• Title/Summary/Keyword: Management clinical practice

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A Study on New Graduate Nurses' Clinical Experience of Adaptation (신규간호사의 임상적응 경험에 관한 연구)

  • Yun, Suk-Hui
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.1
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    • pp.55-72
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    • 2002
  • Purpose : This study aimed at understanding the lived experience of new graduate nurse in hospital setting.Method : This study was based on a phenomenological approach. For this study, 8 new graduate nurses participated. The unstructured in-depth interviews were carried out from June to October, 1998. The data was analyzed Van Kaam's method.Results : Clinical new graduate nurses experienced clinical adaptation and endeavor, professional conflict of nursing, disability of nursing performance, work stress and management, maladaptation of human relationships, diverse emotions of interpersonal relationships, change of personal identity, difference between theory and reality of nursing.Clinical adaptation and endeavor included to get familiar with hospital life, satisfaction and worth for nursing, to get familiar with scoldings, calm down by oneself, efforts for self-development. Professional conflicts of nursing included future uncertainties in the hospital, dissatisfactions in work, doubts and regrets in nursing.Disability of nursing performance included lack of knowledges and skills, desolate working, stresses from mistake in working. Work stress and management included psychological signs and symptoms, physical signs and symptoms, management of stress. Maladaptation of human relationships included unsuitabilities in nursing unit climate, difficulties in human relationship. Diverse emotions of interpersonal relationships included regrets and absurdities to clients, thanks and regrets to colleagues, difficulties with doctors, sense of rivalry with colleague nurses. Change of personal identity included to become narrowing life circle, change of personality. The differences between theoretical knowledge and practice included needs of systematic pre-education for clinical nursing practice, differences between nursing educations and clinical practices.Conclusion : Therefore, the human resource management reflecting new graduate nurses' experiences should be developed.

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The Effect of Doctor's Payment Method on Practice Behavior (지불보상체계가 의사의 진료행태에 미치는 영향 : 미국사례 분석)

  • Lim Jae-Young
    • Health Policy and Management
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    • v.14 no.4
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    • pp.48-74
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    • 2004
  • Considering the existence of asymmetric information between doctor and patient, the doctor's reimbursement method has been considered as a desirable policy device of improving efficiency of patient's use of medical care in terms of its affecting doctor's practice pattern by determining doctor's practice revenue. By using the Community Tracking Study (CTS) physician data set, which includes not only various information on doctors practice arrangements and sources of practice revenue, but also vignettes of various clinical presentations, this paper investigates doctor's reaction to the financial incentive under the control of patient's specific medical situation. Under the econometric model for exploring the effect of doctor's reimbursement method on his/her practice patterns; referring patients, recommend doctor-visit or medical tests, the Hausman's specification test was used for checking out the possibility of the doctor's reimbursement method being endogeneized explanatory variable. In the case where the endogeneity problem of doctor's reimbursement method exists, the 2SLS method was used for correcting that problem, and the multiple regression method was used in the case where the problem is found to be nonexistent. Based on the empirical results, this paper finds that doctors do appear to respond to financial incentive. The empirical results show that the doctor's reimbursement method statistically significantly affects doctor's practice pattern and are coincident with the theoretical result proposed by previous researches, This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would more refer their patients to specialists, and hesitate in recommending doctor-visit or medical exam.

Knowledge, Attitude, and Practice of Medical Waste Management in Medium-sized Hospital among Health Care Workers

  • Mi-Young Kim;Sang-Ha Kim;Young-Kwon Kim;Young-Bin Yu;Sunghyun Kim
    • Biomedical Science Letters
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    • v.30 no.3
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    • pp.143-151
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    • 2024
  • This study was on the knowledge, attitude, and practice of medical waste management in medium-sized hospitals located in D Metropolitan City in Korea. This work was intended to be used as basic data for improving the level of medical waste management. The questionnaire data were analyzed by t-test, one-way ANOVA, Scheffé's test, and multiple regression methods. The Factors influencing the knowledge of medical waste management were that males had a lower knowledge level of medical waste than females (β=-0.272, P<0.01), and it was found that the more adequate medical waste containers were provided, the higher the knowledge level of medical waste management (β=0.180, P<0.05). The factors affecting the attitude were not significant, and the factors affecting the practice showed that the higher the attitude score, the higher the level of practice (β=0.465, P<0.001). It was shown that gender and sufficient provision of medical waste containers had an effect on the knowledge of medical waste management, and the attitude toward medical waste management was identified as a factor influencing the practice. Individual education and training according to the characteristics of medical workers, and periodic guidance and inspection of medical waste managers will be required to increase the attitude of medical workers toward medical waste management. We need to construct a management process that thoroughly separates medical waste from the beginning of the medical waste generation, leading to the establishment of a positive attitude toward medical waste management.

Development of Web-based Multimedia Contents for the Critical Care Practice of Nursing Students through Inter-College Collaboration (대학 간 통합 웹기반 중환자간호실습 콘텐츠 개발 및 적용)

  • So, Hyang-Sook;Bae, Yeong-Suk;Kim, Young-Ock;Kim, Su-Mi;Kang, Hee-Young;Choi, Ja-Yun;Yang, Jin-Ju;Kim, Nam-Young;Ko, Eun;Hwang, Seon-Young
    • Korean Journal of Adult Nursing
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    • v.20 no.5
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    • pp.778-790
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    • 2008
  • Purpose: This study was conducted to develop Web-based multimedia contents for supporting student nurses' clinical practice on critical care, and to evaluate learners' responses. Methods: Based on the steps of Assessment, Design, Development, Implementation, & Evaluation(ADDIE) model, a total of 13 self-directed learning modules including live lectures and real video clips were developed through faculty collaboration of nine nursing colleges in Gwangju and Chonnam province. The finally developed multimedia contents were published on the Web of the learning management system at a local e-learning center. Results: The Web contents were evaluated after self-learning by 81 junior college nursing students who were encouraged to study it at their own pace during their two-week clinical practice at a medical or surgical intensive care unit of a university hospital and two hospitals. The knowledge (t = -27.66, p < .001) and self-evaluated clinical performance level(t = 7.54, p < .001) were significantly increased after learning of the Web contents and clinical practice, and satisfaction level that measured post-test only was 4.0 out of 5 point. Conclusion: The use of Web contents for critical care need to be extended as a complimentary material in a class room lecture or clinical practice of students to increase their self-learning ability and understandings of clinical knowledge and situation.

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The Value and Limitations of Guidelines, Expert Consensus, and Registries on the Management of Patients with Thoracic Aortic Disease

  • Pacini, Davide;Murana, Giacomo;Leone, Alessandro;Marco, Luca Di;Pantaleo, Antonio
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.413-420
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    • 2016
  • Doctors are often faced with difficult decisions and uncertainty when patients need a certain treatment. They routinely rely on the scientific literature, in addition to their knowledge, experience, and patient preferences. Clinical practice guidelines are created with the intention of facilitating decision-making. They may offer concise instructions for the diagnosis, management (medical or surgical treatments), and prevention of specific diseases or conditions. All information included in the final version are the result of a systematic review of scientific articles and an assessment of the benefits and costs of alternative care options. The final document attempts to meet the needs of most patients in most circumstances and clinicians, aware of these recommendations, should always make individualized treatment decisions. In this review, we attempted to define the intent and applicability of clinical practice guidelines, expert consensus documents, and registry studies, focusing on the management of patients with thoracic aortic disease.

Relationship of Locus of Control, Difficulties in Emotion Regulation, and Clinical Practice Stress (간호대학생들의 내·외통제소재, 정서조절곤란 및 임상실습스트레스의 관계)

  • Choi, Yeon-Sook;Lee, Eunju;Lee, Dohyeon
    • The Journal of the Korea Contents Association
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    • v.18 no.1
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    • pp.540-550
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    • 2018
  • The purpose of this study was to investigate the relationship of internal-external control, difficulties in emotion regulation, and clinical practice stress among college nursing students. The study was conducted, based on a sample of 220 students at one college and the data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and stepwise regression analysis. As a result of correlation analysis, there were significant positive correlation in difficulty of emotion regulation score and clinical practice stress score according to external control score. Factors affecting on clinical practice stress were locus of control, difficulties in emotion regulation, college satisfaction, grade, and religion having explanation rate of 17%. Therefore, to decrease clinical stress among nursing students, Nursing students should be considered the emotion regulation with external control disposition. The results can contribute as a basic data in developing education strategies and clinical adjustment programs for regulating clinical stress with emotion management and adaptation on clinical environment.

Teeth discoloration during orthodontic treatment

  • Baik, Un-Bong;Kim, Hoon;Chae, Hwa-Sung;Myung, Ji-Yun;Chun, Youn-Sic
    • The korean journal of orthodontics
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    • v.47 no.5
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    • pp.334-339
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    • 2017
  • Objective: Teeth discoloration is a rare orthodontic complication. The aim of this study was to report the clinical progression of discoloration during orthodontic treatment. Methods: Discolored teeth, detected during orthodontic treatment between January 2003 and December 2012 by a single dentist using similar techniques and appliances, were analyzed. Results: The total number of teeth that showed discoloration was 28. Progression of discoloration was evaluated in only 24 teeth that were observed without any treatment. During the observation period, the discoloration "improved" in 8 of the 24 teeth (33.3%) and was "maintained" in 16 (66.6%). The electric pulp test performed at the time of initial detection of discoloration showed 14.3% positivity, which improved to 21.4% at the final follow-up. None of the initial and final follow-up radiographic findings showed any abnormalities. Conclusions: When teeth discoloration is detected during orthodontic treatment, observation as an initial management is recommended over immediate treatments.

COVID-19 vaccine-induced immune thrombotic thrombocytopenia: a review

  • Siti Nur Atikah Aishah Suhaimi;Izzati Abdul Halim Zaki;Zakiah Mohd Noordin;Nur Sabiha Md Hussin;Long Chiau Ming;Hanis Hanum Zulkifly
    • Clinical and Experimental Vaccine Research
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    • v.12 no.4
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    • pp.265-290
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    • 2023
  • Rare but serious thrombotic incidents in relation to thrombocytopenia, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), have been observed since the vaccine rollout, particularly among replication-defective adenoviral vector-based severe acute respiratory syndrome coronavirus 2 vaccine recipients. Herein, we comprehensively reviewed and summarized reported studies of VITT following the coronavirus disease 2019 (COVID-19) vaccination to determine its prevalence, clinical characteristics, as well as its management. A literature search up to October 1, 2021 using PubMed and SCOPUS identified a combined total of 720 articles. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline, after screening the titles and abstracts based on the eligibility criteria, the remaining 47 full-text articles were assessed for eligibility and 29 studies were included. Findings revealed that VITT cases are strongly related to viral vector-based vaccines, which are the AstraZeneca COVID-19 vaccine (95%) and the Janssen COVID-19 vaccine (4%), with much rarer reports involving messenger RNA-based vaccines such as the Moderna COVID-19 vaccine (0.2%) and the Pfizer COVID-19 vaccine (0.2%). The most severe manifestation of VITT is cerebral venous sinus thrombosis with 317 cases (70.4%) and the earliest primary symptom in the majority of cases is headache. Intravenous immunoglobulin and non-heparin anticoagulant are the main therapeutic options for managing immune responses and thrombosis, respectively. As there is emerging knowledge on and refinement of the published guidelines regarding VITT, this review may assist the medical communities in early VITT recognition, understanding the clinical presentations, diagnostic criteria as well as its management, offering a window of opportunity to VITT patients. Further larger sample size trials could further elucidate the link and safety profile.

The Influence Factors on Nursing Practice by Clinical Nurses (in the COVID-19 Situation) (코로나19 상황에서 간호사의 간호업무수행 영향요인)

  • Park, Eun Hee
    • Journal of Industrial Convergence
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    • v.20 no.10
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    • pp.121-129
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    • 2022
  • The purpose of this study was to identify the factors affecting nursing practice of clinical nurses in the COVID-19 situation and provide basic data that could improve nursing practice in the pandemic situation. For this descriptive research, a survey was conducted to collect data from 119 clinical nurses in G City for six weeks from June 15 to July 20, 2022. Descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression were used. The results showed that infection control practice (r=.428, p<.001) and resilience (r=.324, p<.001) were statistically significantly correlated with nursing practice. As a factor affecting nursing practice of clinical nurses, infection control practice (B=.529, p<.001) had an explanatory power of 18.3%. This result is thought to be due to the fact that COVID-19 infection control acted as a new burden on nursing work in the COVID-19 pandemic, and recovery elasticity and job stress did not have an influence. It is however necessary to help clinical nurses relieve job stress and perform high-quality nursing through regular counseling for clinical nurses suffering severe job stress.

The Moderating Effect of Emotional Intelligence on the Relationship between Transition Shock and Adaptation on Clinical Practice among Nursing Students (간호대학생의 전환충격과 임상실습적응의 관계에서 감성지능의 조절효과)

  • Lee, Oi Sun;Kim, Eun Jae
    • Journal of Digital Convergence
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    • v.17 no.11
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    • pp.387-394
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    • 2019
  • The purpose of this study was to identify the moderated effects of emotional intelligence on the relationship between transition shock and adaptation on clinical practice among nursing students. Subjects were 185 associate nursing students associate nursing students(3rd). The data were collected using self -report questionnaire from May 1 to June 14, 2019. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson correlation and hierarchical multiple regression with SPSS/WIN 23.0. Mean point of transition shock(4 point scale) was 2.32. Mean point of emotional intelligence(5 point scale) was 3.61, and adaptation on clinical practice(5 point scale) was 3.40. Transition shock were significantly negative correlation with emotional intelligence(r=-.26. p <.001) and adaptation on clinical practice(r=-.43. p <.001) in nursing students. Emotional intelligence were significantly positive correlation with adaptation on clinical practice(r=.36. p <.001). Emotional intelligence has been shown to modulate the relationship between transition shock shock and adaptation on clinical practice(${\Delta}R^2=0.21$, p <.001). Therefore, to decrease the transition shock and to increase the adaptation on clinical practice of nursing students, It is necessary to develop the program for increase emotional intelligence of nursing students.