Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current nursing productivity of nurses is not desirable unless the quality of care considered. Moreover. nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. As for the nurse scheduling, the critical problem of it in the hospital is determining the day-to-day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. Nurse scheduling, however, involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. Under these backgrounds, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. This study was performed to develop a system computerizing nurse staffing and scheduling based on the patient classification. As a preliminary step for the system development, nursing workload in a secondary hospital was measured from Sep. to Oct. 1994. On the grounds of this result, computerization of nurse staffing and scheduling was proceeded with three options. First one is based on the current medical law. Second one is based on the assigned number of nursing staff. And the last is based on the request by patient classification. Computer languages used in this study were MS Visual Basic 3.0 for the staffing and Access 2.0 for the scheduling, respectively. Prospective users may operate this system easily because icons and mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurse administrators manage nursing manpower efficiently and nurses develop quick and easy schedule generation and allow more time for the patient care.
Purpose: The aim of this study was to examine the types of nursing problems in oriental nursing practice. Methods: This study employed a descriptive survey design. Nursing documentation was retrospectively reviewed for patients discharged from an oriental medicine hospital during three months. Nursing diagnoses documented were mapped into the Clinical Care Classification System. Data were summarized using descriptive statistics. Results: Data were collected from 110 patients using nursing documentation. The number of nursing diagnoses documented was 204 with a mean of 1.9 per patient. The frequently occurring nursing diagnoses were 'risk for trauma' (48.0%), 'pain' (13.7%), and 'urinary elimination alteration' (7.8%). According to the Clinical Care Classification system, the safety component (51.5%) was the most common nursing problem in oriental nursing practice. Conclusion: The study finding suggested that major nursing problems in oriental nursing practice were related to patient safety. Therefore, oriental nursing education on patient safety should be emphasized to improve the quality of nursing care in oriental medicine hospitals.
Purpose: The purpose of this study was to identify nursing intervention performed by nurses on gynecological nursing units. Methods: The instrument in this study is based on the fifth edition of Nursing Interventions Classification (NIC) (2008). Data was collected by Electronic Medical record from August, 2010 to October, 2010 at one hospital and analyzed by using frequencies in the Microsoft Excel 2010 program. Results: Of a total of 82 NIC, domains of the nursing interventions showed higher percentages for physiological: basic (36.3%) and physiological: complex (34.5%). The classes of nursing interventions showed higher percentage for health system medication (12.1%), perioperative care (10.0%), and drug management (8.6%). The most frequently used top interventions were Discharge Planning. The thirty least used interventions was environmental management. Top thirty most frequently used interventions belonged to the domain of physiological: basic (37.9%), physiological: complex (31.1%), and behavioral (5.4%). Conclusion: These findings will help in the establishment of a standardized language for gynecological nursing units and enhance the quality of nursing care.
The purpose of this study was to classify, from collected home health care records data, nursing diagnoses according to the NANDA system and nursing interventions according to the NIC system, and to link nursing interventions to nursing diagnoses. For this study, 101 home health care records of clients seen between September, 1994 and November, 1996 at Yonsei Medical Center, Seoul, were analyzed. The results of this study are summarized as follows : 1. The most frequent nursing diagnoses were ‘Risk for infection’ and ‘Altered nutrition : Less than body requirements’, then ‘Impaired skin intergrity’ and ‘Ineffective airway clearance’ in the Exchange pattern of NANDA nine human response patterns. 2. The most frequent nursing interventions were the interventions in the Physiological : Complex domain, there were 690(50.7%) interventions among a total 1347 interventions. This results corresponds to Yom, Young Hee(1995)’s research, both Korean and U.S. nurses used the interventions in the Physiological : Complex do main most often on a daily basis. And respiratory nursing interventions were most frequent because 32.7% of the subjects were respiratory patients. 3. The next step was to link the nursing interventions to nursing diagnoses. The most frequent nursing diagnosis was ‘Risk for infection’ and 19 interventions for ‘Risk for infection’ were used 267 times. Then 14 interventions for ‘Impaired skin integrity’ were used 258 times, 12 interventions for ‘Ineffrective airway clearance’ were used 193 times, 12 interventions for ‘Altered nutrition : Less than body requirements’ were used 122 times, 10 interventions for ‘Activity intolerance’ were used 75 times, and 11 interventions for ‘Knowledge deficit’ were used 52 times. 4. The use of standardized classification in the areas of nursing diagnoses and nursing interventions facilitates clinical decision making and prompt nursing activity, and so enhances the effectiveness of nursing care.
Purpose: The purpose of study was to determine differences in patient outcomes that exists in terms of Nursing Outcomes Classification (NOC) during hospital days of neurosurgical and respiratory patients. Method: Before starting clinical practicum, nursing students were received two hours' lecture on how to apply NOC to patient care plan and they were required to evaluate patient condition using NOC at the beginning and at the end of their clinical practicum. Data were extracted from 62 neurosurgical patients and 66 respiratory patients and analyzed by frequency and paired t-test. Results: The most frequently used NOC were Pain Level (37.1%), Mobility Level (25.8%), and Bowel Elimination (19.4%) in neurosurgical patients and Nutritional Status (37. 9%), Respiratory Status: Ventilation (37.9%) and Pain Level (25.8%) in respiratory patients. The numbers of outcomes used were 75 and 46 neurosurgical and respiratory patients respectively. During the hospital days, the level of patient outcomes increased significantly in all patient groups. Conclusion: The finding clearly suggests that nursing interventions make differences in patient outcomes and make contribution to the patient health achieved. To more effectively use NOC, however, nursing information system should be developed and included standardized nursing languages regarding nursing diagnoses and interventions.
Purpose: The purpose of this study was to identify the frequency with which nursing interventions according to domains and classes, and core nursing interventions of the Nursing Intervention Classification (NIC) were performed by nurses on orthopedic surgery nursing units. Method: For this purpose, the third edition of NIC was used. Of the 486 nursing interventions, 424 were selected at 75% consent by experts. Data were collected from June, 2003 to July, 2003 5 hospitals and 69 nurses(return rate : 95.8%) in Gwang-ju and Chonnam region. 5 point Likert scale describing frequency was used. Results: The most frequently performed domain was 'physiological : basic'($2.97{\pm}.60$), followed by 'health system'($2.65{\pm}.65$) and 'physiological : complex'($2.55{\pm}.46$). The most frequently performed class was 'activity and exercise management'($3.82{\pm}.89$), followed by 'immobility management'($3.64{\pm}.62$), 'skin/wound management'($3.41 {\pm}.60$), 'physical comfort promotion'($3.23{\pm}.68$) and 'thermoregulation'($3.01{\pm}.91$). The most frequently performed nursing intervention was 'medication administration' ($4.96{\pm}.21$), followed by 'medication administration : intravenous'($4.93{\pm}.31$), 'analgesic administration'($4.91{\pm}.51$), 'pain management'($4.87{\pm}.34$) and 'medication administration : intramuscular'($4.78{\pm}.68$). Conclusion: In conclusion, the third edition of NIC was found to be a general and comprehensive classification system for application on orthopedic surgery nursing units. These findings will help in building of a standardized language for orthopedic surgery nursing units and enhance the quality of nursing care.
Purpose: This study was done to report nursing case for ADL improvement of elders who have CVA(Cerebrovascular Accident) sequelae. Methods: The client had registered in the C visiting nursing center after being decided a long-term care Grade 2. Data were collected through consultation logs for recipients, Activities of Daily Living (ADL) records, fall risk assessment (Huhn) sheets, decubitus ulcer risk assessment (Braden Scale) sheets, cognition assessment (K-MMSE) sheets, long-term care benefit provision records, and interviews with visiting nurse. Data were collected and analyzed according to the Omaha System problem classification. The intervention scheme and the problem rating scale for performance were applied to present the case for home-visit nursing. Results: The client registered in August, 2018, was provided home-visit nursing care once a week as of September 2020. ADL, cognitive levels and decubitus ulcer risks were found to have improved. Conclusion: This case report presents the value of classifying nursing problems and checking nursing intervention provided to patients with problems of ADL. The presentation of home-visit nursing cases applying a standardized nursing problem classification scheme for clients with various problems showed that a high quality level of care is guaranteed and evidence-based nursing can be provided by visiting nurses.
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.
Objective: This study explored the reuse of data captured into an electronic nursing record system using the International Classification for Nursing Practice to support nursing research of inpatient's falls. Methods: Risk factors relevant to inpatients falls ;n an acute setting were identified from the literature review. Four risk assessment tools and two risk identification studies were selected. To examine the availability of coded data in an electronic nursing record system for the identified fall fisk factors, we reviewed 11.319 hospital-day records of 118 patients who were reported by the self-report system. Results: We identified 24 fall risk factors of five categories from the literature review, which were used to identify the standard nursing statements addressing fall risks. One hundred thirty five nursing statements were searched from the hospital's nursing data dictionary of statements and were matched with 14 fall fisk factors. Using the 135 statements. we found that mental status, catheter of drip in situ, abnormal gait, insomnia, surgical procedure. and dizziness/vertigo appeared frequently in the nursing records of inpatients with fall s. Also we found 6 risk factors more through the record review. Conclusion: The electronic records would be a good research source for inpatients' falls. Specifically international classification for nursing practice based nursing record system has the potential for promoting clinical researches.
The purpose of the study was to compare home care nursing intervention activities analyzed by the Nursing Intervention Classification (NIC) system for hospice and general patients. Method: For the descriptive survey study, data was collected by reviewing charts of 151 hospice patients and 421 general patients who registered in the department of home health care nursing at K Hospital. Results: According to the NIC system application, there were 2380 total nursing interventions used for the hospice patients and 8725 for the general home care patients. For both sets of patients (hospice vs. general), the most frequently used nursing intervention in level 1 was the Physiological: Complex domain (40.13 vs. 31.06 percent), followed by the Safety domain; in level 2, the Risk Management class (28.4 vs. 27.70 percent), followed by Tissue Perfusion Management; and in level 3, Vital Sign Monitoring (6.18 vs. 4.84 percent), followed by Health Screening. Conclusion: The study showed that there was a lack of specialized hospice nursing interventions such as emotional, family and spiritual support, and care for dying hospice patients.
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