• Korean Journal of Adult Nursing
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• v.13 no.4
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• pp.632-640
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• 2001

Purpose: This study was to examine the effects of supportive nursing care on surgical patients in the operating room. Method: This study was nonequivalent control group none-synchronized design. The data were collected during the period of July 26 through October 8, 1999 at K hospital in Kwangju. The subjects for the study were selected from those patients who were admitted to K hospital for abdominal surgery. Forty-eight adult subjects were selected and evenly divided into two groups: 24 for the experimental group and the other 24 for the control group, respectively. The tool used for measuring state and trait anxiety was the one originally worked out by Spilberger(1976), and translated by Kim Jung- Taek and Shin Dong-Kyun(1978) for suitable application for Koreans. Data were analyzed by $\chi^2$- test, t-test, Chronbach's ${\alpha}$ coefficient using SAS/PC+. Result: Results were as follows : 1. The degree of State anxiety was found to be lower in the experimental group who received supportive nursing care in the operating room immediately before an operation than the control group who did not."(p<.001). 2. There was no significant difference on the post-test blood pressure and pulse rate immediately before operation between the two groups(p>.05). Conclusion: Results of the above study reveals that the supportive nursing care in the operating room is effective in alleviating the anxiety of patients. I suggest that it is highly desirable to apply supportive nursing care for those patients who are waiting for immediate surgery.

• Journal of Korean Clinical Nursing Research
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• v.28 no.2
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• pp.137-145
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• 2022

Purpose: This retrospective chart review study was conducted to examine the frequency of delirium and to identify the risk factors of delirium in elderly surgical patients. Methods: The subjects of this study were 394 patients aged 65 years or older who underwent surgery. The diagnosis of delirium was based on the nursing assessment records with scores from the day of surgery to the 4th day after surgery. The collected data were analyzed by binary logistic regression analysis. Results: The incidence of delirium was 4.3%, and delirium occurred most frequently on the first day of surgery and lasted for 2.16 days on average. Of delirium patients, 76.5% underwent gastrointestinal surgery, and the most common delirium pattern was disorientation. In terms of the characteristics of the subjects, the occurrence of delirium was statistically different by age (𝝌²=10.79, p=.005), systemic-specific disease (𝝌²=9.63, p=.047), use of delirium-inducing drug(benzodiazepine) before surgery (𝝌²=15.90, p<.001), walking ability before surgery (𝝌²=7.65, p=.006), history of delirium (𝝌²=35.92, p<.001), and emergency surgery (𝝌²=16.40, p<.001). As risk factors of delirium, gastrointestinal surgery was found to increase the risk of delirium by 12.57 times (95% CI=2.45~64.46, p=.002), and the use of benzodiazepines before surgery was shown to increase delirium by 10.07 times (95% CI=2.21~45.87, p=.003). Conclusion: It is necessary for nurses to actively evaluate delirium using screening tools for early detection and prevention of delirium in elderly surgical patients with delirium risk factors.

• Journal of Korean Academy of Nursing
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• v.21 no.3
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• pp.349-364
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• 1991

Recognition of the usefulness and the importance of the nursing diagnosis is increasing. There is a prevailing opinion that nursing diagnosis should be used to improve the quality of nursing care. Developing standardized nursing care palns based on nursing diagnoses is therefore considered one of the most essential projects for professional growth and improvement in the nursing world of Korea. Consequently, in the first stage of this research project, the ten nursing diagnses used most frequently with patients on medical and surgical wards were determined and related nursing care plans were developed, implemented and evaluated. The application of the standardized nursing care plans raised the nurses' confidence and proved to be effective in enhancing the quality of nursing care. This study was initiated as the next stage, to develop, test, and determine the validity of nursing care plans for the remaining nursing diagnoses. Nineteen medical and surgical wards were selected for the study ; the 176 staff nurses working on those wards and 1211 patients hospitalized there (603 patients during the nursing care plan use) took part in the project. The following summarizes the results of the study : 1. After listing all the nursing diagnoses up to the 20th in frequency from each ward except the ten used in the first study, 22 nursing diagnoses were selected. Two related to ‘self care deficit’, were combined into one. Standardized nursing care plans were established for these 21 nursing diagnoses. 2. The first page of each nursing care plan lists the related factors and defining characteristics as supporting data. The application rate distribution revealed that the majority were recorded less than 50% of the time. For each nursing diagnosis, only one to three related factors were recorded more than 50% of the time regardless of the number of suggested related factors, and similarly, only one to five defining characteristics were recorded more than 50% of the time regardless of the number of suggested defining characteristics. Therefore, these factors and defining characteristics were proposed as the common related factors and the typical signs and symptoms for each nursing diagnosis. 3. The application rate distribution for the expected outcomes, and the nursing orders that were the main data of each nursing care plan occurred more than 50% of the time, unlike the related factors and the characteristics that occurred less frequently. These findings supported the clinical validity. 4. In an effort to evaluate indirectly the effect of the use of the standardized nursing care plans, nurses' job satisfaction and perceptions of their ability in the use of the nursing process were measured and compared. Scores after the use of the plans were significantly higher than those before. The experience in actually using the standardized nursing care plans with patients increased the nurses' professional and emotional satisfaction and their confidence in using the nursing process. Also when the nurses who actually used the nursing care plans were asked to rate their effectiveness, the highest score was given to ‘the ease of establishing the nursing goal’, followed by ‘improved professional advice and care for patients’, ‘the efficiency and systemization of charting’, ‘the definite recognition of the nursing problem’, and ‘the selection of effective and appropriate nursing interventions’ in descending order. The results indicate the nurses were very positive about the effect of the real clinical application of standardized nursing care plans, and that the objective of this study to utilize the nursing diagnosis to strengthen the nursing process was attained.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.1
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• pp.76-93
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• 2006

Purpose: The purpose of this study was to define the core components required of nurses to provide quality nursing care to patients and analyze the significance of these components in the hospital's various units to maintain a high level of competence among nurses. Method: The study evaluated 3 categories included 35 subcategories with 148 core components that were derived from literature review and interviews of nursing professionals. The nursing professional category included 18 subcategories with 98 components, the organizational culture category included 4 subcategories with 16 components, and the temperament-attitude category included 13 subcategories with 34 components. The study included 335 nurses with more than one year of hospital experience and measured disparities among different hospital units. The data was analyzed with SPSS-Win 10.0, differing perceptions of the importance of general traits among the participants were measured using standard deviation, and differing perceptions of the importance of professional traits among the participants were assessed using ANOVA and subsequently with the Bonferroni Test. The reliability of the aforementioned research tools were evaluated using the Cronbach's ${\alpha}$. Result: The results of the study were as follows: 1. Among the three categories, temperament-attitude category was perceived to be the most important, followed by nursing professional category and organizational culture category. Among the ten most important subcategories within the three categories, safety and infection prevention as well as responsibility were perceived to be the most important, followed by promotion of physiologic adaptation, document management and presentation, self-control, ethics, observance law, coping with emergency, humanity, and medication. 2. The relative importance of category associated with the core competencies within the hospital unit were as follows : 1) The units that rated nursing professional category as being the most significant were: internal medicine, surgical unit, mother-child unit, emergency room, intensive care unit, and operating room, in that order. 2) The units that rated the organizational culture competencies as being the most significant were: mother-child unit, internal medicine, surgical unit, emergency room, operating room, and intensive care unit, in that order. 3) The units that rated temperament-attitude category as being the most significant were: internal medicine, surgical unit, emergency room, mother-child unit, operating room, and intensive care unit, in that order.

• Journal of Korean Biological Nursing Science
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• v.20 no.3
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• pp.159-168
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• 2018

Purpose: This study aimed to explore nursing students' experiences of observing surgeries in the operating room. Methods: The data were collected through written scripts of nursing students who participated in the operating room practice. Data were analyzed via qualitative content analysis. Results: Five themes emerged from the data: 'preparing with the thrilled hearts toward unknown area', 'drawing back in front of the mirror of realities', 'becoming an audience at a lifesaving orchestra', 'reaching a tipping point of knowing', and 'redrawing the trajectory of dream to be a nurse'. Conclusion: This study will prove helpful in describing their needs for systemic and emotional support. Findings indicated that major contributions of surgical observations to nursing students are more integrated understandings of nursing and the determinations of their career preferences.

• Journal of Korean Academy of Nursing
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• v.41 no.2
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• pp.157-164
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• 2011

Purpose: This study was performed to identify changes in blood glucose at preoperative fasting time in surgical patients over 60 yr. Methods: Data collection was performed from July, 2008 through July, 2009. Participants consisted of 80 nondiabetic surgical patients. Blood glucose was checked from 3 to 5 times. The 5 times were 2-hr fasting on the pre-operative day (T1, n=80), 8 hr (T2, n=80), 10 hr (T3, n=17), 12 hr (T4, n=34) and 14 hr fasting on the day of the operation (T5, n=29). Results: Of the patients, 27.5% had a blood glucose level of less than 79 mg/dL at T2; 17.6% at T3; 32.4% at T4; and 17.2% at T5. Mean blood glucose levels were 93.8 mg/dL at T1; 88.4 mg/dL at T2; 91.7 mg/dL at T3; 87.4 mg/dL at T4: and 94.1 mg/dL at T5. Blood glucose was the lowest at T2 (p<.001). Conclusion: As 17.6-32.4% of the patients showed the blood glucose level of less than 79 mg/dL at 8-14 hr pre-operative fasting, the authors recommend that surgical patients p>60 yr-of-age be observed for hypoglycemia during pre-operative fasting of more than 10 hr and that surgical patients >60 yr-of-age with risks for hypoglycemia be scheduled for operation within 10 hr preoperative fasting.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.589-603
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• 1992

This study investigated a process to estimate the need for nursing staff on the basis of a patient elassification system and the required care needs and activities. The investigation was carried out in the following four steps. Step 1. Patients were classified according to the amount of nursing care need on each shift as class I (mildly ill), class II (mederately ill), class III (acutely ill), and class IV (critically ill). Step 2. Measurement of the direct nursing care hours needed for each patient class, and measurement of indirect nursing care hourse and personal time of the nursing staff. Step 3. Calculation of he total nursing workload in a nursing unit. Step 4. Estimation of the nursing staff needed. The investigation was carried out from July 17th to 30th, during 24hours every other day. The subjects were the patients and the nursing staff on two units of Seoul National University Hospital, Korea. Some of the results from the investigation are as follows : 1) Distribution of patient classification On the neuro surgical (N.S.), the distribution was class I, 22 patient, 3, class II, 27 patients, class III, 26 patients, and class IV, 25 patients, For the orthopedic surgical unit(0.5.), it was class I, 43 patients, class II, 43 patients, class III, patients, and class IV, 3 patients. 2) Direct nursing care hours per day On the N.S. unit, 3.2 hours of direct nursing care were needed for class I, 3.9 hours for class II, 5.1 hours of class III, and 6.2 hours for class IV patients, while 2.0 hours for class I, 2.5 hours for class II, 3.5 hours for class III, 5.0 hours class IV patients were needed on the 0.5. units. 3) Analysis of direct nursing care activities Activities were classified into assessment and observation(47%), medication(38.7%), communiontion(5.1%), exercise(2.4%), elimination and irrigation(1.3%), treatmemt(1.1%), hygiene(0.8%), nutrition(0.8%), and hot and cold compress(0.1%). 4) Average hours of indirect nursing care per day. On the N.S. unit 4.2 hours, and on the O.S. unit, 3.5 hours of RN indirect care was needed. 5) The average personal time used by the of nursing staff was 17 minutes for both RNs and nursing assistants in the N.S. unit, and 32 minutes for both RNs and nursing assistants in the O.S. unit. 6) Estimation of nursing staff needed on two specialized units of a university hospital For the N.S. nursing unit of 43 beds, 31 nursing staff would be indicated. For the 0.5. nursing unit of the same number of beds, 19 nursing staff would be indicated.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.4
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• pp.449-457
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• 2004

Purpose: This study seeks to identify situations where nurses are required to consider alternatives, for the delivery of nursing care, appropriate to the needs of a medical care unit, surgical care unit, and intensive care unit in a university hospital. Method: Data was collected from 100 nurses using an open questionnaire, during a one week period in May, 2003. These nurses all had at least two years of experience within a medical care unit, surgical care unit, or intensive care unit at a university hospital. Results: The situations that nurses typically faced were categorized into 21 problems for nurses including : respiratory problems(26.8%), pain(23.6%), problems in relation to bowel habit(23.2%). In cases where nurses were faced with making decisions in relation to solving respiratory problems, the alternatives included ; applying oxygen(29.3%), physical assessment and monitoring(14.7%), refining and modifying order and suggestion order(9.3%). Ventilator care(9.3%), was chosen to solve pain problems ; doing pm orders(30.3%), placebo medication(27.3%), and to refine and modify orders and suggestions(18.2%). To solve problems in relation to bowel habits ; enemas accounted for 32.3%, and laxative medication 30.8%. Conclusion: To improve the quality of nursing, the outcome of nursing care associated with 21 problems for nurses including : respiratory problems, pain, and problems in relation to bowel habit, should be identified and the best alternative nursing care should be developed.

• Journal of Korean Academy of Nursing
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• v.35 no.1
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• pp.125-134
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• 2005

Purpose: The purpose of this study was to identify the influencing factors on the development of pressure ulcers in patients undergoing surgery which lasted more than two hours. Method: One hundred nineteen surgical adult patients were included in the study. Data was measured on each participant from December 2003 to February 2004. It was collected using a structured researcher-administered sheet and analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis. Result: The prevalence of a perioperative pressure ulcer was 26.1%. The level of moisture, friction and shear, length of surgery, and perioperative irrigation were significantly higher in the pressure ulcer group than those in the non-pressure ulcer group. The level of activity and level of consciousness were significantly lower in the pressure ulcer group than those in the non-pressure ulcer group. Significant influencing factors on the development of pressure ulcer were 'moisture' and 'irrigation' and those variables explained 23.1% of varience in the development of a pressure ulcer during surgery. Conclusion: It is necessary to develop a strategy to prevent pressure ulcer by taking 'moisture' and 'irrigation' into account during the preoperative, perioperative and postoperative period.

• Journal of Korean Critical Care Nursing
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• v.3 no.1
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• pp.53-65
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• 2010

Purpose: The purpose of this study was to identify the intensity and types of discomfort caused by an endotracheal tube in patients during ventilator therapy after cardiac surgery, and to analyze the differences in the intensity and types of discomfort by sociodemographic and clinical characteristics and characteristics related to endotracheal tubes. Methods: The intensity of discomfort was measured using an 11-point numeric rating scale and the types of discomfort were measured using a 4-point numeric rating scale. Sociodemographic and clinical characteristics and characteristics related to endotracheal tube were collected by observation and the electronic medical chart using a structured questionnaire. Results: The mean intensity of discomfort in patients due to endotracheal tubes was 6,91 points, 84% of patients reported discomfort over 5 points, The most severe discomfort was pain during endotracheal suctioning, and dry mouth and breathing difficulties were also found to induce discomfort. Patients who had more severe surgical site pain, longer duration of intubation and higher cuff pressure demonstrated more severe discomfort due to the endotracheal tube. Conclusion: These results can be used as basic data for developing nursing intervention to relieve the discomfort caused by endotracheal tubes in patients during ventilator therapy.