While, the need for education program decreased, the adequacy of education content and method, consistency of education, understanding of learner, and learner's performance increased. All the factors except for the need for education program and the adequacy of education content showed statistically significant difference. 3)Rehospitalization rate of premature babies decreased. According to analysis of the cause of rehospitalization, breast-feeding related apnea turned out to be the highest. Conclusion: Through QI, satisfaction of mothers and nurses improved more than 10%. And rehospitalization rate of premature babies decreased by the same amount as well. Therefore, with the help of the standardized discharge education program, mothers who is not easy to take care of after leaving hospital can be seen to significantly affect their healthy growth and development.

한국 시설호스피스의 원리와 실제

  • Gang Seung-Gye;Kim Su-Ho;Kim Sin-Su;Park Hui-Myeong;Song Geun-Ok;Won Ju-Hui;Lee Myeong-Suk;Lee Seong-Ok;Lee Ok-Je;Lee Eun-Ui;Lee Chae-Yeong;Lee Hyeon-Mi;Heo Pil-Seok
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.87-111
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    • 2002
  • The hospice activities in Korea have still stood in the premature stage, although the contemporary hospice program, which professionally accommodates terminally ill patients, appeared in the history 35 years ago. Especially, the availability of the facility hospice is not only poor in number, but also lack of a guideline for the conduct of the facility. Saemmul Hospice has keenly felt the necessity of more facility hospices and has interchanged experiences and informations with people interested in hospice. However, the number of facilities has fallen short of one's expectations, and many problems have been revealed in order to maintain the operation. This paper was written in order to improve these atmospheres and to help more terminally ill cancer patients properly. This paper clarifies in detail the principle of management, the method of practice in each departments of Saemmul Hospice, expected effects and supplemental items. We try to provide concrete and practical informations and to help extensively for all peoples who are to begin or currently working. 1.Facility: It secures, maintain, and manage the hospice environment for all around care of patients effectively. 2.Education and Volunteer: It trains and manages hospice volunteers devoted to hospice. 3.Financial: It manages donation by healthy soul with an effective method. 4.Administration and Organization: It executes the administration efficiently and constitutes the organization to operate. 5.Medical and Nursing: It offers the maximum professional supports to a hospital. 6.Medicine and alternative medicine: It improves the quality of life of patients by medical and pharmaceutical approach and by other possible methods available. 7.Nutrition: It helps patients to have diets in accord with the order of the creation. 8.Belief: It offers spiritual care which allows the profound relationship with God. 9. Funeral ceremonies: Funeral ceremonies may heal grieves of families faced with their deaths. 10. Bereaved families: It supports the families after the deaths of patients. 11.Reception and consultation: It seeks to help the patients who meet the purposes for which Saemmul Hospice is established. 12.Publication: It allows publicity activities for Saemmul Hospice. Facility hospice programs are able to overcome the disadvantages that the other type of the hospice possess, like as the economic burdens of the families, and the patients' losses of comforts of home after being transferred to a hospital. Facility hospice can provide home atmosphere with professional manpower and facilities like hospital to the patients. Therefore, it can also improve patients' qualities of life and make them comfortable death. We anticipate that the hospice program in Korea would be more active to let more people be indebted to maintain the nobel human dignity and to cross beautifully in the most painful process of dying in the journey of their lives.

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The Evaluation of Teicoplanin Usage in a University Hospital (대학병원에서의 Teicoplanin의 사용 현황 조사 및 실태 평가)

  • Kim, Eun A;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.11 no.1
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    • pp.19-29
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    • 2001
  • Teicoplanin, a glycopeptide antibiotic, has potential for use as an alternative to vancomycin in the treatment of gram-positive bacterial infections. However, unlike vancomycin, there is a lack of study on teicoplanin's efficacy and safety and the guideline for its use is not available, yet. The objective of this study was to investigate and evaluate the pattern of teicoplanin usage in a university hospital. A retrospective study was performed on 72 adult patients, who took teicoplanin for 3 continuous days at D. University hospital from 1 January 1999 to 30 June 2000. The microorganisms treated with teicoplanin were methicillin-resistant Staphylocorcus aureus $(69\%)$, coagulase-negative Staphylococci $(12\%)$, Enterococcus $(4\%)$, vancomycin-resistant Enterococci $(2\%)$, Streptococci $(2\%)$, and Bacillus $(1\%)$. The types of infection treated with teicoplanin were surgical wound infection $(58\%)$, lower respiratory infection $(11\%)$, bactremia $(7\%)$, urinary tract infection $(5\%)$, pleural fluid infection $(4\%)$, and peritoneal fluid infection $(2\%)$. The mean duration of teicoplanin usage was 16.5 days and teicoplanin was used with 1.4 other antibiotics, which were aminoglycosides (isepamicin, amikacin, netilmicin, astromicin) or quinolones (ciprofloxacin, tosufloxacin) or the third generation cephalosporin (ceftazidime). Only 24 cases $(28.6\%)$ met with the criteria for the justification of use, and the rest of 60 cases $(71.4\%)$ did not meet the criteria. In 84 cases $(100\%)$, blood culture tests were performed prior to the initial dose of teicoplanin. In 83 cases $(99\%)$, serum creatinine were conducted before the initial doses. In 45 cases $(53.6\%)$, serum creatinine was monitored at least twice weekly. In 55 cases $(65.5\%)$, WBC was tested at least twice weekly. In 84 cases $(100\%)$, body temperature was monitored at least once per nursing shift. In 15 cases out of 56 cases, maximum temperature decreased at least 1 degree within 3 days of teicoplanin use. In 15 case out of 35 cases, WBC values were within the normal range after treatment. In 23 cases $(27.4\%)$, dosage regimen was appropriate. Drug-related adverse effects were reported in 13 cases. Nephrotoxicity (progressively increasing SCr. or sustained SCr increase of $\geq$0.5 mg/dl from baseline) was noted in five cases. Neutropenia (absolute neutrophil count <1,500 $cells/mm^3$) was noted in one case and eosinophilia (total eosinophil count >350 $cells/mm^3$) was noted in seven cases. A more strict control on use of teicoplanin is required, considering that teicoplanin is categorized as one of restricted antibiotics.

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A study on practice of obesity control by school nurses (보건교사의 비만관리실태 조사연구)

  • Ju, Hyun-Ok;Song, Mi-Gyoung
    • Journal of the Korean Society of School Health
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    • v.15 no.2
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    • pp.249-261
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    • 2002
  • This study was a research study to find out the real picture and practice of student obesity control by primary, middle and high school school nurses. The study sampled 196 school nurses working in the Busan City and Northern Gyungsang Province, who agreed on the purpose of the study. When it comes to the study process, at the meeting of the whole school nurses, the researcher explained the purpose of the study and asked them to complete questionnaires and return on the spot. The study is designed to provide basic data for school nurses in field to systematically and efficiently control student obesity by examining perception of school obesity control and the real picture or practice of obesity control as well as its problems. The study used SPSS 10.0 to analyze data. The results are as follows: Annual plans about obesity control appeared significant at the primary school, 89.3%, higher than 77.3% of the middle and high school(p<0.05). Annual project evaluation showed a significant difference by regions, 56.0% of metro cities vs. small cities(p<0.01). The number of measuring weight of obese students was higher at the primary school than at the middle and high school(p<0.05). Also small cities conducted the weight measurement more often than metro cities(p<0.001). Among the health education methods for obesity, counseling appeared statistically significant(p<.01). The health education showed a significant difference in more experienced school nurses. Among the educational media, environment postings were used at the primary school, 24.0%, higher than 5.3% of the middle and high school. It showed a significant difference(p<.001). OHP or epidiascopes were used at the primary school, 36.4%, significantly higher than the middle and high school(p<.001). In addition, computer was used at the primary school, 21.5%, higher than the middle and high school(p<.05). Problems of obesity education data included a lack of textbooks and programs and a short of educational media. However it didnt show a significant difference in schools or in regions. Counseling activities for obesity showed a significant difference in schools(p<.01) and in regions(p<.001). When parents with obese students were in counseling, those in their 20s used home correspondence and those in their 30s and 40s used phone call(p<.01). The rate of equipment to measure obesity was higher at the middle and high school than the primary school, showing a significant difference(p<.001). Therefore, regular health education curriculums for school nurses should be systematically created to promote student health. Furthermore, it needs to make standard textbooks for health education by grades as well as by levels and to develop various educational programs and educational media.

Health Conditions, Activities of Daily Living, Depression, Sleep, and Cognitive Functions of the Elderly at Care Facilities and Their Related Factors (요양시설 노인들의 건강상태, 일상생활수행능력, 우울, 수면과 인지기능정도와 관련요인)

  • Kim, Jong-Im
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.11
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    • pp.463-473
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    • 2016
  • The purpose of this study was to investigate the relations between the cognitive functions, health conditions, activities of daily living, depression and sleep states among the elderly at care facilities. The subjects include 204 elderly people aged 65. The data collected were analyzed using descriptive statistics, the t-test, ANOVA, Pearson correlation, and hierarchical multiple regression. The findings show that the cognitive functions of the elderly at care facilities are related to their engagement in regular exercise, duration of residency, grade of care, lack of physical freedom, listening ability, state of teeth, urinary incontinence, activities of daily living, and state of sleep. Their cognitive functions had positive correlations with activities of daily living and negative correlations with state of sleep. Their cognitive impairment was significantly influenced by their engagement in regular exercise, duration of residency, grade of care, listening ability, ADL, IAD dependency, and sleep disorder. In short, the cognitive functions of the elderly at care facilities are highly related to their health conditions as perceived and felt by them. It is thus required to develop, apply, and consistently assess and manage cognitive rehabilitation training programs to provide interventions for the factors that influence their cognitive impairment.

The Effect of Korean-Japanese College Students' Perception of Welfare, Dementia Perception, and Dementia Attitude on Dementia Policy Perception (한·일 대학생의 노인복지 인식, 치매 인식, 치매태도가 치매정책 인식에 미치는 영향)

  • Ae-Ran Ryu;Kuk-Gwen Lee
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.5
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    • pp.349-355
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    • 2023
  • This study attempted to examine the effect of Korean and Japanese college students' perception of welfare for the elderly, dementia perception, and dementia attitude on dementia policy. The main results are as follows. As a result of analyzing the impact of Korean-Japanese college students on their perception and attitude of dementia policy, it was found that Korean-Japanese college students' perception of welfare for the elderly and dementia attitude had a positive (+) effect on dementia policy perception. As a result, I would like to present the following implications. Korea and Japan have developed social insurance systems for the elderly in a low birth rate and aging society, and are developing and implementing support services suitable for the culture of both countries. In the perception of dementia policies of college students in Korea and Japan, the influence of long-term care insurance for the elderly in Korea and nursing care insurance in Japan has led to changes in the perception of dementia among college students. However, it has been shown that dementia awareness does not affect dementia policy awareness, indicating that college students lack dementia awareness. Dementia awareness can increase the demand for the development of various dementia-related services or dementia policies, but low dementia awareness can lead to misunderstanding or negative perceptions of dementia. This can also affect the perception of dementia policies, and services and policies such as social support, prevention, and treatment related to dementia may not be sufficiently developed. In order to compensate for these problems in the future, efforts should be made to improve awareness through the provision of various information such as the government and society to help improve and understand dementia awareness for college students.

Lack of Effects of HER-2/neu on Prognosis in Colorectal Cancer: a Meta-analysis

  • Han, Jun;Meng, Qing-Yang;Liu, Xiao;Xi, Qiu-Lei;Zhuang, Qiu-Lin;Wu, Guo-Hao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5551-5556
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    • 2014
  • Background: The prognostic value of human epidermal growth factor receptor-2 (HER-2/neu) for survival of patients with colorectal cancer (CRC) is still ambiguous. We therefore performed a meta-analysis to evaluate its prognostic significance. Materials and Methods: We searched the MEDLINE and EMBASE databases for published literature investigating associations between HER-2/neu status and overall survival of patients with CRC. A meta-analysis was performed using a DerSimonian-Laird model and publication bias was investigated by Begg's and Egger's tests. Subgroup analysis was also conducted according to the study design type, study quality score, cut-off value for HER-2/neu overexpression, publication region, patient number and publication year. Results: A total of 17 eligible studies involving 2,347 patients were identified for this meta-analysis. The combined hazard ratio (HR) was 1.31 (95% confidence interval (CI): 0.96-1.79), suggesting that HER-2/neu overexpression was not significantly associated with overall survival of patients with CRC. However, subgroup analysis revealed that HER-2/neu overexpression had an unfavorable impact on survival when the analysis was restricted to subgroups of study quality score ${\leq}5 $(HR=1.56, 95%CI: 1.17-2.10), Asian patients (HR=1.74, 95%CI: 1.22-2.49), patient number ${\leq}106$ (HR=1.57, 95%CI: 1.01-2.44), publication year before 2003 (HR=1.59, 95%CI: 1.02-2.49), and prospectively designed study (HR=3.62, 95%CI: 1.42-9.24). The effect disappeared in subgroups of study quality scores > 5 (HR=0.69, 95%CI: 0.33-1.44), non Asian patients (HR=1.14, 95%CI: 0.77-1.70), patients' number > 106 (HR=1.07, 95%CI: 0.67-1.72), publication year after 2003 (HR=1.13, 95%CI: 0.76-1.69), and retrospectively designed study (HR=1.22, 95%CI: 0.89-1.67). Conclusions: Our meta-analysis suggests that HER-2/neu overexpression might not be a significantly prognostic indicator for patients with CRC. Further studies are required to confirm these results.