• Title/Summary/Keyword: Clinical health management

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Association of Job Stress with Health-promoting Behaviors and Health Status in Clinical Nurses (임상간호사의 직무 스트레스와 건강증진행위 및 건강상태의 관련성)

  • Kim, Jung-Suk;Kim, Chun-Ja
    • Korean Journal of Occupational Health Nursing
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    • v.25 no.4
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    • pp.311-319
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    • 2016
  • Purpose: This study examined association of job stress with health-promoting behaviors and objective health status in 129 clinical nurses working at a university hospital. Methods: A cross-sectional and descriptive design was used. Job stress and health behaviors were measured with Korean Occupational Stress Scale and Heath Promoting Lifestyle Profile-II, respectively. Health status measured with afternoon plasma cortisol, C-peptide, and lipid profiles. Results: The level of job stress among clinical nurses was moderate with 51.41 on average. The mean for health-promoting behavior in the low stress group was significantly higher than that in the high or moderate stress groups (p<.001). The proportions of nurses with high C-peptide and cortisol levels, or low high-density lipoprotein levels, ranged from 14.0% to 35.7%. In particular, the percentage of nurses with high C-peptide levels was significantly higher in moderate and high stress groups than in the low stress group (24.1% versus 11.6%, p<.05). Conclusion: The study findings affirmed the associations of job stress with health-promoting behaviors as well as selected health status indicators such as C-peptide in clinical nurses. Job stress management intervention can help clinical nurses to improve their health-promoting behaviors and health status.

Critical Thinking Disposition, Professional Self-Concept and Clinical Competence in Nursing Students (간호대학생의 비판적 사고성향, 전문직 자아개념 및 임상수행능력)

  • Park, In-Soon;Kim, Ran
    • The Korean Journal of Health Service Management
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    • v.7 no.4
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    • pp.105-117
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    • 2013
  • The purpose of this study was to identify the relationships among critical thinking disposition, professional self-concept and clinical competence in nursing students. The participants were 291 nursing students in Gwangju Province. A questionnaire survey was conducted from March 02 to 16, 2013. Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffe test, pearson's correlation coefficients, and stepwise multiple regression analysis with SPSS/WIN 20.0 version. There was a significant positive correlations among critical thinking disposition, professional self-concept, and clinical competence. The variable predicting clinical competency were professional self-concept and critical thinking disposition. These factors accounted for 44.1% of the variance. The findings of this study suggest that the most influential factor for clinical competence was professional self-concept. Therefore it is necessary to improve professional self-concept through effective education program.

A Study on status of school health and analysis of factors affecting school nursing activities in the secondary school in Seoul (서울지역 국민학교(國民學校) 양호교사의 학교간호업무(學校看護業務) 수행정도(遂行程度)에 관(關)한 연구(硏究))

  • Kim, Eun Hee
    • Journal of the Korean Society of School Health
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    • v.1 no.2
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    • pp.50-65
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    • 1988
  • This study was conducted in order to grasp the condition of about the school nurse's service and to offer the basic materials of improving the school health service. The objects were comprised of 98 volunteered school nurses who take service in the elementary school. The material of this study was the questionaire suited to the purpose of this research which has been made through studying references and this questionaire has been corrected and revised three times. All the questionaire written by school-nurses. The results are as follows; 1. General features of the objects of study Average age was 35.9 and average career was 9.2 years. Except working as school-nurse, the past career was that average clinical-field was 3.4 years and health service was 4 months. Their educational level was as high as 72.4% of the objects were graduated from above 3 years college and 89.8% were married. 76.5% have religions and 94.8% were working at with national and public schools. 99.0% were doing only nursing service. 2. The conditions of the school health resources. The ratio of school-nurse to students was one to 2630. School-nurse to classes, one to 49.3, and school-nurse to teachers, one to 54. For total amount of a year budget of school health, from three hundred thousands to fifty nine hundred thousands won was most common. Expenses for purchasing medicine were used most. 58.2% of school-nurses hasn't known a year budget. There was an organization for school health in 74.2% of schools. 42.9% of nursing rooms were in the center of school and 88.8% were on first floor. Nursing room were used alone without being used by another purpose and the room size of 71.6% was below 10 pyong. 3. The conditions of school health service Average users of nursing room were 413 a month. The most of them had digestive trouble. Sending letters to home was 15.9 times a year. The most contents of letters was about health education. Object spent much time managing nursing room. 4. The degree of school health service When 2 points was given to "perform" and 1 point was to "not perform" the total average was 1.75, health education 1.89, environmental management 1.86, plan of project and evaluation 1.83, management of nursing room 1.82, health management 1.78, run of school health organization 1.32. 5. Correlation between the school health services and variables (1) The part of project plan and evaluation of school health service has relationship to existence or none-existence of school health organization (P<0.01), past health service career (P<0.05), number of classes (P<0.01), number of students (P<0.01), sending letters to home about health education (P<0.01) and number of users (P<0.05). (2) The part of nursing room management has relationship to ages (P<0.05) past clinical career (P<0.05), number of classes (P<0.05), number of students (P<0.05) and sending letters to home about health education (P<0.01). (3) The part of health education has relationship to existence or none-existence of school health organization (P<0.05), past clinical career (P<0.05), the ratio of health management to school nurse's all work (P<0.05) and the ratio of health education to school nurse's all work (P<0.01). (4) The part of environmental management to ages (P<0.01), career as a school-nurse (P<0.01), salary step(P<0.01), sending letters to home about health education (P<0.01), sending all letters to home (P<0.001), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.05) and area of school-nurse's room to be used. (5) The part of school health organization management to number of classes (P<0.05). (6) The part of health management to number of classes (P<0.05), sending letters to home about health education (P<0.001), sending all of letters to home (P<0.01) and the ratio of health management to school nurse's all work (P<0.05). (7) The part of school health service to ages (P<0.05), past clinical career (P<0.05), past health career (P<0.01), number of classes (P<0.05), number of student (P<0.05), sending letters to home about health education (P<0.05), sending all letters to home (P<0.05), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.01) and area of school - nurse's room to be used (P<0.05). ## Suggestion for further studies are as follows. 1. School-nurse should exert herself to advance a quality to take care of school population's health. 2. It is necessary that systematic support required to keep school population's health. 3. Home, school and community should make efforts cooperatively and the proper roles of students, teachers, health team members and parents must be achieved.

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Evaluation of the Effectiveness and the Level of Self-Management Support on the Metabolic Syndrome Management Program at Public Health Centers in Seoul Metropolitan City (서울시 보건소 대사증후군관리사업의 효과와 자가관리 지원수준 평가)

  • Kim, Dong-Ok
    • Health Policy and Management
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    • v.29 no.1
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    • pp.19-26
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    • 2019
  • Background: The purpose of this study was to evaluate the effectiveness and the level of self-management support on the Metabolic Syndrome Management Program at public health centers in Seoul metropolitan city. Methods: The effectiveness on the Metabolic Syndrome Management Program were analyzed using secondary data from 1,312 community residents who were receiving program. The level of self-management support on Metabolic Syndrome Management Program was evaluated using an 'Assessment of Primary Care Resources and Supports for Chronic Disease Self-Management' from four public health centers. Results: The effectiveness on the Metabolic Syndrome Management Program was showed that decreased smoking (p= 0.044) and drinking (p< 0.001), and increased healthy dietary habit (p< 0.001) in health behaviors. It was showed that decreased triglyceride (p= 0.002) and increased high-density lipoprotein cholesterol (p< 0.001) in clinical indicators. The level of self-management support on Metabolic Syndrome Management Program was 98.1 points and it meaned that implementation is done in an organized and consistent manner using a team approach. There was difference in the level of self-management support by public health centers (p= 0.003). Conclusion: The Metabolic Syndrome Management Program in public health centers was effective, and level of self-management support was done as organizational level, but patient input and mental health were insufficient.

Mediation Effect of a Positive Stress Coping Strategy in the Relationship between Clinical Practice Stress and Clinical Practice Satisfaction (임상실습 스트레스와 실습 만족도의 관계에 미치는 적극적 스트레스 대처의 매개효과)

  • Lee, Sun-Young;Jeon, Seon-Yeong;Kim, Yun-Young
    • The Korean Journal of Health Service Management
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    • v.10 no.2
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    • pp.193-204
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    • 2016
  • Objectives : The purpose of this study was to identify the mediation effect of a positive stress coping strategy between clinical practice stress and clinical practice satisfaction in nursing students. Methods : In this study, data was collected from 248 nursing students at K University in South Korea from October of 2015 to November of 2015. The collected data was analyzed using the SPSS 22.0 Statistics Program. Results : Clinical practice stress and a positive stress coping strategy were significant predictors of clinical practice satisfaction (${\beta}$=.442, p<.001). The explanatory power of the measure of clinical practice satisfaction was increased to 29.3% (p<.001) with solely clinical practice stress, and it reached 44.2% (p<.001) when a positive stress coping strategy was reflected. The results of this study confirmed that a positive stress coping strategy has a mediation effect on clinical practice stress and clinical practice satisfaction levels. Conclusions : It is necessary to develop a program to take advantage of positive stress coping skills so that nursing college students can smoothly overcome stress during their clinical training and thus improve their clinical practice experience.

Nurses' Evidence-Based Pain Management Knowledge, Performance and EBP Attitude in Small-medium Sized Hospitals (중소병원 간호사의 근거기반 통증 관리 지식과 수행 및 근거기반 실무에 대한 태도)

  • Hong, In-Hwa;Eun, Young
    • Journal of Korean Clinical Health Science
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    • v.3 no.4
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    • pp.476-489
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    • 2015
  • Purpose. The purpose of this study was to investigate the evidence-based pain management knowledge, performance and Evidence-Based Practice(EBP) attitude of nurses at small-medium sized hospitals. Methods. The sample of this study were 214 nurses. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation and stepwise multiple regression using SPSS/Win 21.0 Results. Evidence-based pain management knowledge score averaged $3.95{\pm}0.43$, with significant differences depending on clinical experiences. Performance score averaged $3.77{\pm}0.51$. EBP attitude score averaged $3.21{\pm}0.57$, and significant differences were evident depending on hospital division and clinical setting. Evidence-based pain management knowledge and EBP attitude were significant predictors of evidence-based pain management performance. Conclusions. This result indicates that education and training programs to facilitate evidence-based pain management knowledge, performance, and EBP attitude are needed among nurses.

Development of Clinical Practice Guidelines in a Hospital (병원단위의 임상진료지침 개발과정)

  • Shin, Youngsoo;Kim, Chang-Yup;Oh, Byung-Hee;Han, Kyou-Sup;Yoon, Byung-Woo;Han, Joon-Koo;Khang, Young-Ho
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.82-103
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    • 1997
  • Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

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The Study on the Cost Analysis Based on ABC System in Clinical Laboratory (활동기준원가시스템을 이용한 임상병리과 검사 서비스 원가 분석)

  • 전기홍;김보경;안태식;조우현
    • Health Policy and Management
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    • v.8 no.2
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    • pp.88-109
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    • 1998
  • The main purpose of this study is to compare the traditional cost system and ABC(Activity Based Cost) system of clinical laboratory department in a hospital. The study subject was 296 services in clinical laboratory from March, 1997 to August, 1997. In a new costing system, cost for a lab test consist of direct cost element, activity based cost element, and allocated common cost element. In a traditional cost system, cost elements included direct cost element and indirect cost allocated based on test volumes The major findings of this research were as follows. 1. In the application of ABC system, total cost was analyzed as follows. Direct cost was 39.3% of total cost. Activity cost and allocation were 20.9% and 39.8%, respectively. The results of analysis to use traditional cost system were as follows. Direct cost was 39.3% and it was as same as the result of direct cost of ABC system. Indirect cost was 60.7%. 2. Activities of clinical laboratory of subject hospital were registration, pre-test operation, test, test result handling, delivery, culture, post-test operation, technical support, management support, and educational support. 3. The differences of the case of higher number of test case being carried out, the cost of ABC system was lower than the cost of traditional cost system. Otherwise in the case of lower number of test case being carried out, the rests have not been appropriately evaluated, and effective management were needed in clinical laboratory.

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Analysis of Appropriate Outpatient Consultation Time for Clinical Departments (진료과별 적정 외래 진료시간에 관한 연구)

  • Lee, Chan Hee;Lim, Hyunsun;Kim, Youngnam;Park, Ai Hee;Park, Eun-Cheol;Kang, Jung-Gu
    • Health Policy and Management
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    • v.24 no.3
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    • pp.254-260
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    • 2014
  • Background: The purpose of this study is to assume appropriate outpatient consultation time for each clinical department on the basis of measured outpatient consultation time and satisfaction of outpatient. Methods: We surveyed the feeling and satisfactory outpatient consultation time, satisfaction, revisiting intention and recommendation to others to 1,105 patients of single general hospital in Gyeonggi-do and measured their real outpatient consultation time from October 28 to November 27 in 2013. On the basis of satisfaction, we estimated appropriate outpatient consultation time through area under the receiver operating characteristic curve in logistic regression model. Results: Feeling outpatient consultation time was 5.1 minutess, satisfactory outpatient consultation time which was suggested by patient was 6.3 minutes, and real outpatient consultation time was 4.2 minutes. Department which had longest real outpatient consultation time was infection (7 minutes) and department which had longest satisfactory outpatient consultation time was neurology (9.4 minutes). From the univariate and the multiple linear regression analysis, real outpatient consultation time was longer in pulmonology patient, new patient and afternoon patient, satisfactory outpatient consultation time was longer in infection, neurology, neuropsychiatry, neurosurgery, and rehabilitation patient. Appropriate real outpatient consultation time was suggested as 5.6 minutes which differentiated high and low satisfied patient group. However, we could not assume appropriate outpatient consultation time for each clinical department because the number of patient who had bad satisfaction was too low. Conclusion: To improve patient's satisfaction, we hope outpatient reservation system is operated as each patient's outpatient consultation time is at least 5.6 minutes.

The Effects of Clinical Education Program for Nurses in Regional Public Hospital (공공보건의료인력 임상교육효과 평가: 지역거점공공병원 간호사 대상)

  • Shin, Yoonhee;Park, Kwanjun;Byun, Eunkyung;Lee, Dongwon;Ju, Woong
    • Health Policy and Management
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    • v.26 no.4
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    • pp.373-381
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    • 2016
  • Background: The purpose of this study is to evaluate the outcomes of clinical education program for nurses in regional public hospital, utilizing the Kirkpatrick's model. Methods: Kirkpatrik's 4-level model was applied to this study. Trainees were asked to fill out questionnaires in the middle and at the end of the program. Also administrators of excellent trainees were asked to fill out the questionnaires regarding nursing management performance after 1-2 months from the end of the training course. Results: All trainees had positive reactions to the clinical education program. Not only the results of individual level (satisfaction and achievement scores, academic achievement scores, practical application rate, and educational transition factors) but also the scores of organization level (nursing management performance scores) are improved. Conclusion: By showing a correlation between the effectiveness factors we need to verify the relationship between these factors in a future study. In addition, development of quantitative and qualitative performance indicators are needed. To establish a long-term education system, it is required to applying the excellent trainee's successful experiences.