• 제목/요약/키워드: Unit Nursing Process

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Experience of Gastric Cancer Survivors and their Spouses in Korea: Secondary Analysis

  • Yi, Myungsun;Kahn, David
    • 대한간호학회지
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    • 제34권4호
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    • pp.625-635
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    • 2004
  • Purpose. The purpose of this study was to explore the experiences of gastric cancer couples in Korea and to generate a substantive theory integrating the experiences of gastric cancer survivors and their spouses as a whole. The specific aims of this study were to explore major problems gastric cancer couples faced and how they resolved these problems, focusing on inter-relational dynamics within the couples and on similarities and differences between the couples. Methods. This was a secondary analysis study using grounded theory techniques. The study used the data of 11 married couples which was collected from in-depth interviews from two primary studies. The unit of analysis was dyads of gastric cancer survivors and their spouses. Results. The basic social psychological process that emerged from the analysis was 'taking charge of their health.' Major categories involved in this process were identified as 1) adjusting to new diets, 2) reinforcing physical strength, 3) seeking information, 4) strengthening Ki, 5) lowering life-expectations, and 6) going their separate ways. These six categories represent major strategies in overcoming critical problems that occurred in day-to-day experiences. In terms of the process, the first five categories characterize the earlier stage of the process of 'taking charge of their health,' while 'going their separate ways' indicates the later stage and also the beginning of their separate ways: 'pursuing spiritual life' for the survivors, and 'preparing for the future' for the spouses. Conclusions. The results of this study will help design family care for the people with gastric cancer by providing in-depth understanding and insight on the lives of gastric cancer couples.

혈액투석 환자 가족의 적응 과정 (Adaptation Process of The Family with Hemodialysis)

  • 이영애
    • 재활간호학회지
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    • 제2권2호
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    • pp.184-192
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    • 1999
  • Hemodialysis is a way of treatment for the patients with acute and chronic renal failure. "Marginal man" depicts the enormous amount of stress that hemodialytic patients suffer. It is known that family with chronic illness get stressed along with the patients and they need nursing care also. This qualitative study was conducted in order to identify the family adaptation process in patients with hemodialysis. 6 dyads of hemodialytic patients and caregivers were interviewed for this research. By way of grounded theoretical strategy the data was collected from October 20, 1999 to November 20, 1999. at a hemodialytic unit that was located in Iksan, Chonbuk by the researcher. The main research questions were "What's the adaptation experience of a patient since after being received with hemodialysis?" to the patients, and "What's the family adaptation experience of hemodialysis?" to the caregivers. The collected data was analyzed by grounded theoretical strategy built by Glaser & Strauss in 1967. Results were as follows; 7 grounded concepts were observed from the patients with hemodialysis and 4 grounded concepts were found from the caregivers. Two categories were derived ; 1) Holding hope that is related with treatment 2) Changing a value system.

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간호분야 실무지침의 수용개작 방법론에 따른 구강간호 실무지침의 개발 (Development of Oral Care Nursing Practice Guideline using the Guideline Adaptation Process)

  • 조용애;은영;구미옥;김경숙;곽미경;김정혜;이선희;박동아;노화경
    • 임상간호연구
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    • 제21권2호
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    • pp.154-168
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    • 2015
  • Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.

병동형 호스피스 대상자를 위한 전인적 호스피스 간호중재 프로그램의 개발 (Development of Wholistic Hospice Nursing Intervention Program for In-patient of Hospice Palliative Care Unit)

  • 강은실;최성은;강성년
    • 호스피스학술지
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    • 제7권1호
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    • pp.29-45
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    • 2007
  • People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

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중환자실 내 가습기의 소독방법과 시간적 경과에 따른 균집락 수 (Colony Counts by Different Disinfecting Processes and Operating Time for Humidifiers in an Intensive Care Unit)

  • 박순미;정인숙;장철훈;이영순
    • Journal of Korean Biological Nursing Science
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    • 제11권1호
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    • pp.92-98
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    • 2009
  • Purpose: This study was aimed to investigate the colony counts by different disinfecting processes and duration of the operation for humidifiers in an intensive care unit (ICU) in Busan. Method: The four steps of disinfecting process were taken with four different humidifiers according to the use of disinfectant (1:100 $Deconex^{(R)}$ 50FF/nothing) and refilling water (tap water/distilled water). First, the colony counts using water sample from wick was conducted at 0 hr, 24 hr, and 48 hr respectively after turning on the humidifiers. Next, the colony counts using waterdrop from the outlet was done at 0 hr, 24 hr, 48 hr, and 72 hr respectively after turning on the humidifiers. Result: No colony was counted after disinfecting with 1:100 $Deconex^{(R)}$ 50FF until 72 hr after turning on the humidifiers. However, without disinfecting with $Deconex^{(R)}$ 50FF, the colony count was increased in the humidifiers from 24 hr after turning on the humidifiers. The result was the same regardless of the refilling water. Conclusion: According to the results, the study found that disinfection of humidifiers in the ICUs with 1:100 $Deconex^{(R)}$ 50FF every 72 hr is effective to remove general bacteria.

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병원 간호단위관리자의 다면평가($360^{\circ}$ feedback)에 관한 연구 (A Study on $360^{\circ}$ Feedback of Nursing Unit Manager in a Hospital)

  • 이정희;권성복;지성애
    • 간호행정학회지
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    • 제9권3호
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    • pp.495-505
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    • 2003
  • Purpose: The purpose of this study was to develop 360 feedback for nursing unit manager based on the current personnel evaluation system and to evaluate the new tool according to evaluation subjects. Total of 277 subjects of nurse unit managers and staff nurses were participated in this study. Method: The study was conducted in three phases each for development, application, and analysis of 360 feedback. SAS program was utilized for data analysis with descriptive statistics, t-test, and analysis of variance. Result: The evaluation criteria of the developed 360 feedback tool consisted of 13 subscales such as professional knowledge, apprehension & judgement, job performance, applicability, creativity, leadership, responsibility, promptness & accuracy, administrative ability & sense of mission, activeness, cooperation, communicability, and general attitude. The internal consistency of the tool was Cronbach's alpha .939. The evaluation score by! peers(M=4.30) was the highest one, followed by self-evaluation(M=4.23), evaluation by supervisor(M=4.17), and evaluation by subordinate(M=4.10). The differences in the total evaluation scores among the subjects supervisor, self, peer, and subordinate were not statistically significant, but significant differences were found in some subscales scores. Conclusion: Further research is required to test the reliability and validity of the $360^{\circ}$ feedback tool, and to test the outcome and the process of $360^{\circ}$ feedback system.

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Adaptation of Evidence-based Surgical Wound Care Algorithm

  • Han, Jung-Yeon;ChoiKwon, Smi
    • 대한간호학회지
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    • 제41권6호
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    • pp.768-779
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    • 2011
  • Purpose: This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit. Methods: This study used, the 'ADAPTE process', an international clinical practice guideline development method. The -'Bonnie Sue wound care algorithm' - was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75. Results: A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were ${\leq}$.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations. Conclusion: The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

요골동맥을 통한 경피적 관상동맥 중재술 후 압박밴드의 공기제거 방법에 따른 통증 강도, 통증 감각, 출혈 및 혈종 비교 (Comparison of Pain, Sense, Bleeding and Hematoma Depending on the Process of Air Elimination of Pressure Band after Percutaneous Coronary Intervention through Radial Artery)

  • 김미석;오지선;조혜영
    • 임상간호연구
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    • 제18권2호
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    • pp.275-283
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    • 2012
  • Purpose: This study was conducted to compare pain, sense, bleeding, and hematoma that patients feel depending on the process of eliminating air of pressure band that was applied to patients after percutaneous coronary intervention (PCI) through radial artery. Methods: It was a nonequivalent control group pretestposttest design to compare pain, sense, bleeding, and hematoma by amount and time of eliminating air of pressure band after PCI through radial artery. Results: On arrival at Coronary Care Unit, meaningful difference didn't exist between pain and sense, however, after two hours of starting eliminating air, the points of pain and sense were meaningfully low (p<.001). Also, there was meaningful difference in reciprocal action between group and time (p<.001). Conclusion: After PCI, the conclusion showed there is positive effect in decreasing wrist pain and sense without any influence of bleeding by eliminating air from patients' pressure bands.

대학종합병원 수간호사의 업무분석과 모형연구 (Analysis of the Work of the Head Nurse and a Work Model for the Head Nurse in University Hospitals in Korea)

  • 김인숙
    • 대한간호학회지
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    • 제19권2호
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    • pp.212-222
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    • 1989
  • When the head nurse who is pivotal in the nursing service administration of the hospital performs efficiently as a first-line manager, the effectiveness of the nursing unit, which includes the quality of nursing care, the jab satisfaction of staff members, and the cohesiveness of staff members is increased. With this point of view in mind, the researcher carried out a study to determine the actual work (the content of the work, the work process, the role of the head nurse, the activity media, and the purpose of the work) of the head nurse in a university hospital in Korea. In addition, this study was also carried out for the purpose of preparing an ideal model for the work of the head nurse. The research subjects were 39 head nurses. This included all the head nurses in two university hospitals except those who were working in outpatient care, operating rooms, central supply, nursing administration, in-service education and emergency care. Data were collected from September 24th to October 21th, 1987 and April 4th to 12th, 1988. A work activity record on which the head nurse recorded directly in a chronological narrative form, was used as the research instrument. The 234 work activity records, 39 head nurse's continuous recording over 6 days(from Monday to Saturday) were collected and analysed. The results were as follows ; 1. With regard to the work content for the total daily work of the head nurse, 45.2% of the activities were managerial activities but 58.1% of the head nurse' s time was spent in direct patient care. 2. With regard to the work process of the head nurse, specifically the location, the size and membership of groups contacted, the results were as follows : 1) Of the total daily work activities 92.4% were carried out in the nursing unit and this occupied 84.5% of total daily work time. Direct patient care was generally performed on the nursing unit and managerial work was performed in other areas. 2) Of the total daily work activities, 73% was with one or more persons and 51.2% of total daily work time was spent in groups. 3) A total of 51 persons, working in different capacities were contacted. These included 21 persons giving patient care, 19 persons working in nursing unit management, and 7 persons working in human resource management. 3. With regard to the head nurse's role in work activity, 53.3% of total daily work activities involved the informational role, 26.9%, the interpersonal role and 19.9%, the decisional role. With regard to time, 57.7% was spent in the informational role, 23.9%, in the interpersonal role and 18.3%, in the decisional role. When the head nurse performed managerial work, she gave nearly equal emphasis to all three roles when she gave direct patient care the informational role was increased. 4. With regard to the activity media, the number of unscheduled activities accounted for 27.1% of the activities, scheduled activities, 24.3%, desk work activity, 22.1%, rounds, 12.5% and telephone calls, made or received, 14.0%. In daily total work time managerial work related to desk work and scheduled activities were high, ranging from 29.8% to 29.9% but for direct patient care time, scheduled activities and unscheduled activities were high, ranging from 23.6% to 35.3%. 5. With regard to the purpose of the work performed, 54.4% of the total daily work was concerned with the team and 41.4% was concerned with the agency. The managerial work was concerned mainly with the team and the direct patient care was concerned mainly with the patient. When the frequency of an activity and time were compared no significant difference was found between the days for which the work was recorded for any of the variables : the work content, the work process, the work role, the activity media and purpose of the work. On the basis of this study the following are proposed as an ideal model for head nurse work in Korea : The managerial work should be increased to 70%. The decisional role activities should be increased to 40%. Twenty percent of the work activity should be allocated to agency, community and profession. It is believed that this model for the head nurse's work can contribute to guidelines for job description development. Finally, educational programs, organizational and structural devices, and administrative support are needed for the proper function of the head nurse in this proposed model.

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상대가치(Resource-Based Relative Value)를 이용한 간호행위별 간호원가 산정 (Estimation of nursing costs for hospitalized patients using the resource-based relative value scale)

  • 박정호;송미숙;성영희;조정숙;심원희
    • 간호행정학회지
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    • 제5권2호
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    • pp.253-280
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    • 1999
  • A cost analysis for hospitalized patients was performed based on the RBRVS in order to determine an appropriate nursing fee schedule. The study was conducted through three phases as follows: 1) Nursing activities provided for the inpatients currently in Korea were identified and classified using a taxonomy which was developed by our research team through the Delphi process. 2) The resource-based relative points for every nursing activity according to nursing time, mental effort and judgement, technical skill, physical effort and stress were determined through a survey of 300 clinical RNs working at 5 tertiary hospitals from May 25 to July 25. 1998. 3) The nursing cost of every nursing activity for hospitalized patients was estimated based on the RBRVS. As a result, 136 nursing activities were identified and classified by nursing processes and nursing domains. However, our classification system of nursing activities should continue to be refined, and all nursing practices should be standardized. The nursing activities were given resource-based relative points ranging from 100 to 400 points, then each nursing activity was assigned a value for the RBRVS, which was determined by the exponential function of 2resource-based relative point/100. Thus, a value of 2 was calculated for 100 points, 4 for 200 points, 8 for 300 points, and 16 for 400 points. Meanwhile, the unit cost of nursing was calculated as 170 Won. The nursing cost of 136 nursing activities was estimated using the RBRVS as shown in

    . A proper nursing fee schedule for a new reimbursement system based upon the results of the above study should be prepared in the near future.

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