• Title/Summary/Keyword: Critical Patient

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Convergence Factors Affecting Critical Thinking Disposition, Clinical Decision Making Ability, Patient Safety Knowledge and Attitude to Perform Safety Nursing Activities in Clinical Practice on Nursing Students (간호대학생의 비판적 사고성향과 임상의사결정능력 및 환자안전 지식, 태도가 임상실습 시 환자안전 수행능력에 미치는 융복합적 영향요인)

  • Moon, MI-Young;Kim, JI-Young
    • Journal of Digital Convergence
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    • v.16 no.12
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    • pp.511-521
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    • 2018
  • The purpose of this study was to investigate the effect of critical thinking, clinical decision making ability, patient safety knowledge and attitude ability to perform patient safety activities during clinical practice on nursing student's. Data were analyzed using t-tests and one-way ANOVA using the SPSS 21.0 program. As a result, the subjects' safety nursing activities was positively correlated critical thinking disposition(r=.278, p=.001), clinical decision making ability(r=.202, p=.014), patient safety attitude(r=.421, p<.001).The significant predictors of perform safety nursing activities were gender(${\beta}=.175$, p=.031), patient safety education(${\beta}=-2.266$, p=.025), critical thinking disposition(${\beta}=3.354$, p=.001), patient safety attitude(${\beta}=.368$, p<.001). These factors explained 31.5% of the variance(R2=.561, F=4.56 p<.001). It is necessary to establish a curriculum for critical thinking disposition, clinical decision making ability, and patient safety education in order to improve patient safety performance necessary for clinical practice education of nursing college students.

The Relationships among Awareness of Patient Safety Culture, Critical Thinking Disposition and Patient Safety Nursing Activities of Nurses among Comprehensive Nursing Care Service Ward (간호·간병통합서비스병동간호사의 환자안전문화인식, 비판적 사고성향과 환자안전간호활동의 관계)

  • Cheon, Goun;Kim, Jiyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.345-354
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    • 2018
  • This study was conducted to identify the levels of patient safety culture, critical thinking disposition, and patient safety nursing activities and determine the factors affected by patient safety nursing activities among nurses in comprehensive nursing care service wards. Subjects consisted of 150 nurses from general hospitals in B city, Korea, and data were analyzed using the SPSS Win 21.0 program. The mean scores of awareness of patient safety culture, critical thinking disposition, and patient safety nursing activities were $3.32{\pm}0.32$, $3.50{\pm}0.31$, and $4.28{\pm}0.46$, respectively. The awareness of patient safety culture was significantly different by clinical career in the present unit (F=4.79, p=0.001). The critical thinking disposition was significantly different by age (F=3.89, p=0.010) and position (F=6.40, p=0.002). There were differences in the scores of patient safety nursing activities according to position (F=3.19, p=0.044). Additionally, hospital environment (${\beta}=0.25$, p=0.014), supervisor attitude (${\beta}=0.20$, p=0.046), and position (${\beta}=0.14$, p=0.040) accounted for a 44.4% variance in patient safety nursing activities. To promote patient safety nursing activities in comprehensive nursing care service wards, positive awareness of the hospital's safety environment and support from the manager are required.

Intensive Care Unit Relocation and Its Effect on Multidrug-Resistant Respiratory Microorganisms

  • Kim, Hyung-Jun;Jeong, EuiSeok;Choe, Pyoeng Gyun;Lee, Sang-Min;Lee, Jinwoo
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.238-245
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    • 2018
  • Background: Infection by multidrug-resistant (MDR) pathogens leads to poor patient outcomes in intensive care units (ICUs). Contact precautions are necessary to reduce the transmission of MDR pathogens. However, the importance of the surrounding environment is not well known. We studied the effects of ICU relocation on MDR respiratory pathogen detection rates and patient outcomes. Methods: Patients admitted to the ICU before and after the relocation were retrospectively analyzed. Baseline patient characteristics, types of respiratory pathogens detected, antibiotics used, and patient outcomes were measured. Results: A total of 463 adult patients admitted to the ICU, 4 months before and after the relocation, were included. Of them, 234 were admitted to the ICU before the relocation and 229 afterward. Baseline characteristics, including age, sex, and underlying comorbidities, did not differ between the two groups. After the relocation, the incidence rate of MDR respiratory pathogen detection decreased from 90.0 to 68.8 cases per 1,000 patient-days, but that difference was statistically insignificant. The use of colistin was significantly reduced from 53.5 days (95% confidence interval [CI], 20.3 to 86.7 days) to 18.7 days (95% CI, 5.6 to 31.7 days). Furthermore, the duration of hospital stay was significantly reduced from a median of 29 days (interquartile range [IQR], 14 to 50 days) to 21 days (IQR, 11 to 39 days). Conclusions: Incidence rates of MDR respiratory pathogen detection were not significantly different before and after ICU relocation. However, ICU relocation could be helpful in reducing the use of antibiotics against MDR pathogens and improving patient outcomes.

Convergence Effects of Nursing Professionalism and Critical Thinking Disposition on Patient Safety Attitude in Nursing Students (간호대학생의 간호전문직관과 비판적 사고성향이 환자안전에 대한 태도에 미치는 융 복합적 영향)

  • Park, Mi Hwa
    • Journal of Digital Convergence
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    • v.15 no.11
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    • pp.317-327
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    • 2017
  • This study examined convergence effects of nursing professionalism and critical thinking disposition on patient safety attitude of nursing students. The subjects were 172 senior nursing students in S city. The data were collected from May 15 to May 25, 2017. The data collected were analyzed using SPSS Statistics version 23.0. Nursing students showed 3.76, moderate level in patient safety attitude. Nursing professionalism and critical thinking disposition were positively correlated with patient safety attitude. The variables that have significant influence on the patient safety attitude were 'recommendation' among motivation of admission, academic score, satisfaction with nursing major and nursing professionalism. These factors explained 17.8% of variance. In conclusion, to improve the patient safety attitude of nursing students, it is necessary to systematic management for developing motivation of admission, academic score, satisfaction with nursing major and nursing professionalism.

A Case of Segniliparus rugosus Pulmonary Infection in an Immunocompetent Patient with Non-cystic Fibrosis

  • Lee, Jung Yeon;Chon, Gyu Rak;Jung, Tae-Young;Sung, Heungsup;Shim, Tae Sun;Jo, Kyung-Wook
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.227-229
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    • 2014
  • Segniliparus species is a novel genus that is reported to be the new emerging respiratory pathogens. Here, we report a very rare case of S. rugosus pulmonary infection in an immunocompetent patient with non-cystic fibrosis. The organism was identified by 16S rRNA gene sequencing. The patient was successfully treated with antibiotics.

Effects of High-fidelity Simulator and Standardized Patient on Nursing Care for Children with Fever in Nursing Students (고충실도(High-fidelity) 시뮬레이터와 표준화 환자 (Standardized Patient)를 활용한 발열환아 간호 교육의 효과)

  • Ha, Young-Ok
    • Korean Parent-Child Health Journal
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    • v.20 no.1
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    • pp.10-17
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    • 2017
  • Purpose: This study was conducted to investigate the effects of simulation-based education using high-fidelity simulator and standardized patient in nursing care for children with fever on nursing students. Methods: A total of 166 senior nursing students who completed pediatric nursing practicum courses participated in this study. The single group study design with pretest and posttest was used. The simulation education was provided for 200mins including orientation, simulation preparation, simulation practicum, and debriefing. Pre and post surveys were performed using questionnaires on clinical performance competency, communication skills, critical thinking disposition and self-confidence. Results: The mean scores of clinical performance competency (t=-2.56, p<.05), communication skills (t=-6.39, p<.001), critical thinking disposition (t=-3.43, p<.001), and self-confidence (t=-3.72, p<.001) in posttest were significantly higher than those in pretest. Also, clinical performance competency in nursing care for children with fever has significant relationships with communication skills, critical thinking disposition and self-confidence. Conclusion: The results indicate that simulation-based education using high-fidelity simulator and standardized patient is an effective strategy for improving clinical performance competency, communication skills, critical thinking disposition and self-confidence in nursing students. Further study is needed to verify the effects.

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Effects of Professional Autonomy, Organizational Commitment, and Perceived Patient Safety Culture on Patient Safety Management Activities of Nurses in Medium and Small-Sized Hospitals (중소병원 간호사의 전문직 자율성, 조직몰입 및 환자안전문화인식이 환자안전관리활동에 미치는 영향)

  • Hwang, Hyun Jung;Lee, Yun Mi
    • Journal of Korean Critical Care Nursing
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    • v.10 no.1
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    • pp.63-74
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    • 2017
  • Purpose: The purpose of this study was to examine the effect of professional autonomy, organizational commitment, and perceived patient safety culture on patient safety management activities of nurses in medium and small-sized hospitals. Methods: A cross-sectional design was employed. Self-reported questionnaires were completed by 121 nurses with at least 3 months of working experience in medium and small-sized hospitals located in B city. Data were analyzed using descriptive statistics, a t-test, a one-way ANOVA, Pearson correlation coefficients, and a multiple regression analysis. Results: Professional autonomy (r=.22, p=.016), organizational commitment (r=.34, p<.001), and perceived patient safety culture (r=.55, p<.001) had a statistically significant positive correlation with patient safety management activities. The factors that might affect patient safety management activities were professional autonomy (${\beta}=.23$, p=.003) and perceived patient safety culture (${\beta}=.55$, p<.001). The explanatory power of these factors for patient safety management activities was 33.5% (F=21.19, p<.001). Conclusions: The development of repetitive and continuous education programs is needed to improve a nurse's professional autonomy and perceived patient safety culture.

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Mycobacterium abscessus Lung Disease in a Patient with Kartagener Syndrome

  • Kim, Jung Hoon;Song, Won Jun;Jun, Ji Eun;Ryu, Duck Hyun;Lee, Ji Eun;Jeong, Ho Jung;Jeong, Suk Hyeon;Kang, Hyung Koo;Kim, Jung Soo;Lee, Hyun;Chon, Hae Ri;Jeon, Kyeongman;Kim, Dohun;Kim, Jhingook;Koh, Won-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.3
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    • pp.136-140
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    • 2014
  • Primary ciliary dyskinesia (PCD) is characterized by the congenital impairment of mucociliary clearance. When accompanied by situs inversus, chronic sinusitis and bronchiectasis, PCD is known as Kartagener syndrome. The main consequence of impaired ciliary function is a reduced mucus clearance from the lungs, and susceptibility to chronic respiratory infections due to opportunistic pathogens, including nontuberculous mycobacteria (NTM). There has been no report of NTM lung disease combined with Kartagener syndrome in Korea. Here, we report an adult patient with Kartagener syndrome complicated with Mycobacterium abscessus lung disease. A 37-year-old female presented to our hospital with chronic cough and sputum. She was ultimately diagnosed with M. abscessus lung disease and Kartagener syndrome. M. abscessus was repeatedly isolated from sputum specimens collected from the patient, despite prolonged antibiotic treatment. The patient's condition improved and negative sputum culture conversion was achieved after sequential bilateral pulmonary resection.

A Case of Mycobacterium abscessus Lung Disease in a Patient with H1N1 Influenza Pneumonia (H1N1 Influenza 폐렴 환자에서 발생한 Mycobacterium abscessus 감염 1예)

  • Jung, Kyoung-Won;Yu, Hoon;Lee, Tae-Hoon;Kwon, O-Sung;Choi, Suk-Won;Kang, Se-Hun;Shim, Tae-Sun;Kim, Dong-Soon;Song, Jin-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.3
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    • pp.207-211
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    • 2010
  • Novel influenza A (H1N1) virus is a common pathogen of febrile respiratory infection recently. Here, we report the case of a 63-year-old male patient who presented with 3 days' ongoing cough and fever. He was diagnosed with novel influenza A (H1N1) pneumonia by real-time reverse-transcriptase-polymerase-chain-reaction (rRT-PCR). During treatment for novel influenza A (H1N1), his symptoms and radiologic findings improved initially, but multiple lung nodules developed subsequently and found on chest x-ray (on the 5th hospital day). Mycobacterium abscessus was isolated repeatedly from sputum and bronchoalveolar lavage fluid. To our knowledge, this is the first reported case of Mycobacterium abscessus lung disease in a patient with H1N1 influenza pneumonia.

Bronchogenic Cyst Rupture and Pneumonia after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Case Report

  • Hong, Goohyeon;Song, Junwhi;Lee, Kyung-Jong;Jeon, Kyeongman;Koh, Won-Jung;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.4
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    • pp.177-180
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    • 2013
  • We report a 54-year-old woman who presented with a well-defined, homogeneous, and non-enhancing mass in the retrobronchial region of the bronchus intermedius. The patient underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histological confirmation. Serous fluid was aspirated by EBUS-TBNA. Cytological examination identified an acellular smear with negative microbiological cultures. The patient was finally diagnosed with bronchogenic cysts by chest computed tomography (CT) and EBUS-TBNA findings. However, 1 week after EBUS-TBNA, the patient developed bronchogenic cyst rupture and pneumonia. Empirical antibiotics were administered, and pneumonia from the bronchogenic cyst rupture had resolved on follow-up chest CT. To our knowledge, this is the first reported case of pneumonia from bronchogenic cyst rupture after EBUS-TBNA.