• Title/Summary/Keyword: Patient care

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Case Report of Hypertension Patient by Community Health Practitioner (보건진료소의 고혈압 환자 간호사례)

  • Park, Do Soon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.14 no.1
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    • pp.17-22
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    • 2019
  • Purpose: This study was done to describe a community health practitioner's nursing case study for a hypertension patient. Methods: For this purpose, data were collected through interviews and nursing records. The nursing process was carried out from January to March in 2019. Results: For this patient, blood pressure was checked 5 times and total cholesterol test was performed 5 times over 41 consultations. Even though the patient was 84 years old, he was very interested in health. When the blood pressure and cholesterol level measured by community health practitioner were high, he was embarrassed by the recommendation to get a hospital checkup. After referral to a medical clinic and hospital, he was satisfied with the results of the tests and medical treatment, and constantly practiced daily walking exercise. Conclusion: It is very important for community health practitioners to assess patient symptoms correctly and refer the patient timely to manage complications.

A proposal of an assessment method of physiologic oral malodor care prognosis by a case report (증례 보고를 통한 생리적 구취증 관리의 예후 평가 방법 제안)

  • Kim, Young-soo;Choi, Eun-mi;Hong, Hae-kyung
    • The Journal of the Korean dental association
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    • v.57 no.2
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    • pp.64-73
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    • 2019
  • Authors have selected a physiological bad breath patient( 62 years old, male ) among the bad breath outpatients who have visited the halitosis control clinic in Korea University Medical Center(KUMC). The patient visited the halitosis control clinic for his oral malodor control, 3 times from April to June in 2018, and in August the patient visited to KUMC malodor control clinic again for his assessment of his two months efforts. Getting the data about the patient's endeavor to get over his physiologic oral malodor and the estimation of the patient's satisfaction level at his oral malodor improvement by a questionnaire method, and the organoleptic level assessment by the dentist, then we could propose an estimation method of the physiologic oral malodor patient care prognosis.

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A Study on the Care Needs of Family-Caregivers to the Patients with Stroke (뇌졸중환자 가족의 간호요구)

  • Kim Mi-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.175-192
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    • 1997
  • The purpose of this study was to identify the care needs of family-caregivers to the patients with stroke. Subjects were 115 family-caregivers caring for the patients while they were in-patients or out-patients with stroke in two general hospitals and one oriental medicine hospital located in Seoul and Kwang-Ju. The instrument used for this study was made by the researcher on the basis of results of literature review and interviews with family-caregivers, composed of 35 items. Internal validity by calculation of cronbach's alpha with data of respondents was 0.91, which was regarded as high. The Data were analyzed by SAS program, with percentage, mean, t-test, and ANOVA. Factor structures of care needs of family-caregivers were elicited by factor analysis(PCA, Varimax rotation). Datum collection had been from July 1 to August 14, 1997. The results of this study were as follows : 1. The mean score of the sum of the care needs of family-caregivers was 3.96 and the highest-mean item was 'need for immediate care(M=4.77)', and the lowest-mean item was 'need for chaplian's visit (M=2.82)'. 2. Care needs of the family-caregivers were : Need to be informed of the disease, treatment and care ; need of education and assistance related to physical functional level ; need of social support and consultation ; need of management of nursing problem related to immobility ; need of appreciation ; need of the way to communicate with patients ; need of immediate care and help. The highest mean factor was the 'need for immediate care and help(M=4.74)', and the lowest mean factor was the 'need of appreciation(M=3.58)'. 3. The variables influencing the degree of care needs perceived by family-caregivers to the patients with stroke were as follows : There were significant differences between need to be informed of the disease, treatment and care and general characteristic factors, which were family caregiver's sex (p=.0178), caring period(p=.0223) and patient's suffering period(p=.0244). There were significant differences between need of education and assistance related to physical functional level and general characteristic factors, which were patient's paralysis(p=.0177), patient's ADL dependency(p=.0032). There were significant differences between need of social support and consultation and general characteristic factors, which were family caregiver's sex(p=.0055), occupation(p=.0159), religion(p=.0093) and patient's sex(p=.0134). There was significant difference in the degree of need of management of nursing problem related to immobility, according to the patient's ADL dependency(p=.0493). There were significant differences between need of appreciation and general characteristic factors, which were family caregiver's age(p=.0107), sex(p=.0133), and patient's age(p=.0338). There were significant differences between need of the way to communicate with patient and general characteristic factors, which were patient's paralysis(p=.0002) and aphasia(p=.0001). There were significant differences between need of immediate care and help and general characteristic factors, which were family caregiver's caring period(p=.0162) and patient's suffering period(p=.0116). 4. The mean score of patient's ADL dependency was 3. 38 and the highest-mean item was 'ascending and descending stairs(M=4.12)', and the lowest-mean item was 'drinking(M=2.60)'. There was no significant difference in the degrees of care needs related to the patient's ADL dependency. 5. The highest information source of family-caregivers was from the doctors about the disease, treatment and care(26.1%). The second highest one was from mass media(20.8%), and the third one was from the nurses. The above findings may be used as the basic data to seek more efficient way of elevating nursing practice and quality for family-caregivers to the patients with stroke.

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Path Analysis of Performance of Multidrug-Resistant Organisms Management Guidelines among Intensive Care Unit Nurses : With Focus on the Theory of Planned Behavior and Patient Safety Culture (중환자실간호사의 다제내성균 감염관리지침 수행에 영향을 미치는 요인에 관한 경로 분석 ; 계획된 행위이론과 환자안전문화를 중심으로)

  • Gu, Ji Eun;Ha, Yi Kyung;Hwang, Su Ho;Gong, Kyung Hee
    • Journal of Korean Critical Care Nursing
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    • v.11 no.1
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    • pp.89-100
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    • 2018
  • Purpose : The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO). Method : Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized. Results : The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %. Conclusion : The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses' perceptions of patient safety culture should also be surveyed.

The Changes in Psychopathological Behavior of Schizophrenics in the Ward (정신분열증환자 간호에 대한 임상적 고찰)

  • 강흥순
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.1-4
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    • 1972
  • A study designed to provide effective nursing care for schizophrenic patient was carried out to 22 patients who were admitted to the psychiatric in-patient service, St. Malays Hospital, Catholic Medical Center. The main purpose of the study was to provide effective means of discriminating the effects of nursing care for schizophrenic patients. The experimental group sampled consisted of 10 male and female patients who have been given patient-centered nursing care while the control group consisted of 12 male and female patients who have been given only routine care. The administration of the WBI manual in both groups obtained the changes in the psychopathological behavior of them. The result were found to be as follows. 1. The greater number of the patient in both groups were below 30 years of age (70%). 2. Uptill 15 days after admission there was no difference between the change of the psychopathological behavior the subject group and that of the control. 3. There as a difference between the change of the psychopathological behavior of the subject group and that of the control uptill 30 days after. admission(p<0.08).

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Development of a Recording System for Home Health Care for Postpartum Women adn Their Newborns (병원 포괄 수가제 도입에 대비한 산욕부 및 신생아 가정간호 기록지 개발)

  • Kim, Hea-Sook
    • Women's Health Nursing
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    • v.2 no.1
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    • pp.25-39
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    • 1996
  • The Korean government has a new system for charging patient care for patients in hospital, on hold for the present(9 / 1995) but to start implementation in certain areas of patient care next year. From the latter half of next year the Ministry of Health and Welfare would like to start demonstration projects for hospitals who want to start using DRGs for frequently seen medical diagnosis and for patients with a course that is predictable and for whom non-insurance costs are minimal : such as the patient who has a delivery, cesarean deliveries, cataract surgery, tonsillectomy or an appendectomy, and apply the DRG system of payment for hospital care for these patients. The purpose of this study was to establish a recording system to give effective home health care to postpartum women and their newborns. Recently the government announced a DRG system to apply to postpartum women for pilot purposes starting next year. This gives impetus to the need to develop home care records that will allow for systematic recording and provide continuity and consistency in care across all health professionals and with in-depth communication between the professions to assure high quality care. There has been a rise in medical costs and a shortage of patient bed space in hospitals, particularly since the introduction of national medical insurance. The study focused on developing client selection criteria, a primary assessment tool, progress notes and nursing diagnoses applicable to postpartum and newborn clients. Selection criteria for home health care, assessment tool content, nurses progress notes and diagnoses were developed through a review of the literature, advice from professionals who are expert in home health care and actual practice in the use of recording tools through workshops. The recommendations based on the research results are as follows : 1) Replication and application of these tools is needed to test the validity of the tools 2) In order to have systematic nursing records standardization of records has to be done after nurses have had experience using them. 3) Reliability and validity of the tools has to be established through applicability to actual care situation.

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Association of Higher Continuity of Primary Care with Lower Risk of Hospitalization among Children and Adolescent Patients (어린이와 청소년 환자에서 일차의료의 지속성과 입원 위험도의 관련성)

  • Choi, Yong-Jun;Kang, Sung-Hyun;Kim, Yong-Ik
    • Health Policy and Management
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    • v.18 no.1
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    • pp.85-107
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    • 2008
  • This study aims to describe levels and distribution of the continuity of primary care among children and adolescent patients who are 2-19 years old, and analyze the effects of it on the risk of hospitalization. Study population was 2-19 year old child and adolescent patients as of 2002, who had more than three ambulatory care visits in the years of 2002-3 and whose most frequent provider was the primary care practices (189,660 persons). Association of levels of primary care with the risk of hospitalization was evaluated using multiple event survival analysis. Outcome variables were whether the patient had hospitalized or not, and whether the patient had hospitalized due to ambulatory care-sensitive conditions or not. Multiple event survival analysis revealed statistically significant association of the levels of primary care with the risk of hospitalization. Hazard ratio was 1.34 [1.27-1.41] at the medium level of continuity and 1.47 [1.39-1.55] at the lower level where outcome variable was whether the patient had been hospitalized or not. Hazard ratios were 1.35 [1.21-1.50] at the medium level of continuity and 1.60 [1.44-1.78] at the lower level, where outcome variable was whether the patient been had hospitalized due to ambulatory care-sensitive conditions or not. This study produced some evidences on the benefits of continuity of care, which will in turn support the introduction of personal doctor registration program in the future.

The Nurse Staffing in Intensive Care Units based on Nursing Care Needs: A Multicenter Study (중환자 간호요구도에 근거한 중환자실 간호사 배치수준 산정 : 다기관 연구)

  • Park, Miok;Yang, Eunjin;Lee, Mimi;Cho, Sung-Hyun;Shim, Miyoung;Lee, Soon Haeng
    • Journal of Korean Critical Care Nursing
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    • v.14 no.2
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    • pp.1-11
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    • 2021
  • Purpose : The aim of this study was to propose appropriate nurse staffing of adult intensive care units considering patients' nursing care needs according to the Workload Management System for Critical Care Nurses (WMSCN). Methods : In a cross-sectional survey conducted in September 2017, 1,786 patients' WMSCN scores, surveys from 2,145 nurses, and administrative data from 118 units in 41 hospitals were analyzed. The means (standard deviations) of the aforementioned scores and nursing hours per patient day were presented. Nurse-to-patient ratios and nurse-to bed ratios for staffing to meet patients' nursing care needs were calculated. Results : The mean WMSCN scores were 109.50±17.17 in tertiary hospitals and 96.38±19.26 in general hospitals. Nursing hours per patient day were 12.47±2.80 in tertiary hospitals and 11.01±2.45 in general hospitals. Nursing hours per patient day correlated with WMSCN scores. Nurse-to-bed ratios required for the provision of ICU nursing care ranged from 1: 0.36 to 1: 0.48. Conclusion : Our findings provide evidence that current ICU nurse staffing is insufficient for meeting patients' nursing care needs. We suggest adjusting the legal standards for adequate nurse staffing considering these needs.

What Will We Learn from the Paradigm Shift in Safety Science for Improving Patient Safety? (안전과학 패러다임의 전환과 환자안전의 개선)

  • Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.27 no.1
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    • pp.2-9
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    • 2021
  • Patient safety remains one of the most important health care issues in Korea. To improve patient safety, we have introduced concepts from the field of safety science such as the Swiss cheese model, and adopted several methodologies previously used in other industries, including incident reporting systems, root cause analysis, and failure mode and effects analysis. This approach has enabled substantial progress in patient safety to be made through undertaking patient safety improvement activities in hospitals that are systems-based, rather than individual-based. However, these methods have the shared limitation of focusing on negative consequences of patient safety. Therefore, the paradigm shift from Safety I to Safety-II in safety science becomes the focus of our discussion. We believe that Safety-II will complement, rather than replace, Safety-I in the discipline of patient safety. In order to continuously advance patient safety practices in Korea, it is necessary that Korea keeps abreast of the recent global trends and development in safety science. In addition, more focus should be placed on testing the feasibility of new patient safety approaches in real-world situations.

Factors affecting the Patient Safety Attitude and Safety Control on Safety Care Activities among Nurses in Small and Medium-sized Hospitals (중소병원 간호사의 환자안전태도, 안전통제감이 안전간호활동에 미치는 영향)

  • Kim, Eun-Jeoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.564-572
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    • 2016
  • This study investigated the factors affecting the safety care activities of 227 nurses in 7 small and medium-sized hospitals in G-city. Data were collected from May 16th to 23rd, 2016, and analyzed using descriptive statistics, the t-test, one-way ANOVA, Pearson's correlation, and multiple regression with SPSS 18. The levels of patient safety attitudes, safety control and safety care activities were 4.11, 3.74 and 4.33 out of 5, respectively. In the analysis of the patient safety attitudes, there were significant differences in education level and job satisfaction. In the analysis of safety control, there were significant differences in age, education level, working experience, position, experience of safety education, experience of safety accidents, and job satisfaction. In the analysis of the safety care activities, significant differences were found in the education level, work department, experience of safety education, and job satisfaction. The patient safety attitudes, safety control, and safety care activities were positively correlated (with each other). The major factor affecting the safety care activities was the patient safety attitude, followed by safety control and experience of safety education. These findings emphasize the need for nurses to change their perception of patient safety attitudes and safety control, in order to reinforce their safety care activities. They also suggest that various safety nursing cases and systematic support should be provided for continuous patient safety education.