• Journal of Korean Academy of Nursing
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• v.25 no.4
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• pp.709-728
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• 1995

The job related activities of sixty nine nurses, working in the emergency rooms of three university hospitals, were analyzed for six days according to preestablished checklist of nursing activities ; the frequency of these activities and the amount of time spent in each specific nursing activity. The established checklist was monitored every five minutes for the duration of the duty autu, thus producing 414 items of data. The data were not gathered on consecutive days but over the period of one month from May 6, 1994 to June 5, 1994. The following conclusions are derived from analysis of the data : 1. Twelve categories of nursing activities were obtained : The primary activity was communication related to the patient and all information pertaining to the patient. Other activities included maintaining the patient's record, observation and assessment of the patient, cooperation with other medical personnel, management of equipment and drugs, procedure and treatment, specimen collection, consultation and education for the patient, including drug management and personal hygiene and any other relevant education to the patient's condition. 2. The average frequency of categorized nursing activity can be classified as follows : communication related to patient was the highest at 17.6 times. The next was maintaining the patient's record at 17.3 times. The observation and assessment occurred 16.9 times. Consultation and education for patients and family, 8 times, medication, 5.7 times, and procedures and treatments, 6 times. 3. The average time required for each activity was as follows : 230.1 minutes (or maintaining the patient's record, 204.9 minutes for communication related to the patient, 199.2 minutes for observation and assessment, 71.2 minutes for medication, 66 minutes for consultation and education of the patient and family, and 51.8 minutes for procedures and treatment. 4. The most demanding nursing activity in the emergency room for the nurse was answering questions from the patient's family, maintaining communication between the medical staff, maintaining and reviewing the patient's charts, writing prescriptions and monitoring 1. V. infusion rates. 5. The most time consuming nursing activities for the emergency room nurse include maintaining and following the patient's charts, communication between the medical staff, answering questions from the patient's family, observation of the patient and relaying all of the appropriate patient information to the incoming nurses during a shift change. 6. The F-test was administered to measure the required time for the categorized nursing activities according to day, evening, and night-shift nurses. There were significant differences (p<.05) in specimen collection, observation and assessment, cooperation between medical staffs, personal hygiene, communication related to patient, education and re-search. Posterior multiple comparison test showed that specimen collection, cooperation between medical staffs and personal hygiene were mostly done by the evening-shift nurses. Also most observations and assessments were done by the night-shift nurses. Education and communication to patients were done by day-shift nurses. Thus there were significant difference between shifts for the main nursing activities. So there should considev a reallocation of the duty of nurses on each shift. 7. The F-test also indicated that there wes a similarity in time duration for procedures and treatments and for cooperation between medical staff and nurses in all three hospitals. However, the remaining categories of nursing activities also showed a significant difference between the three hospitals. This indicated that there were differences in each emergency room that influence time for each categorized nursing activities and this should be given more consideration. Recommendations : 1. A seasonal difference should be considered in the activities of nurses in the emergency room and a comparative analysis should be carried out to deter-mine seasonal differentiation. 2. A study on more objectively measurable nursing activities should be administered as well as one determining the subjective responds towards nursing activities in the emergency room.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1455-1466
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• 2000

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.111-118
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• 2019

Objectives : The purpose of this study was to investigate the clinical characteristics of antipsychotic medication prescription for the symptom control in patients with delirium. Methods : One hundred and eighty-five patients referred to consultation-liaison psychiatric services for delirium due to general medical condition were included in this study. All subjects were divided into two groups (antipsychotics users vs. antipsychotics nonusers), and comparison analyses on their clinical characteristics were performed. Results : One hundred and twenty nine patients (66.5%) used antipsychotics for their delirium, and 56 patients (30.3%) did not use antipsychotics. The history of psychotropic medication was more frequently observed in antipsychotic users (5.4% vs. 18.6%, χ²=5.498, p=0.022). Especially, the history of benzodiazepine use was significantly high in antipsychotics users. The total score and sub-items of delirium rating scale-severity items except for the psychomotor retardation item showed higher scores in antipsychotic users than in nonusers (all p<0.05). The total score of the delirium rating scale-diagnosis items was higher in antipsychotic users than in the nonusers (p=0.010). Conclusions : Delirium patients with more severe delirium symptoms and with more history of benzodiazepine use were treated with antipsychotics more frequently than those without. These findings imply that benzodiazepine may not only exacerbate delirium but be associated with aggression or psychomotor agitation that need immediate intervention. Clinicians may need to pay attention not only these external symptoms but also to hypoactive symptoms that may lead to misdiagnosis and undertreatment.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.669-689
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• 2002

Purpose : The purpose of the present study is to develop a clinical pathway applied with activity-based management methodology for efficient clinical management to cope with rapid changing medical environments. Method : After making a preliminary pathway based on which a conceptual frame of reference was established to develop a clinical pathway, the final one was confirmed by verifying experts validity and clinical validity. The ultimate activity-based clinical pathway was restructured after clarifying, schematizing and analyzing the whole activities of clinical pathway in accordance with the conducting process of activity-based management. Result : A clinical pathway for total hip replacement was developed, in which the vertical axis consisted of assessment, examination, consultation, medication, treatment, diet, activity, and education, and the horizontal axis was composed of six days of hospitalization. Then, on the basis of the development, the clinical pathway including the improved contents and information was restructured after making the reform measure by analyzing each of activities in the pathway. And the list of contents related to the clinical management activity was made, which was described its main contents and the pre-activities that ought to be completed before conducting each of activities in the pathway. Conclusion : The clinical pathway applied with activity-based management may be used as a standard guidance for providing continuous and consistent patient care. It will provide the information for nursing activities to nurses and the management information about hospital and nursing activities to the hospital administrators. It will also be used as a tool for communication between medical staff. Besides, it will contribute to creating profits for the hospital by shortening the length of stay in patients.

• Asian Oncology Nursing
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• v.4 no.2
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• pp.110-123
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• 2004

The purpose of this study was to develop a clinical pathway for the allogeneic bone marrow transplantation donor. For this study, a conceptual framework was developed through a review of the literature including six steps which are using in Jones Hopkins Hospital. USA. The researcher reviewed 129 medical re-cords of donor who had bone marrow donation between January 2002 to January 2004, to identify the overall service contents required by these patients and to make a preliminary clinical pathway. A content validity test was done for the preliminary clinical pathway, a professional group screened 51 medical re-cords and adopted with 3 hospitalization days as the clinical pathway framework. In the fifth step, clinical pathway test was also done to 7 donors from April 28th to July, 2004. After these processes the final clinical pathway was developed. The results of this study are as follows: 1. The vertical axis of the clinical pathway Includes the following 9 items: vital signs, nursing assessment, activity, diet, intervention, medication, test, consultation and patient teaching. The duration of the horizontal axis was 3days from admission to discharge 2. Analysis of the 129 medical records indicated that the average length of stay was 3 4 days. The medical performance according to the vertical axis in the preliminary clinical pathway consisted of 51 items After clinical validity test, it steel consisted of 51 items in the final form. 3. Clinical Validity test was done to 7 bone marrow donors. During these process, The first patient was deleted because he was out of the criteria the investigate set and 6 patients were used, finally The result of this study indicated all of 7 donors were discharged on expected day. 4. Clinical pathway enables to improve the quality of care, multidisciplinary team work It also helps nursing bone marrow donor, effective education to donor or medical member. The results of this study suggest that clinical pathway may be able to improve the quality of nursing care for bone marrow transplantation donors.

• Research in Community and Public Health Nursing
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• v.12 no.3
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• pp.705-715
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• 2001

This study examined 19 papers published from 1977 to 2000 based on the objective frame evaluation. This purpose of this study was to examine the trend of Hwabyung research and to serve as a guide for the future 'Hwabyung' study. The results of studies were as follow. In the design of research, clinical studies are definitely dominant. As for the fields of research, the concept of Hwabyung was studied more frequently than the others. As for the authorship. psychiatrists prevailed but nursing professionals are on the increase. Research subject in clinical and survey study, patient was definitely dominant and the place of study was almost always a hospital (75%), data collection was higher on interview (58.3%). Hwabyung was considered unique culture bounded syndrome related to Korean culture. Frequent etiologic factor of Hwabyung were a husband's extra-marital affair, conflicts between houses wives and mothers-in-laws, and financial loss and suffering. From the incidence of Hwabyung, a greater number of patients with Hwabyung were middle aged women in the low economic and educational classes, and these were connected with the culture and the family system. The symptoms of Hwabyung included psychological and physical symptom, neurological disorder and disease behavior. Defense mechanisms and coping strategies for Hwabyung were somatization, suppression, orality, withdrawal, isolation, regression, help-seeking, complaining, and wreaking anger. Treatment of Hwabyung were medication, effort by herself, communication with families, consultation with psychologist, acupuncture, negative therapy, moxa, and Qi-kong. Psychiatric therapy, behavior therapy, nursing intervention on multi-interdisciplinary approach and psychiatric nursing approach were recommended for the nursing care of a Hwabyung patient.

• Korean Journal of Clinical Pharmacy
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• v.30 no.4
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• pp.243-249
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• 2020

Background: Despite the increased use of direct-acting oral anticoagulants, warfarin is still recommended as first-line therapy in patients with mechanical valves or moderate to severe mitral stenosis. Anticoagulation management services (AMSs) are warranted for patients receiving warfarin therapy due to the complexity of warfarin dosing and large interpatient variability. To overcome limited health care resources, we developed a messenger app-based chatbot that provides information to patients taking warfarin. Methods: We developed "WafarinTalk" as an add-on to the open-source messenger app KakaoTalk. We developed the prototype chatbot after building a database containing seven categories: 1) dosage and indications, 2) drug-drug interactions, 3) drug-food interactions, 4) drug-diet supplement interactions, 5) monitoring, 6) adverse events, and 7) precautions. We then surveyed 30 pharmacists and 10 patients on chatbot reliability and on participant satisfaction. Results: We found that 80% of the pharmacists agreed on the consistency of chatbot responses and 44% agreed on the appropriateness of chatbot. Furthermore, 47% of pharmacists said that they were willing to recommend the chatbot to patients. Of the seven categories, information on drug-food interaction was the most useful; 90% of patients said they were satisfied with the chatbot and 100% of patients said they were willing to use it when they were unable to see a pharmacist. We updated the prototype chatbot with feedback from the survey. Conclusion: This study showed that warfarin-related information could be provided to patients through a messenger application-based chatbot.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.112-119
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• 2012

Objectives : Delirium is a disorder defined as a sudden disturbance in thinking, speaking, acting and sleep pattern due to altered level of consciousness and cognitive function. The objective of this study is to analyze characteristics and therapeutic methods of the delirious patients during the recent 5 years, and provide basic data for further studies and investigation regarding delirium in the occurrence and treatment. Methods : We retrospectively reviewed medical records of 475 patients who were consulted for delirium in Kyunghee University Medical Center from January 2007 to December 2011. Results : During the 5 years, among the 475 patients who were diagnosed as delirium, men were more common(61.7%). The most commonly consulted reason and cause were sleep disturbance(80.8%) and post-operational delirium(30.9%), respectively. The medication prescription percentage was 76.6% and was significantly increased year after year. Ratio of using antipsychotics were 76.4% among prescribed medication and the most frequently prescribed antipsychotic drug was quetiapine(46.8%). Other specialists commonly misdiagnosed delirium when the patient was previously diagnosed as dementia(6.8%). Conclusions : In our study, post-operational delirium was the most commonly referred reason and the percentage of medication prescription tended to increase. Patients with history of dementia were more easily misdiagnosed as diseases other than delirium. Our study suggests that we should evaluate symptoms, causes, reasons of consultation, management tendency of delirium. We should also closely observe changes in sleep patterns and establish the prevention strategies for post-operational delirium and therapeutic bases for pharmacotherapy.

• Research in Community and Public Health Nursing
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• v.7 no.2
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• pp.183-202
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• 1996

This study was designed out to develop a home health care service for nurses working in community care services. This study investigates actual conditions at welfare institutions related to health needs the demands of clients, and the state of home health care services we hope that this study will improve upon the current service system. In Korea home health care services are still developing and only new becoming a part of the health care supply system. The data was collected by recording the client home nursing assessments modified to the situation of UTMB home health agency. In this study 107 clients were selected for home care who needed care for physical and mental deficits. The study lasted from March to November of 1995 at one of the welfare service institutions in Chunchon city. The results show that those who most frequently needed care services were over 50 years old with a health deficit of 80.3%, followed by sex as women who needed care at 59.8%. 50.5% of the clients had very little education. 99.1% of the clients live with their family, and a medical diagnostic analysis reveals that 73.9% of the 5 year period of illnesses were the following : 38.8% - muscular -skeleton system disorder, 24.4% - hypertension and stroke, 25.7% sole disease of arthritis. For behavioral conditions 43.3% of the patients were without care services, 56.6% of the patients were taking treatment that 73.5% of those were taking medication. The most main complaint of patients were 22.4% of pain in the extremities, next were 16.8% of a limitation of body activities, 15.0% was lumbo-sacralgia. According to the investigator who was a senior student nurse, the following suggestions were made: 32.7% for curative medical services, 29.9% for physical exercise, 19.6% for emotional support. Consultation nursing services consisted of 67.2% for physical therapy, 11.2% for the maintaining healing, 9.4% for counseling. The patients at home, required assistance most frequently for muscular-skeleton problems under the category of physical systems (33.3%). But, on the other hand, 49.5% of the patients required care givers at home, 28.2% had a knowledge deficit, 21.0% had malnutrition, 18.4% had bad impaired communication. The character of health problems were devided into chronic disease(67.0%), accidents(I3.1%), and general disease(15.9%). 86% of the disabled client had an impairment of the physical system. Eating (86.9%) , Toileting(77.6%), and personal care showed much the same of ADL condition, the level and range of achievement of mobility, the most frequently self performed was 81.3% only in a room size area, and 40.2% were completely dependent when going out. Although there were a large number of home care services in th community at these welfare institutions, many clients needed a variety of curative services. As policy changes have gathered momentum, responsibility for the development of a more suitable program was demanded by the clients from the community.

• Journal of dental hygiene science
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• v.16 no.3
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• pp.249-255
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• 2016

The Ministry of Health and Welfare in Korea has enforced the oral health promotion program for elderly in Korea. There are the denture delivery program and the fluoride application-scaling program for elderly. Donggu Public Health Center in Daejeon has delivered the fluoride application-scaling program for elderly since the demonstration project in 2009. The official dental hygienists had a prior consultation with Dong-gu branch of Korean Senior Citizens Association in Daejeon. We expanded the program through government office, welfare centers, and nursing homes. The participants were satisfied with the public relations (95.2%), scaling (99.7%), fluoride application (91.5%), toothbrushing education (98.6%), and denture cleaning education (96.6%). After a medial accident with persistent bleeding, the pre-inspection survey about systemic disease and medication was reinforced. The official dental hygienists have agonized over the low participation of the low-income group and the overlap benefit with health insurance benefit of scaling. We suggested it be needed the assessment of the public oral health program to overlap with health insurance benefit.