Purpose: The purpose of this research was to describe the decision making experience of VIP ward nurses in the clinical practice adjustment process. The research question was about "how nurses adjust their clinical practice to nursing situations and develop decision making process in a VIP ward." Method: The methodology of collecting and analyzing the data was based on the grounded theory of Strauss and Corbin(1998). The data was collected through in-depth interviews with 10 nurses from July to November, 2007. Results: The core category of nursing care decision making process was named as "adjusting with flexibility and deepened insight." The clinical practice adjustment process in nursing care decision making has progressed through four preceding interlocking phases: 1) dependent phase, 2) defensive phase, 3) independent phase, 4) integrative phase. These phases were classified by the level of nurses' dependency, proactivity, presupposition and integration. Conclusion: The result of this study indicated that nurse's decision making depended on their experiences and the nature of social context in which nursing occurs. Therefore, it is important to elaborate an effective training program for nurses to develop the phases of nursing care decision making.
Purpose : The purpose of this study is to investigate the current status of operation and ward environment of psychiatry in regional public hospitals. Methods: The method of this study utilized legal system and statistical data analysis, and drawing analysis of psychiatric ward. Results: In addition to treatment, psychiatric wards require additional space for special purposes such as psychological stability, social rehabilitation, and psychotherapy and so on. The room should improve the quality of the environment, taking into account the patient's psychological state, privacy, safety, amenity and hygiene. In addition, various types of room are needed to ensure sufficient area per bed. Implications: Psychiatric wards should be provided with a preference for psychological consideration of patients. The result of this study would be useful as a reference to plan psychiatric wards.
Purpose : The purpose of this study was to identify pediatric nurses's knowledge related to children's pain and pediatric nurses' career including educational experience and to examine whether there is a difference of their knowledge according to their career. Method : Subjects of this study was 115 pediatric nurses of one university hospital who understood purpose of this study and accepted to participate in this study. Subjects responded questionnaire by self report. The data were gathered for 7 days during the period from October 20 to October '2:7, 2003. The pediatric nurses' knowledge and attitude survey regarding pain developed by Manworren(2001) was used to identify the knowledge related to children's pain of pediatric nurses. Nurses' career consisted of level of education, presently working ward, duration of experience at clinic, pediatric clinic and presently working ward and educational experience related to children's pain during undergraduate courses, ward orientation and continuing education. Educational experience regarding children's pain was measured by whether they had education related to children's pain during undergraduate courses, ward orientation and continuing education or not and their perception on the contents of education was measured by 5 point Likert type scale. SPSS Windows was used to analyze the data. Scores of the knowledge regarding children's pain and career including educational experience of pediatric nurses were presented as mean and standard deviation. Mean percentage of correct answers responded by the subjects was presented under the category of introduction, assessment, pharmacological and nonpharmacological intervention for children's pain. The difference of scores of the knowledge regarding children's pain according to nurses' career was analyzed using t-test, ANOVA and Tukey as a post hoc. Statistical significance was accepted at the level of p<.05. Result : Pediatric nurses had deficient knowledge related to children's pain on the whole and did not trust pain complaint and underestimated the pain. They were short of concrete practical knowledge about pain assessment and pharmacological and nonpharmacological intervention for children's pain. They were excessively concerned with side effect and addiction of analgesic drugs and had a negative view point on nonpharmacological pain intervention. About 50% of the subjects received education regarding children's pain while their undergraduate courses. The number of nurses who received education regarding children's pain while their undergraduate courses was found to be greater among the recently graduated nurses. In ward orientation and continuing education, only less than 10% of the nurses received education regarding children's pain. Nurses perceived their experienced educational content deficient; experienced educational content consisted of pain introduction, assessment and pharmacological and nonpharmacological intervention for children's pain while their undergraduate course, ward orientation and continuing education. There were no significant differences of the knowledge regarding children's pain of pediatric nurses according to level of education, duration of experience at clinic, pediatric clinic and presently working ward. Scores of the knowledge regarding children's pain of nurses at neonatal ward were significantly greater than those of nurses at pediatric intensive care unit. Scores of the knowledge regarding children's pain of pediatric nurses who received education during their undergraduate course were significantly greater than those who did not receive it during their undergraduate courses. Also scores of the knowledge regarding children's pain of pediatric nurses who received one kind of educational experience were significantly greater than those who had no educational experience. Conclusion : Pediatric nurses had deficient knowledge of children's pain and underestimated the pain of children. Also they were short of concrete practical knowledge on pain assessment and intervention for children's pain.
The purpose of this study is to suggest various index concerning the nursing services and traffic efficiency between two types of nursing care system - Team Nursing Method and Functional Nursing Method. Through the investigations on activities of 5 day-duty nurses of ward in each general hospital occupying one method of them. So, it can be suggested that the basic data for the archtectural planning of wards in general hospitals must be considered to accept the hospital environmental requests.
Purpose: The purpose of this study was to identify and compare role conflict and job satisfaction between nurses in ICU and nurses in general ward. Method: The subjects of this study consisted of 141 nurses employed at ICU and 201 nurses employed at general ward, who were recruited from 5 university hospitals with 500 beds located in Seoul and Gyeonggido. The instruments included role conflict scale developed by Kim and Park(1995) and job satisfaction scale translated and modified by Lee(1996). The collected data were analyzed using the SPSS WIN 10.0 program for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. Result: In the two groups, there was a inverse correlation between role conflict and job satisfaction. In ICU, nurses' role conflict levels differed significantly depending on religion(p<.05), total experience(p<.05), scheduled to work as a nurse(p<.05). And nurses' job satisfaction levels differed significantly depending on total experience(p<.05), working period in current post(p<.001), scheduled to work as a nurse(p<.001), motive of choosing the nursing science(p<.01), and job satisfaction(p<.001). In general ward, nurses' job satisfaction levels differed significantly depending on marital status(p<.05), educational level(p<.01), total experience(p<.001), motive of choosing the nursing science(p<.01), and job satisfaction(p<.001). Conclusion: Summing up, the nurses at ICU showed higher level of role conflict than the nurses ay general ward. Therefore, it is needed to decrease the level of nurse's role conflict and improve their job satisfaction in ICU.
Purpose: The purpose of this study was to develop the adapted standard items of situation, background, assessment, recommendations (SBAR) processing for handover between nursing units in Korean hospitals and evaluate the validity and relevance of the standard items. Methods: A delphi method with 33 experts was used to evaluate content validity of the standard items. Then, 1,175 nurses working in general hospitals of more than 500 beds were recruited to evaluate the validity and relevance of the standard items for clinical implication. Results: Content validity was higher than 0.8. The highest scores for relevance among items in handover standards were state of consciousness in the assessment domain for a ward to a ward transfer ($3.82{\pm}0.40$), for a ward to an ICU ($3.85{\pm}0.38$), an ICU to a ward ($3.81{\pm}0.39$) and an ER to a ward ($3.85{\pm}0.37$). Congenital malformation was the highest relevance score for handover from a delivery room to a neonatal unit ($3.91{\pm}0.30$). Conclusion: This study evaluated validity and relevance of the essential contents for handover standards between units to improve communication quality among nurses. The findings of this study should also be applied in clinical nursing areas and the quality of information and effectiveness of usage of the standard should be evaluated.
간호간병통합서비스는 적정 간호인력 배치를 통한 팀 간호체계의 총체적인 전문 간호 제공과 병동 환경개선 및 환자 안전관리 등 제반 여건을 갖춘 병동에서 제공하는 입원 서비스이다. 연구 대상은 경기도내 일 종합병원의 해당 병동 입원환자로서 연구 목적을 이해하고 참여하기를 동의한 92명이며, 연구방법은 ICT 기반의 설문 자료를 SPSS/WIN 21.0 프로그램을 활용하여 빈도, 백분율, 평균, 표준편차, t-test, ANOVA을 적용하였으며, 사후검정은 Scheffe test를 하였다. 또한, 간호만족도와 서비스 평가의 상관관계는 Pearson's correlation으로 분석하였다. 본 논문은 만족도의 중요성을 재확인하고 간호간병통합서비스 병동 입원 환자들의 서비스의 질 향상을 위한 기초자료를 제시했다는 점에서 그 의의가 있다.
The purpose of this study is to design strategic hospital service based on each hospital's features. For this study, an assessment was conducted by 398 in-patents of one university hospital located in Seoul. The self-questionnaires, which were investigated from Oct. 15th to 29th in 2008, compared central reception desk with ward reception desk in satisfaction and re-use rate of patients. The major results of this study are as follow. First, according to each reception desk user, they have different satisfaction of it. As for the staff kindness, admission procedure, discharge procedure and manner of staff, those made patients be gratified as well. Second, when it comes to the intention of re-use, there were no significant features between them. Only convenience in admission and discharge procedure, however, was an attractive factor for the recommendation. Third, this study found out the reasons for higher re-use rate of central reception desk users. Regarding service, they were contented with the time for test and treatment. As for the hospital service, they would like to re-use this hospital because of convenient steps of paying interim fee and getting certificates. Forth, this study found out the reasons for higher re-use rate of ward reception desk users. As a point of hospital service view, they responded that respected privacy, hospital facility and general service were good for staying. As for the manner of staff, they mentioned nurses and staff in charge and whole staff members were kind. When it comes to the procedures of patient management, steps of discharge and paying interim fee were convenience. In conclusion, the results of this study suggest that providing a ward reception desk service can boost the satisfaction and re-use rate of in-patients. Furthermore, this strategic management method would be good for not only cutting the moving line but also efficient in-patient care system. These results can be used for the strategic hospital marketing field, as well. Even though this study has a limitation of the targeted populations which were only in a ward reception desk running hospital, it can say that having competitiveness in satisfaction of hospital service is good for promoting and differencing each hospital. Consequently, whole general management system would be adjusted first for differencing each hospital; however, this sort of additional factor should be concerned as well. I expect that this study would give meaningful data for designing strategic and differencing marketing method to lots of hospitals.
Purpose: The aim of this study was to develop instrument measuring the relocation stress syndrome for patients transferred from intensive care unit to general ward in Korea. Method: For item construction, components were drawn from an extensive review of the literature, existing instruments and the result of qualitative approach. A total 48 items were selected for the first draft. Ten experts evaluated this instrument for content validity and the number of items was reduced to 29. To refine and test reliability and validity of the instrument, data were collected from the 594 patients following transfer from intensive care unit. Results: Preliminarily twenty-nine items were generated through content validity and a pilot study. Using corrected items to total correlation coefficient, this instrument was further shortened to a 25 item scale. Factor analysis extracted a total of 23 items with a 5-point Likert-type scale. Relocation Stress Syndrome (RSS) included three subscales; physical factors (12 items), Patient's recognition to health care providers (8 items), and emotional factors (3 items). The RSS established content validity, construct validity, and reliability. Conclusion: This instrument demonstrates good reliability and validity, and therefore it is an appropriate measurement of assessing relocation stress syndrome in ICU to ward transition period.
Purpose: The purpose of this study was to examine comparison in the frequency and importance of nurse's job in new graduate nurses working in musculoskeletal ward. Method: A descriptive design was used with convenience sampling of 72 new graduate nurses working in musculoskeletal ward of the 2 hospitals with over 500 beds. Data were collected using a structured questionnaire. Results: 1) The total score for frequency of nurse's job was $2.57{\pm}.41$ and the total score for importance of nurse's job was $3.00{\pm}.37$. 2) The most frequent category was to manage for a medication and the most frequent item was to administer a medication in the order. 3) The most important category was to control of tissue perfusion and the most important item was to keep the aseptic techniques. 4) The frequencies among the work places were different significantly in 3 categories. 5) The importances among the work places were different significantly in 2 categories. Conclusion: New graduate nurses perceived the importance than the frequency of nurse's job. Also check or analysis the vital sign and nurses job associated with medication were higher score. Therefore, further research is needed to develop the educational strategies to strengthen not only theory also practice.
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