• Journal of Korean Biological Nursing Science
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• v.22 no.3
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• pp.213-221
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• 2020

Purpose: The purpose of this study was to explore the role performance and related factors of clinical research nurses (CRN) in the process of clinical trials of new drug development. Methods: Study participants were CRN whose affiliation was in non-capital areas and who had been working longer than three months at the time of the data collection. The data collection was conducted with a semi-structured questionnaire development by Hwang & Go, 2011 comprising 16 items of participants' characteristics and 60 items of role performance via in-person and online. Additionally, opinions which would be necessary to establish the CRN role were questioned for the future. A total of 141 questionnaires of 151 questionnaires responses were analyzed using descriptive statistics, t-test, and ANOVA for data analysis as appropriate. Results: The level of overall role performance was above average (5.61±0.90) with the highest in subject care (6.04 ± 0.96) and management and the lowest in self-development (4.39 ± 1.52). The only factor affecting overall role performance was employment status and the only sub-category affected by factors of employment status, and some general characteristics was self-development. Conclusion: From study results, it can be concluded that the CRN seem to perform their proper role. Nonetheless, self-development should be considered as critical aspect for better CRN competency, which is an important aspect toward improving the CRN role performance. Additionally, efforts to improve the level of role performance must be established through stable employment and concrete departmental placement as suggested in this study.

• Journal of Korean Clinical Nursing Research
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• v.22 no.3
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• pp.265-275
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• 2016

Purpose: The purpose of this study was to develop an evidence-based guideline for fever management for critically ill adult patients after a brain injury. Methods: Development of the guideline process was done according to the De Novo development Korean Medical Guideline Information Center (KoMGI) and consists of 12 steps. Results: This developed guideline included 3 domains and 19 recommendations. The number of recommendations for each domain was 7 on measuring temperature, 9 on managing fever, and 3 on managing shivering. The level of evidence was as follows: 58% were at level I, and 42% at level II. Of the recommendations, 58% were graded as A, 37% as B, and 5% as C. Conclusion: These findings indicate that this guideline can be used as a guide for nursing in critically ill adult patients with brain injury. This guideline can also contribute to improvements in the quality of nursing care for critically ill adult patients with brain injury.

• Korean Journal of Adult Nursing
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• v.20 no.3
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• pp.489-499
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• 2008

Purpose: The purpose of this study was to assess the importance and contribution of 9 nursing outcomes and their indicators that could be applied to cerebrovascular patients. Methods: Data were collected from 175 neurosurgical nurses working at two university affiliated hospitals and five secondary hospitals located in Gwang-ju. The Fehring method was used to estimate outcome content validity(OCV) and outcome sensitivity validity(OSV) of nursing outcomes and their indicators. Stepwise regression was used to evaluate relationship between outcome and its indicators. Results: The core outcomes identified by the OCV were Tissue Perfusion: Cerebral, Nutritional Status, Neurological Status, and Wound Healing: Primary Intention, whereas highly supportive outcomes identified by the OSV were Oral Health, Self-Care: ADL, and Nutritional Status. All the critical indicators selected for Fehring method were not included in stepwise regression model. By stepwise regression analysis, the indicators explained outcomes from 19% to 52% in importance and from 21% to 45% in contribution. Conclusion: This study identified core and supportive outcomes and their indicators which could be useful to assess the physical status of cerebrovascular patients. Further research is needed for the revision and development of nursing outcomes and their indicators at neurological nursing area.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.4
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• pp.574-586
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• 2006

Purpose: This paper is intended to provide a clauses of scope of nursing practice with nursing act. Method: This was a planning study. The provision of scope of nursing practice is constructed through critical review of literatures and regulations. The validity of the legal definition was tested through expert and staffs in affiliates of Korean Nurses Association review. Result: 'Nursing is an activity that assesses and diagnoses the reaction of an individual, family, and community for health promotion and maintenance, illness prevention and rehabilitation and to provide intervention and evaluate the results. This practices are done through nursing knowledge and skills. The nursing practices include basic nursing services (general hygiene, environment and safety control, emotional and physical comfort, examination and surgery related care, systematic observation and reporting about patients, activity and organ function maintenance), practice of doctor's regimen, consulting and education to patients, reference, collaboration and management with other health personnel, public health activity by regulation. And nursing standards are set by a separate code. Conclusions: The result of this study can be used to offer for nursing act. So, This legal definition will be constantly discussed and extended to reflect actual nursing practice.

• Journal of East-West Nursing Research
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• v.17 no.2
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• pp.87-95
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• 2011

Purpose: The aim of this study was to share the experience of clinical performance examinations (CPXs) using standardized patients, which was to test comprehensive clinical competence of fourth-year nursing students for four years. Methods: The assessment strategies for CPXs were developed. It included clinical scenarios, the roles of standardized patients, and appraisal criteria in the areas of fundamental and comprehensive nursing care. The CPXs were implemented to about 60-70 fourth-year nursing students of C University in G-city, South Korea, during every second semester from the year of 2006 to 2009. Results: The effects of CPXs were measured by 10 or 25-item rating checklist. Internal reliability of the checklists was distributed from .511 to .956 and interrater agreement between faculties and standardized patients was moderate (r=.250-.949). Students' satisfaction level was 4.27 out of 5 points for four years. Conclusion: The use of CPXs was an innovative educational strategy to evaluate nursing students' comprehensive performance ability including knowledge, skills and attitude. Further studies are needed to evaluate the levels of critical thinking and problem solving skills of clinical nurses who were taken CPXs as well as employers' satisfaction.

• Journal of Korean Academy of Nursing
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• v.36 no.4
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• pp.621-629
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• 2006

Purpose. The purpose of this study was to identify the clinical variables that predict functional and cognitive recovery at 1- and 6-month in both severe and moderate/mild traumatic brain injury patients. Methods. The subjects of this study were 82 traumatically brain-injured patients who were admitted to a Neurological Intensive Care Unit at a university hospital. Potential prognostic factors included were age, motor and pupillary response, systolic blood pressure, heart rate, and the presence of intracranial hematoma at admission. Results. The significant predictors of functional disability in severe traumatic brain injury subjects were, age, systolic blood pressure, the presence of intracranial hematoma, motor response, and heart rate at admission. In moderate/mild traumatic brain injury patients, motor response, abnormal pupil reflex, and heart rate at admission were identified as significant predictors of functional disability. On the other hand, the significant predictors of cognitive ability for severe traumatic brain injury patients were motor response and the presence of intracranial hematoma at admission, whereas those for moderate/mild patients were motor response, pupil reflex, systolic blood pressure at admission, and age. Conclusions. The results of the present study indicate that the significant predictors of TBI differ according to TBI severity on admission, outcome type, and outcome measurement time. This can be meaningful to critical care nurses for a better understanding on the prediction of brain injury patients. On the other hand, the model used in the present study appeared to produce relatively low explicabilities for functional and cognitive recovery although a direct comparison of our results with those of others is difficult due to differences in outcome definition and validation methods. This implies that other clinical variables should be added to the model used in the present study to increase its predicting power for determining functional and cognitive outcomes.

• Journal of Korean Clinical Nursing Research
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• v.26 no.2
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• pp.207-216
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• 2020

Purpose: The purpose of this study was to investigate the motor subtypes of delirium in patients in a Surgical Intensive Care Unit (SICU), and identify the factors related to the characteristics of patients according to the motor subtypes of delirium. Methods: Data were collected in the SICU of a tertiary hospital in ^⁎ city from October 2018 to June 2019. Delirium was detected using the Confusion Assessment Method for the ICU (CAM-ICU) and motor subtypes of delirium were measured with the Delirium Motor Subtype Scale (DMSS)-4. Patients' characteristics were obtained by using the electronic medical records. Descriptive statistics were used to analyze the data. Results: Among 1,112 patients, 172 patients showed delirium (15.5%). After excluding dementia patients and patients refusing to participate in the study, 126 patients included in the final analysis. Delirium patients were classified as hyperactive delirium (32.5%), hypoactive delirium (42.9%), mixed delirium (11.9%), and non-motor subtype delirium (12.7%). Conclusion: The study results suggest that hypoactive delirium is the most prevalent motor subtype of delirium in SICU. More application of ventilators, more administration of sedatives, more use of catheters, and higher nursing severity were reported for hypoactive delirium cases than hyperactive ones. Therefore, it is necessary to assess early the motor subtypes of delirium using structured tools and develop appropriate nursing interventions suitable for each subtype of delirium.

• Journal of Home Health Care Nursing
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• v.6
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.11
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• pp.4723-4726
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• 2014

Background: Breast cancer is the second most common cancer in the world and by far the most frequent cancer among women. Objective: The present study was undertaken to assess the awareness of breast cancer warning signs and screening methods among the women of Pokhara valley, Nepal. Materials and Methods: A cross-sectional questionnaire survey was carried out in a community setting with the female population. The questionnaire was administered in face-to-face interviews by trained research assistants. Results: Nepalese women demonstrated poor awareness of warning signs like a breast lump, lump under the armpit, bleeding or discharge from the nipple, pulling of the nipple, changes in the position of the nipple, nipple rash, redness of the breast skin, changes in the size of the breast or nipple, changes in the shape of the breast or nipple, pain in the breast or armpit, and dimpling of the breast skin. While 100% of nurses were aware about breast self-examination(BSE), mammography and warning signs of breast cancer. Levels of knowledge were significantly poorer in women with other occupations. Graduates were more aware about BSE, mammogram and warning signs of breast cancer compared to those with other educational levels. Conclusions: The findings indicated that the level of awareness of breast cancer, including knowledge of warning signs and BSE, is sub-optimal among Nepalese women.

• Health Policy and Management
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• v.16 no.3
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• pp.1-18
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• 2006

The organizational effectiveness of hospital in various environmental fluctuations is a large and complex problem. Hospital CEO leadership characteristics may be a critical determinant of employees' job satisfaction and turnover intention. Several empirical studies on transformational leadership found that transformational leadership behaviors were positively related to workers' job satisfaction and turnover intention. Very little research related to this subject has been done in health care settings in Korea. The author explores the relationship between hospital CEO leadership style and its effect on job satisfaction and turnover intention among the all staffs of general hospital. The relationship of hospital CEO leadership style to employees' job satisfaction was investigated using the Bass's leadership paradigm of transformational and transactional leadership. The Multifactor Leadership Questionnaire(MLQ) and the index of job satisfaction and turnover intention were completed by 493 hospital employees(doctors, nurses, hospital administrators, technicians, and assistants). The findings show a similar trend to the previous studies. Hospital CEO leadership behaviors and employee outcomes were significantly correlated. Correlations showed a significant positive relationship between those hospital CEO exhibiting a transformational leadership style and the job satisfaction of their staffs. The results of multiple regression analysis indicate that the effect of charisma in transformational leadership behaviors is more higher than other variables. Transformational leadership style may be a more effective strategy and have a greater effect on staff outcomes, attitudes and behaviors. The findings of this study reveal implications for efficient hospital management and the importance of understanding relationship between hospital CEO's leadership style and subordinate behaviors in the context of CEO's desirable role and function for hospital strategy planning and future direction.