• Korean Journal of Adult Nursing
• /
• v.13 no.3
• /
• pp.385-396
• /
• 2001

The purpose of this study is to present an actual example for procedures for developing a PBL package based on philosophical backgrounds derived from Problem-based learning. To perform a systemic study on the operations of an intergrated curricula under multidisciplines, a research team made up of several professors with different academic backgrounds was formed. Among the four situations for the patients with perception-adjustment disorder, especially a procedure for the development of PBL package which can be used in the emergency room situation has been proposed. The little(2000)'s PBL package model has been applied for this study. Tha package includes course objectives, learning objectives, concept map, situation scenario, tutor guide, and evaluation method. It is believed that learning objectives achievement procedures designed as a part of a problem-based learning package development procedures for the nursing of patients with perception-adjustment can be achieved at the same level as the learning objectives for the science of nursing founded by the Korean Nurses Association.

• Journal of Korean Academy of Nursing
• /
• v.42 no.3
• /
• pp.351-360
• /
• 2012

Purpose: The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. Methods: A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. Results: The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. Conclusion: Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.

• Korean Journal of Clinical Pharmacy
• /
• v.25 no.4
• /
• pp.264-272
• /
• 2015

Background: The over-prescription of acid-suppressive therapy for the provision of stress ulcer prophylaxis (SUP) in hospitalized patients has been identified in a proceeding study. Objective: This study was conducted to evaluate clinicians' beliefs, knowledge and other factors that influence the over-prescribing of SUP in low-risk, non-intensive care unit (non-ICU) patients. Method: A cross-sectional survey consisting of multiple-choice queries and close-ended questions was distributed to healthcare personnel at a major teaching hospital in Korea. Results: More than half of total respondents reported that they would continue SUP following patients discharge from the ICU (77.8%, 43.5%, and 39.7% in the physician, pharmacist, and nurse groups, respectively). Over 55% of physicians would also initiate non-ICU patients on SUP upon hospital admission, and 42.6% of physicians would even continue prophylaxis post hospital discharge. The mean knowledge score regarding SUP indications and side effects was higher in pharmacists compared to physicians and nurses (12.44, 7.40, and 7.28, respectively; p<0.001). High-prescribing behavior was associated with a prescriber's belief that SUP is effective for preventing bleeding (odds ratio 7.40; 95% confidence interval 1.57 to 31.94; p=0.012). Low knowledge score and computerized order set also showed statistically significant association with the overutilization of SUP.

• Research in Community and Public Health Nursing
• /
• v.19 no.3
• /
• pp.398-407
• /
• 2008

Purpose: The purpose of this study was to examine the association among change in the sensation of the arms, the range of motion in the shoulders and depression in breast cancer patients. Method: This is a descriptive study on correlation. The participants were 132 patients who had been diagnosed with breast cancer and had mastectomy at a university hospital, and had participated in a breast cancer self-help group. The degree of depression was assessed by SCL-90-R scores. Collected data were analyzed with SPSS 12.0 for windows. Results: The participants complained of 'heaviness' as the most frequent and serious symptom of change in the sensation of the arms. 'Completely zip up the dress with a back-fastening zipper' was the most difficult motion of the shoulders. Participants who were in a worse stage of disease were in a worse condition in shoulder functions, and on a higher degree of depression. The degree of change in sensation and shoulder functions showed a positive correlation with each other, and both of them showed a negative correlation with the degree of depression. Conclusion: Sensation and motion change in the arms and the shoulders were common phenomena that affected depression in patients who had mastectomy. Nurses should consider not only depression but also discomfort of the arms and the shoulders for patients with mastectomy.

• Archives of Craniofacial Surgery
• /
• v.14 no.2
• /
• pp.89-95
• /
• 2013

Background: If patients have a better understanding about their problem and treatment, compliance and satisfaction with treatment will increase. For this purpose, simple repeated explanations regarding a patients' problem and treatment are essential. Critical pathway (CP) has a very wide range in medicine with the exception of the plastic surgery field. The authors developed a CP for facial bone fractures and implemented it clinically. The aim of this study was to evaluate the effectiveness of the CP on the degree of recognition of the problem along with patient satisfaction with the treatment process. Methods: From May 2011 to October 2011, a total of 82 patients suffering from facial bone fractures were studied. The CP for facial bone fractures was developed by plastic surgeons, residents and nurses. Subsequently, the authors investigated the degree of recognition of the disease and patient satisfaction with the treatment through the use of a questionnaire. The authors compared the score of the questionnaires before and after implementation of the clinical pathway. Results: The degree of the recognition of the problem changed from 3.1 to 4.2 (p<0.001). Further, the degree of satisfaction with the treatment process changed from 3.6 to 4.3 (p<0.05). Overall, there was a two point increase in improvement. Conclusion: Implementation of the CP for facial bone fractures was effective in improving the degree of recognition and satisfaction. The authors expect that hereafter, the CP for facial bone fractures will be implemented actively in the plastic surgery field.

• Child Health Nursing Research
• /
• v.1 no.1
• /
• pp.37-46
• /
• 1995

The effects of different discharge packs on the rate of breast-feeding practice were investigated in 2, 4 and 8 postpartal weeks. The subjects were those who have made delivery at Chonnam University Hospital from Jan to Feb 1994. They were divided into three groups by the discharge pack provided at the nursery room : the one group was given with formula discharge pack, another with breast-feeding discharge pack and the other nothing. The formula discharge pack contained formula samples, a feeding bottle and a pamphlet prepared by a formula company, and breast-feeding discharge pack contained a manual pump and a pamphlet made by Korean Nurses Association. Following results were obtained : 1. Different discharge packs significantly affected the rate of breast-feeding practice at 2 week postpartum, while not at 4 and 8 week postpartum. 2. At 2 week postpartum, the rate of breast-feeding practice was significantly higher in the group given with breast-feeding discharge pak than in that given with formula discharge pack. It was also significantly higher in the group given with breast-feeding discharge pack compared with the group given nothing. The breast feeding rate, however, did not significantly differ between the formula discharge pack group and the group given nothing. 3. The most common cause for the artificial feeding was 'lacking breast milk'. The most common cause to select a specific brand of formula milk was 'the same as in the nursery room'. In conclusion, it is suggested that encouraging mothers to perform breast feeding and providing them with a breast-feeding discharge pack instead of a formula pack at the nursery room are helpful in promoting the breast-feeding.

• The Korean Nurse
• /
• v.23 no.1 s.124
• /
• pp.25-35
• /
• 1984

인간 궁극의 목적은 ''행복한 생활''이며 이를 위한 가장 중요한 조건이 ''건강''이라는데 이론을 제기할 사람이 없다. 그간 우리나라는 1970년대를 거치면서 절대빈곤을 해결하느라고 경제개발계획을 수립하는 등 최선의 노력을 해 왔으며, 따라서 보건정책은 등한시 해 왔던 것이 사실이며 이는 극히 당연한 일이라고 생각한다. 최근 경제 개발 계획의 성공적인 시행으로 중진국의 대열에 서게 되었다. 산업 전략이 빚는 인구 이동의 불가피성, 인구의 도시집중 현상과 사회 구조의 변화는 생활방식 뿐 아니라 의식구조의 변화와 가치관의 변화를 가져왔으며 질병 양상과 건강 문제의 양상을 변화시켰다. 이로 말미암은 경제적, 지역적, 심리적 및 문화적 불균형 상태는 건강관호와 보건의료제도에도 불균형 상태를 갖고 와 불가피하게 된다. 이러한 불균형은 해소되어야 하는 시점에 온 것이며 정부가 목표로 하는 복지사회 건설을 위한 가장 중요한 보건 정책에 정부가 역점을 두게 된 것은 극히 당연하다. 이에 1976년 발족한 한국 보건 개발 연구원이 1977년부터 시작한 시법 사업을 실시한 결과, 지역 주민의 반응, 수용성, 의료 이용도, 의료비 절감 등을 분석하고 그 효율성을 인정받아 1981년 12월 31일 농어촌 보건의료를 위하여 특별 조치법을 제정하고 의료시설, 요원의 도시편중 교통의 불편, 고가의 의료 수가로 소외되어 오던 보건의료 취약지역 주민에게 기본권으로서의 기초 건강 서비스를 제공하기에 이르렀다. 이 건강 관호 제도에 그 바탕을 두며 보건 진료원이 그 척추의 역할을 담당한다. 1981년도와 1982년도에 선발되어 교육을 받고 배치된 738명의 보건 진료원은 38만명의 벽오지주민에게 현재 의료의 손길을 펴고, 질병의 예방을 위한 조치를 취하며 건강의 유지, 증진을 위하여 활동하고 있다. 건강관호는 시설이나 장비가 하는 것이 아니고 건물이 하는 것은 더욱 아니며, 지식과 기술을 갖춘 자격있는 의료인이 소명의식을 갖고 임할 때만 가능하다. 오랜숙원이었던 보건의료의 지역간 경제, 사회적, 문화적 계층간의 불균형을 해소하고 온 국민에게 기본권으로서의 건강을 갖도록 하는 이 새로운 제도는 패기에 넘치는 열정을 지닌 많은 젊은 간호학도들의 참여없이는 성공을 기대할 수 없다. 어떠한 제도이건 새로운 제도가 사회에 정착되기까지는 여러 해 동안의 시행착오와 고난이 반드시 수반되어 왔다는 사실을 우리는 역사를 통해 알고 있다. 그러나 그 제도가 다수를 위해 정의롭고 바람직한 제도일 때 반드시 성공을 거두었다는 사실도 알고 있다.

• The Korean Nurse
• /
• v.32 no.5
• /
• pp.78-92
• /
• 1994

The purposes of this study were to evaluate the results of the hospital self inspection with the medical insurance and to offer basic materials to the medical insurance inspection and the education of medical insurance. The study was undertaken with 4,730 cases among the total 13,810 medical insurance in patients from Jan. 1990 to Dec. 1990 at one university hospital in Pusan. The major contents of the inspection were the omission of diagnosis and medical fee, curtailment, application mistake, the rates of inclusion, subtraction and total accumulation. The data were collected using patients charts and bills. The results of the paper analysis were as follows. 1. From the pre-discharge hospital self inspection, major omission were treatment and material fee but medication fee were moderately high and high curtailment was operation fee. 2. Decreasing order of operation fee adjustment were digestive(22.4%) muscular(22%) and neuro system operation(21.4%). Majority of the medication fee adjustments were injection form of medication(95.7%). 50% of the treatment fee adjustments were composed of injection fee(27.9%) and dressing or post-operative dressing fee(22.3%). 74.7% of material costs were composed of oxygen(30.6%), blood and the blood composed materials(44.1%). 3. Pre-discharge inspection showed 6% adjustment rate, 4.3% addition and 2.1% curtailment rate. Most of the adjustment were omission(66.1%). 4. Omission were divided by event omission(92.6%)and application mistake(7.4%). The decreasing order of omission fee were operation(21.84%), treatment(18.71 %) diagnosis(18.68%), medication (14.53%) and material costs(10.84%). So operation and treatment part were the major part of the total omission fee(40.55%). 5. The average omission of diagnosis were 1,800 per month.

• The Korean Nurse
• /
• v.37 no.3
• /
• pp.62-77
• /
• 1998

지역 사회 서비스는 노인들이 질적으로 보다나은 삶을 영위할 수 있도록 돕는 기능을 해야 한다. 적절한 서비스의 공급을 위해서는 지역사회 서비스 욕구 사정의 과정이 우선적으로 요구되어지며, 이에 본 연구는 호주 NSW주 Illawarra지역내의 retirement village에 거주하는 자가 돌봄이 가능한 노인들의 지역사회 서비스에 대한 욕구를 평가하는데 그 목적을 두었다. Illawarra지역내의 여덟개 retirement village에 거주하는 98명의 자가 돌봄이 가능한 노인들을 대상으로 그들의 1) functional status; 2) 지역 사회 서비스에 대한 지식정도; 3) 지역 사회 서비스 사용정도; 4) 지역 사회 서비스 만족도; 5) 잠재적인 지역 사회 서비스 욕구 등에 대한 자가 보고형 설문조사가 이루어졌다. 수집된 자료들은 JMP(for Mackitosh) program으로 통계 처리되었고, computed frequencies가 본 연구의 목표 달성을 위해 주로 사용되었다. 연구 결과를 요약하면 아래와 같다. 1. 평균 연령 76세인 대상자들의 80%이상이 그들의 일상 생활 운영에 다른 사람의 도움을 필요로 하지 않으며 건강상태 또한 양호하다고 자각했다. 2. 90%이상의 대상자들이 지역 사회 서비스를 이용하지 않았다. 3. 70%이상의 대상자가 지역 사회 서비스의 존재에 대해 지각하고 있었다. 4. 60%이상의 대상자가 필요시에는 지역 사회 서비스에 관한 정보를 어렵지 않게 얻을 수 있다고 생각했다. 5. 40%의 대상자가 기존의 지역 사회 서비스에 대한 양과 질에 만족을 나타냈고, 그 외의 대상자들 (60%)은 그 지역 사회 서비스에 대한구체적인 지식이 없다고 보고했다. 6. 25%의 대상자들이 여러 지역 사회 서비스에 관한 관심을 보였다. 결론적으로 대다수의 대상자들은 대부분의 지역 사회 서비스들을 필요로 하지 않았고, 이러한 결과는 현재 자가간호가 가능한 retirement village 거주 노인들에게 당연한 것으로 보여진다. 그러나, 자존감이 강한 노인들에게 서비스 욕구는 자가 돌봄이 건강에 대한 포기정도로 왜곡되어 자각될 가능성이 있는 만큼, 본 연구를 통해 보고된 대상자들의 지역 사회 서비스에 대한 관심도는 고려해 볼만한 가치가 있다고 여겨지며, 이에 노인들의 자존감이 서비스 욕구에 미치는 영향에 대한 연구를 제언하는 바이다.

• The Korean Nurse
• /
• v.37 no.3
• /
• pp.78-91
• /
• 1998

This descriptive study was conducted in order to develop a standard criteria for nursing laboratory facilities and equipment for use by the 3 year nursing colleges. The data was collected from Aug. 28 to Sept. 30, 1997 by mail from 44 3 year nursing schools. To develop a standard criteria, the syllabi for Fundamentals of Nursing laboratory and for Physical Assessment were collected and analyzed. The following information was elicited and analyzed by the researchers : 1. for each procedure in the syllabus, the percentage of schools using the procedures 2. the facilities and equipment recognized as necessary and the percentage of schools which possess each item 3. calculation of the standard criteria for size of the nursing laboratory together with a list of the necessary facilities and equipment. The results of the study were as follows : 1. The Size of facility was 181.2m2 for fundamentals of Nursing laboratory and 56.4m2 for the storage room. For those whose number of students exceed 120, 1.98m2 is required for each students. 2. The number of items included in the standard criteria was 92 for Fundamentals of Nursing and Physical Assessment and 47 for other nursing subjects. The items made of rubber, plastic and the disposable ones were suggested but excluded from the standard criteria. Based on the above findings, the following suggestions were made : 1. Periodic review of the standard criteria is necessary to update the standard. 2. A study on the standardization of the curriculum for basic science laboratory, including experiment and a standard criteria of equipment, is necessary. 3. A study to develop a computer program for management of nursing laboratory facilities and equipment is needed.