• 제목/요약/키워드: Nursing care activity

검색결과 493건 처리시간 0.027초

조기퇴원 제왕절개 산욕부를 위한 가정간호 표준서 개발 (Development of validated Nursing Interventions for Home Health Care to Women who have had a Caesarian Delivery)

  • 황보수자
    • 간호행정학회지
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    • 제6권1호
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    • pp.135-146
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    • 2000
  • The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.

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장기요양시설 및 요양병원 입소 치매대상자의 억제대 적용 관련 요인 (Factors related to Use of Physical Restraints for Older Adults with Dementia in Long-term Care Settings)

  • 이해정;박명화;이성화;이미현;고영혜;김춘길;김정선;김경숙;이영휘;임영미;송준아;박영선;윤종철;김기웅;홍(손)귀령
    • 노인간호학회지
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    • 제21권2호
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    • pp.125-134
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    • 2019
  • Purpose: The purpose of this study was to investigate factors related to use of restraints for older adults with dementia in long-term care settings. Methods: This study analyzed secondary data from the Nationwide Survey on Dementia Care in Korea (NaSDeCK). Demographic characteristics, disease characteristics, and functional characteristics were analyzed. Data were analyzed with χ2 test, t-test, ANOVA, and logistic regression analysis. Results: Among participants, 8.2% experienced use of restraints. 'Strap' (78.3%) was the most commonly used restraint and 'Behavioral problem' (51.3%) was a major reason for the restraint. Persons who have low levels of daily activity and cognition deficits, higher levels of dependence, histories of falls within the past 3 months, and living in long-term hospitals have greater probability of restraint experience. Conclusion: Developing interventions for older adults who have a high risk of being restrained is essential to minimize unnecessary restraint use among older adults with dementia in long-term care settings. Further study exploring the interacting roles of organizational and staff factors related to use of physical restraints would provide more comprehensive perspectives in understanding this phenomenon.

지역사회 간호 서비스 전달 체계 모형 개발 -가정방문서비스를 중심으로- (Development of Community Health Nursing Service Model: - Based on the Visiting Nurses Project in Seoul, Kyonggi, and Kang-won Area-)

  • 김성실
    • 지역사회간호학회지
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    • 제12권2호
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    • pp.361-374
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    • 2001
  • This study was done to identify a status of home visiting project as a community health nursing system, that was the organization. personal who have age, educational background, marital status, position, experience of the home visiting in the public sectors in part of Seoul. Kyonggi, Kang-won area, It was done to provide basis data for the development of effective visiting nurses project in the health sectors, where was Health Centers in urban and rural. Branch of Health Center in rural and Health posts. The question airs were distributed 352 public health workers who working place was 118 health workers in 12 health centers in Seoul. 56 public health workers among 39 health center and other public health sectors in Kyonggi and 178 public health workers among health center and health care sectors. Data collected from October to December. 2000. The analysis by SAS system with F test, percentage and frequency. The major result were as follows. The general characteristics of the respondent show that most of them were graduates from community college and RN-BS with broadcast that they had not completed CPHN course but only two health workers have trained for the visiting nurses project. As for their grade in the position, the most of health workers have seventh level and the other CHP were above sixth level in the health care post that in the government structure. This indicates that workers do not have great authority in decision making, the most period of works in the position was one and two years indicating that they change jobs frequently. On an average their clinical experience was 4.11 years which is ideal for the total service. As for preparation of staff for home visiting workers education on visiting nurses program have to receive short term or longer term training course for strong emphasis. The analysis showed that public health visiting workers responds about active job performance that based on an area, approach of acting by districts, education and position are shown statistically significant difference between acceptance of the visiting nursing job show the same as well as visiting nurses project. Special concerns for visiting Nursing care spread came to burden, many of activity carry out main solution is covered the health problem connective support system needs of quality and quantity which out health problem. As 71.1% of visiting health service held on the poor population was under the guardianship of the law, but people who health insurance wide application under law shown a tendency to increase gradually. The general characteristics of the patients showed 56.2% of female on average of age was 66.1 years old, they have health problem was the most of 47.6% of high blood pressure and stroke, the other and as a problem that economics, which is complex welfare with out health problem. Community health care service should be combined health and social work program. The form of delivery of visiting health care given the most guide and education with counselling and support. (33.6%) Among the six category of visiting care service shown statistically significant difference and next is fundamental care, remedy care with priority.

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심폐소생술금지 결정에 대한 간호활동의 변화 (Changes of Nursing Activities after DNR(do-not-resuscitate) Decision)

  • 장서연;황솔지;정지은;김여진
    • 대한한의정보학회지
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    • 제21권2호
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    • pp.25-33
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    • 2015
  • Purpose: The purpose of this study was to examine hospital nurses' nursing activities changes after DNR(do-not-resuscitate) decision. Methods: The subjects were 120 registered nurses working in two university hospitals. The data were collected from September 1 to September 15, 2015 using self-report questionnaires. The data were analyzed using SPSS 20.0 program. Results: DNR awareness of the educational needs was very high(91.7%). But DNR educational experience was low(59.2%). Nursing activity change was classified as the physical, emotional, spiritual, and social areas. There were significant difference among religion(F=3.459, p=.010), working unit(F=3.410, p=.036), DNR awareness of the educational needs(t=5.048, p=.027), DNR educational experience(t=-2.816, p=.006) and nursing activities changes. Conclusion: Nurses are needed DNR educational programs to take care of DNR patients. And the criteria for nursing activities related to DNR is required.

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비부가가치 간호활동(Non-Value-Added Nursing Activity) 유형과 발생원인 분석 (Types and Causes of Non-Value-Added Activities in Nursing Practice in Korea)

  • 최주순;양영희;백혜순
    • 임상간호연구
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    • 제17권3호
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    • pp.363-374
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    • 2011
  • Purpose: The purpose of this study was to identify the types and causes of non-value-added (NVA) activities in nursing practice, and to determine the frequency of each NVA type and causes of NVA in clinical area. Methods: This study was conducted using Delphi technique. First, in order to identify NVA and their causes, 24 nurses with 7 years or more of clinical experience were recruited from medical/surgical units in six general hospitals in Korea. Then the NVA types and causes were tested using a larger sample of 130 nurses with more than 3 years of clinical experience at two general hospitals in Korea. Results: NVA was categorized into 6 different types, which are repeating, duplicating, waiting, reverse-proxy working, reworking, and searching. The most prevalent NVAs were repeating and duplicating works. Reworking and searching were less frequent types than others. The causes of NVA were classified into personnel-related, supporting departments, records, regulations, information, materials or instruments, and others. Among them, personnel-related and supporting departments were reported with the highest scores. Conclusion: NVA leads to waste cost and time. These results demonstrated the situations and causes of NVA occurred in nursing practice. Further studies on the typology and moderation of NVA activities are warranted to improve the efficiency and quality of nursing care in day-to-day practice.

뇌.척추질환 노인 환자 주 가족수발자의 부담감에 영향을 미치는 요인 (Factors Influencing the Burden Felt by Main Family Caregivers of Elderly Patients with Brain and Spinal Diseases)

  • 박희경;박경민
    • 지역사회간호학회지
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    • 제22권4호
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    • pp.389-398
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    • 2011
  • Purpose: This study of this study was to identify factors influencing the burden of main family caregivers who take care of elderly patients with brain and spinal diseases. Methods: This was conducted as descriptive research and data were collected from 255 main family caregivers who were taking care of elderly patients with brain and spinal diseases from 4 hospitals in Daegu and Gyeongbuk Province. Stepwise-multiple regression was used to identify the influencing factors of burden felt. Results: As the score of burden felt by the main family, economic, social, physical, interdependent and emotional burdens were high in order. Factors influencing burden felt by main family care givers taking care of elderly patients with brain and spinal diseases were changed relation with patient after hospitalization, daily life ability, marital status, education and family caregiver's personality (explanatory power of 24.6%). Family caregivers felt a heavier burden when their relation with the patient was changed negatively or when the patient's activity of daily living was low. Conclusion: Based on these results, we need to develop coping measures and interventional programs for reducing the burden felt by the main family caregivers of elderly patients with brain and spinal diseases.

오마하체계에 따른 보건소 방문간호사의 간호업무 수행도와 필요도 (Nursing Performance and Requirements of Visiting Nurses at Public Health Centers according to Omaha system)

  • 최인희
    • 보건의료생명과학 논문지
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    • 제8권2호
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    • pp.143-154
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    • 2020
  • 본 연구는 오마하체계를 이용하여 보건소 방문간호사의 간호업무 수행도와 필요도를 조사한 서술적 조사연구이다. 방문간호사의 간호업무는 '개인위생', '통증', '약물요법', '영양', '신체활동', '위생', '수면과 휴식양상', '구강건강', '정신건강', '인지'순으로 수행도가 높았다. '성생활', '산후', '수입', '가족계획', '임신', '영성', '학대', '생식기능', '방임', '말과 언어' 순으로 간호업무 수행도가 낮았다. '성생활', '학대' '방임', '생식기능' 문제는 문제의 사정 및 적극적 개입을 위한 교육적 지원이 필요하다. '산후', '임신', '가족계획' 등의 문제는 출산지원을 위한 지역의 정책방향에 따라 방문간호사의 역량 강화가 필요하다. '수입', '주거', '지역사회자원과의 의사소통'은 보건복지 연계 및 정부와 지방자치단체의 정책적 지원이 필요하겠다. 본 연구결과는 방문간호사의 역할규명 및 역할확대를 위한 기초자료로 활용할 수 있을 것으로 본다.

양호겸직교사의 학교보건간호 업무활동에 관한 조사연구 (A Study of School Health Nursing Activity Performed Teachers Holding Additonal school Health)

  • 정찬규;정연강
    • 한국학교보건학회지
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    • 제2권1호
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    • pp.108-130
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    • 1989
  • The purpose of this study is to provide the basic data for the development of school health nursing activities by surveying realities of school health nursing activities in schools lacking in a school nurse performed by teachers holding additional school health. The subjects for the study was selected from teachers holding additional school health who participated in the annual training course for teachers holding additional school health in 1988 organized by Province Education Council. 105 teachers holding additonal school health from Kyung-gi Province, 85 from Chung-buk province, 50 from Chun-buk Province, answered the questionaire. The results can be epitomized as follows. 1. General characteristics of Teachers Holding Additional School Health. The majority of the subjects are female (94.3%) and 64.1% of the subjects are in their twenties, 79.5% of them graduated from four-year teacher's college, 54.5% of them are unmarried, 74.5% has less than one-year experience as a teacher holding additional school health. 2. General characteristics of schools 92.4% of schools are national, of public schools, and 91.9% are located in country, elementary schools are 64%, junior high schools are 35.4%. The annual school nursing budget is unknow to 89.2% of them. The school nursing organization is non- existent to 85.6%. 82.4% of the school nursing clinics occupy their place solely, or jointly. 3. Status of School Health Nursing Activities In the questionaire, School Health Nursing Activities arc divided into Health Program planning and Evaluation (4 items), Clinic Management (4 items), Health Education (4 items), Management of School Environment 98 items), Operating of School Health Organization (1 item) and Health Care Service (25 items). The answers to each item measured by the Likert-type scale reveals that in the activities of techcrs holding additional school health the practice rate in Management of School Environment is 55%, 47% in Health Education, 45% in Health Program Planning and Evaluation, 32% in Health Care Service, 27% in Operating of School Health Organization, and 27% in Clinic Management. 4. The Relation between Influencing variables and School Health Nursing Activities. The results are as follows. (1) Health Program Planning and Evaluation: religion, marital status ($P<0.05^{**}$) (2) Clinic Management: age, school health organization ($P<0.05^{**}$) (3) Health Education: age ($P<0.01^*$), religion ($P<0.05^{**}$), business except for school nursing ($P<0.05^{**}$), form of operation ($P<0.05^{**}$), the number of clinic client a month ($P<0.05^{**}$). (4) Management of School Health Environment: age, marital status, business except for school nursing ($P<0.05^{**}$), presence of the annual school health nursing budget ($P<0.01^*$), school health organization ($P<0.05^{**}$). (5) Operating of School Health Organization: There is a statistical significance in Education, Interest in School Nursing ($P<0.05^{**}$). 5. The Regional Relationship of School Health Nursing Activity. There is a statistically significal difference in Health Education ($P<0.05^{**}$) and Health Care Service ($P<0.01^*$) of elementary school located in Kyung-gi, Chung-buk, Chun-buk Province. There is a statistically significant difference Health Program Planning and Evaluation of junior high Schools located in Kyung-gi, Chung-buk, Province ($P<0.05^{**}$). 6. The Correlation in School Health Nursing Activities. The analysis of the correlation in the 6 fields of school Health Nursng Activities shows that there is a statistically significant difference between Clinic Management and health Education, Clinic Management and Operating of School Health Organization, and between management of School Environment and operating of School Health Organization ($P<0.05^{**}$). The conclusions are as follows The 40.5 percent of schools should arrange nurse teachers by regulation 38, relative to the application of the Law of Education. But, in reality, teachers who have nothing to do with nursing, hold school health as an additional job. And it is very difficult to expect the qualititive health management of school faculty and students. In the 85.6 percent of schools, there is no organization for school health. And also, persons in charge of pracitcal affairs perform the school health activity without any knowledge about annual school health nursing budget. In the school health nursing activity of teacheres holding additional school health, operating of school, health organization and clinic management are the most difficult to get the cooperation from the persons relate to school and communities. There are a lot of problems in performing the school health nursing activity without any disposition of school health teachers, therefore, it is necessary to supplement school health teachers who had a professional training in order to make efficient the school health nursing management for children who are about to attend a school.

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치매노인과 부양자를 위한 휴식서비스의 효과에 대한 고찰 - 국외 휴식서비스 중재연구를 중심으로 - (A Review of the Effects of Respite Care for Patients with Dementia and Caregivers)

  • 김진선;이은현
    • 대한간호학회지
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    • 제31권6호
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    • pp.1077-1087
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    • 2001
  • The purpose of this study was to analyze the effects of respite care. The analysis was conducted by reviewing published intervention studies on the effects of formal respite care for caregivers of dementia patients, patients with dementia, and the prevented or delayed rate of institutionalization of the patients. Method: Two computerized databases (MEDLINE, CINAHL) were searched to find respite care-related articles published from the year of 1981 to 2000. A total of 49 published articles were identified. Of them, nine studies, which met for the inclusion criteria of this study, were included. Results: Results revealed that there was little evidence of the effect of respite care on, not only caregivers' burden, stress, depression and well-being, but also the rate of institutionalization of the patients. It was noteworthy that dementia patients reported fewer problems in behavior, although cognitive functioning and activity of daily living abilities continued to decline. However, these findings should be carefully interpreted because of methodological problems, such as non-random sampling, non random group assignment, a small sample size, uncontrolled confounding variables, limited period of services, and no specific types of services. Conclusion: It is recommended to conduct intervention studies of respite care being conducted in Korea with the corrections of methodological problems suggested from this study.

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낙상 peer review group 운영을 통한 낙상발생률 감소 (Reduction of Fall Incidence through Operation of the Staff Nurse-Centered Peer Review Group)

  • 성일순;송미라;김희선;김은숙;정미아;이수미;;하국희;김성화;이혜란;안경진;심미옥;김낙희;성영희
    • 한국의료질향상학회지
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    • 제14권1호
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    • pp.49-54
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    • 2008
  • Background : This study was to reduce incidence of falls by analyzing actual problem and drawing out improvement plan applicable to the clinical practice through operation of the staff nurses-centered fall peer review group. Method : The fall peer review group was composed of 8 nurses having patient nursing experience for over 5 years, and each of fall cases was reviewed and the root cause was analyzed. As a result, it was found that the patients and their families did not fully understandthe content of the education, and the staff nurses did not completely inspect the risk factors of falls and perform immediate intervention when patient's condition changed. Based on the above-mentioned results, improvement activity was conducted for the purposes of consolidating patients education method and supplementing computerized system to support nurses' decision making as well as devices and facilities. Result : As a result of conducting improvement activity in the aspects of education for patients, support of nurse's decision-making, and devices and facilities through operation of the staff nurses-centered fall peer review group, falls decreased by 9.5% compared to before improvement activity. Conclusion : It is concluded that operation of the clinical nurses-centered fall peer review group played a role of promoter to draw out practical and applicable improvement plan to the clinical practice and apply directions of the field-centered, and increased nurses' interest in falls and ultimately, reduced incidence of falls. Therefore the Center will continue to operate the staff nurses-centered peer review group, and recommends participation of nurses who actually take the charge of nursing patients in further analysis of patients' safety accidents.

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