The Journal of Korean Academic Society of Nursing Education
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v.13
no.2
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pp.246-256
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2007
Purpose: The purpose of this study was to explore the role of nurse specialist in the general hospital, and to provide basic data for the role management of nurse specialist. Method: The subjects were 38 staff nurses who worked in a medical, surgical, or other department in one general hospital. Survey tools were developed with criteria for a clinical nurse specialist by American Nurses Association(1986), Korean Nurses Association(2001), Kim(2005)'s research, and the nurse specialists' self job description. Validity of the tool was examined by 5 clinical nursing experts and nurse specialists. Data analysis was done by using SPSS Win 12.0 program. Result: The results of domains for the job of nurse specialists were 61.6% for direct clinical practice, 21.7% for education, 5.7% for consultation, 5.2% for management, 5.2% for research, and 1.1% for other domains. The results for the large classifications in nurse specialists domains were 57.6% for direct nursing practice in direct clinical practice domain, 89.1% for patient education in education domain, 57.5% for medical consultation in consultation domain, 57.5% for medical research in research domain, and 39.2% for documentation in management domain. Conclusion: This research revealed that direct clinical practice domain was higher than the other domains of research, education, and management. Discussion and development about the nurse specialist's various roles needs to be addressed on a continual basis.
Purpose: This study examined differences in nursing care activity, work performance outcomes, and job satisfaction associated with upgrading nurse staffing of a nurse-to-patients ratio. Methods: Descriptive design was used in this study. In total, 148 medical and surgical nurses were recruited from one university hospital. Three instruments were used for data collection: Scale of Nursing Care Activity, Nurses' Work Performance Outcome Measurement Scale and Nurses' Job Satisfaction Scale. Data were analyzed by using descriptive statistics, t-test, ANOVA, and paired t-test. Results: There were significant differences in nursing care activity (t=-5.06, p<.001), in work performance outcomes (t=-5.46, p<.001) and in job satisfaction (t=4.61, p<.001) when the grading for the nursing staff was changed from three to two indicating increasing number of nurses. Conclusion: The findings from this study showed that there were more nursing care activities, better work performance outcomes, and higher job satisfaction when numbers of nurses were increased. The changes in the scale to evaluate nursing staff influence nursing activities, work performance and job satisfaction.
Nosocomial infection is important in the management of the nursing care and has been found to be related with the airborne microbes contamination. The purpose of this study is to identify the differences of the airborne microbes between hospitals, nursing units, days and times and to identify the difference in the types of microorganisms between hospitals, nursing units, days and times. This study was conducted from May 25, to July 10, 1981, according to R. Koch's methods for quantative samplings of airborne microbes and the results of this study were reviewed in a statistical method. The following conclusions were obtained: 1. There was a significant difference in the types of airborne microbes between 8 hospitals (F=5.0491, p<0.01) 2. There was a significant difference in the types of airborne microbes between surgical, medical, nursery, 1.C.U., operating theatre and outpatient nursing unit. (F=2.1764, p<0.05) 3. There was not a significant difference in the types of airborne microbes between Monday, Thursday and Saturday (F= 1.6365, p>0.05) 4. There was a significant difference in the types of airborne microbes between AM 7 : 00, AM 11:00 and PM 3 : 00. (F=7.2951, p<0.01) 5. 4061 colonies were divided into more 48 types and the classification was as follows. gram positive cocci (2024 colonies) 49.3% gram positive bacillus (1211 colonies) 29.8% gram negative bacillus (577 colonies) 14.2% fungus(200colonies) 4.9% gram negative cocci (41 colonies) 1.0% other's(8 colonies) 0.3% 6. There was a significant difference of airborne microbes between 8 hospitals. (F=7.7943, P<0.01) 7. There was not a significant difference of airborne microbes between 6 nursing units. (F= 1.8461, P>0.05) outpatient nursing unit : 12.6 colonies surgical nursing unit. 10.4 colonies Medical nursing unit : 9.8 colonies nursery nursing unit : 9.4 colonies operating theatre nursing unit:8.2 colonies Intensive care nursing unit : 7.8 colonies 8. There was not a significant difference of airborne microbes between Monday, Thursday and Saturday. (F=1.4371, p>0.05). Saturday : 11.0 colonies Monday : 9.1 colonies Thursday : 9.1 colonies 9. There was a significant difference of airborne microbes between A. M. 7 ; 00, A. M. 11 : 00 and P .M. 3:00 (F=7.6658, p<0.05) P. M. 3 : 00 : 12.2 colonies A. M. 11 : 00 : 10.0 colonies A. M. 7 : 00 : 7.1 colonies.
Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=-2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.
Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.
Chyloperitoneum or chylous ascite after trauma is a rare condition. It can develop after direct injuries of lymphatic vessels or cisterna chyli. Though isolated chyle duct injury has sometimes been reported, chyloperitoneum is generally accompanied by various kinds of damage to other intraabdominal organs. There's still no established therapeutic protocol regarding the treatment of chyloperitoneum when it is accompanied by the serious injuries of intraabdominal organs. We describe a 66-year-old male with serious intraabdominal organ injuries after blunt trauma. In our case, chyloperitoneum developed due to the injuries to the mesenteric lymph vessels and compression of cisterna chyli by hematoma around aorta.
Sohn, Seil;Chung, Chun Kee;Han, Kyung Do;Jung, Jin Hyung;Hyeun, Joung Ho;Kim, Jinhee;Chang, Ung-Kyu;Sohn, Moon Jun;Kim, Sung Hwan
Journal of Korean Neurosurgical Society
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v.62
no.1
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pp.46-52
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2019
Objective : The aim of this nationwide study was to analyze the current state of patients with newly diagnosed metastatic spine tumors according to surgical methods. Methods : Data was extracted from the Korean Health Insurance Review and Assessment Service database. Surgery was categorized into three methods : fusion, decompression, and vertebroplasty. Data included patient age, sex, health insurance type, and co-morbidities. Survival rates of metastatic spine tumor patients according to each surgical method were evaluated. Results : Among 1677 patients who had an operation, 823 patients were treated by fusion, 141 patients underwent decompression, and 713 patients were treated by vertebroplasty. The three most prevalent primary tumor sites were the lung, breast, and liver & biliary. On the other hand, the three most prevalent primary tumor sites of patients who underwent surgery were the lung, liver & biliary, and the prostate. The median survival periods for each surgical method in the metastatic spine tumor patients were 228 days for those who underwent surgery, 249 days for decompression, and 154 days for vertebroplasty. Age, sex, and comorbidities significantly affected survival rate. Conclusion : For every primary tumor site, decompression was the least common surgical method during the study period. Although the three surgical methods did not significantly affect the survival period, patients with a poor prognosis tended to undergo vertebroplasty.
Purpose: The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated. Methods: This mixed-method research was performed as a time-motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed. Results: The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p<.001, F=53.08 and p<.001, and F=29.13 and p<.001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics-educational background, practice period, and experience of using paper records-significantly affected the system usability and satisfaction scores. Conclusion: The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.
Purpose: This retrospective study aimed to investigate nursing interventions in patients with severe thoracic injury in trauma bay of a regional trauma center. Methods: Of the 1,780 patients admitted to the trauma bay of a regional trauma center in a university hospital in the Gyeonggi Province between January 1, 2019 and December 31, 2019, 120 adult patients with severe thoracic injury who met the inclusion criteria were enrolled. Participants' clinical characteristics and nursing interventions were collected from electronic medical records after receiving ethical approval. Nursing interventions were classified using the terminology in the Nursing Intervention Classification. Results: The mean age of participants was 52.25 years and 72.5% of participants were male. The main areas of thoracic injury included lung parenchyma and pleura (95.8%). The mean Abbreviated Injury Scale (AIS) for thoracic injury was 3.13 and the mean Injury Severity Score (ISS) was 17.81. Fluid resuscitation, invasive hemodynamic monitoring, chest tube care, respiratory monitoring, artificial airway management, gastrointestinal tube care, mechanical ventilation management: airway insertion and stabilization, blood product administration, allergy management, and surgical preparation were performed significantly more frequently in thoracic injury patients with unstable vital signs or a higher AIS score. Conclusion: This study is significant as it investigated the types of nursing interventions given to patients with severe thoracic injury in the trauma bay. These results would contribute to developing more detailed educational materials for initial nursing interventions in trauma bay.
Kim, So Sun;Chae, Gye Soon;Kim, Kyeong Nam;Park, Kwang Ok;Moon, Seong Mi
Journal of Korean Clinical Nursing Research
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v.16
no.1
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pp.167-175
/
2010
Purpose: This study investigated nursing care delivery systems in 44 university affiliated hospitals and satisfactions with the systems perceived by 226 unit managers (head nurses) of general medical surgical wards. Methods: Data were collected with questionnaires consisting of checklists asking the unit managers their nursing care delivery systems and their satisfactions with the systems. Results: Four models of nursing care delivery systems (primary, modified primary, team, and functional models) were drawn from the participants' responses. Among the four key models 35% of the units adopted team model whereas 24.3% adopted primary model and 22.6% adopted modified primary model. In spite of 35% of team model being under use, 60.6% (n=137) of the unit managers answered the nursing delivery system of their units as team model and only 6.2% (n=14) answered their units having primary or modified primary models, instead of 46.9% combining both. In regard to the satisfaction, critical thinking ability of staff nurses (members in their units) was the most dissatisfactory area regardless of models of service delivery. Conclusion: Introducing team model supplemented with core concepts of primary model (primary team delivery model) into nursing practice will reform the workplace and therefore deliver safe health care services to patients.
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