• 제목/요약/키워드: Nursing Assessment

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구강점막의 통합성 사정기록 체계화를 위한 최소자료세트(Minimum Data Set) 규명 (Identifying Minimum Data Sets of Oral Mucous Integrity Assessment for Documentation Systematization)

  • 김명수;정현경;강명자;박남정;김현희;류정미
    • 중환자간호학회지
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    • 제12권1호
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    • pp.46-56
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    • 2019
  • Purpose : The purpose of this study was to identify minimum data sets for oral mucous integrity-related documentation and to analyze nursing records for oral care. Methods: To identify minimum data sets for oral status, the authors reviewed 26 assessment tools and a practical guideline for oral care. The content validity of the minimum data sets was assessed by three nurse specialists. To map the minimum data sets to nursing records, the authors examined 107 nursing records derived from 44 patients who received chemotherapy or hematopoietic stem cell transplantation in one tertiary hospital. Results: The minimum data sets were 10 elements such as location, mucositis grade, pain, hygiene, dysphagia, exudate, inflammation, difficulty speaking, and moisture. Inflammation contained two value sets: type and color. Mucositis grade, pain, dysphagia and inflammation were recorded well, accounting for a complete mapping rate of 100%. Hygiene (100%) was incompletely mapped, and there were no records for exudate (83.2%), difficulty speaking (99.1%), or moisture (88.8%). Conclusion: This study found that nursing records on oral mucous integrity were not sufficient and could be improved by adopting minimum data sets as identified in this study.

수정욕창위험 사정도구의 예측타당도 평가 (Evaluating the Predictive Validity for the New Pressure Sores Risk Assessment Scale)

  • 김시숙;최경숙
    • 성인간호학회지
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    • 제16권2호
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    • pp.183-190
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    • 2004
  • Purpose: The purpose of this study was To exam the skin and pressure sore and To evaluate the predictive validity for the new pressure sores risk assessment scale. Method: There was finally 211 neurosurgery subject admitted in Chung-Ang Univ. Hospital from Nov, 11, 2002 to Feb, 11, 2003. Data was collected three times per week from 48-72hr after admission until incidence of pressure sores or discharge or die. Inclusion criteria were; (1) no pressure sores at admittance, (2) at least 3 times assessment, (3) adults older than 16yrs, (4) patients consent to participate in study. Result: 1. 34 case of 211 developed pressure sores(11.6%). 2. The coccyx area was the most common occurrence site of pressure sores. 3. At the cutoff point 23 of sensitivity 100%, specificity 76.3% was higher in 2003 than specificity 63.8% at the cutoff point 26 of sencitivity 100% in 1991. 4. "Moisture" of subscale for pressure sores risk factor was the strongest predictor. Conclusion: This study shows that the New Pressure Sores Risk Assessment Scale still predict the risk of developing pressure sores in neurosurgical subject.

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뇌졸중 후 연하곤란 사정과 중재 체크리스트 개발 및 활용정도 (Development and Utilization of Assessment and Intervention Checklist for Post-stroke Dysphagia)

  • 이은하;최자윤
    • 성인간호학회지
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    • 제25권2호
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    • pp.113-124
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    • 2013
  • Purpose: Purposes of this study were to develop a reliable and valid checklist to assess and manage post-stroke dysphagia and to identify its utilization. Methods: The first step was to develop checklist through systematic literatures reviews, to test the content validity from 11 clinical experts, and to test the construct validity and the internal consistency from 97 patients with post-stroke dysphagia. The second step was to identify clinical use of the checklist from the same 97 patients. Results: A total of 18 items compromised the assessment checklist and 64 items for intervention checklist. Internal consistencies of assessment checklist and intervention checklist were .84 and .98, respectively. In both checklists, level of utilization of general appearance was the highest, while that of early signs of aspiration was the lowest. The utilization levels of two checklists were significantly higher among patients who were less than 60 years old, and had liquid diet, facial paralysis, and previous history of aspiration pneumonia. Conclusion: We found that the checklists were reliable and valid. Further study is needed to develop specific strategies to improve nurses' use of assessment and intervention checklists for post-stroke dysphagia.

Effects of a Case-Based Sepsis Education Program for General Ward Nurses on Knowledge, Accuracy of Sepsis Assessment, and Self-efficacy

  • Kim, Bohyun;Jeong, Younhee
    • Journal of Korean Biological Nursing Science
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    • 제22권4호
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    • pp.260-270
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    • 2020
  • Purposes: Sepsis is a critical condition in which nurses should detect clinical manifestations and provide early intervention to prevent unwanted serious conditions in the patients. The initial occurrence and management of sepsis take place in general units, but there is a lack of knowledge in nurses. The purpose of this study was to examine the effects of a case-based sepsis education program and compare the case-based education program with and without smartphone applications. Methods: A quasi-experimental pre-test-post-test design with a control group was used. We provided a case-based education program with and without smartphone applications to the nurses and tested the effects of the program on knowledge, the accuracy of sepsis assessment, and self-efficacy as outcome variables. A total of 60 nurses in general units participated. To test differences in knowledge, the accuracy of sepsis assessment, and self-efficacy regarding sepsis between the groups over time, a mixed-design ANCOVA was used for parametric analysis, and generalized estimating equations (GEE) were used for nonparametric analysis. Results: There were significant differences in knowledge, the accuracy of sepsis assessment, and self-efficacy between the groups and within the groups over time. The intervention groups treated with the case-based education program showed improved outcome variables compared to the control group. There was no difference between case-based education with the smartphone application or without the application. Conclusions: The case-based education improved knowledge, the accuracy of sepsis assessment, and self-efficacy in the care of sepsis by nurses working in the general wards. The results suggest that the case-based education program for nurses was effective and eventually improved patient health outcomes.

요양병원 환자분류체계 개발 (Development of Patient Classification System in Long-term Care Hospitals)

  • 이지윤;윤주영;김정회;송성희;주지수;김은경
    • 간호행정학회지
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    • 제14권3호
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    • pp.229-240
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    • 2008
  • Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

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가정간호대상자의 영양상태 평가 (Nutritional Assessment of Patients Receiving Hospital-based Home Care Services)

  • 김경례;김미예;김광숙
    • 가정간호학회지
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    • 제15권2호
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    • pp.99-105
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    • 2008
  • Purpose: We evaluated patient nutritional status in a home care setting. Method: We recruited 81 patients who received in-home care using a screening sheet. The level of nutrition-related serum marker (albumin) was checked via medical records and data analyzed using descriptive analysis, t-tests, and $X^2$-test. Results: Nutritional status varied according to the primary medical diagnosis. Poor nutritional status was significantly higher in cancer patients than in other diseases. Serum albumin levels were significantly lower in the malnutrition group than the good nutrition group. Conclusions: Nutrition screening can determine the nutritional status in home care patients. Home care nurse practitioners should consider nutritional status when assessing patient health.

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지역사회중심의 독립형 가정간호 시범사업소 운영체계 개발 및 운영결과 분석 (Development and Analysis of Community Based Independent Home Care Nursing Service)

  • 박정호;김매자;홍경자;한경자;박성애;윤순녕;이인숙;조현;방경숙
    • 대한간호학회지
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    • 제30권6호
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    • pp.1455-1466
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    • 2000
  • The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

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간호활동을 중심으로 한 아동간호시뮬레이션 실습 분석 (Nursing Activities Identified through Pediatric Nursing Simulation)

  • 신현숙;심가가;이유나
    • Child Health Nursing Research
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    • 제19권2호
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    • pp.111-119
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    • 2013
  • 목적 본 연구는 간호대학 4학년생을 대상으로 아동간호 시뮬레이션 실습동안에 관찰된 간호활동을 분석한 기술연구이다. 시뮬레이션 실습동안 간호활동의 빈도와 그 내용을 알아보고자 함이다. 방법 아동간호 시뮬레이션 실습동안 총 36개의 에피소드가 녹화되었다. 녹화된 자료는 언어적, 비언어적으로 전사하고 분석하였다. 도출된 의미단위에서 간호활동의 횟수와 상호작용의 목적을 확인하였다. 결과 각 시뮬레이션 평균 운영 시간은 27분이었고 최소 3분 30초에서 최대 32분 54초로 나타났다. 시뮬레이션 에피소드에서 간호활동은 활력징후 측정, 관련증상 사정, 환자상태확인하기 등과 같은 간호사정 영역과 투약, 미온수 마사지, 수액요법, 산소제공, 흡인, 고혈당 및 저혈당 관리 활동이 포함된 간호중재 영역 그리고 보호자 교육, 처치 및 시술 기준설명, 의료진 간의 의사소통과 같은 의사소통 영역으로 구분되었다. 간호사정 영역의 활동이 가장 빈번하게 이루어지는 것을 확인하였다. 결론 학생들은 시뮬레이션 실습동안 간호사정, 의사소통, 중재영역에서 다양한 간호활동을 경험하는 것으로 확인되었다. 그러므로 시뮬레이션 실습은 강화된 실습경험을 학생들에게 제공하기 위한 하나의 교육전략으로 고려할 수 있겠다.

입원환아 가족의 간호요구도와 만족도 (Nursing Need and Satisfaction of Families with their Hospitalized Children)

  • 서지영
    • Child Health Nursing Research
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    • 제8권2호
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    • pp.195-203
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    • 2002
  • This study was done to evaluate the need and satisfaction for nursing care of the families with their hospitalized children. The data were collected through the questionnaire from March 15, 2002 to April 7. Subjects were the 103 families caring for their hospitalized children at pediatric ward in two university hospitals in Daegu. The nursing need instrument was developed by Seo(1999) and modified by the researcher of this study based on the classification of nursing care area(nursing assessment, direct nursing, education and counseling, and facilities and environment). The nursing satisfaction instrument was developed by Wandelt & Ager(1974) and modified by Park(1994) based on classification of nursing care area (psychosocial care, physical care, general care, professional care, and communicative care). The data were analyzed for mean, percent, t-test, ANOVA, and Pearson correlation coefficient using SAS program. The results are summarized as follows: 1. The scores in the nursing need showed in the Direct nursing(3.41±.42), Facilities and Environment(3.38±.46), Education and Counseling (3.35±.40), and Nursing Assessment(3.14±.41) area in order. 2.The scores in the nursing satisfaction showed in the Psychosocial care(3.70±.74), Commu- nicative care(3.60±.72), General care(3.42±.76), Professional care(3.38±.82), and Physical care(3.32±.70) area in order. 3.General characteristics of families which influence on the satisfaction showed a significant difference according to their educational(F=5.63, p=.001) and economical level(F=4.47, p=.006), and hospitalized experience(t=2.30, p=0.02). 4. There was no correlation between the nursing need and the nursing satisfaction.

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진수기 단계 가족의 가족건강에 대한 연구 (A Study of Family Health During the launching stage of family)

  • 노승옥;성명숙;장희정
    • 기본간호학회지
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    • 제5권1호
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    • pp.19-31
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    • 1998
  • Nursing science is focusing increasingly on family health care. Especially during the launching stage of family the grown-up sons daughters, and middlescent parents daughters have experienced a lot of change. The purpose of this study is to investigate the family health during the launching stage of the family by utilizing the family health assessment tool based on Roy's adaptation model. The Roy adaptation model was used as it is the best practice-based framework for Family Health Nursing Care. The data was collected using a structured questionnaire. The structure of the questionnaire was developed from the Family Health Assessment Tool by S.O. Jang(1996). The sample of 276 subjects was a convenient sample and data was obtained from November 14, 1996 to December 4, 1996. In order to analyze the collected data, this study utilized frequency, percentile, average, ANOVA, Cronbach's, and factor analysis. The results from this research are summarized as follows : 1. The degree of family health is average $95.24{\pm}9.40$ ranged in middle. 2. The significant difference between general characteristics and family health was only revealed with the major decision making person in the family. This research thus suggests the following : 1. The legal system is needed in order to check the family members' health state regularly. 2. With family nursing care, it has to identify who is the major decision maker in that family. 3. There is a need to redefine the family health assessment tool. 4. Further research will attempt to investigate family health in each family's developmental stage.

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