• 제목/요약/키워드: Clinical Decision making ability

검색결과 44건 처리시간 0.021초

간호학적 비판적 사고능력에 대한 문헌고찰 (Critical Thinking in Nursing Science: A Literature Review)

  • 신수진;정덕유
    • 성인간호학회지
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    • 제21권1호
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    • pp.117-128
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    • 2009
  • Purpose: The purposes of this study were as follows; 1) To review the definitions of critical thinking from various perspectives, 2) To examine the critical thinking measurements throughout nursing research, and 3) To review the nursing studies with regard to critical thinking. Methods: This study was a literature review with regard to the critical thinking in nursing in aspects of conceptual meaning, measurements, and research. Results: The definition of critical thinking in nursing included decision making in clinical setting, inference with logical construct to increase nursing quality, interpretation in the context, and evaluation. The critical thinking was a core concept, which meant not only simple nursing process, but included decision making ability. The critical thinking has been conceptualized by both critical thinking disposition and skill. However, there was no nursing specified critical thinking measurement. Critical thinking research has been conducted to describe critical thinking disposition and critical thinking, to determine relationships between critical thinking and clinical competency, and to evaluate the effectiveness of educational programs. Conclusion: The instruments for measuring critical thinking disposition and skill that contain cultural difference and clinical specificity need to be developed to measure critical thinking and increase it.

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임상의사결정 향상을 위한 근거 기반 간호과정 시스템 개발-대장암 간호진단을 중심으로- (Development of an Evidence-based Nursing Process System to Improve Clinical Decision Making with Colorectal Cancer Nursing Diagnosis)

  • 박현상;조훈;김화선
    • 한국멀티미디어학회논문지
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    • 제19권7호
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    • pp.1197-1207
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    • 2016
  • The purpose of this study was to develop an evidence-based Nursing Process System on Nursing Diagnosis, Nursing Outcomes, and Nursing Interventions Classification targeting nurse students. We use standard classification-focused research data on the basis of Nursing Diagnosis Classification established by NANDA (North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification) and NIC (Nursing Interventions Classification) mainly developed by Iowa Sate University. The existing research methods are difficult to be applied the consistent nursing process, since such methods need to repeatedly enter the same nursing process without systematic guidelines. But, this study was coded data of standardized nursing process in accordance with the 10 clinical condition in order to implement the nursing process macro, and developed a system that reflects the needs of nursing educators. Therefore, nurse students can improve clinical decision-making ability, and naturally learn the nursing process through a system developed.

ICF Tool을 적용한 뇌졸중 환자의 바닥에 앉고 일어서기에 대한 중재전략의 증례 (A Case Report of Intervention Strategy applied ICF Tool about Floor to Stand and Stand to Floor for Stroke Patient)

  • 윤태원;김태윤
    • 대한물리치료과학회지
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    • 제18권1호
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    • pp.33-49
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    • 2011
  • The process of physical therapy uses a problem-solving approach to enhance a patients's functioning status. The International Classification of Functioning, Disability and Health(ICF) is the common concept for the functioning in the world. Physical therapists require the ability to identify problems, formulate hypothesis, and plan intervention strategies through clinical reasoning. In the clinical process, physical therapists need to use standard and common languages in speech and in documentation. The purpose of this study was to suggest the process of making strategy for efficient intervention, examining and evaluating the functional problem of the person with stroke using ICF tools. For the first step in this process model, therapists could list the information relating to functional problems used by the ICF Core set and then could identify the interaction among the problems using the ICF assessment sheet. For the next step, therapist is needed to make the hypothesis and hypothesis testing, and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Finally, after setting the identified problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems, and find out the outcomes using the ICF evaluation display. This report illustrates how to apply the process based on ICF concept into physical therapy practice. Making a decision for the most efficient intervention requires that therapists use the clinical reasoning process based on ICF concept.

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고관절 인공관절 치환술 환자의 보행능력 증진을 위한 문제해결 접근: ICF Tool을 적용한 단일사례연구 (The Problem-Solving Approach for Improving Walking Ability in Patient with Total Hip Replacement: Applied ICF Tool for Case Study)

  • 송현승;김선엽
    • 대한정형도수물리치료학회지
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    • 제21권2호
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    • pp.63-71
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    • 2015
  • Background: The purpose of the study, using the ICF Tool in the process of rehabilitation of artificial joint replacement surgery of the hip joint, goal setting and understanding of the problem, through the process of creating intervention strategies, useful clinical practical course for rehabilitation I try to present the data. Methods: Fracture was the left total hip replacement (THR) surgery due to women of 76 years old. I proceed in order screening, evaluation, diagnosis, prognosis, treatment planning and intervention, re-screening. Needs of the patient was walking short distances for using the toilet. In order to improve was carried out arbitration, after you have created a list of issues that limit the ability to walk short distances. Results: It was revealed improved results in self-paced walk test (SPWT) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to examine whether the goals. In addition, MMT VAS, DGI, and TUG is a detailed goal was improved. Conclusions: It can be shown objectively the results of interventions performed for the purpose of solving the problem which is grasped through clinical Practical course for short-range walking ability enhance patient THR. I considered practical clinical course using the ICF Tool would be useful.

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신경계물리치료에서의 근거중심실기(1) -임상의사결정과정에 EBP 적용하기- (Evidence-Based Practice in Neurological Physical Therapy (1) -Applying EBP to Clinical Decision Making-)

  • 이문규;임재헌;김태윤
    • PNF and Movement
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    • 제14권3호
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    • pp.157-176
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    • 2016
  • Purpose: The purpose of this study was to share an experience about processes and lessons learned to execute evidence-based practice (EBP) in neurological physical therapy. Methods: The most important thing in applying EBP to practice is to search, find, and appraise the existing evidence. Many evidence databases are available, such as CENTRAL, PEDro, PUBMED, and EMBASE. However, the knowledge represented in these databases is not always perfect. The practice model is a set of processes to resolve client problems. Therapists should make hypothesis-focused decisions through EBP. Integrating clinical reasoning and evidence is most important when it comes to the execution of EBP. Results: The process of EBP consisted of following: coming up with clinical questions, followed by searching for, appraising, evaluating, and integrating evidence. To integrate EBP into practice, it is necessary to consider clinical expertise, patient value and preferences, as well as research wth the best evidence. We provided an example of a clinical case with a stroke patient to show how this process and framework concerning clinical reasoning through evidences can be integrateds. During this process, we also utilized information technology to improve EBP ability. Conclusion: We should recognize what manner of information is needed to resolve eash patient's problem, and we should search for this information efficiently. Then, we should judge the value of the information obtained as it applies, to the clinical setting.

가중연관규칙 탐사를 이용한 재활훈련운동과 근육 활성의 연관성 분석 (Analysis on Relation between Rehabilitation Training Movement and Muscle Activation using Weighted Association Rule Discovery)

  • 이아름;박용군;권대규;김정자
    • 전자공학회논문지CI
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    • 제46권6호
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    • pp.7-17
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    • 2009
  • 효과적인 재활 시스템을 구상하는데 있어서 훈련 데이터의 정교한 분석은 다음 단계 훈련을 위한 피드백 자료로서 매우 중요하다. 현재 다양한 생체 역학적 실험을 통해 인간의 운동 능력을 평가하고 이로부터 생성된 데이터의 분석을 위한 객관적이고 신뢰성 있는 연구결과들이 발표되고 있다. 그러나 대부분의 기존 연구들은 기초 통계적인 방법에 근거한 정량분석만을 수행함으로써, 획득된 정보를 임상에 적용 하는데 있어서는 충분한 신뢰성을 보장할 수 없다. 데이터마이닝은 대용량 데이터에 들어있는 숨겨진 규칙과 패턴을 탐사함으로써 임상 데이터에 숨어있는 의미 있는 정보추출에 성공적으로 사용되고 있으며, 특히 임상 연구 분야에서는 훌륭한 의사 결정 지원 시스템으로서 점점 그 사용이 증가되고 있다. 본 연구에서는 신뢰성 있는 자세 제어 능력(Postural control ability) 평가를 위해서 측정된 훈련 데이터에 가중연관규칙 탐사를 적용하여 자세 훈련 유형에 따른 근육 활성 패턴과의 연관성을 분석, 효율적인 재활 훈련 규칙을 탐사하였다. 탐사된 규칙은 재활 및 임상 전문가의 의사결정에 더욱 정성적이고 유용한 선험적 지식으로 사용 될 수 있으며, 이를 근거로 환자 맞춤형 최적의 재활 훈련 모델을 구상하기 위한 지표로서 사용될 수 있다.

중증도 분류간호사의 비판적 사고성향, 문제해결능력과 중증도 분류역량 (Emergency Nurses' Critical Thinking Disposition, Problem Solving Ability, and Triage Competency)

  • 박재형;배선형
    • 근관절건강학회지
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    • 제29권2호
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    • pp.124-132
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    • 2022
  • Purpose: The purpose of this study was to investigate the relationships among critical thinking disposition, problem solving ability, and triage competency in nurses working in Emergency Rooms (ERs). Methods: This cross-sectional study, conducted in August and September 2021, involved 118 ER nurses from three hospitals in the Gyeonggi-do metropolitan area. The data were analyzed using t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple linear regression analysis using SPSS for Windows version 25.0. Results: The mean score of triage competency among ER nurses was 87.63±15.65. In the regression model, age, ER experience, triage experience, critical thinking disposition, and problem solving ability predicted 52% of the triage competency. Both critical thinking disposition and problem-solving ability were noted to be significant (β=.32, p<.001; β=.36, p<.001, respectively). Conclusion: Critical thinking disposition and problem solving ability of ER nurses were identified as major factors in triage competency. To improve ER nurses' triage competency and enhance critical thinking disposition and problem solving ability, a systematic and ongoing program should be developed and implemented.

간호대학생의 환자안전관리 수행자신감에 영향을 미치는 요인 (Factors Influencing Confidence in Patient Safety Management in Nursing Students)

  • 정현숙;공정현;전미양
    • 한국융합학회논문지
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    • 제8권6호
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    • pp.121-130
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    • 2017
  • 본 논문은 간호대학생의 환자안전관리 수행자신감에 영향을 미치는 요인을 파악함으로써 간호대학생의 환자안전관리역량 증진 융합교육프로그램을 개발하는데 필요한 근거를 마련하고자 수행하였다. 본 연구는 간호학과 4학년 재학생 228명을 대상으로 하였다. 간호대학생의 환자안전관리 수행자신감에 영향을 미치는 요인을 규명하기 위해 다중회귀분석을 실시하였다. 간호대학생이 임상에서 경험한 환자안전 사고는 낙상(50.0%), 주사바늘 찔림(18.5%), 환자확인 오류(12.0%), 주사투약 오류(7.5%), 경구투약 오류(4.3%)순이었다. 간호대학생의 환자안전관리 수행자신감의 유의한 영향요인은 환자안전관리 태도(t=6.09, p<.001), 임상의사결정능력(t=3.97, p<.001) 및 성별(t=2.56, p=.011)로 나타났다. 이와 같은 연구결과를 근거로 간호대학생의 환자안전관리 수행자신감을 증진시키기 위해서는 환자안전관리 태도, 임상의사결정능력 및 성별을 고려한 융합교육 프로그램을 개발할 것을 제안한다.

시뮬레이션에서의 간호대학생의 임상적 판단 기술 분석: Tanner의 Clinical Judgment Model을 적용하여 (Nursing Students' Clinical Judgment Skills in Simulation: Using Tanner's Clinical Judgment Model)

  • 김은정
    • 한국간호교육학회지
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    • 제20권2호
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    • pp.212-222
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    • 2014
  • Purpose: The purpose of this study was to evaluate the nursing students' clinical judgment skills in simulation using Tanner's Clinical Judgment Model. Method: Forty-five teams of a total 93 nursing students participated in a post-operative patient care scenario using human patient simulator. Data were collected from students' responses in scenario and guided reflective journaling according to the framework of Tanner's model which comprised noticing, interpreting, responding, and reflecting on response. Data were analyzed using descriptive statistics. Results: The students' responses of the situation were in accordance with the goals of scenario, i.e. relieving patient' pain and preventing pulmonary complications. However, most of students needed clinical cues and focused on a given clue to solve the issues. They were lack of ability to collect additional information as well as connect the relevant clues in simulated clinical situation. Conclusion: The nursing students have difficulty in what they notice, how they interpret finding, and respond appropriately to the situation. The simulation training using Tanner's model could provide faculty and nursing students with an effective teaching and learning strategy to develop the clinical judgment skills.

근거 중심 치의학 1. 기초개념, 질문하기, 그리고 근거검색 (Evidence-Based Dentistry - 1. Basic Concepts, Question, and Searching)

  • 홍순민
    • 대한치과의사협회지
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    • 제45권2호통권453호
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    • pp.89-102
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    • 2007
  • Evidence-based dentistry is a new, worldwide trend in the field of clinical dentistry. Despite this fact, it has been neglected in Korean dental community. Thus, its basic concepts and the 5-step procedures are introduced and described in this 2-part series report. Evidence-based dentistry is a method of clinical practice where the clinicians use the best available research evidence for their own clinical decision making. By using this method, the clinical outcomes can be improved and the clinicians themselves can have the ability to keep watch over their daily practices. To clinically apply the principles of evidence-based dentistry, dental practitioners have to formulate a clear question, find the best available research evidence efficiently, critically appraise the evidence systematically, apply the results of the evidence to their practice, and evaluate the clinical outcomes comprehensively. In building a clinical question, it is essential to categorize questions according to their types followed by their organization using the key elements. Then, literature search must be done. There are many web sites for searching evidence, but PubMed is considered to be the leading site. To efficiently search the literature, search term must be selected appropriately and the search results should be limited.

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