• 대한영양사협회학술지
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• 제22권1호
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• pp.53-69
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• 2016

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.

• 간호행정학회지
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• 제10권1호
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• pp.141-159
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• 2004

Purpose: The purpose of this study was to investigate the degree of information technology application, and to identify the effect of information technology application en knowledge management process in clinical nurses. Method: Participants were 629 regular clinical nurses who had worked for over 1 year in general units of 9 tertiary medical hospitals including 2 national university hospitals, 5 university hospitals, and 2 hospitals founded by business enterprises. Data were collected from March to May 2003 through questionnaires. Thee structured instruments were used to collect the data: Information Technology Application scale, Knowledge Management Process Scale(Jeong, Lee, Lee, & Kim, 2003), and one for general characteristics. The data were analyzed using reliability analysis, descriptive analysis, one-way ANOVA, $Scheff{\acute{e}$ test, correlation analysis, partial correlation analysis, and multiple regression analysis with the SPSS for Windows 10,0 program. Result: 1) The HIS application degree, IT application ability, and IT application frequency were significantly correlated with the degree of knowledge management process activation and 4 elements of knowledge management process, Knowledge Creation, Knowledge Storage, Knowledge Sharing, and Knowledge Utilization(p=.000). 2) The 3 variables, HIS application degree, IT application ability, and IT application frequency explained 47.2% of the total variance of the degree of knowledge management process activation, and 352% of me total variance of Knowledge Storage. And 2 variables, HIS application degree and IT application frequency explained 17.6% of the total variance of Knowledge Creation, 39.9% of the total variance of Knowledge sharing, and 33.8% of the total variance of Knowledge utilization(p=.000). 3) As a result of multiple regression analysis, the key determinant of the degree of knowledge management process activation for nurses was HIS application degree The HIS application degree, IT application frequency, position, IT application ability, and continuous total numbers of years working at the present hospital explained 51.1% of the total variance of the degree of knowledge management process activation(p=.000). Conclusions: These results suggest that the information technology application positively affects the nurses' knowledge management process. From the above findings, information technology application is empirically verified as a useful and effective method to activate knowledge management process, and knowledge management.

• 간호행정학회지
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• 제9권3호
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• pp.415-427
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• 2003

Purpose: The purpose of this study was to investigate the degree and pattern of knowledge management process, and to identify the relationship between knowledge management process and organizational effectiveness in clinical nurses. Method: Participants were 665 regular clinical nurses who had worked for over 1 year in general units of 9 tertiary medical hospitals including 2 national university hospitals, 5 university hospitals, and 2 hospitals founded by business enterprises. Data were collected from March to May 2003 through questionnaires. Four structured instruments were used to collect the data: Knowledge Management Process Scale(Jeong, Lee, Lee, & Kim, 2003), cCommitment Questionnaire(Mowday, Steers, & Porter, 1979), General Satisfaction Scale(CooK, Hepworth, Wall, & Warr, 1981), and one for general characteristics. The data were analyzed using factor analysis, reliability analysis, descriptive analysis, cluster analysis, one-way ANOVA, Scheffe test, correlation analysis with the SPSS for Windows 10.0 program. Result: 1) The average score for knowledge management process in nurses was $3.08{\pm}.54$ on a 5-point Likert scale. In order from highest mean score, the elements of knowledge management process, were Knowledge $Utilization(3.35{\pm}.57)$, Knowledge $Sharing(3.07{\pm}.58)$, Knowledge $Creation(2.99{\pm}.63)$, and Knowledge $Storage(2.91{\pm}.82)$. 2) Four knowledge management patterns for nurses, which were derived from cluster analysis, were inactivate pattern, delayed pattern, activate pattern, and high-activate pattern of knowledge management. 3) The degree of knowledge management process activation and 4 elements of knowledge management process, Knowledge Creation, Knowledge Storage, Knowledge Sharing, and Knowledge Utilization, were significantly correlated with nurses' organizational commitment and job satisfaction(p=.000). 4) The nurses' organizational commitment and job satisfaction showed significant differences according to the knowledge management patterns derived from cluster analysis of high-activate pattern, activate pattern, delayed pattern, inactivate pattern(p=.000). Conclusion: These results suggest that there are four knowledge management patterns for nurses, and knowledge management process positively affects the nurses' organizational commitment and job satisfaction. From the above findings, knowledge management process is empirically verified as a useful and effective method to increase organizational effectiveness, and develop the organization.

• 간호행정학회지
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• 제19권1호
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• pp.39-47
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• 2013

Purpose: This practice study was done to describe the process and outcomes of application of Evidence Based Nursing (EBN) Education to nursing management clinical practicum and suggest strategies to diffuse EBN into nursing management education. Methods: Education on the evidence based nursing management process was provided to 65 senior nursing students from a university. Nursing management clinical practicum integrated with EBN. The setting was a five full day-clinical practicum. Group and individual training on EBN process with lectures, small group discussions, conferences, and educational prescription were provided. Outcomes were analyzed using paired t test for 65 participants. Results: Evidence based nursing competency increased significantly showing improvement in understanding EBN, formulating clinical question, searching & classifying the evidence, recognizing level of evidence, considering patient preference, and evaluating outcomes. Nursing students' access and use of evidence based information resource also improved. Conclusion: The results of this study indicate that the application of EBN to nursing management clinical practicum is effective to improve EBN competency in undergraduate students and should be further applied in nursing education using the systematic strategies.

• 한국농촌간호학회지
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• 제19권1호
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• pp.35-43
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• 2024

Purpose: This study aimed to explore the influence of knowledge, problem-solving processes, and self-efficacy on the clinical competency of nursing students in the home health nursing management of diabetes mellitus (DM). Methods: The subjects of this study were 136 nursing students. Data were collected from April 18 to April 29, 2022, and analyzed using the SPSS 23.0 program. Results: The total mean scores of nursing students' knowledge, problem-solving process, self-efficacy, and clinical competency in DM home health nursing management were 71.24, 3.92, 7.47, and 4.09, respectively. Clinical competency was significantly and positively correlated with the problem-solving process (r=.60, p<.001) and self-efficacy (r=.48, p<.001) but not with knowledge (r=.09, p=.311). The problem-solving process was also positively correlated with self-efficacy (r=.41, p<.001). Regression analysis revealed a 41.4% variance in the nursing student's clinical competency with problem-solving process (β=.47, p<.001) and self-efficacy (β=.28, p<.001). Conclusion: The results of this study provide valuable evidence for the development of educational interventions aimed at enhancing the clinical competency of nursing students in relation to home-visit healthcare services for DM management.

• 임상간호연구
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• 제15권1호
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• pp.133-147
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• 2009

Purpose: This study was conducted to construct evidence based clinical guidelines and to develop nursing process based performance measures for prevention and management of pressure ulcers, falls and pain. Method: Clinical guidelines were drafted through a comprehensive review of relevant literature, national guidelines and hospital protocols. The proposed guidelines were reviewed by a panel of experts and 90 hospital nurses, and refined on the basis of their suggestions. Nursing process based performance measures were developed based on the clinical guidelines and content validity was examined by surveys from 90 hospital nurses. Results: All items, except timetable for position change and pressure ulcer nursing record, in the guidelines for prevention and management of pressure ulcer were appropriate. Most items, except fall risk assessment tools, were appropriate for the guidelines of fall prevention. All other items, except the purpose of pain management, were appropriate for the guidelines of pain management. Performance measures developed in this study were acceptable as a tool to evaluate quality of nursing care. Conclusion: Nursing process based performance measures provide important indicators to monitor whether necessary nursing care is implemented and can be used as the primary resources to improve quality of nursing services.

• 간호행정학회지
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• 제22권1호
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• pp.80-90
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• 2016

Purpose: The purpose of this study was to analyze students experiences during clinical practice in nursing management. Methods: Assessing through computerized databases, self-reflection reports of 57 students were analyzed. Text network analysis was applied to examine the research. The keywords from each student's reports were extracted by using the programs, KrKwic and NetMiner. Results: The results of the keyword network analysis of what students learned in the nursing process included 27 words. The keyword network analysis of what students learned from the problem solving process included 23 words and the keyword network analysis of improvements in Clinical Practice of Nursing included 31 words. Conclusion: Studies related to clinical practice have been increasing, and themes of the studies have also become broader. Further research is required to investigate factors affecting clinical practice specifically in nursing management. Further comparative studies are necessary to define differences in clinical practice systems related to improving nursing students competency.

• 대한영양사협회학술지
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• 제20권3호
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• pp.199-211
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• 2014

The increasing elderly population has created an urgent need for well-managed convalescent hospitals, which should provide appropriate clinical nutrition services. The new accreditation policy requiring participation of all convalescent hospitals since 2013 may promote improvement of clinical nutrition services. This study examined whether or not the accreditation policy has increased practice level and dietitians' perception of the importance of clinical nutrition management. Of the 177 convalescent hospitals accredited by January 30, 2014, dietitians from 73 hospitals (41.2%) completed the survey questionnaire. The pre-tested questionnaire surveyed general characteristics of the hospital and dietitians, current status of clinical nutrition management, and changes in the perception and practice levels of various aspects of food and clinical nutrition management. In average, dietitians with more than 5 years of work experience (68.1%) provided food and clinical nutrition services (71.2%). After accreditation, dietitians' perception of the importance and practice level of clinical nutrition service increased (P<0.001). Level of perception, however, was significantly (P<0.001) higher than practice level before and after accreditation. During perception and practice level of initial nutrition assessment, a compulsory accreditation item, notably and significantly (P<0.001) improved after accreditation. The significant difference between perception and practice level disappeared after accreditation. In conclusion, the accreditation process had positive effects on clinical nutrition management in terms of dietitians' perception and practice levels. Making more accreditation items compulsory and providing motivation and professional education to dietitians in convalescent hospitals could lead to additional improvements.

• 산업공학
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• 제20권4호
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• pp.488-497
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• 2007

In order to provide appropriate decision supports in medical domain, it is required that clinical knowledge should be implemented in a computable form and integrated with hospital information systems. Healthcare organizations are increasingly adopting tools that provide decision support functions to improve patient outcomes and reduce medical errors. This paper proposes a process centric clinical decision support system based on medical knowledge. The proposed system consists of three major parts - CPG (Clinical Practice Guideline) repository, service pool, and decision support module. The decision support module interprets knowledge base generated by the CPG and service part and then generates a personalized and patient centered clinical process satisfying specific requirements of an individual patient during the entire treatment in hospitals. The proposed system helps health professionals to select appropriate clinical procedures according to the circumstances of each patient resulting in improving the quality of care and reducing medical errors.

• Annals of Clinical Neurophysiology
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• 제14권1호
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• pp.1-6
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• 2012

Low back pain is a common clinical condition with heterogeneous causes and challenges to manage. High prevalence and numerous assessments result in an enormous socioeconomic burden. Clinician must conduct efficient and stepwise evaluation process to rule out serious spinal pathology, neurologic involvement, and identify risk factors for chronicity. The process can be achieved through the focused history taking and physical examination. Certain factors related to serious spinal pathology include age (>50 years), trauma, unexplained fever, recent urinary or skin infection, unrelenting night or rest pain, unexplained weight loss, osteoporosis, immunosuppression, steroid use, and widespread neurological symptoms. In non-specific low back pain, diagnostic imaging and laboratory studies are often unnecessary and can disturb an appropriate management. For the management of acute low back pain, patient education and medication such as acetaminophen, non-steroidal anti-inflammatory drugs, and muscle relaxants are recommended. For chronic low back pain, behavior therapy, back exercise, and spinal manipulation are beneficial. The evidence based approach could improve success rate of management, result in prevention of acute low back pain from being chronic intractable pain.