• Title/Summary/Keyword: Clinical Nurse Expert

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Development and Evaluation of Integrated Management Program for Hemodialysis Patients (혈액투석 환자를 위한 통합적 관리 프로그램의 개발 및 효과)

  • Kim, Bora;Yoo, Hana
    • Journal of Home Health Care Nursing
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    • v.31 no.1
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    • pp.66-76
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    • 2024
  • Purpose: This study aimed to develop and evaluate an integrated management program to enhance self-efficacy, compliance with sick-role behaviors, symptom management, and biomarker indication in hemodialysis patients. Methods: The integrated management program was developed through a systematic review of literature, analysis of relevant online data, and expert validation. It comprised 480 min of video-based education delivered eight times over four weeks, supplemented by weekly phone consultations and text message support from a nurse. To evaluate the program's effectiveness, it was administered to 44 patients with hemodialysis in a single group in a pre-post test experimental study. Changes in self-efficacy, sick-role behavior compliance, dialysis symptom index, and biomarkers were assessed. Results: The program yielded statistically significant improvements in self-efficacy (t=-7.13, p<.001), sick-role behavioral compliance (t=-7.35, p<.001), dialysis symptom index (t=4.32, p<.001), and blood urea nitrogen levels (t=2.55, p=.014) among the participants. Conclusion: The integrated management program is an effective intervention for improving hemodialysis patients' self-efficacy, compliance with sick-role behaviors, and experience of symptoms. Additionally, it is considered an intervention with high clinical applicability and efficiency through video reproducibility.

Development of Nursing Practice Standards of Hemodialysis Care According to Admission Types (내원유형별 혈액투석 간호업무 표준개발)

  • Kim, Min Sun;Kim, Moon Sil;Kim, Jung A;Jeong, Eun Ju;Heo, Eun Hwa;Hong, Hwa Jeong;Shin, Hye Sun;Jeong, Yeo Won
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.3
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    • pp.293-308
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    • 2015
  • Purpose: This study aimed to develop nursing practice standards of hemodialysis care according to admission types. Methods: The standards were developed in four phases. Phase 1: The preliminary standards of hemodialysis care were developed based on literature review and evaluation of professional experts. Phase 2: Content validity was evaluated by 34 professional experts and the standards were modified and revised. Phase 3: Clinical validity was evaluated by 212 hemodialysis nurses. Expert group validated and verified the final outcome. Phase 4: Final standards of hemodialysis care according to admission types were developed. Results: The standard of hemodialysis care for out-patients included 5 standards, 9 contents, 43 nursing activities. The standard for in-patients included 6 standards, 10 contents, 50 nursing activities. The standards for critical patients included 4 standards, 10 contents, 43 nursing activities. There were differences in nursing activities according to admission type. Time required to meet the standards were different according to admission types. Conclusion: The findings of this research demonstrated that the time required for hemodialysis care and appropriate number of nurse would be different according to admission types. Different nursing workload according to admission type of hemodialysis patients need to be considered in allocating nursing manpower.

Triage Accuracy of Pediatric Patients using the Korean Triage and Acuity Scale in Emergency Departments (한국형응급환자분류도구를 적용한 응급실에서 소아 환자의 중증도 분류 정확성)

  • Moon, Sun-Hee;Shim, Jae Lan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.626-634
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    • 2018
  • This retrospective study investigates the accuracy of triage procedures for pediatric patients in emergency departments (EDs) using the Korean Triage and Acuity Scale (KTAS). The study includes 250 randomly selected initial nursing records and clinical outcomes of pediatric patients who visited one regional ED or a local ED from October 2016 to September 2017. The collected data were analyzed by a qualified expert to determine the true triage score. The accuracy of triage was defined as the agreement between the triage score of the emergency nurses (ENs) and the true triage score as determined by the expert. Based on expert comments, the cause of the triage error was analyzed and the KTAS score was compared with the discharge, length of stay (LOS), and medical cost. The results showed that the degree of agreement in the triage score between the experts and the ENs was excellent (weighted kappa=0.77). Among the causes of triage discordance, the most frequent was the incorrect application of vital signs to the KTAS algorithm criteria (n=13). Patients with high severity KTAS levels 1 and 2 were discharged less often (${\chi}=43.25$, p<0.001). There were significant differences in the length of stay (F=12.39, p<0.001) and cost (F=11.78, p<0.001) between KTAS scores when adjusting for age. The results of this study indicate that KTAS is highly accurate in EDs. Hence, the newly developed triage tool is becoming well established in Korea.

Comparative Study of the Nursing Education Systems In China and South Korea (한국과 중국 간호교육체제의 비교 연구)

  • 이춘옥
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.39-46
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    • 2000
  • This study, was done to compare the nursing education systems of China and South Korea (Korea), then, on the basis of this comparison, to examine the direction of nursing education in China. The results the study are as follows : 1. Nursing education in Korea was influenced by social change, political policy, but as it was established, nurses in Korea, were able actively involved in presenting nursing education development proposals to the government, and in developing nursing education through their own efforts. Nursing education in China developed through the political policy of a socialist Country. During the period of modernization after 1977, a nursing education developed very quickly, In 1983, the first baccalaureate nursing education program was established and, in 1992, the first masters program was opened. 2. In Korea, there are two nursing education systems; diploma and baccalaureate, and there is only one entry level, high school graduation. In China today, on the other hand, there are three types of nursing education systems; technical, diploma, and baccalaureate, and they have middle school and high school graduation as the two levels of entry. 3. There are similarities between China and Korea in curriculums for nursing education which include the major nursing concepts. But in descriptions of the education objectives, China the emphasis is on training the 'expert' in clinical nursing which is not consistent with their educational philosophy. Korea differs from China in that the focus is on training for 'multiple ability' to be used in both clinical and community environments. 4. In Korea, the curriculum is organized with the theoretical and clinical experience combined. The curriculum is oriented to the life cycle and human developmental process. In China, however, the curriculum is organized so that after finishing the theoretical part of the curriculum, the students begin a one year intensive field experience in which the major clinical field is the hospital, and the focus is on disease oriented care and research ability. 5. In order for nurses to be proposed to address nursing education system needs follows : to change as The new nursing education system should be baccalaureate education in order to improve the education level in all nursing education programs, to develop doctoral programs, to open nurse specialist programs, and to develop a new curriculum based nursing philosophy and health delivery system change. New nursing curriculum for health care in China in the 21st century should be directed by a framework based on nursing philosophy, objectives and nursing content. In conclusion, the study will contribute China nursing education system revolution for policy develop and curriculum research. According to these results, in the future, nurses in China should be more actively involved in research and in a nursing education revolution, Also they should be involved in building information networks and in developing long term projects in nursing education.

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Comparison of Intelligent Color Classifier for Urine Analysis (요 분석을 위한 지능형 컬러 분류기 비교)

  • Eom Sang-Hoon;Kim Hyung-Il;Jeon Gye-Rok;Eom Sang-Hee
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.10 no.7
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    • pp.1319-1325
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    • 2006
  • Urine analysis is basic test in clinical medicine using visual examination by expert nurse. Recently, this test is measured by automatic urine analysis system. But, this system has different results by each instrument. So, a new classification algorithm is required for accurate classify and urine color collection. In this paper, a intelligent color classifier of urine analysis system was designed using neural network algorithm. The input parameters are three stimulus(RGB) after preprocessing using normalization. The fuzzy inference and neural network ware constructed for classify class according to 9 urine test items and $3{\sim}7$ classes. The experiment material to be used a standard sample of medicine. The possibility to adapt classifier designed for urine analysis system was verified as classifying measured standard samples and observing classified result. Of many test items, experimental results showed a satisfactory agreement with test results of reference system.

Validity and Reliability Tests of Neonatal Patient Classification System Based on Nursing Needs (간호요구 정도에 의한 신생아중환자 분류도구의 타당도 및 신뢰도 검증)

  • Ko, Bum Ja;Yu, Mi;Kang, Jin Sun;Kim, Dong Yeon;Bog, Jeong Hee
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.3
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    • pp.354-367
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    • 2012
  • Purpose: This study was done to verify validity and reliability of a neonatal patient classification system (NeoPCS-1). Methods: An expert group of 8 nurse managers and 40 nurses from 8 Neonatal Intensive Care Units in Korea, verified content validity of the measurement using item level content validity index (I-CVI). The participants were nurses caring for 469 neonates. Data were collected from November 11 to December 14, 2011 and analyzed using descriptive statistics, ANOVA, intraclass correlation coefficient, and K-cluster analysis with PASW 18.0 program. Results: Nursing domains and activities included 8 items with 91 activities. I-CVI was above .80 in all areas. Interrater reliability was significant between two raters (r=.95, p<.001). Classification scores for participants according to patient types and nurses' intuition were significantly higher for the following patients; gestational age (${\leq}29$ weeks), body weight (<1,000 gm), and transfer from hospital. Six groups were classified using cluster analysis method based on nursing needs. Patient classification scores were significantly different for the groups. Conclusion: These results show adequate validity and reliability for the NeoPCS-1 based on nursing needs. Study is needed to refine the measurement and develop index scores to estimate number of nurses needed for adequate neonatal care.

Job Description of the Nurses Who Work in Operating Room Using DACUM Technique (데이컴 직무분석 기법을 이용한 수술실 간호사의 직무분석)

  • Cho, Kyung-Sook;Son, Haeng-Mi;Kang, Hyun-Sook;Kim, Joo-Hyun;Lim, Nan-Young;Yoon, Kye-Sook;Han, Hye-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.4
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    • pp.566-577
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    • 2008
  • Purpose: Developing a curriculum(DACUM) is a method of analyzing job focused competency, which is obtained from the data of an expert belonging to a certain career. In this study the DACUM method was used to analyze the jobs of operating room nurses. Method: Through the DACUM workshop which was arranged by two DACUM facillitators, a definition of the role of operating room nurses was developed and then duties and tasks of operating room nurses' were identified. For the workshop, a DACUM committee with 10 operating room nurses was organized. Finally, the duties and tasks which were identified were validated by 422 nurses for importance, difficulty and frequency. Results: Thirteen duties and 105 tasks were identified on the DACUM chart, where importance, difficulty, and frequency of tasks were represented by alphabet letters A, B, and C as higher degree of importance. The determinant coefficient(DC) showed that the most important duty was assisting with operations(DC=6.61), and the least, managing operating materials(DC=4.22). For tasks, the most important ones were assisting in orthostatic surgery(DC=7.60), and assisting in thoracic surgery(DC=7.38), and the least important making gauze ball(DC=2.39), and saving of operation site((DC=3.27). Conclusion: The results suggest a need to develop an education program using the DACUM chart as a basis for the development and as a clinical career ladder and for curriculum of operating room nursing.

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Assessing the Suitability of Interruption Intervention Strategies in Nursing Medication Administration: A Delphi Study (간호사의 투약업무흐름 중단 중재전략 적합성 연구: 전문가 델파이 조사를 중심으로)

  • Seung Ju Baek;Seung Gyeong Jang;Sang Hee Hong;Soo Ok Han;Won Lee
    • Quality Improvement in Health Care
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    • v.30 no.1
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    • pp.88-104
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    • 2024
  • Purpose: This study explored the suitability of interventions for medication interruption and intervention preferences. Methods: Two rounds of Delphi surveys were conducted with 18 expert panels comprising staff (or charge) nurses, nursing managers, and Quality Improvement (QI) team nurses working in a tertiary general hospital. For 47 situations involving the location of interruption, medication step, and source of interruption, the suitability of three interventions (no-interruption zone, medication safety vest, and education) was evaluated using a 5-point scale. Results: A total of 51 interventions for each situation were found appropriate by satisfying the degree of convergence and consensus. Patients or caregivers, peer nurses, doctors, telephones, and call bells were sources of interruption and were identified as appropriate for the application of interventions. 'Responding to requests and inquiries' by patients or caregivers showed high overall suitability. The nurses' preferred color for the intervention design (no-interruption zone, medication safety vest) is blue text on a yellow background. The priority groups for education related to medication interruptions were patients or caregivers, nurses, and non-nursing staff, in that order. Conclusion: Effective implementation of tailored intervention strategies that consider the specific characteristics of medication interruptions is crucial for mitigating interruptions and enhancing patient safety. Comprehensive educational programs aimed at reducing medication interruptions by improving awareness are necessary. Moreover, future research should evaluate these strategies in clinical settings to ensure their effectiveness in enhancing patient safety.

The Trend and Prospect of the Nursing Intervention Classification (간호중재분류의 동향과 전망)

  • Park, Sung-Ae
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.75-85
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    • 1996
  • Nursing Intervention Classification(NIC) includes the 433 intervention lists to standardize the nursing language. Efforts to standardize and classify nursing care are important because they make explicit what has previously been implicit, assumed and unknown. NIC is a standardized language of both nurse-initiated and physician-initiated nursing treatments. Each of the 433 interventions has a label, definition and set of activities that a nurse does to carry it out. It defines the interventions performed by all nurses no matter what their setting or specialty. Principles of label, definition and activity construction were established so there is consistency across the classification. NIC was developed for following reasons; 1. Standandization of the nomen clature of nursing treatments. 2. Expansion of nursing knowledge about the links between diagnoses, treatments and outcomes. 3. Devlopment of nursing and health care information systems. 4. Teaching decision making to nursing students. 5. Determination of the costs of service provided by nurses. 6. Planning for resources needed in nursing practice settings. 7. Language to communicate the unigue function of nursing. 8. Articulation with the classification systems of other health care providers. The process of NIC development ; 1. Develop implement and evaluate an expert review process to evaluate feedback on specific interventions in NIC and to refine the interventions and classification as feedback indicates. 2. Define and validate indirect care interventions. 3. Refine, validate and publish the taxonomic grouping for the interventions. 4. Translate the classification into a coding system that can be used for computerization for articulation with other classifications and for reimbursement. 5. Construct an electronic version of NIC to help agencies in corporate the classifiaction into nursing information systems. 6. Implement and evaluate the use of the classification in a nursing information system in five different agencies. 7. Establish mechanisms to build nursing knowledge through the analysis of electronically retrievable clinical data. 8. Publish a second edition of the nursing interventions classification with taxonomic groupings and results of field testing. It is suggested that the following researches are needed to develp NIC in Korea. 1. To idenilfy the intervention lists in Korea. 2. Nursing resources to perform the nursing interventions. 3. Comparative study between Korea and U.S.A. on NIC. 4. Linkage among nursing diagnosis, nursing interventions and nursing outcomes. 5. Linkage between NIC and other health care information systems. 6. determine nursing costs on NIC.

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Status of Infection Control in Jeju-area General Hospitals (제주특별자치도 종합병원의 감염관리 현황)

  • Chong, Moo Sang;Lee, Kyutaeg
    • 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.