• Title/Summary/Keyword: Nursing Information system

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Development and Long Term Evaluation of a Critical Pathway for the Management of Microvascular Decompression

  • Lee, Jeong A;Kim, Jung Sook;Park, Kwan;Kong, Doo-Sik
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.1
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    • pp.117-127
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    • 2014
  • Purpose: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed. Methods: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group. Results: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002). Conclusion: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.

A Study of Moral Development and Ethical Values of the Nurse (임상 간호사의 도덕성 발달과 윤리적 가치관에 대한 연구)

  • Kim, Mee-Jeong;Kim, Myung-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.337-353
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    • 1999
  • This study is to provide the basic sources to develop educational data that can establish ethical values with research on the interrelation between moral development and ethical values of nurses. The subjects of this study are the convenience sample from 111 nurses working in clinical settings from 5 general hospitals located in Pusan area. The questionnairs for this study are comprised two parts: Part 1 is SRM-SF(1995) guestionnaire, and translated by Kil, 1m Ju(1997): Part 2 is the guestion papers about the ethical values, and disigned by Jung, Hee Ja. The data were collected from June lth to 31th, 1997 and analyzed by S.A.S(Statistical Analysis System) Package for frequency, percent, and Pearson's correlation coefficient. The results of the study is as the followings: 1) According to the moral development. the nurses are in the levels of Stage3 or Transition3/4, which are generally focused on the personal relations or personality. Thus, nurses are considered to need to get the stage4 of education that helps them recognize a person as a member of society. a family as an unit of society, and human life as the values of human dignity. 2) According to the ethical values, nurses have the positive ethical values of respecting the right of the patients, providing information, keeping the secret, truth. and credit of patients. But they also experience some troubles by the patients to care and the clinical situation. Thus, to overcome the problems, nurses are considered to need to get the education that establishs the right ethical values. 3) The analysis result on the interrelation between moral development level and ethical values shows as r=0.28 and p=0.003. This indicates that the interrelation between them is low. In conclusion, it is considered that the moral development level is viewed broadly from a person and family to a society, and then it can affect to the ethical values positively.

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Husbands' Awareness of Sanhujori, Needs for Education and Family Strength (남편의 산후조리 인식, 교육요구도 및 가족건강성에 관한 연구)

  • Joo, Eun Kyung;Yoo, Eun Kwang
    • Women's Health Nursing
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    • v.21 no.2
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    • pp.93-105
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    • 2015
  • Purpose: We conducted a descriptive study to: 1) understand how husbands are aware of the importance of Sanhujoiri(i.e, Korean traditional postpartum care) and 2) identify their needs to learn how to take care of postpartum women and newborns and to strengthen family bonding. Methods: The subjects consisted of 123 husbands who had children under the age of 5 years. Data were analyzed with t-test, one-way ANOVA, $Scheff{\acute{e}}^{\prime}s$ test, and Pearson's correlation. Results: The mean age of subjects was $37.1{\pm}4.63$ years. The mean scores of awareness, needs for education on postpartum mother and newborn care, and family strength were $4.57{\pm}1.18$, $4.61{\pm}1.18$, $4.92{\pm}1.07$, and $4.01{\pm}0.95$, respectively, indicating higher scores. There were statistically significant differences in awareness (F=5.08, p<.05), newborn care (F=3.70, p<.05), and family strength (F=4.64, p<.05) by husband's role in Sanhujori There was a positive correlation among study variables. Conclusion: This study shows that even though husbands want to participate in Sanhujori, they do not have enough information on Sanhujori and mother/newborn care and adequate paternity leave. Realistic paternity leave system and effective Couple Centered Childbearing (from pregnancy to postpartum) Education Program CCCEP development are required to help husbands' participation in mother/newborn care with confidence and competence in home based Sanhujori.

A Study on the Influencing Factor of Unplanned Endotracheal Extubation in ICUs (중환자실 환자의 우발적인 기관튜브이탈 관련요인 연구)

  • Choi, Yun-Kyoung;Kim, Keum-Soon
    • Quality Improvement in Health Care
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    • v.9 no.1
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    • pp.74-89
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    • 2002
  • Background : The purpose of this study was to investigate the incidence of unplanned endotracheal extubation and to identify the influencing factor of unplanned extubation in ICUs for providing baseline data in developing prevention strategies and administrative standards. the medical records and hospital information system. In order to analyze factors related to unplanned extubation, the subjects of this study were divided by unplanned extubation group and planned extubation group and were matched by its sex, age, and disease groups in a ratio of one to two. The data were analyzed by descriptive statistics, ${\chi}^2$- test, t-test, Fisher's exact test, and logistic regression analysis with SPSSWIN 10.0 program. Result : 1) Forty-seven(4.99%) of 942 intubated patients experienced unplanned extubation 65 times during the twelve-month period. Thirtyfour( 72.34%) of 47 unplanned extubated patients required reintubation, whereas thirteen patients(27.66%) did not. 2) About half of unplanned extubation(46.8%) occurred during the night shift. 3) As for the nursing activity, respiratory nursing activity score(P=.0.06) and total nursing activity score(P=.011) showed statistically significant differences between unplanned extubation group and planned extubation group. 4) As for the patient status, unplanned extubation group showed more lower consciousness level(P=.000), more irritable or agitated behavior(P=.000), and had more applied physical restraints(P=.000) than planned extubation group. 5) As for the intubation related variables, unplanned extubation group revealed more intubated with respiratory failure(P=.000), more dependent on mechanical ventilation(P=.015) than planned extubation group. 6) Factors affecting unplanned extubations in intensive care unit patients were irritable or agitated behavior(odds ratio=13.757), night shift(odds ratio=7.166), and mechanical ventilation(odds ratio=6.257) from conditional logistic regression analysis. Conclusion : The most affecting factor of unplanned extubation was agitated or irritable behavior. Therefore the results of this study could be helpful to ICU nurses for meticulous care, decision making, timely intervention, and development of intervention strategies for preventing unplanned extubation.

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A Study on the Influencing Factors of Women향a Adoption of Sterilization (여성 불임술 수용의 영향 요인에 관한 연구)

  • 배은경;이미라
    • Journal of Korean Academy of Nursing
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    • v.16 no.3
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    • pp.11-21
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    • 1986
  • The purposes of this study were to clarify whether the health belief model could explain the women's adoption of sterilization and to find the factors which influence the adoption of sterilization. To achieve these purpose, 35 women, who visited the family planning hospital to undergo an surgical operation for sterilization, were selected and named the group of adoption. Also, 36 women, who have the same demographic characteristics as the group of adoption, and have no sterilization among the married women, were selected and named the group of non-adoption. The measuring instruments used in this study were made by the researchers on the basis of the results of the review of the related literatures. The validity of these instruments was examined by one professor majoring in nursing and two family plmanning practioners. The reliability was proven by calculation of Cronbach's α with data of the group of adoption. The data was analyzed by t-test, X²-test, and ANOVA using Computer SAS system. The results were following: 1. Health belief model could be said to explain whether women accept the sterilization or not, because the degrees of susceptibility and severity for future pregnancy and the degree of benefit or adoption of sterilization in the group of ad-option are higher than those of the group of non-adoption. 2. Influence of demographic variables on health belief variables was as follows. With advancing ages, degree of susceptibility increased in the group of adoption, and the higher the number of artificial abortion increased, the higher degree of barrier increased in the group of non-adoption. Suggestions for further studies and application to the nursing practice are as follows 1. If one wants to educate the non-adoption women, one would be better to give such information as to increase the perception of susceptibility, severity and benefit. 2. New instrument to measure the perceived barrier which includes such items as fear on well-ness of the existing children, objection of husband and postoperative complication, is needed. 3. A study to find the change of perception on health belief variables is needed, after education to increase the level of perceived susceptibility and severity on the future pregnancy, and benefit on sterilization is given.

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Continuity of Care in Chronic Diseases: A Concept Analysis by Literature Review

  • Hu, Jingjing;Wang, Yuexia;Li, Xiaoxi
    • Journal of Korean Academy of Nursing
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    • v.50 no.4
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    • pp.513-522
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    • 2020
  • Purpose: This study aimed to utilize concept analysis to obtain a better understanding of the concept of "continuity of care" in chronic diseases. Methods: The concept of continuity of care was analyzed using the Walker and Avant method. Covering literature in English from 1930 to 2018, the data sources included CINAHL Complete, Academic Search Complete, MEDLINE, PsyARTICLES, Health Source: Nursing/Academic Edition, Google Scholar, Science Direct, and the Cochrane Library. Results: A comprehensive definition of concept of continuity of care was developed based on a systematic search and synthesis. The key defining attributes were identified as (a) care over time, (b) the relationship between an individual patient and a care team, (c) information transfer, (d) coordination, and (e) meeting changing needs. The antecedents of continuity of care were having a chronic disease, inexperienced with disease management, a poorly coordinated healthcare system, and medical care limitations. The consequences of continuity of care were decreasing hospital admissions, reducing costs, reducing emergency room visits, improving the quality of life, improving patient satisfaction, and delivering good healthcare. Conclusion: The thorough concept analysis provides insight into the nature of "continuity of care" in chronic diseases and also helps ground the concept in healthcare.

A Grounded Theory Approach of the Treatment Pattern of Patients with Arthritis (관절염 환자의 치료추구행위에 대한 근거이론적 접근)

  • Lee, Eun-Ok;Kang, Hyun-Sook;Lee, In-Sook;Eun, Young
    • Journal of muscle and joint health
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    • v.4 no.1
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    • pp.26-47
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    • 1997
  • The purpose of this study is to explore the treatment pattern of treatment of patients with arthritis. The grounded theory approach methodology was used in this study. The purposive sampling was conducted. 16 subjects who experienced RA, lived in middle sized city in Korea, and all women The results of this study were as follows : 1. The process of treatment was composed of the stage of symptom experience and the stage of sick role experience. The naming of the symptom was conducted in the stage of symptom experience through, the doctor shopping. The sick role experience was patterned by the choice of the treatment mode. 2. The treatment modes were roughly devided by western medicine and oriental or ethnic medicine. Several factors which affected the choice of the treatment mode were patient's economic state, educational level, religion, the acknowledgement of the cause of illness, duration of illness, lay referral system, the relationship of medical staff, and the acculturation of medical professionalism. The key component of the decision of the treatment was the level of the acculturation of medical professionalism. To enhance the acculturation of medical professionalism, we have to provide the information of cause and the prognosis of the disease to the patients and the variety of communication channel between medical staff and patients, and we should understand the medical culture according to the ages, gender, locations in Korea.

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Life of the Institutionalized Elderly (시설노인의 삶)

  • Lee, Ga-Eon
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.32-38
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    • 2001
  • This study focused on the understanding the life of the elderly in the institution by phenomenological method. The participants were seven. who were 4 men and 3 women living in the elderly institution in Taegu. The data were collected through the indepth interviews and participant observation from June 20. 1999 to January 10. 2000 and analyzed by phenomenological analytic method by Giorgi. The structure of the meaning were as follows: Unhappy life: irresponsibility. self-centered thought. hardness. Irresistible life: misfortune. unhealthiness. Reading their son's intention. Bitter life: unfair treatment from their sons and daughters, betrayed feeling for their being thrown away. Outside oriented life: a fear of others' attention, wrong information about institutionalized life, maladjustment. Self-consolation life: comfortableness, convenience, economic merit of low cost. Dissatisfied life: discomfort from communal living. unkindness of the institution staffs, depreciated tendency to the elder people, irrational social security system. economic distress, physical pain, restrained feeling. Tenacity to their sons and daughters longingness for their sons and daughters, regretableness, waiting, Regretable life: remorse for their past life. agony, guilty, loneliness, grief, self-abandonment, self-depreciation, other residents' death in common. Inharmonious life with other residents complaint, conflict, ignorance, selfishness. Yearning life for opposite sex: sexual interest. Preparing for their life: control over their body and mind, consideration for others. A life with hope: blessing death, forever healthfulness, affiliation to their family. From the results of this study an education and consultation should be done as soon as possible to remove the negative recognition of the institutional life to the facility residents. the family and the future consumers of elderly institution. To minimize the maladjustment to facility life of residents, a new program and interventions for the new comer's are needed. The thesis with above results will widen the understandings of institutional residents and an important guidance for a better nursing care in elderly institutions of korea.

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Evaluation of Validity of the Korean Triage and Acuity Scale (한국형 응급환자 분류도구의 타당도 평가)

  • Choi, Heejung;Ok, Jong Sun;An, Soo Young
    • Journal of Korean Academy of Nursing
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    • v.49 no.1
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    • pp.26-35
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    • 2019
  • Purpose: The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS). Methods: This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value. Results: In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively. Conclusion: The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

A Study on Emotional Labor of Home Elderly Welfare Center Certified Nursing Assistants

  • Jung Seo, Lee
    • Journal of the Korea Society of Computer and Information
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    • v.28 no.1
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    • pp.103-110
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    • 2023
  • The purpose of this study is to improve the operation and working environment of welfare centers through this study on emotional labor of Certified Nursing Assistants at home welfare centers for the elderly. For the study, 138 Certified Nursing Assistants belonging to the Home elderly welfare center in K-si and J-do were studied. For statistical analysis, Cronbach's α, t-test, ANOVA, Pearson correlation analysis, and multiple regression analysis were performed using SPSS/WIN 17.0. First, as a result of the study, the difference in emotional labor among Certified Nursing Assistants at home-based senior welfare centers was higher in the degree of emotional labor in the order of dementia education, work experience, employment type, education level, and age. Second, the degree of burnout of the survey subjects was highest in the order of work experience, dementia education, employment type, and age. Finally, work stress and emotional labor were found to have a significant positive effect on work burnout. In conclusion, it is necessary to study Certified Nursing Assistants' cases of systematic emotional control experience to prevent work burnout, dementia education, work feedback on how to cope with services, and work conditions improvement measures to relieve work stress.