Purpose: The purpose of this study was to identify nursing interventions frequently used with cancer patients. Nursing records from 5 general hospitals for patients with stomach, liver, lung or colon cancer were analyzed. Method: A descriptive study methodology was used and nursing records for 15 patients in each disease category at each hospital, who were admitted and discharged during June 2007 were analyzed. Results: Five domains of NIC were found and the physiological(basic) domain was most frequent (31.52%). Twenty two classes of NIC were identified with risk management for safety being most frequent (22.49%). For the 119 nursing interventions identified, the most frequent was pain management with 7,827 (12.31%), followed by prevention of falls (11.76%), surveillance (6.79%) and wound care (5.12%). Nursing activities of pain management and prevention of falls were comparable to activities listed in literature on guidelines for evidence based and best practices in nursing care. Eight of the 17 nursing activities for pain management, and 9 of 14 for fall prevention were consistent with these guidelines. Conclusion: In this study, nursing interventions were found to be focused on physical care, monitoring patients' condition and education. We have to develop diverse nursing interventions and a convenient recording process.
Background: Workplace violence (WPV) is becoming an issue that needs immediate attention in the United States, especially during this period as more states are adopting the "stand your ground laws to promote worker protection." This study was conducted to investigate how WPV has contributed to an unsafe environment for nurses and nursing assistants who work in long-term medical care facilities. Methods: A structure questionnaire was used to collect data for the study. Three facilities were sampled and 80 nurses and certified nursing assistants participated in the study. Ninety-two percent (n = 74) were female and 8% (n = 6) were male. Approximately 62% were black or African American, approximately 33% were Caucasians, and only 2% were from other ethnicities. Results: We found that 65% of the participants had experienced WPV while 41% believed that management shows little or no concern for their safety. Approximately 23% of respondents believed that reporting supervisor's WPV act is an unsafe action. In addition, 22% of those who reported that they have experienced WPV believed that the work environment is not safe to perform their duties. This significant difference in perception of workplace safety between those who had experienced WPV and those who had not was significant (t = 3.95, df = 158, p < 0.0001). Conclusion: WPV is an epidemic problem that affects all health-care professionals. The findings of this study could help long-term medical care facilities' management identify the areas to focus on mitigating, controlling, and/or eliminating incidents of WPV.
International journal of advanced smart convergence
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제11권2호
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pp.194-204
/
2022
This study is a one-group pretest-posttest design to evaluate the effect of problem-based learning (PBL) for patient safety on self-leadership, patient safety competencies, and reflective thinking of nursing students. The research was conducted from March 2 to April 15, 2022, in which 57 nursing students participated. PBL for patient safety was examined in a total of 8 sessions in the order of motivation, problem identification, task performance planning, problem-solving methods, summary and solution, presentation, and evaluation. The following topics of patient safety were selected for each team: nursing records, high-alert medication, medication error and intravenous fluid regulation, blood transfusion care, fall, bedsore, infection control, and pain management. We provided feedback on the learning process and outcomes of nursing students. According to the results, self-leadership showed a statistically significant improvement in self-expectations (t=2.60, p=0.01), goal setting (t=2.84, p<0.01), self-reward (t=3.32, p<0.01), and self-criticism (t=2.32, p=0.02). Patient safety competencies showed a statistically significant improvement in patient safety knowledge (t=13.05, p<0.001) and patient safety skills (t=4.87, p<0.001) but not in reflective thinking. The results prove that PBL for patient safety is an effective teaching-learning strategy to improve self-leadership and patient safety competencies. Future studies must develop and validate specific and long-term teaching-learning methods to improve reflective thinking.
This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. Methods: The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using $X^2$-test, factor analysis, and the Analytical Hierarchy Process. Results: Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. Conclusion: PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.
Purpose : This concept analysis identified attributes and defined triage competency among emergency nurses. Method : Walker and Avant's approach was used to guide the concept analysis. A literature review was completed including 26 studies, 5 reports of related associations, and 5 books. Results : The concept of triage competency in emergency nurses was identified as five attributes: clinical judgment, expert assessment, management of medical resources, timely decision, and communication. Antecedents of the concept were triage education and emergency room experience. The consequences of the concept were efficiency of care, patient rating, and safety. Triage competency in emergency nurses was defined as the comprehensive ability to prioritize patients' urgency and allocate limited medical resources. Conclusion : This study is meaningful since it clarified triage competency among emergency nurses. The attributes and empirical indicators of this study will likely lay the foundation for development of triage competency metrics.
Purpose: This study aimed to identify the characteristics of patient safety incidents (PSIs) related to nursing and to provide primary data for preventing the recurrence of similar incidents. Methods: This secondary analysis study included damage claims rulings filed for clinical negligence from 2014 to 2018 that contained the keyword 'nurse'. It excluded judgments irrelevant to nursing care and in which clinical negligence or causal damages were overruled. A total of 93 cases were analyzed. The characteristics of PSIs were derived through descriptive statistics, and two instances of nursing-related PSIs were examined by qualitative content analysis focusing on root causes. Results: The analysis of PSIs related to nursing suggested that the medical institutions where the PSIs occurred most frequently were hospitals, and the most common types of PSIs were medication, surgery, and treatment/procedure, in that order. In addition, it indicated that nursing-related PSIs occurred most frequently in general wards during the day shift, with the most common related nursing practice being managing potential risk factors. The qualitative analysis showed that careless monitoring and institutional inertia were causes of PSIs. Conclusion: To prevent nursing-related PSIs, nurses need to individually monitor and assess patient conditions. In addition, support should be accompanied by the improvement in the systems in place aimed at preventing the recurrence of nursing-related PSIs at the institutional and national level, such as securing appropriate nursing personnel and improving labor conditions.
Occupational health services in Korea have been operated as dual types: one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative. health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area: 154 places (39.4%) managed by designated. health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation due to the characterstics of each variable and analyzed for impacting factors with relation to the using multiple regression analysis using SPSS PC program, especially using t -test method in order to compare each type of health care management. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. The common sickness management is the most accomplished item in health care area of occupational health care services, while the preventive care and control for the workers who have serious health problems are insufficient in workers health care area. 3. An insufficient accomplishment of overall health education has been shown because it is difficult to perform health education due to almost no chance of the direct introduction at workplaces. Therefore a strong support system for making and supplying the media is necessary in order to activate indirect health education by means of media. 4. Because health care managers and the agencies managers where take the workplaces for this study are almost nurses who have been comparatively high work site rounding rate about an environmental management at the workplaces, that non-profession can also do it, the activities about the professional area not enough. Therefore, an appropriate referral system should be established in order to complement professional area. 5. Two factors which have an effect on the coverage rate of occupational health care services are : one is those from the workplaces such as type of services, the number of workers, the number of harzadous factors and safety & health committee, the other from health care organization about whether there is its own manager or not.
Purpose: This study was conducted to understand the situation of general hospital worker's health management and health promotion. Methods: To investigate the current situation of health management in the hospital, structured questionnaires were sent to 122 occupational health providers by post. About 79% hospitals returned questionnaires. The data were analyzed using descriptive analysis, ${\chi}^2$-test by SPSS 12.0 program. Results: A quarter hospitals responded set up separated health care office for workers, 87.5% provided health educations, and 56.5% operated health promotion projects. In the contents of health promotion program embraced both health behavior practice and disease prevention, musculoskeletal disease control, infection control, smoking cessation, and exercise program were most commonly provided to the workers in order. Occupational health care provider chose the item such as budget limitation, manager's apathy, lack of employee's participation, cooperation provider, and so on as the reason of difficulty to run health promotion program in the hospital setting. Conclusion: Hospital managers need to construct infra to manage and promote worker's health. For example, establishing Industrial safety and health committee in hospital and arranging nurses who being fully responsible to worker's health. And occupational health care provider should advertise health promotion projects both managers and workers actively.
Purpose: This study aimed to investigate perception of patient safety culture, incident reporting, and safety care activities among clinical nurses and to identify factors associated with the safety care activities. Methods: Structured questionnaires were used to collect data from 155 nurses who were involved in direct patient-care. Results: Descriptive statistical anaylses revealed that the mean score of patient safety culture was $3.26{\pm}0.32$ and $4.19{\pm}0.41$ was for the safety care activities. In incident reporting, reporting intention ($3.56{\pm}0.68$), belief in improvement ($3.42{\pm}0.60$), worry about appraisal ($3.37{\pm}0.65$) and reporting knowledge ($3.36{\pm}0.72$) respectively. Correlational analyses showed that perceived patient safety culture (r=.36), reporting intention (r=.34), belief in improvement (r=.32), and the knowledge (r=.38) in incident reporting were positively correlated with safety care activities, while the worry about appraisal in incident reporting attitude was negatively correlated. The factors associated with safety care activities were incident reporting knowledge (${\beta}=.31$, p<.001), supervisor/managers' attitudes toward patient safety culture (${\beta}=.29$, p<.001), belief in improvement of incident reporting attitude (${\beta}=.16$, p=.041). Conclusion: These results suggest that to improve safety care activities among hospital nurses, it is necessary to educate nurses on incident reporting. Also, a system-level approach is needed to support leadership in patient safety and to provide positive feedback on incident reporting.
Purpose: The purpose of this study was to examine the health care management status of preschoolers depending on the children's characteristics. Methods: The sample of this study were 212 mothers of preschoolers attending Child Care Centers in three cities, Seoul, Daejon, and Suwon, in Korea. A self administered questionnaire developed by investigators was used to collect data from September 15 to October 31, 2002. Data was analyzed with SPSS 11.5 Win program. Results: 5.7% of the children had not completed their vaccination programs. Children who were second or later birth order showed less complete vaccination rates than firstborn babies. Children who had working mothers showed less complete vaccination rates than those whose mothers did not work. Among the various vaccinations, the DPT and MMR booster vaccination rates were the lowest. Home safety scores were higher when mothers have younger children. higher monthly incomes and reside in apartment type houses. Forty one(41%) of the preschoolers experienced accidents, and the accident rate was higher in boys and children with easy temperament. The most frequently experienced accident was laceration. Twenty eight point eight percent(28.8%) of the children experienced hospitalization because of various diseases. Most of the mothers perceived their children healthy. However, children who were second or third born were perceived less as healthy. Children in families with less monthly income were perceived as less healthy. Conclusions: This study provided basic data about preschoolers' health care management status focusing on vaccinations and accident rates. More attention should be paid to preschoolers' health and safety. Related factors found in this study should be considered when providing anticipatory guidance for parents.
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