• Title/Summary/Keyword: critical care nursing

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Measuring Effects of Quality Improvement through the Development of Critical Pathway for Gamma Knife Radiosurgery (당일 감마나이프수술 환자의 표준진료지침 개발을 통한 질 향상 효과 측정)

  • Kim, Moo Seong;Ha, So Young;Bae, Yoon Hyuk;Jung, Yong Tae;Kim, Sung Tae;Lee, Won Hee;Go, Yeon Joo
    • Quality Improvement in Health Care
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    • v.18 no.1
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    • pp.27-36
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    • 2012
  • Objectives : A protocol called "critical pathway" was developed to standardize the management of hospital patients the day after they underwent gamma knife radiosurgery. The quality of improvement in patient outcomes was evaluated. Methods : Critical pathway was developed, according to the regulations of the I hospital, by analyzing the medical records of 22 inpatients who underwent gamma knife surgery within the period from January to April 2011 on the day of the surgery. The study included a group of 22 patients admitted to the hospital the day after they underwent gamma knife radiosurgery, between July and September 2011. The control group included 22 patients who had surgery employing the same method within the period from May to June 2011. To measure the effects on quality improvement, the average length of stay, the execution rate of the hospital discharge notice system, daily hospital revenue, and the satisfaction of the patients and the medical team were assessed. The patient questionnaire employed a four-point Likert scale while the medical-staff questionnaire employed a five-point Likert scale. Result : The average length of stay was significantly shorter in the study group compared to the control group (2.3 days vs. 3.8 days, P<0.05). The execution rate of the hospital discharge notice system was higher in the study group (100% vs. 72%) than in the control group. Daily hospital revenues were higher by 264,178 Korean won in the study group when compared to the control group. The study group showed greater satisfaction of patients compared to the control group based on a four-point Likert scale (P<0.05). The study group showed greater satisfaction in medical team compared to the control group based on a five-point Likert scale (P<0.05). Conclusion : The development and implementation of a critical pathway protocol for hospital admission the day after gamma knife radiosurgery is an effective care process that improves the clinical quality.

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A Study on the Prevention of Nosocomial Respiratory Infection in Critical Care Nurses (중환자실 간호사의 호흡기병원감염 예방에 관한 연구)

  • Choi Ji-Youn;Park Kyung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.397-413
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    • 1999
  • The purpose of study is to prevent Nosocomial Respiratory Infection after understand the Correlation about Recognition and Performance of Critical Nurses. Data were collected from Critical Nurses 300 persons who has worked in 14 Subsidary Hospitals of University in Seoul and the collection periode is from Nov. 1st, 1997 to Jul. 14th. 1998. There are 40 questions and constructed by 6 Domains which Hand Washing, Suction Management, Airway Management, Respiratory Instrument. Ventilation and Respiratory Intervention. Also, the Data were analized with SPSS program. The obtained results are as follows : (1) The Mean of Recognition for Prevention of Nosocomial Respiratory Infection is 4.649 and by Domains, Respiratory Intervention(4.758), Suction Management (4.669), Airway Management(4.660), Hand Washing(4.651), Ventilation(4.605) and Respiratory Instrument(4.561) according to the Mean. (2) The Mean of Performance for Prevention of Nosocomial Respiratory Infection is 3.991 and by Domains, Respiratory Intervention(4.498), Airway Management (4.107), Hand Washing(4.084), Suction Management(3.898), Respiratory Instrument(3.860) and Ventilation(3.690) according to the Mean. (3) In the Correlation of Recognition and Performance for the Prevention of Nosocomial Respiratory Infection, Hand Washing(r=0.755, p=0.000), Airway Management(r=0.724, p=0.000), Respiratory Intervention(r=0.693, p=0.000) are mentioned significant correlation level. The Performance is good whenever the Recognition is high for Respiratory Instrument(r=0.143, p=0.054) but it's not significant level and Suction Management and Ventilation has no Correlation. (4) In Normal Properties, The Recognition is good(p<.05) when Nurses has plenty Clinical Career, Attendance of the Education and Exclusive Nurse for the Respiratory Infection is in Hospital. The Age is not significant correlation level statistically but represent a little correlation. The Performance is good(p<.05) when Elder Age, Attendance of the Education and the plenty Clinical Career is not significant correlation level statistically but represent a little correlation. Another properties has no menas. According to the results, Suggestion is as follows ; (1) Required Education to advance Recognition and Performance about Prevention of Nosocomial Respiratory Infection for a little clinical career of Nursing and younger Nurses. (2) It needs to analyze Performance about Prevention of Nosocomial Respiratory Infection by observation of research worker.

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New Roles of the Professional Nursing in the Era of e-Health/u-Health (e-Health/u-Health 시대를 대비한 간호의 역할 확대)

  • Kim, Jeong-Eun
    • Perspectives in Nursing Science
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    • v.5 no.1
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    • pp.59-71
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    • 2008
  • e-Health/u-Health has generally been considered as an expansion of current medical and medical relevant segments. However. as e-Health/u-Health has been known to have typical attributes and characteristics of services supporting a physically and mentally well-balanced life of its users, we can rationally assume that e-Health/u-Health can be not only an expansion of the existing medical field but also a result of the complex and sophisticated convergence among diverse industries such as the ICT industry. traditional care-relevant segments, etc. Thus, in this study, we carefully and cautiously consider e-Health/u-Health in accordance with both possible scenarios: 1) an expansion of a typical industry, and 2) a result of a convergence among various industries. The advent of new technologies, rapid development of current technologies, and convergence trends in various fields are creating dramatic innovations in the next generation health services market. Consumerism as a characteristic of c-Health/u-Health can be expected to find a solution of the existing healthcare service problems. In the initial phase. mainly due to the absence of a vanguard, as well as to various legalistic and regulative limitations, the role of the government would be immensely critical for the successful early settlement of the e-Health/u-Health industry. Both the government and private sector need to practice continuous and effective public education and publicity mainly to increase the overall recognition and usability of e-Health/u-Health services. Nursing as a unique professional discipline should be well aware of the new paradigm shift of the healthcare market, and make maximum use of the possibility of this trend to the advent of the professional nursing's new role.

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

  • Yi, Myungsun;Kahn, David
    • Journal of Korean Academy of Nursing
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    • v.34 no.4
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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.

Development of a Play Toolkit for Supporting Infant and Toddler Development in Kyrgyzstan with a Focus on the Symbolic Functioning and Fine Motor Development of Infants 6 to 36 Months Old (키르기스스탄 영유아 성장발달을 위한 놀이도구 개발 및 사용효과 평가: 6~36개월 영유아의 상징적 기능 사고와 미세운동 발달 중심으로)

  • Chun, Hyojin;Do, Soyeon;Jung, Soyoon;Jin, Su hyun;Shin, Hyunsook
    • Child Health Nursing Research
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    • v.25 no.2
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    • pp.154-164
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    • 2019
  • Purpose: The study aimed to develop a play toolkit to facilitate infants' and toddlers' symbolic thought and fine motor development. Methods: This study used a methodological study design including two phases of development and evaluation. After reviewing the play culture and developmental health issues in Kyrgyzstan through a literature review and interviews with local experts and parents, the toolkit was developed and evaluated using content validity and utilization tests. Results: The toolkit was based on Westby's symbolic play and the fine motor milestones in the Bright Futures Guidelines. The Toolkits were composed of an overall suggested play schedule according to the child's age, four kinds of play props, and a utilization guidebook for parents. The play props were a felt book, sorting and assembling blocks, cup blocks, and a tangram. The guidebook contained age-appropriate operating methods and alternative ways to use the materials. Conclusion: A play toolkit was developed to enhance nurturing practices among parents of infants and toddlers. The findings may help facilitate effective interactions between parents and their children. Considering that nurturing care is critical for achieving better child health outcomes, enhancing parenting resources and parent-child relations could function as an effective strategy for promoting child health.

A Study on Factors Affecting the Workplace Selection, Job Performance Difficulties, and Turnover Intention of Nurses in Gyeongsangnam-do (경상남도 간호사의 직장선택, 직무수행의 어려움, 이직의도에 영향을 미치는 요인)

  • Hong, Hyunmi;Kim, Hyewon;Lee, Seunggeun;Kim, Minju;Kim, Youngsoo;Jeong, Baekgeun
    • Journal of Korean Academy of Rural Health Nursing
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    • v.18 no.1
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    • pp.57-71
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    • 2023
  • Purpose: This study aims to provide primary data for policy alternatives by identifying the problem of the nursing workforce shortage. Methods: For quantitative data, 446 questionnaires were analyzed. The mean and standard deviation were used for content description. ANOVA analysis and Scheffe? test were used to compare the differences according to the hospital level. For qualitative data, 1:1 in-depth and group interviews were conducted for six participants. Results: The factors nurses prioritized when choosing a workplace were salary, commuting distance, and work-life balance. Clinical nurses cited low wages, heavy workloads, and burnout as the most considerable difficulties in performing their duties. Factors influencing nurse's turnover intention were low wages, unmanageable workload, and rotation to unwanted departments in that order. New nurses tend not to apply to small-medium-sized hospitals, experienced nurses in their 30s-40s leave hospitals due to childcare and shift work difficulties, and nurses in their 50s and older tend to move to nursing homes rather than acute hospital settings. Conclusion: In this study, wage and workload were mentioned as the most critical factors in nurses' workplace selection, job performance difficulties, and turnover intention, so it is necessary to pay attention to this aspect when improving treatment for nurses.

Prevalence of workplace violence against registered nurses and their perceptions of relevant management systems in acute care hospitals (병원간호사의 직장 폭력 경험 실태 및 대응 체계에 대한 인식)

  • Park, Seungmi;Kwak, Eunju;Lee, Ye-Won;Park, Eun-Jun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.29 no.3
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    • pp.319-334
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    • 2023
  • Purpose: This study investigated the prevalence and perceptions of workplace violence against registered nurses (RNs) in hospitals. Methods: One thousand RNs replied to a nationwide survey from November 14 to December 22, 2022. They reported their general characteristics, prevalence of and their responses to different types of workplace violence from patients, family caregivers, physicians, and nurse peers, as well as their perceptions of workplace violence management systems. Results: A total of 71.1% of the RNs reported that they had experienced workplace violence in the last six months. The violence and sexual harassment experienced from patients and family caregivers were 57.3% and 19.1%, respectively. Furthermore, violence, sexual harassment, and workplace harassment from physicians were experienced by 24.6%, 4.0%, and 7.4%, respectively, of the RNs, and those from nurse peers by 21.4%, 3.1%, and 11.3%, respectively. The RNs stated that they often responded to workplace violence with passive and inactive behaviors, which were more serious toward physicians' workplace violence or sexual harassment from different perpetrators. Only 69.5% were aware of their hospital's workplace violence management systems, while only 14.7%~27.4%, according to the type of hospital (p=.471), perceived the systems as effective. Multiple important strategies were identified to prevent workplace violence. Conclusion: Critical suggestions are discussed for the prevention of workplace violence, including protecting the human rights of healthcare professionals, inter-organizational collaboration, and a culture of person-centered healthcare, and training nurse managers' competency in managing workplace violence.

A Study on the development of leadership training program for first-line nurse managers (일선 간호관리자를 위한 리더십 훈련 프로그램 개발)

  • Koh, Myung-Suk;Han, Sung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.333-345
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    • 2000
  • The health care environment becomes more competitive every day. It has fallen to nurse managers - from vice presidents of patient care to nurse managers and their assistants - to recruit and develop a workforce that successfully meets the needs of both patients and the organization. This means employees who demonstrate advanced critical thinking skills, creative problem solving, and sound decision making skills combined with clinical skills and patient advocacy. The environment which nurse managers create and the way they relate to their workforce, are pivotal to organizational viability. Especially leadership of first -line nurse managers contributes to the success of their organizations. First-line nurse managers are deserved to be one of the most administrative supervisors through the middle stratum in a hospital organization as being a manager in the field service if assessed from the overall aspects of hospital, as being an interim managers in the nursing department as well as being a supreme supervisor in a unit in terms of an organizational structure in the hospital. Similarly, as a compete leader, the first-line nurse managers have not only a professional which is qualified to perform a role of appropriate coordination with medical staff and key personnel but also hold an important key position a being responsible for performing his or her given role. The first-line nurse manager is expected to manage human and fiscal resources in ways not required before. While an identified need for well-prepared first-line nurse manager continues to plague the profession, first-line nurse managers often have difficulty providing the leadership required. The need leadership training to function effectively in their positions. But we hardly find a useful leadership training program for first-line nurse managers, therefore the purpose of this study was to developed the leadership training program for them. The steps of leadership program development were below: 1st step, 2 studies were done before develop a leadership program. One was done to ask to first-line nurse managers what they want to learn through leadership training, the other one was to ask the staff nurses what their opinions are for their first-line nurse managers leadership. 2nd step was searching other leadership programs contents. The results of this study were below: The total amount of hours is 24. Leadership training program contents are : Future of nursing profession (210min), understanding basic factor's of leadership and leadership theories(310 min), self understanding as first- line nurse managers(320 min), basic principle and practice of interpersonal relationship(210 min), assertiveness training, conflict management (180min), and group study(210min). This is challenging time to be a leader, especially in nursing. As nurse managers look toward the new millennium, it seems as through the same struggles are ahead that are behind. So nurse managers need to embrace change with a positive attitude. They need to demonstrate risk taking and support it in their staffs. All these things are possible that after they participate the leadership training program.

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Body Weight Changes and Lifestyle in Women within 1 year after Childbirth (여성의 출산 후 체중변화와 생활양식)

  • Chung, Chae Weon;Kim, Hyewon;Kim, Hyojung
    • Perspectives in Nursing Science
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    • v.13 no.2
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    • pp.88-95
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    • 2016
  • Purpose: Gestational weight gain and prepregnancy body weight are important factors of childbirth outcomes, which further cause obesity, metabolic diseases, or psychological problems later in women's lives. Changes in diet, westernized lifestyle, traditional postpartum care, and childbirth at older age are thought to be threats to proper weight management in Korean women of reproductive age. Public health and antenatal care need to focus on the proper body weight management of women by carefully planning pregnancy to postpartum periods. Purpose: This study explored the body weight changes from pregnancy to postpartum and the related characteristics in women within 12 months after childbirth. Methods: A cross-sectional, retrospective study was conducted with 102 Korean women within 12 months after childbirth. Data were collected using an online survey system, and a structured questionnaire available for electronic self-administration was modified to include demographics, obstetrical history, and body weight at 6 time points. The International Physical Activity Questionnaire and Eating Habit Measurement instruments were also used in data collection. A professional survey agency recruited the participants, and data were automatically saved and then analyzed. Results: The average age of the participants was 33.8 years, 48% were housewives and were well-educated. Seventy-two percent of the participants were primiparas and 82% had breastfed their babies. The body mass index (BMI) ranged from 17.3 to 27.8, indicating that 21.5% of the participants were overweight or obese. The mean gestational weight gain was 11.8 kg, and weight loss was apparent during the first 3 months postpartum. The mean decline in weight was 3.4 kg at one year after childbirth. Women wanted to lose 5.6 kg (range: 3~20 kg), however 44% of them reported that they had not engaged in any weight control efforts. Further, 72% of them reported having engaged in a low level of physical activity. Body weight was not associated with women's characteristics, physical activity score, and diet. Conclusion: Women's awareness of gestational weight gain, lifestyle modification, and the risk of prolonged weight retention should be promoted through the antenatal and women's healthcare systems. As pregnancy and childbirth are critical events that affect women's health, integrative education to ensure healthy transition to life after delivery is required.

Comparison of Activities of Daily Living Differences with Dementia Stage (치매 단계별 일상생활수행능력의 차이 비교)

  • Jang, Jong-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.557-563
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    • 2017
  • This study aims to obtain information about the ADL and I-ADL functions of people with dementia living in the community and nursing care facilities regarding their dementia stages for the purpose of supporting occupational therapists working in dementia care centers. The information was collected from 100 people with dementia living in the community and 100 people with dementia staying in care facilities from October 1 to November 20, 2015. 15 facilities participated in this study, including nursing homes, day care centers, health centers, geriatric hospitals and metropolitan dementia centers. All of the assessors were trained in the use of the instruments, ADCS-ADL, S-IADL, S-ADL and MMSE-K, by the researcher before conducting any evaluations or interviews. In order to compare the differences in the levels of ADL according to the dementia stage, an analysis was made via the post-hoc test after conducting a one-way ANOVA. An analysis of the residence type and dementia stage was made through the independent t-test. The comparison of the level of ADL between the people with dementia living in the community and those living in nursing homes showed differences in the moderate level of dementia for all items of the I-ADL and ADL (p<.01). The post-hoc test showed that there is a difference among the minimum, mild, and moderate levels. When the differences in ADL according to the residence type were examined, there were no significant differences in any of the stages (p>.05). Considering these results, it may be critical to identify the changes in the I-ADL rather than those in the ADL for the outcome index when conducting future intervention studies on dementia.