• Title/Summary/Keyword: clinical nurses

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Design of a Hospice Referral System for Terminally Ill Cancer Patients Using a Standards-Based Health Information Exchange System

  • Lim, Kahyun;Kim, Jeong-Whun;Yoo, Sooyoung;Heo, Eunyoung;Ji, Hyerim;Kang, Beodeul
    • Healthcare Informatics Research
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    • v.24 no.4
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    • pp.317-326
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    • 2018
  • Objectives: The demand for hospice has been increasing among patients with cancer. This study examined the current hospice referral scenario for terminally ill cancer patients and created a data form to collect hospice information and a modified health information exchange (HIE) form for a more efficient referral system for terminally ill cancer patients. Methods: Surveys were conducted asking detailed information such as medical instruments and patient admission policies of hospices, and interviews were held to examine the current referral flow and any additional requirements. A task force team was organized to analyze the results of the interviews and surveys. Results: Six hospices completed the survey, and 3 physicians, 2 nurses, and 2 hospital staff from a tertiary hospital were interviewed. Seven categories were defined as essential for establishing hospice data. Ten categories and 40 data items were newly suggested for the existing HIE document form. An implementation guide for the Consolidated Clinical Document Architecture developed by Health Level 7 (HL7 CCDA) was also proposed. It is an international standard for interoperability that provides a framework for the exchange, integration, sharing, and retrieval of electronic health information. Based on these changes, a hospice referral scenario for terminally ill cancer patients was designed. Conclusions: Our findings show potential improvements that can be made to the current hospice referral system for terminally ill cancer patients. To make the referral system useful in practice, governmental efforts and investments are needed.

Comparison of four nutritional screening tools for Korean hospitalized children

  • Lee, Yeoun Joo;Yang, Hye Ran
    • Nutrition Research and Practice
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    • v.13 no.5
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    • pp.410-414
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    • 2019
  • BACKGROUND/OBJECTIVES: Several nutritional screening tools were recently developed to screen the risk of malnutrition in hospitalized children, but have not been validated in Asia. We compared four nutritional screening tools for pediatric patients in evaluating nutritional risks in newly hospitalized children. SUBJECTS/METHODS: Medical records of newly admitted pediatric patients between June 2016 and May 2017 at two tertiary hospitals were reviewed. Initial information by nurses and hospital records by doctors on baseline demographic, clinical, and anthropometric data at admission were collected in all subjects. Nutritional risks were evaluated using four nutritional screening tools including the pediatric nutritional risk score (PNRS), the screening tool for the assessment of malnutrition in pediatrics (STAMP), the paediatric Yorkhill malnutrition score (PYMS), and the screening tools for risk of nutritional status and growth (STRONGkids). RESULTS: A total of 559 patients (310 boys and 249 girls, mean age $6.3{\pm}5.5years$) were recruited. Patients in medical and surgical departments were 469 (83.9%) and 90 (16.1%), respectively. The prevalence of patients at risk of malnutrition were 31.1% for low risk, 52.2% for medium risk, and 16.6% for high risk by PNRS; 11.4%, 39.7%, and 48.8% by STAMP; 26.5%, 25.4%, and 48.1% by PYMS; and 35.6%, 58.9%, and 5.5% by STRONGkids. PNRS versus STRONGkids and STAMP versus PYMS showed moderate agreement (kappa = 0.566 and kappa = 0.495, respectively). PYMS and STAMP revealed a relatively high sensitivity of 87.8% and 77.6% for wasting. CONCLUSION: Different nutritional screening tools revealed considerably different results in evaluating nutritional risks in newly hospitalized children. Since pediatric patients are at risk of malnutrition at admission and during hospitalization, screening tools should be applied properly according to the situation of each hospital.

Development of Evidence-Based Nursing Practice Guideline for Prevention of Ventilator-Associated Pneumonia (인공호흡기 관련 폐렴의 예방을 위한 근거기반 간호실무지침 개발)

  • Kim, Hwa-Young;Ryu, Seang
    • The Journal of the Korea Contents Association
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    • v.21 no.10
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    • pp.630-644
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    • 2021
  • This study was conducted to develop evidence-based nursing practice guideline for the prevention of VAP. This is a methodological study to develop guideline and verify the effectiveness according to the hybrid method of the NECA. Topics and key questions were derived through literature review and interviews, and recommendations were converged and developed through guidelines review and SR and meta-analysis. This was verified through the RAND and evaluated through AGREEII. The clinical feasibility of the nursing practice guideline, consisting of 44 recommendations in 9 categories, was evaluated by 122 ICU nurses. Conclusively this evidence-based nursing practice guideline for the prevention of VAP was confirmed methodological quality and content validity and was suitable for our nursing practice environment.

The Effect of Simulation-Based Chest Tube Drain Management Nursing Education on Nursing Students' Response to Scenario Experiences, Confidence in Learning, and Problem Solving Ability (시뮬레이션 기반 흉관배액 관리 간호교육이 간호학생의 시나리오 경험에 대한 반응, 학습에 대한 자신감 및 문제해결능력에 미치는 효과)

  • Kim, Eun-ha;Jo, Sang-hee
    • Journal of Digital Convergence
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    • v.19 no.1
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    • pp.229-237
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    • 2021
  • The purpose of this study is to verify the effects of Simulation-based Chest Tube Drainage Management Nursing Education on the Nursing Students' Response to Scenario Experiences, Confidence in Learning, and Problem Solving Abilities. This study was performed with a one-group pretest-posttest design, and a total of 133 junior nursing students have participated in the research (31 teams of simulation-based education). According to the results of the study, most of the students have shown a positive response to the scenario experience after the simulation training, while their confidence in learning and problem-solving skills have improved significantly. This proves that simulation-based training using simulators can be very effective in practical nursing training. It is expected that this research could make a meaningful contribution to improving the overall quality of field-oriented practical training and clinical practice.

Effects of Uncertainty, Social Support, and Sick Role Behavior on Health-Related Quality of Life in Patients with Peripheral Arterial Disease (말초동맥질환자의 불확실성, 사회적 지지, 환자역할행위 이행이 건강 관련 삶의 질에 미치는 영향)

  • Lee, Hye Ju;Kim, Youn Kyoung
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.3
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    • pp.314-326
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    • 2020
  • Purpose: This study was conducted to examine the effects of uncertainty, social support, and sick role behavior on health-related quality of life in patients with peripheral arterial disease. Methods: This study is a descriptive research using self-reporting questionnaire. Data were collected from 167 patients with peripheral arterial disease. Measurement tools were Multidimensional Scale of Perceived Social Support(MSPSS), Mishel's Uncertainty in Illness Scale (MUIS), Sick role behavior measurement tools and SF-36 Version I. The data were analyzed using descriptive statistics, correlation, and regression analysis by using SPSS/WIN 24.0. Results: Factors that significantly influenced physical health-related quality of life were age (β=-.19, p=.010), monthly income (β=.17, p=.027), uncertainty (β=-.29, p<.001), and exercise and rest (β=.28, p<.001) that all together accounted for 32.6% of the variance. Factors that significantly influenced mental health-related quality of life were monthly income (β=.20, p=.015), drinking (β=.17, p=.040), uncertainty (β=-.24, p=.001), and exercise and rest in sick role behavior (β=.26, p=.003) that all together accounted for 18.2% of the variance. Social support was an insignificant factor on physical and mental health-related quality of life. Conclusion: To improve the health-related quality of life of people with peripheral arterial disease, it is necessary to develop a systematic nursing intervention program including a strong support system, education, strategies for alcohol abstinence, and exercise and rest therapy.

Cross Mapping of Standardized Nursing Diagnoses and Problems with NANDA-I in 4 Tertiary Hospitals (표준화된 간호진단 및 문제와 NANDA-I 교차분석: 4개 상급종합병원 사례를 중심으로)

  • Song, Mi Ra;Shim, So Yun;Kim, Dae Sung;Lee, Kyung Soon;Lee, Yu Na;Won, Mi Suk
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.3
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    • pp.374-384
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    • 2020
  • Purpose: To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. Methods: A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. Results: 65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. Conclusion: It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

The effects of diagnostic hysteroscopy on the reproductive outcomes of infertile women without intrauterine pathologies: a systematic review and meta-analysis

  • Yang, Soo Yeon;Chon, Seung-Joo;Lee, Seon Heui
    • Women's Health Nursing
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    • v.26 no.4
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    • pp.300-317
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    • 2020
  • Purpose: Hysteroscopy can be used both to diagnose and to treat intrauterine pathologies. It is well known that hysteroscopy helps to improve reproductive outcomes by treating intrauterine pathologies. However, it is uncertain whether hysteroscopy is helpful in the absence of intrauterine pathologies. This study aimed to confirm whether hysteroscopy improves the reproductive outcomes of infertile women without intrauterine pathologies. Methods: We conducted a systematic review of 11 studies retrieved from Ovid-MEDLINE, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data and used risk-of-bias tools (RoB 2.0 and ROBINS-I) to assess their quality. Results: Diagnostic hysteroscopy prior to in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) was associated with a higher clinical pregnancy rate (CPR) and live birth rate (LBR) than non-hysteroscopy in patients with recurrent implantation failure (RIF) (odds ratio, 1.79 and 1.46; 95% confidence interval, 1.40-2.30 and 1.08-1.97 for CPR and LBR, respectively) while hysteroscopy prior to first IVF was ineffective. The overall meta-analysis of LBR showed statistically significant findings for RIF, but a subgroup analysis showed effects only in prospective cohorts (odds ratio, 1.40 and 1.47; 95% confidence interval, 0.62-3.16 and 1.04-2.07 for randomized controlled trials and prospective cohorts, respectively). Therefore, the LBR should be interpreted carefully and further research is needed. Conclusion: Although further research is warranted, hysteroscopy may be considered as a diagnostic and treatment option for infertile women who have experienced RIF regardless of intrauterine pathologies. This finding enables nurses to educate and support infertile women with RIF prior to IVF/ICSI.

Factors Influencing on Vision-related Quality of Life in Patients with Retinal Diseases Receiving Intravitreal Injections (유리체강 내 주입술을 받는 망막질환자의 시각 관련 삶의 질 영향요인)

  • Kim, Hyunyoung;Ha, Yeongmi
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.1
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    • pp.54-65
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    • 2021
  • Purpose: The purpose of this study was to identify influencing factors on vision-related quality of life in patients with retinal diseases receiving intravitreal injections by examining relationships among anxiety, depression, coping, eye health behaviors and vision-related quality of life. Methods: One hundred and five outpatients who were diagnosed with macular degeneration and diabetic retinopathy were recruited from one university hospital during August 16, 2019 to March 25, 2020. Data were analyzed using descriptive statistics (frequency and percentage, mean, standard deviation), and t-tests, ANOVA, Scheffé test, Pearson's correlations, and stepwise multiple regressions using the IBM SPSS Statistics 25.0. Results: The vision-related quality of life according to general characteristics of retinal disease patients with intravitreal injection showed significant differences in age (F=3.01, p=.034), subjective economic status (F=5.83, p=.004), types of retinal disease (t=2.62, p=.010), and disease in both eyes (t=-3.04, p=.003). The vision-related quality of life showed a significant positive correlation with age (r=.24, p=.012), and negative correlations with anxiety (r=-.66, p<.001), depression (r=-.48, p<.001), and emotion-focused coping (r=-.20, p=.036). The hierarchical regression analysis indicated that factors affecting vision-related quality of life in patients with retinal diseases were anxiety and subjective economic status, accounting for 47.0% of the variances of the vision-related quality of life. Conclusion: Based on our results, health professionals need to pay attention to patients with low socioeconomic status due to frequent treatments. Also, a program needs to be developed to decrease anxiety for outpatients receiving intravitreal injections to improve their vision-related quality of life.

Factors Influencing Posttraumatic Growth in Patients with Lung Cancer (폐암 환자의 외상 후 성장에 영향을 미치는 요인)

  • Kim, Young Suk;Moon, Jin Ha;Lee, Young Suk;Kim, Yeon Woo;Heo, Gyu Rim;Oh, Soon Keum
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.1
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    • pp.98-108
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    • 2021
  • Purpose: This study was conducted to identify the factors influencing the posttraumatic growth (PTG) in patients with lung cancer and to provide basic data for nursing intervention development to improve PTG and adaptation. Methods: The study included 126 non-small cell lung cancer patients initially diagnosed at the Lung Cancer Center, C University Hospital in S city, Gyeonggi-do. Patients were asked to complete a questionnaire consisting of demographic characteristics, disease characteristics, posttraumatic growth, cancer coping, social support, and resilience. Data were analyzed using t-tests, ANOVA, and Pearson's correlation and multiple regression analysis. Results: The mean score for PTG in lung cancer patients was 56.39, cancer coping was 61.31, social support was 61.09, and resilience was 92.77. Significant positive correlations were found for PTG and cancer coping (r=.75, p<.001), social support (r=.52, p<.001) and resilience (r=.63, p<.001). Factors contributing to PTG of lung cancer patients were cancer coping (β=.53 p<.001), perceived health status(β=.20, p=.002), resilience (β=.21, p=.010) and importance of religion (β=.15, p=.013). This model explained about 64.0% of variances of PTG (F=29.58, p<.001). Conclusion: It is necessary to develop new nursing intervention programs to improve PTG for patients with lung cancer based on strategies to enhance coping and resilience to recovery. Longitudinal studies examining temporal changes in PTG among patients with lung cancer are suggested for future studies in this regard.

Self-care in Patients with Atrial Fibrillation Based on the Theory of Unpleasant Symptoms (불쾌 증상 이론을 적용한 심방 세동 환자의 자가관리)

  • Kim, Min Young;Lee, Sun Hee;Park, Han Jong
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.1
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    • pp.23-33
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    • 2022
  • Purpose: This study aimed to identify the relationships among disease severity, anxiety, depression, social support, unpleasant symptoms and self-care among patients with atrial fibrillation based on the unpleasant symptom theory, and to examine the mediating effects of unpleasant symptoms. Methods: A cross-sectional study was conducted. The participants were 216 patients with atrial fibrillation who were being followed up on an outpatient basis at a university hospital in Seoul. Data were collected from November 1, 2020 to June 30, 2021, using self-report questionnaires. Data were analyzed using IBM SPSS/WIN 27.0 and PROCESS macro with 95% bias-corrected bootstrap confidence interval(CI). Results: The average age of participants in this study was 66.0years. Disease severity (β=10.19, p<.001) and depression (β=1.53, p<.001) had significant positive relationships with unpleasant symptoms. Also, unpleasant symptoms (β=-0.03, p=.006) had a negative relationship with physical activity, which is a subscale of self- care. Social support (β=0.06, p<.001) was positively related with physical activity. Unpleasant symptoms showed a mediation effect in the relationship between disease severity and physical activity (Bias corrected bootstrap CI -0.65, -0.04). Depression had an indirect effect on physical activity that was mediated by unpleasant symptoms (Bias corrected bootstrap CI -0.11, -0.00). Conclusion: The findings of this study suggest that integrated strategies including physical, psychological, and social factors should be considered to promote self-care in patients with atrial fibrillation.