• The Korean Journal of Emergency Medical Services
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• v.13 no.3
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• pp.71-76
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• 2009

서론(Introduction) : 의학 시뮬레이션(medical simulation)은 교육생 학습과정에서 내재된 위험이 환자에게 가해짐 없이 교육생이 실제적인 환자 상황을 경험할 수 있게 하고 여러 다양한 임상내용이 포함한 상황에 적용될 수 있다. 시뮬레이션 기술의 사용은 의학교육(medical education), 인증서(certification), 면허교부(Licensure)와 의료의 질 형성에 큰 잠재력을 가지고 있다. 복강경 수술, 내시경검사, 전문심장구조술, 응급기도관리와 외상소생을 포함한 다양한 임상시술의 수행에서 시뮬레이션이 교육생의 술기를 달성하고, 측정하고, 유지하는 유효성을 증명하였다 컴퓨터로 조절되는 시뮬레이터는 맥박, 혈압, 호흡, 대화가 가능하고, 중증질환 또는 외상환자의 치료에 필요한 같은 인명구조 시술을 수행할 수 있다. 의학 시뮬레이션은 의사, 간호사, 응급구조사와 응급 진료를 필요로 하는 환자를 치료하는 사람에게 필요하다. 최신 전문심장구조술 과정수업은 전통적인 강의와 제한된 팀 상호작용이 포함된 이틀 과정이다. 우리는 비 영어권 국제 응급구조학생의 전문심장구조술 술기능력을 알아보고, 그것을 미국 응급구조학생과 비교하고자 한다. 목적(Objective) : 이 연구의 목적은 다양한 전문심장구조술 증례 시나리오를 가진 의학 시뮬레이터를 이용하여 미국과 한국의 응급구조 학생의 능력을 비교하는 것이다. 시행 장소(Site Location) : 이 연구는 한국 제주도에 위치한 제주한라대학 스토니브룩 응급의료교육원에서 진행되었다. 학생들의 평가는 스토니브룩에 위치한 스토니브룩 대학 의료원의 한 명의 평가자(Dr. lee)에 의해 수행되었다. 방법(Methods) : 15명의 한국 응급구조학생들은 세 팀으로 무작위로 선정하였다. 5명이 한 팀이 되어 같은 증례의 시나리오를 받았다. 세 가지 시나리오는 : 첫째, 천식지속상태(Status asthmaticus), 둘째, 긴장기흉을 동반한 만성폐쇄성폐질환(COPD with tension penumothorax) 그리고 마지막으로 메가코드(megacode)를 가진 심정지 이다. 세 팀을 각각 그리고 기본인명구조술(BLS)과 전문심장구조술(ACLS)과정을 마친 미국 응급구조학생들과 비교하였다. 15명의 미국 응급구조학생들 또한 세 팀으로 무작위로 선정하였다. 이 응급구조 학생들은 플러싱병원 의료원 소속으로 그곳에서 이 연구에 참여할 뿐만 아니라 지속적인 의학교육(CME)이수를 받았다. 이들에게도 같은 세 가지 증례의 시나리오가 주어졌고 Dr lee는 총 여섯 팀을 평가하였다(한국 세 팀과 미국 세팀). 결과(Results) : 양 국가의 모든 15명의 학생이 의학시뮬레이터를 사용하여 전문심장구조술 메가코드시험을 포함한 시험에 모두 통과하였다. 비록 학생들을 무작위로 세 팀으로 나누었지만 한 팀이 이 모든 세 증례에서 다른 팀보다 뛰어났다. 제주한라대학 2번 팀은 더 나은 기도관리, 리듬인식과 임상술기를 가진 모든 중요한 활동을 얻기에서 우수했다. 그들은 핵심요구사항을 90% 이상 충족시겼다. 한국의 2번팀(G2K)은 메가코드에서 기도개방, 호흡평가, 순환징후 그리고 흉부압박수와 같은 신체검진 술기에서도 탁월했다. 게다가 다른 팀과 비교 시 리듬인식, 약물지식과 임상술기에서도 높은 점수를 받았으며 2번팀(G2K)이 6팀 중에 가장 뛰어나게 역활수행을 하였다. 결론(Conclusion) : 이 비교 연구에서 한국학생과 미국학생간에 전문심장구조술 메가코드 시험의 통과율에는 차이가 없었다. 그러나 미국학생은 세 팀 사이에 더 적은 변이로 더 일괄된 점수를 받았다. 한국학생들도 모든 세 가지 증례를 통과하였지만 이 세 팀은 미국학생 팀보다 점수에서 더 큰 변이를 보였다.

• Journal of Korean Clinical Nursing Research
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• v.28 no.3
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• pp.233-241
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• 2022

Purpose: This study was conducted to identify the nurses' positive psychological capital and adaptation of job rotation and to examine their relationship. Methods: This cross-sectional study was conducted from March 23, 2021 to March 31, 2021, the study participants were 160 nurses who worked at a general hospital in Seoul. The collected data were analyzed using the IBM SPSS/WIN 24.0 program with descriptive statistics, t-test, ANOVA, and Pearson's correlation coefficient. Results: The positive psychological capital of nurses scored an average of 3.30±0.43 out of 5. Nurses' adaptation of job rotation scored an average of 3.00±0.35 out of 5. Positive psychological capital and adaptation of job rotation showed a significant positive correlation (r=.70, p<.001). Conclusion: This study shows that the greater level of positive psychological capital was associated with the increased adaptation of job rotation among nurses. It is necessary to develop an practical program to help nurses, who have recently experienced job rotation, adapt to the changed job by improving the positive psychological capital.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.9
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• pp.93-102
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• 2019

This study examined the nurse's emotional exhaustion and influencing factors, and the relationship between emotional burnout and hospital nursing workload using multilevel logistic regression analysis. The study subjects were 3,083 nurses of 65 hospitals, who participated in the training conducted by the Healthcare Industry Trade Union in 2010 and responded to the questionnaire. First, 71.6% of nurses experienced emotional exhaustion, and the average score of emotional exhaustion was 33.53. Second, the 'non - nursing work experience' showed a significant effect on emotional exhaustion. Third, the 'sufficient nursing staff' variable increased the emotional exhaustion. Fourth, the nursing grades were correlated significantly with emotional exhaustion compared to those with more than four beds per nurse. Fifth, in the case of working in the internal ward, the shorter the clinical career, the higher the emotional exhaustion. In other words, higher emotional exhaustion was associated with more nursing work experience, more perceived insufficient nursing staff, more nurses per bed, the department of internal medicine, and a shorter clinical career.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.3
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• pp.489-498
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• 2016

This study examined the effects of internal marketing and customer orientation on the organizational commitment of nurses in specialized hospitals. This research was conducted from May 1 to 30, 2015 and involved 149 nurses at 5 specialized hospitals in Busan, The collected data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe's test, Pearson correlation coefficients, stepwise multiple regression by the SPSS WIN 18.0 program. As a result, there were significant differences in the organizational commitment according to age, marital status, education, clinical experience, position, work shift, working unit, number of beds, and experience of participation for employee satisfaction survey. Organizational commitment was positively related to the internal marketing. In addition, there was a positive correlation between the organizational commitment and customer orientation. Meaningful variables that influenced the organizational commitment were internal marketing, working unit, education, and position. The total explanation power was 58.5% and the internal marketing was the most influential factor. In conclusion, to enhance the organizational commitment of nurses working in specialized hospitals, educational opportunities need to be provided to increase the professionalism of nurses, and efforts will be needed to improve the working environment and develop internal marketing strategies, such as regular satisfaction surveys.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.2
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• pp.130-136
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• 2016

The aim of this study was to examine and analyze the infection management status of Jeju-area general hospitals, and in order to convey the importance of infection management, and to determine role plans of medical technologists as infection management staff, the infection management status was examined through surveys targeting 7 general hospitals located in Jeju Special Self-Governing Province. The infection management of Jeju-area medical institutions showed excellence in that all institutions operated an infection management room, there was dedicated manpower, and hospital infection management guidelines were established and executed. However most institutions were operating their infection management room with only 1 nurse, reporting many difficulties in securing dedicated manpower, microbe-related culture deciphering, frequency of multiple-resistance bacteria, infection statistics, and details on microbe testing. Accordingly, it is believed that the medical technologist who can perform the practical tasks of infection management has sufficient qualification and experience in infection management as per the medical law enforcement regulations, and in operation of an infection management room. If medical technologists (infection control microbiological technologist) with expert knowledge on microbes and infection control nurses can execute the tasks as dedicated personnel, the operation of the infection management room will be more advanced. In addition, for proper infection management in the future, the introduction of a medical system specialized in infection management and full support for infection management of vulnerable small/medium hospitals in addition to general hospitals across the country is considered important.

• Journal of the Korea Convergence Society
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• v.11 no.11
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• pp.443-450
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• 2020

The purpose of this study was to examine the inter-rater and intra-rater reliability of the oral mucosa pressure ulcer classification system based on the photographs. The study consisted of two stages; development and evaluation. In the developmental stage, 9 photographs of 82 were selected. In the evaluation stage, a total of 49 participants were invited web-based survey by e-mail. Cohen's weighted kappa and Krippendorff's alpha were used to define the inter-rater reliability. Nine photographs consisted of two, three, three, and one in normal, stage 1, stage 2, and stomatitis, respectively. The inter-rater reliabilities of wound care nurse specialist, intensive care nurse specialist, and dentist groups were 0.75, 0.70, and 0.78, respectively. The intra-rater reliability was 0.73. The inter-rater and intra-rater reliabilities of the oral mucosa pressure ulcer classification system showed substantially good agreement.

• Proceedings of the KSCN Conference
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• 2003.11a
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• pp.1087-1088
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• 2003

영양사들이 영양서비스에 대한 중요성을 인지하고 있으나 과중한 급식업무에 많은 시간을 할애하고 있으며, 또한 영양사 인력부족으로 인하여 환자에 대한 영양상담이나 영양교육이 제대로 이루어지지 않은 병원도 있어 간호사들이 영양교육을 실시하는 병원도 있는 형편이다. 따라서 영양사의 원활한 업무수행 및 역할 확대를 위하여서는 이에 영향을 미칠 수 있는 의사, 간호사 등 타 의료진의 영양관리에 대한 인식파악이 필요하다고 생각되어 마산시와 창원시 및 경남 함안군에 위치한 2-3차 의료기관에 종사하는 보건의료인 중 간호사(197명)와 간호조무사(94명) 291명을 대상으로 영양관리 중 영양교육에 대한 인식 및 영양지식을 조사하였다. 환자에 대한 영양교육이 ‘매우 필요하다’에 74.2%, ‘약간 필요하다’에 32.8%를 보였으며, 간호사와 전문대 졸업이상에서 간호조무사와 고졸자에 비하여 영양교육의 필요성에 대한 인식이 높게 나타났다(P < 0.001). 영양관련 과목을 이수하지 않은 자는 47.9%, 이수한 자는 52.1%이였으며, 간호조무사(60.4%)가 간호사(42.1%)에 비하여 (P < 0.01), 그리고 근무경력 2년 이상(51.5-59.4%)에서 2년 미만(34.4%)에 비하여(p < 0.05) 영양관련 과목을 이수하지 않은 율이 높게 나타났다. 영양관련 과목 이수자 중 영양지식 습득정도는58.7%가 ‘부족’한 것으로, 40.6%가 ‘보통’인 것으로 답하여 대체적으로 부족하다고 인정하고 있었으며, 학력이 낮을수록 ‘부족’하다고 답하여 학력에 따른 유의적인 차이가 있었다(P <0.05). 영양교육 연수경험이 있는 대상자는 8.6%, 없는 자는 91.4%로 간호사에게 영양교육 연수가 거의 없는 것으로 나타났다. 영양교육 담당자의 적임자로는 영양사 69.3%, 간호사 21.3%로 답하였으며, 간호조무사는 영양교육 적임자로 영양사 82.7%, 간호사 5.8%로 답한 반면 간호사는 영양사 63.5%, 간호사 27.9%로 답하여 유의적인 차이가 있었다(p<0.001). 기회가 주어지면 영양교육에 참여하겠다는 대상자가 47.2%, 참여하지 않겠다는 자가 52.8%로 약1/2정도는 기회가 온다면 참여하겠다는 의지를 보였다. 영양교육에 참여하지 않겠다는 대상자의 43.4%가 ‘전문지식 부족’, 40.5%가 ‘전문가가 담당하는 것이 바람직하다’, 11.9%가 ‘업무량 과중’을 이유로 들었다. 환자치료 시에 영양에 대한 내용을 지도한 경험이 있는 대상자는 48.8%, 지도경험이 없는 자는 51.2%로 나타났으며, 간호사(60.9%)가 간호조무사(23.4%)에 비하여 지도경험율이 높고(p <0.001), 기혼자(57.4%)가 미혼자(44.2%)에 비하여 높으며(p < 0.05), 근무경력 2년 이상이 2년 미만에 비하여(P <0.05), 그리고 전문대 졸업 이상이 고졸에 비하여 유의적으로 높게 나타났다(p<0.001). 영양지식점수의 분포는 good group 55.3%, fair group 41.2%, Poor group이 3.4%이었으며, good group의 평균 점수는 16.1 $\pm$ 1.1점, fair group은 12.7 $\pm$ 1.4점, poor group은 6.6 $\pm$ 2.8점으로 세 군간에 유의적인 차이가 있었다(p < 0.001). 영양지식 점수의 전체평균은 20점 만점에 14.3 $\pm$ 2.5점이였다. 이상의 결과에서 환자의 영양교육 및 상담업무를 원활하게 수행하기 위하여 영양과 내에 급식관리와는 별도로 임상영양 및 영양교육을 담당하는 부서가 설치되어야 하며 영양사의 인력확보가 필요하다고 사료된다. 이상의 연구결과에서 간호사들은 영양교육이 필요하다고 인식하고 있었으나 간호사를 영양교육의 적임자로 보는 시각이 비교적 높았고 약 1/2정도는 영양교육에 참여하겠다는 의지를 가지고 있을 뿐만 아니라 실제로 영양지도를 한 경험이 있는 것으로 나타났다. 그러나 1/2 정도가 영양관련과목을 이수하지 않았으며, 91.4%가 영양교육 연수경험이 없는 것으로 나타났다.

• Journal of East-West Nursing Research
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• v.24 no.1
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• pp.20-27
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• 2018

Purpose: This study was conducted to investigate nursing professionalism, emotional labor (surface acting, deep acting), empathic concern, and customer orientation, and identify factors contributing to customer orientation among clinical nurses. Methods: The participants in this study were 151 clinical nurses at the three general hospitals. Data were collected using self-administered questionnaires. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression. Results: The significant predictors of customer orientation among clinical nurses were empathic concern (${\beta}=.43$, p<.001), nursing professionalism (${\beta}=.29$, p<.001), nursing career (${\beta}=.16$, p=.007), and deep acting (${\beta}=.14$, p=.021). Theses variables explained 47.6% of the variance of customer orientation. Empathic concern was the most influential variable. Conclusion: The results suggest that it is crucial to improve deep acting, empathic concern and nursing professionalism for increasing clinical nurses' customer orientation. Management-level leaders in the hospitals should develop strategies of promoting nursing professionalism, deep acting and empathic concern to improve customer orientation.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.4
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• pp.536-543
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• 2013

Purpose: The purpose of this study was to identify the mediating effect of professionalism in the relationship between clinical competence and field adaptation in newly graduated nurses. Methods: The participants in this study were 213 nurses from four tertiary hospitals who had less than 12 months of nursing experience. Data were collected during January and February, 2013. A structured questionnaire was used for data collection and data were analyzed using descriptive statistics, Pearson correlation coefficients, and path analysis with the SPSS/WIN 21.0 and AMOS 21.0 programs. Results: The mean score for clinical competence was $2.85{\pm}0.25$, for professionalism, $3.10{\pm}0.30$, and for field adaptation, $2.79{\pm}0.37$. There was a significant positive relationship between clinical competence and field adaptation. Also, professionalism was positively correlated with field adaptation. Professionalism showed mediating effects between clinical competence and field adaptation. Improvement of clinical competence increased professionalism and the increased professionalism raised the field adaptation. Conclusion: Based on these findings, orientation programs including strategies to increase professionalism, should be established to promote effective field adaptation in newly graduated nurses. These orientation programs can strengthen professionalism, the mediator between clinical competence and field adaptation in newly graduated nurses.

• Journal of Korean Academy of Nursing
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• v.40 no.6
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• pp.892-902
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• 2010

Purpose: This study was done to identify participation by home healthcare nurses in clinical decision making and factors influencing clinical decision making. Methods: A descriptive survey was used to collect data from 68 home healthcare nurses in 22 hospital-based home healthcare services in Korea. To investigate participation, the researcher developed 3 scenarios through interviews with 5 home healthcare nurses. A self-report questionnaire composed of tools for characteristics, factors of clinical decision making, and participation was used. Results: Participation was relatively high, but significantly lower in the design phase (F=3.51, p=.032). Competency in clinical decision making (r=.45, p<.001), perception of the decision maker role (r=.47, p<.001), and perception of the utility of clinical practice guidelines (r=.25, p=.043) were significantly correlated with participation. Competency in clinical decision making (Odds ratio [OR]=41.79, p=.007) and perception of the decision maker role (OR=15.09, p=.007) were significant factors predicting participation in clinical decision making by home healthcare nurses. Conclusion: In order to encourage participation in clinical decision making, education programs should be provided to home healthcare nurses. Official clinical practice guidelines should be used to support home healthcare nurses’ participation in clinical decision making in cases where they can identify and solve the patient health problems.