• 제목/요약/키워드: Clinical Nurse Expert

검색결과 32건 처리시간 0.024초

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

  • 김보라;유하나
    • 가정∙방문간호학회지
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    • 제31권1호
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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.

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

  • 김민선;김문실;김정아;정은주;허은화;홍화정;신혜선;정여원
    • 임상간호연구
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    • 제21권3호
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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.

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

  • 문선희;심재란
    • 한국산학기술학회논문지
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    • 제19권11호
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    • pp.626-634
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    • 2018
  • 본 연구는 한국형응급환자분류도구(Korean Triage and Acuity Scale: KTAS)를 사용한 소아 중증도 분류의 정확성을 파악하기 위한 후향적 조사연구이다. 연구자료는 2016년 10월부터 2017년 9월까지 1개 권역응급의료센터, 1개 지역응급의료센터에 방문한 소아환자의 자료 중 무작위로 추출한 250건의 간호초진기록지와 진료결과였다. 수집된 자료를 검정된 전문가가 분석하여 true-triage를 정하였다. 중증도 분류 정확도는 응급실간호사의 중증도 분류 결과와 전문가의 true-triage결과와의 일치도로 평가하였다. 전문가 의견에 따라 중증도 분류 오류의 원인이 분석되었고, KTAS 등급과 퇴원, 체류시간, 진료비와의 연관성이 비교되었다. 연구결과 전문가와 응급실 간호사의 중증도 분류 등급은 높은 일치도를 보였다(weighted kappa=.77). 중증도 분류 불일치의 원인 중 활력징후 결과를 KTAS 알고리즘 기준에 잘 못 적용한 경우가 가장 많았다(n=13). KTAS 1,2 등급과 같이 중증도가 높을수록 퇴원이 적었다(${\chi}=43.25$, p<.001). 연령을 보정했을 때 KTAS 등급에 따라 체류시간(F=12.39, p<.001)과 진료비(F=11.78, p<.001)는 차이가 있었다. 본 연구결과 KTAS는 국내 응급실에서 높은 정확도를 보였으므로, 새로 개발된 중증도 분류 도구가 국내 응급실에 잘 적용되고 있다고 할 수 있다.

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

  • 이춘옥
    • 대한간호학회지
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    • 제30권1호
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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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요 분석을 위한 지능형 컬러 분류기 비교 (Comparison of Intelligent Color Classifier for Urine Analysis)

  • 엄상훈;김형일;전계록;엄상희
    • 한국정보통신학회논문지
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    • 제10권7호
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    • pp.1319-1325
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    • 2006
  • 요 분석은 임상에서의 기본적인 검사항목으로 숙련된 간호사에 의한 육안검사를 시행한다. 최근에는 분석량의 증가와 분석 시간의 단축을 위하여 자동화된 요 분석 시스템을 이용하여 측정한다. 그러나 이들 시스템은 기기별 로 나타나는 결과에 차이가 발생하고 있다. 따라서 요의 컬러에 따른 정확한 검사를 위하여 새로운 요 컬러 분류 알고리즘이 요구된다. 본 논문은 퍼지 논리와 신경회로망 알고리즘을사용하여 요 분석 시스템의 지능형 컬러 분류기를 제작하였다. 입력 파라미터는 전처리 과정을 거친 RGB 3가지 색상을 사용하였다. 구현된 분류기는 퍼지 논리와 신경회로망 알고리즘을 사용하였으며, 적색, 녹색, 청색의 3 가지 입력 데이터를 사용하여 9 가지 시료에 대한 $3{\sim}7$ 개의 각 단계별 분류를 수행하도록 구현하였다. 실험에 사용된 검체는 표준 시약을 사용하였으며, 요 분석 시스템을 위한 개별 표준시료에 따른 분류기의 성능을 비교하고, 신뢰성 및 임상적용가능성 여부를 검토하였다. 설험 결과 지능형 컬러 분류기는 많은 검사 항목에서 육안검색보다 좋은 결과를 보였다.

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

  • 고범자;유미;강진선;김동연;복정희
    • 임상간호연구
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    • 제18권3호
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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.

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

  • 조경숙;손행미;강현숙;김주현;임난영;윤계숙;한혜자
    • 기본간호학회지
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    • 제15권4호
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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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간호사의 투약업무흐름 중단 중재전략 적합성 연구: 전문가 델파이 조사를 중심으로 (Assessing the Suitability of Interruption Intervention Strategies in Nursing Medication Administration: A Delphi Study)

  • 백승주;장승경;홍상희;한수옥;이원
    • 한국의료질향상학회지
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    • 제30권1호
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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.

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

  • 박성애
    • 가정∙방문간호학회지
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    • 제3권
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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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제주특별자치도 종합병원의 감염관리 현황 (Status of Infection Control in Jeju-area General Hospitals)

  • 정무상;이규택
    • 대한임상검사과학회지
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    • 제48권2호
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    • pp.130-136
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    • 2016
  • 제주지역 종합병원 감염관리 현황을 조사하여, 병원감염관리 실태와 문제점을 파악하고자 하였으며 감염관리의 중요성을 인식시키고 감염관리 실무자로서 임상병리사의 역할 방안을 모색하기 위하여 제주특별자치도 제주시와 서귀포시에 위치한 종합병원 7개 기관을 대상으로 감염관리 현황을 설문지를 통하여 조사하였다. 제주지역 의료기관의 감염관리는 모든 기관이 감염관리실을 운영하고 전담인력을 구성하고 병원감염관리지침을 보유하고 수행하는 우수한 점을 보였지만, 대부분의 기관이 간호사 1인 구성의 감염관리실을 운영하여 전담인력 확보 및 미생물 관련 배양 판독, 다제내성균의 출현빈도, 감염통계 등 미생물 검사에 대한 내용을 보고 받는데 많은 부분 어려움을 호소하였다. 이에 감염관리의 실질적인 업무를 담당할 수 있는 임상병리사가 의료법 시행규칙에 있는 감염관리에 경험과 지식이 있는 사람으로 충분한 자질과 경험이 있다고 생각되며 감염관리실을 운영함에 있어 감염관리간호사와 미생물에 전문적인 지식을 갖춘 임상병리사(감염관리임상병리사)가 전담자로서 업무를 수행한다면 지금보다 더욱 발전된 감염관리실 운영이 될 것으로 보이며, 향후 감염관리를 제대로 하기 위해서는 전국적으로 종합병원을 비롯한 취약한 중소병원의 감염관리에 대한 전폭적 지원과 감염관리 전문 의료시스템 도입이 중요한 과제라 사료된다.