• 임상간호연구
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• 제15권2호
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• pp.115-126
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• 2009

Purpose: The purpose of this study was to assess the frequency and characteristics of occupational blood and body fluid exposure for operating room personnel during surgical procedures and identify risk factors. Methods: A self-report questionnaire was used to survey 519 operating room personnel who participated in 132 surgeries in an acute care hospital in Seoul between April 12 and 20, 2006. Results: The response rate was 82% (530/646) and analyzed total 519 except for improper 11 questionnaires. Exposure rate was 45.5% (60/132) during operations and 20.4% (106/519) for operating room personnel. By job categories, the exposure rate was as follows; anesthesiologists and nurses 31.2% (44/141), operators and assistants 22.1% (32/145), circulating nurses 12.0% (11/92), scrub nurses 11.4% (14/123). The mucous membrane-eye exposure with a high risk of transmitting infection was 6.6% (7/106) and the most frequent route of exposure was blood and body fluid touching unprotected skin. In multivariate analysis, the risk factors of exposure were services, duration of operation, a patient who had a peripheral arterial catheter line, and job category. Conclusion: Educational programs and appropriate use of personal protective equipment are necessary to prevent operating room personnel from being exposed to blood and body fluid.

• 간호행정학회지
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• 제1권1호
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• pp.147-211
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• 1995

Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.

• 한국의료질향상학회지
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• 제8권1호
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• pp.56-72
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• 2001

Background : To shorten processing time for variety of medical affairs of the patient at the outpatient clinic of a big hospital is very important to qualify medical care of the patient. Therefore, patient's waiting time for medical examination is often utilized as a strong tool to evaluate patient satisfaction with a medical care provided. We performed this study to investigate factors delaying related with waiting time for medical examination. Methods : The data were collected from June 26 to July 30, 1999. A total 275 case of medical treatment and 5,634 patients who visited outpatient clinics of a tertiary hospital were subjected to evaluate the waiting time. The data were analyzed using frequency, t-test, ANOVA, $X^2$-test by SPSS Windows 7.5 program. Results : The mean patient's waiting time objectively evaluated ($30.9{\pm}33.9$ min) was longer than that subjectively by patient evaluated ($25.1{\pm}26.2$ min). Patient waiting time objectively evaluated was influenced by the starting time of medical examination, consultation hours, patients arriving time etc, as expected. The time discrepancy between two evaluations was influenced by several causative factors. Regarding the degree of patients accepted waiting time with the medical examination is 20 min. Conclusion : The results show that, besides the starting time of medical examination, consultation hours and patients arriving time, influence the patient's subjective evaluation of waiting time for medical examination and his satisfaction related with the service in the big hospital. In order to improve patient satisfaction related with waiting time for medical examination, it will be effective examination rather than to shorten the real processing time within the consultation room.

• Child Health Nursing Research
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• 제2권1호
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• pp.13-26
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• 1996

This descriptive study was done to detect the possibilities of the development of the advocacy concept in nursing. The subjects consisted of 3 nurses who had agreed to participate to the study, working at nursery room in a general hospital. Data was collected from May 22 to June 13 in 1995 through tape recorded intensive-interview, and written down, then content analyzed qualitatively related to the infant advocacy. 1. Derivation fo the meaning about advocacy concept 1) The situations in need of infant advocacy were 12 categories : malpractice, overcharing, negligence, unnecessary services, and services without consent, and so on. 2) Fourteen categories of advocacy activities percived by nurses were derived from participants' statements. Protesting infant or his /her families against their counterpart, providing informations to families, cooperating with medical staffs for her patient, then calling medical staff not so as to be maleficient to her patient in its rank. 3) The expected result of advocacy activities perceived by nurses was respectively positive to her patient or families, but negative to nurse. 4) The feelings of nurses in the sitution of advocacy were expressed in to concern, comprehension, regret, powerlessness, charity, desire, and so on. 5) Nurses perceived that advocacy activities could be influenced positively by factors related to nurses' qualification and negatively by factors related to doctor's overdo and nurse's underdo. 2. Categorization of the meaning and their relationships In case of antecedental situation in need of infant advocacy, nurse perceives her patients need the advocacy to get a benefit through nurse's information, intervention speaking, building cooperations. The expected factors to influence advocacy activities perceived by nurses, are the power imbalance between medical staffs, the nurse's qualification, and the nurse's feeling from the situation. The above results suggest that the infant care situation will be recommendable field work place for concept development of advocacy with hybride model when it involves infant's families.

• 대한물리치료과학회지
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• 제14권1_4호
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• pp.61-69
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• 2007

Physiotherapy may be defined as the use of physical techniques for the treatment of injuries and movement dysfunction. In the world of human medicine, physiotherapy has been proven as an indispensable aid in the recovery of many musculoskeletal conditions, as evidenced by the extensive physiotherapy departments within most hospitals. Nowadays, this important branch of medicine is also rapidly becoming a recognised tool in the prevention, cure, and rehabilitation of many equine, canine and feline injuries. In 1978, canine physical therapy techniques were described by Ann Downer, a physical therapist on faculty at Ohio State University. Animal physical therapy is a new and rapidly developing field of health care for animals. The benefits of physical therapy have long been recognized in humans. More recently, work in the veterinary field has shown the same benefits of physical therapy to be true for animal patients. Performing orthopaedic or neurological surgery, or fitting a human patient with a cast or splint, and then discharging the patient is an outdated approach. In such cases, physical therapy is clearly warranted. Similarly, recent research has shown that post-surgical rehabilitation and therapy after injuries significantly improves the functional outcomes for animals. The goals of physiotherapy are to relieve pain, restore range of motion/movement, improve function, prevent injuries and expand the physical potential of the patient. Once in the field, physical therapists actively continue their education to keep up to date on the latest treatments and technologies. Via continuing education courses, physiotherapists can learn how to apply their unique and specialized knowledge to other animal species.

• 대한간호학회지
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• 제40권3호
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• pp.423-432
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• 2010

Purpose: This study was done to examine effects of Nei-Guan acupressure on nausea, vomiting and level of satisfaction for gynecological surgery patients who were using a patient-controlled analgesia (PCA). Methods: For this study, 51 patients were assigned to one of three groups, a control group (17 patients), experimental group 1 (finger acupressure group) (17 patients), and experimental group 2 (relief band group) (17 patients). The data were collected for 24 hr in the recovery room of a university hospital located in Seoul. The 6 hr-intervals including the time of leaving the recovery room were taken into consideration. Results: The occurrence of nausea between the experimental group with Nei-Guan acupressure treatment and the control group was different. However, there was no difference in nausea and vomiting control or level of patient satisfaction between the finger acupressure group and the relief band group. Conclusion: Nei-Guan acupressure is recommended for nursing practice as a way for alleviating the opioid-induced nausea and accelerating the recovery of patients who are using PCA after surgery.

• 성인간호학회지
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• 제17권5호
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• pp.697-708
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• 2005

Purpose: This study was to develop, implement, and evaluate an e-learning education program for improving practical knowledge and preventing nursing errors and adverse events of nurses working in the operating room (OR). Method: The e-learning program was developed and evaluated according to the following processes: 1) preparation phase 2) implementation phase 3) evaluation phase. In evaluation phase, the effectiveness was analyzed based on the Kirkpatrick's model. Results: The e-learning program consisted of OR basic nursing skills and techniques and nursing activities' manual based on the categories of nursing errors: surgical operation preparation, nursing skills and techniques, environment management, patient safety and comfort, and patient monitoring. The program was provided through on-line, http://cafe.daum.net/pnuhorn, for 4 weeks. The mean score(percent) of participants' satisfaction was $21.24{\pm}1.71$(68.2%). Their total knowledge level was significantly improved(Z=-3.00, p=.003) and specifically in the category of environment management(Z=-3.77, p<.001) and patient monitoring(Z=-2.46, p=.014). The occurrence of nursing errors or adverse events was a little decreased, but not statistically significant(Z=-3.10, p=.756). Conclusion: E-learning for nurses is one way of effective and efficient teaching-learning strategies. For better e-learning, it is important to develop the vital content of the education and objective measures for detecting nursing errors and adverse events.

• 한국산학기술학회논문지
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• 제16권4호
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• pp.2639-2646
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• 2015

본 연구는 수술 전 수술실 간호사의 지지간호중재가 자궁적출술 환자의 불안에 미치는 효과를 검정하기 위한 유사실험 연구이다. 2013년 5월 1일부터 6월 20일까지 불안, 혈압, 맥박에 대한 자료를 수집하였고, 통계 검정은 SPSS 20.0을 이용하여 $x^2-test$, Fisher's exact test, t-test를 수행하였다. 대조군 25명은 기존의 간호중재를 받았고 실험군 25명은 지지간호중재를 받은 자궁적출술 환자이다. 불안(p=.002), 이완기혈압(p=.012), 수축기 혈압(p=.045)은 대조군에 비해 실험군이 유의하게 낮았고 맥박수는 대조군과 실험군에서 유의한 차이가 없었다. 결과적으로 수술 전 지지간호중재가 환자의 불안을 감소시키는데 효과적인 것으로 확인되었다.

• Journal of Trauma and Injury
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• 제21권1호
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• pp.1-7
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• 2008

When man first walked on this planet, injury must have been a close encounter of the first kind. The outbreak of World War I, during a period of rapid scientific growth in the basic sciences, demonstrated the need to develop better methods of care for the wounded, methods that were later applicable to the civilian population. Trauma is a multisystem disease and, as such, benefits from almost any advance in medical science. As we learn more about the physiology and the biochemistry of various organ systems, we can provide better management for trauma victims. Improved imaging techniques, better appreciation of physiologic tolerance, and increased understanding of the side effects of specific surgical procedures have combined to reduce operative intervention as a component of trauma patient care. On the other hand, because of this rapid development of medical science, only a few doctors still have the ability to treat multisystem injuries because almost doctor has his or her specialty, which means a doctor tends to see only patients with diagnoses in the doctor's specialty. Trauma Surgeons are physicians who have completed the typical general surgery residency and who usually continue with a one to two year fellowship leading to additional board certification in Surgical Critical Care. It is important to note that trauma surgeons do not need to do all kinds of operations, such as neurosurgery and orthopedic surgery. Trauma surgeons are not only a surgeon but also general medical practitioners who are very good at critical care and coordination of patient. In order to achieve the best patient outcomes, trauma surgeons should be involved in prehospital Emergency Medical Services, the Trauma Resuscitation Room, the Operating Room, the Surgical Intensive Care and Trauma Unit, the Trauma Ward, the Rehabilitation Department, and the Trauma Outpatient Clinic. In conclusion, according to worldwide experience and research, the trauma surgeon is the key factor in the trauma care system, so the trauma surgeon should receive strong support to accomplish his or her role successfully.

• 동서간호학연구지
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• 제30권1호
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• pp.51-59
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• 2024

Purpose: The purpose of this study was to determine the effect of preoperative guidance and operating room environment experience using virtual reality on increasing satisfaction with information and reducing anxiety in preoperative patients undergoing general anesthesia and local anesthesia. Methods: A non-equivalent control group quasi-experimental design was employed. The participants were 80 surgical patients from 4 wards (40 experimental group and 40 control group) of the general hospital located in Gyeonggi-do. Data collection was conducted from June to November 2023 after completing the control group survey in January 2023. Data were analyzed using Chi-square, t-test, and Mann-Whitney U test using SPSS 23.0 program. Results: Satisfaction with preoperative information was higher in the experimental group than that of the control group. Additionally, anxiety related to surgery in the experimental group was significantly lower than that of the control group. The preoperative state anxiety score in the experimental group was not significantly lower than that of the control group. Conclusions: These results suggest that providing patient education and information using virtual reality technology can not only alleviate patients' anxiety related to surgery, but also have the potential to be used as an effective intervention to improve positive patient experiences.