• 한국엔터테인먼트산업학회논문지
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• 제14권4호
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• pp.321-331
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• 2020

본 연구는 간호대학생의 의사소통능력, 임상수행능력, 인수인계 경험, 인수인계 자기효능감을 파악하고 인수인계 자기효능감에 영향을 미치는 요인을 규명하여 인수인계 교육프로그램을 개발하는데 기초자료를 제공하고자 수행되었다. 연구방법은 서술적 조사연구로서 G시에 소재한 4년제 2개교 간호대학생 255명을 2019년 6월부터 9월까지 구조화된 설문지를 통해 자료수집하였다. 자료분석은 t-test, ANOVA, Pearson's correlation coefficents 그리고 단계적 다중회귀분석을 활용하였다. 연구결과, 간호대학생들의 의사소통능력은 57.3점(100점 만점에 76.4점), 임상수행능력은 69.8점(100점 만점에 73.5점), 인수인계 자기효능감은 33.8점(100점 만점에 51.2점)으로 나타났다. 간호대학생의 인수인계 자기효능감은 성(F=4.60, p<.001), 연령(F=16.72, p<.001), 학년(t=-6.39, p<.001), 임상실습 만족도(F=3.68, p=.027), 인수인계 교육 경험(t=26.44, p<.001), 인수인계 경험(t=4.84, p<.001), 인수인계에 대한 두려움(F=16.97, p<.001), 환자안전에 있어서 인수인계 중요도(F=6.42, p=.002)에 따라 유의한 차이를 보였다. 간호대학생의 의사소통능력, 임상수행능력, 인수인계 자기효능감 간의 상관관계를 분석한 결과, 인수인계 자기효능감은 의사소통능력(r=.249, p<.001)과 임상수행능력(r=.426, p<.001) 간에 유의한 순 상관 관계가 있었다. 간호대학생의 인수인계 자기효능감에 영향을 미치는 요인으로 인수인계에 대한 두려움(β=-.294, p<.001), 임상수행능력(β=.252, p<.001), 학년(β=.191, p=.001), 인수인계 경험(β=.185, p<.001), 성별(β=.150, p=.003), 인수인계 교육 경험(β=.126, p=.017)순으로 모형의 설명력은 40.0%이었다. 결론적으로 간호대학생들의 인수인계 자기효능감을 높이기 위해서는 임상수행능력을 향상시키고 임상실습 시 인수인계 경험을 포함한 인수인계 교육을 제공하여 인수인계 두려움을 감소시키는 인수인계 교육프로그램의 개발이 필요하다.

• 한국산학기술학회논문지
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• 제21권5호
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• pp.384-390
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• 2020

유기인계 살충제를 음독하였을 경우 임상적으로 치명적인 결과를 가져올 수 있다. 이 연구는 유기인계 살충제 음독으로 인해 사망한 환자와 생존한 환자들의 내원 당시 중성구/림프구 비율을 비교 분석하여 사망률을 얼마나 예측할 수 있는지 알아보기 위해 시행되었다. 연구 자료는 전자의무기록에서 추출하였고, 2008년 1월부터 2018년 11월까지 유기인계 살충제를 음독하고 일개 응급실에 내원한 환자들(150명)을 생존 군(135명)과 사망 군(15명)으로 분류하고 후향적으로 비교 분석하였다. 환자들의 특성(나이, 성별, 기저질환 유무, 음독 후 병원까지 걸린 시간, 음독 양), 혈액검사 결과들과 의학적 중증도에 대한 개별 변수들을 먼저 비교한 후, 유의한 차이를 보이는 변수(나이, 혈중 백혈구 수, 아밀라아제 농도, 크레아티닌 농도, APACHE II점수 및 중성구/림프구 비율) 들에 대해 로지스틱 회귀분석을 시행하였다. 연구결과 나이, APACHE II 점수 및 중성구/림프구 비율이 사망 군에서 생존 군에 비해 유의하게 높았다. 이들 중 중성구/림프구 비율은 응급실에 내원하면 기본적으로 시행하는 전혈 검사를 통해 30분 이내에 신속하고 간단하게 얻을 수 있는 예측 인자이다. 본 연구를 통해 사망을 예측하는 도구로 중성구/림프구 비율이 유용하게 사용될 수 있으며, 특히, 수치가 10 이상으로 높은 경우 환자가 사망할 확률이 높음을 인지하고 집중 감시 및 치료를 해야 할 근거를 제시해 줄 수 있을 것으로 생각된다.

• 동서간호학연구지
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• 제30권2호
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• pp.71-78
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• 2024

Purpose: Effective communication is essential for the nursing profession. This study aimed to develop and investigate the impact of SBAR simulation training on nursing students' SBAR ability, hand-off confidence and communication confidence. Method: This study used a non-randomized, pre-post group design. Sixty nursing students were assigned to an experimental group and a control group. The simulation for SBAR training consisted of a 120-minute lecture, simulation, and debriefing for child with enteritis in neonatal intensive care unit. Data were collected from October, 2023 to April, 2024 and analyzed by the descriptive statistics, Chi square test, independent t-test, and paired t-test using the SPSS/WIN 24.0 program. Results: Upon completion of applying SBAR simulation training, the experimental group showed significantly higher SBAR ability (t=5.39, p<.001), hand-off confidence (t=2.58, p=.002) and communication confidence (t=3.12, p=.001) than those of the control group. Conclusions: SBAR communication simulation training for nursing student not only promotes communication skill among healthcare professionals, but also helps reduce communication errors for patient safety. For effective communication with healthcare professionals in neonatal intensive care unit, SBAR simulation training should be included in nursing education for communication.

• 중환자간호학회지
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• 제8권2호
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• pp.13-22
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• 2015

Purpose: This study identified the current status and perception of intensive care unit nurses' handover. Methods: A cross sectional descriptive survey was employed. The population included nurse managers and staff nurses who worked in intensive care units in hospitals with more than 500 beds and excluded nursing homes, psychiatric hospitals, and military hospitals. Results: Of the nurses, 61.7% were satisfied with the current handover method, 68.36% had no handover-related guidelines, and 83.2% of them perceived that the handover was important for patients' safety. The most frequent cause for errors related to handover was that the "nursing workload is heavy." The nurses perceived that their handover was informative ($5.62{\pm}0.79$) and efficient ($5.04{\pm}0.98$). The variables associated with their perception of the handover were the level of satisfaction with the current handover method, existence of handover guidelines, and importance of handover for patient safety. Conclusion: The development of standardized handover guidelines, especially for intensive care units, is necessary to reduce handover time and errors and to improve handover quality for patients'safety and high standards of nursing care.

• 임상간호연구
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• 제28권3호
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• pp.223-232
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• 2022

Purpose: The purpose of this study was to apply patient-engaged bedside handoffs in comprehensive care units, and to evaluate the effects of bedsides to nurses and patients. Methods: This study employed a cluster randomized cross-over design.Electrical Medical Record (EMR)-based handoffs and patient-engaged bedside handoffs were alternatively applied to 104 patients, who were assigned to a total of 30 clusters (nursing handoff teams) in 4 comprehensive care units at the S medical center in Seoul, and the patients evaluated each type of handoffs. A total of 139 nurses were also participated in the same units and evaluated each type of handoffs. Data were analyzed using t-test, Wilcoxon rank sum test, ANOVA, and Kruskal-Walls test. Results: The patient's satisfaction of the patient-engaged bedside handoffs was higher than that of the EMR-based handoffs (Z=-5.16, p<.001). On the other hand, the nurse's satisfaction of the patient-engaged bedside handoffs was significantly lower than that of the EMR-based handoffs (t=13.21, p<.001). There were no differences in length of the reporting time between two types of handoffs (t=-0.48, p=.634). Conclusion: Patient satisfaction with the patient-engaged bedside handoffs was higher than that of EMR-based handoffs, and nurses' satisfaction with the patient-engaged bedside handoffs was significantly lower than that of EMR-based handoffs. Future studies are needed regarding the impacts of patient-engaged bedside handoffs on the quality of healthcare by identifying the benefits of the handoffs.

• 중환자간호학회지
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• 제9권2호
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• pp.1-12
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• 2016

Purpose: This study aimed to develop a nursing handoff protocol for intensive care units and test its relevance. Methods: This is a methodological research to develop a protocol. A preliminary protocol was developed by composing items and testing content validity through literature review and experts' review. We revised and complemented the preliminary protocol following practical relevance assessment of 38 intensive care unit nurses at a university hospital to test content validity and to assess practical relevance of the final protocol. Results: On the basis of the content validity test for the final protocol, 40 items were adopted. The scores for the practical relevance of the final protocol increased significantly for items such as accuracy of handoff, reduction of handoff-related errors, convenience in using the protocol, reduction in handoff time, and simplification of handoff. Conclusions: The nursing handoff protocol for intensive care units in this study is expected to improve nursing performance with a standardized handoff in intensive care units, promote patient safety, and improve communication among the medical staff.

• 한국컴퓨터정보학회논문지
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• 제27권12호
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• pp.251-258
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• 2022

본 연구는 응급구조학과 학생들의 전공 교육과정에 대한 수행도, 중요도 및 요구도를 분석하여 응급구조학 전공자의 학습 역량을 강화하는데 기초 자료를 제공하고자 하였다. 연구대상은 충남지역의 3개 대학 응급구조학과 학생 217명으로 자료 수집기간은 2021년 12월 13일부터 12월 24일까지이며 1급 응급구조사의 직무 기반 핵심 역량을 바탕으로 구조화된 설문지에 응답한 자료를 분석하였다. 연구결과 응급구조학과 학생들의 학습 역량 강화를 위해서 Borich 요구도가 높은 '구급차량 관리 교육', '졸업 후 전문성 유지를 위한 교육', '병원 내 환자 감시 교육'과 LF 모델의 최우선 영역에 해당하는 '의료지도, 인계 교육', '내과적 응급환자 처치 교육', '병원 내 환자 감시교육', '병원 내 응급환자 진료보조 교육'에 해당하는 교과과정의 보강이 필요하다고 판단된다.

• 임상간호연구
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• 제26권1호
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• pp.117-130
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• 2020

Purpose: This study aimed to develop a bedside nursing shift report protocol and evaluate the effect of the protocol in a tertiary hospital in South Korea. Methods: The bedside nursing handoff protocol with patient engagement was developed based on the literature review and the validation of an expert group. The effect of the protocol on clinical implication was tested in three medical-surgical units in a tertiary hospital. Outcomes were assessed by patient perception, nurse perception, and reporting time. Data collected from June to August in 2018 and analyzed with descriptive statistics and One-way ANOVA using SPSS version 25.0. Results: The bedside nursing shift report protocol with patient engagement consisted of two steps: nurse to nurse report and bedside report with patients. Nurse's perception with patient engagement was significantly increased after applying protocol (F=17.85, p<.001). Patient's perception was significantly improved in the areas of discharge plan (F=7.86, p<.001), health information privacy (F=4.46, p=.012) and identify attending nurse (F=3.19, p=.042). There were no differences in reporting time between the bedside nursing shift report and a traditional shift report (F=0.61, p=.054). Conclusion: Patient perception was significantly increased, while nurse perception was not different after applying this protocol. For the change in the perception of nurses, education may be preceded to improve nurses' competence for the bedside shift report. Furthermore, the support in enough nurse staffing should be needed for encouraging the bedside shift report. The bedside shift report may enhance patient engagement. Therefore it may improve patient safety and health outcome in clinics.

• Radiation Oncology Journal
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• 제4권1호
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• pp.55-62
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• 1986

1983년 11월부터 1986년 1월까지 인계의대 부속 백병원 치료방사선과에서 43명의 비 소세포성 폐암 환자를 치료하였다. 그 중에서 분석 가능한 38명에 대한 치료결과를 보고하는 타이다. 33명이 근치적 목적으로 방사선 치료를 받았고 나머지 5명은 수출후 방사선 치료를 받았다. 12명의 환자는 방사선 치료하기전 혹은 방사선치료와 더불어, 그리고 방사선 치료후에 약물치료를 병행하였다. 38명의 환자 중 28명이 편평상피종이었고 10명은 선종이었다. 남자 환자가 29명, 여자 환자가 9명이었고 평균 나이는 58계로 34세로부터 74세까지의 분포를 보였다. 병기별로 보면 1기가 1명, 2기가 7명, 그리고 3기가 30명이었다. 근치적 목적으로 치료한 환자 중 치료 후 흉부 X-선 사진과 컴퓨터 단층촬영 상에서 완전히 종양이 소실된 경우가 $36\%,\;50\%$이상의 종양크기 감소를 보인 경우가 $27\%,\;25\%$ 이상의 종양크기 감소를 보인 경우가 $15\%$였고 반응을 보이지 않은 경우가 $21\%$였다.

• 대한임상독성학회지
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• 제13권2호
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• pp.55-61
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• 2015

Purpose: Many studies have examined the mechanisms of impaired glucose homeostasis after organophosphate (OP) exposure, however no study has evaluated the clinical utility of blood glucose measurements in patients with OP poisoning. The current study was conducted to evaluate the initial glucose level at presentation and the glycemic variables during the first 3 days after admission as a predictor of mortality. Methods: This retrospective observational case series included 228 patients with a history of OP poisoning. Among other clinical data, information on the initial glucose level at presentation and mean glucose level, delta glucose level, and the presence of a hypoglycemic event during the first 3 days of admission, was collected. Results: Survivors had lower initial glucose levels at presentation and glucose variability during the first 3 days of admission compared to non-survivors. The frequency of hypoglycemic events was higher in non-survivors. In multivariate analysis, the initial glucose level (> 233 mg/dl) was an independent predictor of mortality, along with age. Conclusion: The initial glucose level at presentation can be helpful in prediction of mortality in cases of OP intoxication at bedside. The physician should pay attention to patients with a glucose level >233 mg/dl at presentation after ingestion of OP.