• 제목/요약/키워드: Surgical nursing

검색결과 468건 처리시간 0.024초

간호진단 분류체계에 근거한 간호개념틀 개발 (Development of a Conceptual Framework of Nursing from Selected Concepts of Nursing Diagnoses)

  • 김조자
    • 대한간호학회지
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    • 제26권1호
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    • pp.177-193
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    • 1996
  • For the purpose of integrating nursing diagnosis into the nursing curriculum, a descriptive survey research was done using the inductive method with questionnaires and a literature review. Research subjects included nurse educators, textbooks of adult nursing published in Korea, and the course outline for adult nursing used in one college of nursing. The Results show that there was common agreement on 39 nursing diagnosis which should be in cluded in the adult nursing curriculum, textbooks of adult nursing, and patient care on the medical-surgical units. The two existing nursing diagnosis classification systems(NANDA and Gordon's Human Response Patterns) show different basic frameworks and difficulties were discovered in integration of nursing diagnosis into the curriculum. To develop a conceptual framework for a nursing diagnosis classification system, diagnosis were classified into three categories ; health promotion, high risk problem, and actual problem on the basis of the framework used in adult nursing textbooks and Gordon's 11 Functional Health Patterns. Subconcepts for actual problems were classified as ; activity and rest, nutrition and elimination, perception and coordination, stress and coping. Progress in this study supports further development of a conceptual framework of nursing based on a nursing diagnosis classification system, from which improvement in nursing education and clinical practice can be expected.

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종합병원 일반병동 간호행위의 활동기준원가분석 (Activity-Based Costing Analysis of Nursing Activities in General Hospital Wards)

  • 윤호순;김진현
    • 간호행정학회지
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    • 제19권4호
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    • pp.449-461
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    • 2013
  • Purpose: The purpose of this study was to explore the relationship between cost and revenue for inpatient nursing activities in general wards. Methods: Data were collected from 12 medical-surgical wards in one general hospital from January 1 to December 31, 2010. The nursing activities were categorized into 2 groups according to nursing service payment type in terms of the Korea health insurance system. Descriptive statistics were used to identify nursing activities and nursing activity costs. Results: Of 140 nursing activities identified as performed in general wards, payment for 69 items was included in nursing management fees. The percentage of each cost for the nursing units was 90% for labor, 4% for materials, and 6% for operating expenses. The cost for medical support nursing service accounted for 38% of costs and nursing management fees, 62%. The average profit and loss was -237,257,000 won. The cost recovery rate for nursing service was only 44%. Conclusion: The results indicate a need to measure the economic value of nursing activities performed in general wards and use it as a basis for establishing an adequate reimbursement system for nursing service.

환경적 간호중재가 개심술 환자의 중환자실섬망증, 환경적 스트레스 및 수면에 미치는 효과 (The Effect of the Environmental Nursing Intervention on ICU Delirium, Environmental Stress and Sleep in Patients Underwent Cardiac Surgical Procedures)

  • 장인실;최미혜
    • 임상간호연구
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    • 제14권2호
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    • pp.127-138
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    • 2008
  • Purpose: To examine the effects of the environmental nursing intervention using eye-shields and earplugs on the incidence of delirium, environmental stress and sleep among the patients with open-heart surgery in the post-cardiac ICU(intensive care units). Method: This study was a non-equivalent control group non-synchronized design. The subjects consisted of 93 patients who received ICU care after the cardiac surgery. Among those, 32 subjects was assigned in one experimental group with eye-shields, 31 in the other experimental group with earplugs, and 30 in the control group. ICU delirium was measured by CAM-ICU, environmental stress by ICUESS, and sleep by two sleep scales developed by Oh, et al. and Kim. The data were analyzed by the SPSS 13.0 program including frequency, percentage, t-test, $x^2$ test, ANOVA and ANCOVA. Results: There are no statistically significant differences in the incidence of delirium among three groups (p=.139). The ICU environmental stress scores from the subjects of two experimental groups demonstrated lower (F=6.731, p=.002) than the control group. Also, the degrees of sleep pattern (p=.000, p=.000) and sleep satisfaction (p=.000, p=.000) were greater than those of the control group. Conclusion: Although the environmental nursing intervention using eye-shields and earplugs did not demonstrate the effects in decreasing the incidence of ICU delirium, it has affirmative effects in decreasing environmental stress and improving the quality sleep among the patients with open-heart surgery while they stay in ICU. Further nursing implications are discussed.

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간호 대상자별 다빈도 간호진단, 간호중재, 간호결과 및 연계 체계조사 (A Study on Nursing Diagnoses, Interventions, Outcomes Frequently Used and Linkage to NANDA-NOC-NIC in Major Nursing Departments)

  • 김종경
    • 간호행정학회지
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    • 제16권2호
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    • pp.121-142
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    • 2010
  • Purpose: The purpose of this study was to identify NANDA, NIC, and NOC frequently used and their linkages in major nursing departments for development of the nursing process and nursing management system. Methods: This study was a descriptive study. Data were collected from 123 nurses who worked in medical, surgical, pediatric, gynecologic, and psychiatric department. The questionnaire was based on the NANDA, NOC, NIC, and NANDA-NOC-NIC linkage system. This research was analyzed by an EXCEL program and SPSS $Pc^{+}15.0$. Results: Nursing diagnoses frequently used were 'anxiety', 'disturbed sleep pattern', 'activity intolerance', 'social isolation', 'nausea', 'ineffective airway clearance', 'chronic pain', nursing outcomes frequently used were 'thermoregulation', 'bowel elimination', 'pain control', 'vital sign status', 'pain level', and nursing interventions frequently used were 'nausea management', 'airway suctioning', 'bowel elimination management', 'diarrhea management', 'medication management'. NANDA-NOC-NIC linkages in major nursing departments were recognized, and these results were similar to the results of other researches. Conclusion: The results of this study will be provided as a guideline to apply to the nursing process and development of the nursing process system with the NANDA-NOC-NIC linkage in major nursing department.

간호수가 산정을 위한 간호행위의 규명 연구 (Identification of Nursing Activities for Determination of Nursing Cost)

  • 박정호;황보수자;이은숙
    • 대한간호학회지
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    • 제22권2호
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    • pp.185-206
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    • 1992
  • In this study nursing activities were examined to determine the nursing cost. A professional nursing group developed a tool for the investigation. 128 nursing activities were identified by the tool in 16 nursing care areas as referenced in the literature. Each activity was examined for four essential factors to define nursing cost ; time consumed for the care, level of professional skill, degree of independency and performer of the care. The activity was rated by a five point Likert scale. This investigation was conducted with the nursing staffing working in the 21 university hospitals in Korea and having more than four years experience especially in medical or surgical wards. The participating nursing staff were screened on the basic of the recommendation of the nursing director. The data were gathered from June 12th to August 12th, 1989. All the data were analyzed for mean, standard deviation, percent, and correlation coefficients between items. The results are summarized as follows : 1. Direct nursing care was classified into 16 large areas and 128 small activities. 2. No significant correlation was found between the study items of each activity. 3. Among 128 nursing activities, Those performed less than 50% of the time by a nurse were excluded from the nursing cost. Also excluded activities which were given less than 9 marks in all three items, time consumed, level of professional skill, and degree of independency. As a result, 83 activities in 14 nursing care areas were selected for the proposal to estimate nursing cost.

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간호결과에 대한 환자 특성의 영향 - 위장관계 수술 환자를 중심으로 - (The Effect of the Patient's Characteristics on Nursing Outcomes in Gastrointestinal Surgery Patients)

  • 이병숙
    • 간호행정학회지
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    • 제14권3호
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    • pp.249-259
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    • 2008
  • Purpose: This study was performed to identify the patient characteristics significantly affecting nursing outcomes and their predictability in gastrointestinal surgery patients. Method: The subjects were 149 abdominal surgery patients from 3 general surgical nursing units of 3 general hospitals. Two instruments were used to measure nursing outcomes and acuity of the subjects. The nursing outcomes were measured at post-operation 4 and 7days using review of patients' records, observation of patients, and interviews with patients by a trained nurse. For data analysis, T-test or ANOVA, Pearson Correlation and Stepwise Multiple Regression were done. Result: Age, severity score, diagnosis, cancer or not, operation site were the subjects' characteristics that were significantly related to the nursing outcomes in both post-operation 4 and 7days. Cancer or not, age, diagnosis and severity score were the significant predictors for the scores of nursing outcome in post-operation 4days and the predictability was 34.9%. The predictability of cancer or not was highest, 22.6%. Age, diagnosis and cancer or not were the significant predictors for the scores of nursing outcome in post-operation 7days and the predictability was 27.8%. The predictability of age was highest, 17.3%. Conclusions: The patient characteristics affecting nursing outcomes should be considered when nursing care is planned and provided. Especially, careful attention should be given to the patients with cancer and older age. And, these patient characteristics should be adjusted for correct estimation of the effectiveness of nursing interventions on nursing outcomes.

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간호학생을 위한 웹 기반 간호과정 프로그램의 개발 및 만족도 평가 (Development and Effects of a Comprehensive Web-Based Nursing Process for Nursing Students)

  • 홍성정;김화선
    • 기본간호학회지
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    • 제18권4호
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    • pp.497-505
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    • 2011
  • Purpose: This study was conducted to develop a comprehensive web-based nursing process program to assist nursing students and to evaluate the effects of the program. Methods: The system provides nursing students with guidelines based on NNN (NANDA, NOC, NIC) when the nursing students conduct a series of nursing procedures on diagnosis-outcome-intervention for a specific symptom. It also maintains and manages nursing processes actually conducted by students for clinical practices, and provides an environment where the patient information and nursing process can be converted into a formatted document for printing. This web-based program was used to surgical patients from April to June 2011. Results: The overall satisfaction rate was 3.64. The item with the highest score was, 'Do you think a web-based nursing process program is necessary?' (3.87), followed by 'Do you want to use this program when you become a nurse and implement the nursing process?' (3.33). Conclusion: These results indicate that implementation of web-based programs needs to be continued as an effective tool, but more research is needed on the best way to implement web-based programs in various clinical setting.

표준화 환자를 활용한 임상수행능력 평가방법 개발 및 적용효과: 복부수술 후 환자간호 (Effects and Development of Clinical Competency Evaluation using Standardized Patients among Nursing Students: Based on Abdominal Surgical Patients)

  • 석소현;강현숙;김원옥;현경선;이지아;박선희
    • 성인간호학회지
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    • 제21권5호
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    • pp.468-476
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    • 2009
  • Purpose: This study was to develop the clinical competency evaluation, and to examine the effects of the developed evaluation by comparing it with existing evaluation on clinical competency, communication skill, and self-efficacy of nursing students. Methods: Design was a randomized control group post-test design. The subjects were 102 senior nursing students(Experimental group: 48, Control group: 54) at K university in seoul, Korea. The experimental group took the clinical competency evaluation using standardized patients and the control group took the existing evaluation using a doll. The clinical competency and communication skills were measured by evaluators, and self-efficacy was self reported by the nursing students. Results: The experimental group had higher scores in clinical competency, communication skills, and self-efficacy than those in the control group. Conclusion: Through these results, practice education of nursing education programs need to activate the clinical competency evaluation using standardized patients.

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간호등급 상향에 따른 직접간호활동, 간호업무성과와 직무만족 비교 (Differences of Upgrading Nurse Staffing in Nursing Care Activity, Work Performance Outcomes, and Job Satisfaction)

  • 김주연;이영휘;정미경
    • 성인간호학회지
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    • 제28권3호
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    • pp.256-265
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    • 2016
  • Purpose: This study examined differences in nursing care activity, work performance outcomes, and job satisfaction associated with upgrading nurse staffing of a nurse-to-patients ratio. Methods: Descriptive design was used in this study. In total, 148 medical and surgical nurses were recruited from one university hospital. Three instruments were used for data collection: Scale of Nursing Care Activity, Nurses' Work Performance Outcome Measurement Scale and Nurses' Job Satisfaction Scale. Data were analyzed by using descriptive statistics, t-test, ANOVA, and paired t-test. Results: There were significant differences in nursing care activity (t=-5.06, p<.001), in work performance outcomes (t=-5.46, p<.001) and in job satisfaction (t=4.61, p<.001) when the grading for the nursing staff was changed from three to two indicating increasing number of nurses. Conclusion: The findings from this study showed that there were more nursing care activities, better work performance outcomes, and higher job satisfaction when numbers of nurses were increased. The changes in the scale to evaluate nursing staff influence nursing activities, work performance and job satisfaction.

회복실 성인 수술환자의 주요 간호진단, 간호결과 및 간호중재 연계검증 (Validation of Major Nursing Diagnosis-Outcome-Intervention(NANDA-NOC-NIC) Linkage for Adult Surgery Patients of Post Anesthetic Care Unit)

  • 조은장;김남초
    • 임상간호연구
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    • 제14권3호
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    • pp.141-151
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    • 2008
  • Purpose: This study aimed at applying a standardized nursing process to adult surgery patients of post anesthetic care unit, and examining the validity of linkages in the measuring index of nursing outcome by which nursing outcome was applied. Method: The subjects were 184 surgery adult patients admitted at the post anesthetic care unit of Y university hospital. This study was used the measured tool developed by Choi et al.(2004) and by Lee (2004) who had already verified a validity based on Johnson and Bulechek's study(2001). Results: The nursing diagnosis of an acute pain, an urinary retention, a nausea, a decreased cardiac output, an ineffective airway clearance and an ineffective airway clearance were used in taking care for patients. The related factors according to the main nursing diagnosis were as the following: an injurious physical factor in an acute pain, reflex are inhibition in an urinary retention, post surgical anesthesia in a nausea, stroke volume change in a decreased cardiac output, secretory stasis in an ineffective airway clearance, pain in an ineffective breathing pattern. Conclusion: The study results could be facilitated in nursing process application for nurses at post anesthetic care unit. Also this study would provide basic data to develop a computerized program for the improvement of nursing process application.

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