• 제목/요약/키워드: Duty of care

검색결과 268건 처리시간 0.036초

응급의료 센터의 체류 및 입원대기 시간 지연 요인 - 일개 의료기관을 중심으로 - (An Analysis of Primary Causes for Waiting for Inpatient Admission and Length of stay at Emergency Medical Center(EMC))

  • 길숙영;김옥준;박진선
    • 기본간호학회지
    • /
    • 제6권3호
    • /
    • pp.522-531
    • /
    • 1999
  • This research identifies the ingress to egress primary factors that causes a patient to receive delayed emergency medical care. This material was collected between February 1st to 28th, 1998. Research envolved 4,118 people who visited the college emergency medical center in Kyeongido Province, South Korea. Medical records were examined, using the retrospective method. to determine the length of stay and the main cause for waiting. Results are as follows : 1. The age group with the highest admission rate was 10 and under, approximately 1,394 (33.9%). Followed by an even distribution for ages between 11-50 at 10-15% for their respective ranges. The lowest admission rate was 50 years and above. 2. From the 4,118 records examined, 3,489 received outpatient treatment (84.7%); 601 were admitted for inpatient care (14.6%); 25 arrived dead on arrival (0.6%); and 4 people died at the hospital. 3. Between 7PM to 12AM, 42.9% were admitted to the EMC. The hours from 9PM to 11PM recorded the highest admission rate and 5AM to 8AM was the lowest From 8PM to 12AM, the most beds were occupied. 4. For most patients. the average length of stay was approximately 2.2 hours. By medical department, external medicine was the longest for 2.8 hours. Pediatrics was the shortest for 1.6 hours. The average waiting period for inpatient admission was 2.6 hours. Inpatient admission for pediatrics and external medicine was 3.4 hours and 2.2 hours respectively. 5. Theses are primary factors for delay at EMC: 1) pronged medical consultations to decide between inpatient versus outpatient treatment, and delaying to be inpatient, 2) when you call physicians they are delayed to come 3) Understaffing during peak or critical hours, 4) Excessive consulting with different medical departments, 5) some patients require longer monitoring periods, 6) medical records are delayed in transit between departments, 7) repeated laboratory tests make delay the result, 8) overcrowded emergency x-ray place causes delay taking x-ray and portable x-ray, 9) the distance between EMC and registration and cashier offices is too far. 10) hard to control patient's family members. The best way to reduce EMC waiting and staying time is by cooperation between departments, both medical and administrative. Each department must work beyond their job description or duty and help each other to provide the best medical service and satisfy the patient needs. The most important answer to shortened the EMC point from ingress to egress is to see things from a patient point of view and begin from there to find the solution.

  • PDF

퍼지 AHP를 이용한 헬스케어 환자의 빅 데이터 사용의 효율적 관리 기법 (An Efficiency Management Scheme using Big Data of Healthcare Patients using Puzzy AHP)

  • 정윤수
    • 디지털융복합연구
    • /
    • 제13권4호
    • /
    • pp.227-233
    • /
    • 2015
  • 최근 IT 기술의 발전과 함께 의료 기술 또한 급격하게 발전하게 되어 헬스케어 서비스를 제공받는 환자의 정보(의료정보, 질병정보 등)가 의료 서비스에서 다양하게 사용되고 있다. 그러나, 환자의 질병정보가 헬스케어 서비스에서 다양하게 사용되면서 환자 치료 방법에 대한 복잡성과 불확실성 또한 증가하여 병원은 환자 치료에 대한 의사결정이 더욱 어려워지고 있다. 본 논문에서는 헬스케어 서비스를 제공받는 환자의 치료를 효율적으로 처리하기 위해서 환자질병정보를 빅 데이터로 관리 할 수 있도록 효율성을 고려한 다기준의사결정벙법 중 하나인 퍼지 AHP를 사용한 헬스케어 환자의 효율적인 빅 데이터 관리 기법을 제안한다. 제안 기법은 환자의 질병정보들 간의 상관관계를 통해 치료기준들 간의 쌍대비교 척도를 삼각퍼지화하여 환자의 현실적 치료 방법을 찾도록 하는 것을 목적으로 한다. 제안 기법은 쌍대비교를 통해 질병 치료들간 퍼지이론의 삼각퍼지수를 적용하여 상대적인 중요도를 산출 한 후 치료 방밥에 대한 효율성을 구한다. 또한 제안 기법은 환자의 질병치료를 결정하기 위한 방법들을 계층화하여 삼각퍼지수를 이용한 쌍대비교 행렬을 구현한 후 질병치료기준별 대안에 대한 중요도를 계산하여 각 치료별 효율성을 분석하여 최종 질병치료 방법을 선택하기 때문에 기존 질병치료 방법보다 판단 및 치료의 애매함과 부정확성 상태를 5.8% 개선하고 있다.

쪽방지역에 홀로 사는 남성 노인의 삶의 경험 (Study on the Lived Experience of Elderly Men Living Alone in a Single Room Occupancy(Chokbang))

  • 허소영
    • 한국노년학
    • /
    • 제30권1호
    • /
    • pp.241-260
    • /
    • 2010
  • 이 연구의 목적은 쪽방지역에 홀로 사는 남성 노인의 삶의 경험이 갖는 의미와 본질을 밝힘으로서 이들의 경험에 대한 좀 더 풍부한 이해를 하는 것이다. 연구 참여자는 Y 쪽방지역에 거주하는 65세 이상 독거 남성 8명이다. 의도표집방법과 눈덩이 표집 방법을 사용하였으며, 포커스 집단 면담과 개별심층면담을 통해 자료를 수집하였다. 자료의 분석은 Giorgi의 4단계에 의거하였다. 연구결과 4개의 구성요소와 16개의 하위구성요소가 도출되었다. 쪽방에 홀로 사는 남성 노인들의 삶의 4가지 구성요소는 <마음 둘 곳 없어 외로운 신세: 아들, 남편, 아비구실 못해 가족을 지우고 살아옴, 몸은 머물지만 정들지 않는 쪽방 살이, 하루짜리 술친구에 머무는 사귐, 외로움을 안고가기>,<인색한 지원에 근근이 살아감: 쪽방처럼 사방이 막힌 인생살이에 우울함, 수급자라 휘둘리고 무시 받아 속상함>,<편견과 차별에 주눅 드는 삶: 아쉬워도 손 벌리지 못함, 가족을 꾸리지 못해 후회되고 냉대 받음, 다가가지 못하는 바깥세상 >,<사람노릇하며 살다가기: 홀로의 삶을 건사하여 독립을 유지하려함, 빚 갚는 마음으로 도움주기, 하릴없이 보내는 나날이 고역이라 일을 하고 싶음, 쪽방 사람들과 다르게 살아가기, 어른도리 하기, 마음을 다스려 현재의 삶을 수용함, 폐가 되지 않을 죽음을 준비하기>로 나타났다. 이러한 결과를 바탕으로 쪽방지역에 홀로 사는 남성 노인들의 삶의 경험에 대한 의미를 논의하고 사회복지적 함의와 후속 연구를 위한 제언을 제시하였다.

한국인의 건강관행에 대한 민속과학적 접근 (Ethnosientific Approach of Health Practice in Korea)

  • 김귀분;최연희
    • 대한간호학회지
    • /
    • 제21권3호
    • /
    • pp.396-417
    • /
    • 1991
  • In order that nursing care an essential quality of nursing practice be acceptable and satisfying, it is necessary that client's culture be respected and that nursing practice be appropriate to that culture. Since cultural elements are an important influence on health practices and life patterns related to medical treatment, recovery from and prevention of disease, nurses need to have an understanding and knowledge of social and cultural phenomena to aid in the planning of nursing interventions. To understand the health practices surrounding health and illness, the health beliefs and practices of both folk and professional healing systems should be ascertained. Cultural data are required to provide care of high quality to clients and to reduce possible conflict between the client and the nurse. It is nursing's goal to provide clients from various cultures with quality nursing care which is satisfying and valuable. The problem addressed by this study was to identify Korean health practices which would contribute to the planning of professional caring practice with the culture : ultimately this study was intended to make a contribution to the development of the science of nursing. The concrete objectives of this study were ; 1) to identify Korean health practices, 2) to interpret the identitial health practices through traditional cultural thought, and 3) to compare the Korean health practices with those of other cultures. The investigator used the ethnosceintific approach outlined by spradly in a qualitative study. To discover ancestral wisdom and knowledge related to traditional health practeces, the subjects of this study were selected from residents of a small rural mountain village in south west Korea, a place considered to be maintaining and transmitting the traditional culture in a relatively well -preserved state because of being isolated from the modern world. The number of subjects was 18, aged 71 to 89. Research data were collected from January 8 to March 31, 1990. Five categories of health practices were identified : “Manage one's own mind”, “Moderation in all thing”, “Live in accord with nature”, “Live in mutuality with others”, and “Live to the best of one's ability”. Values derived from these ways of thinking from Confucianism, Taoism and Buddhism help fashion a traditional way of life, examplified by the saying “Benifience to all”. Korean thought and philosophy is influenced primerily by Confucianism, Confucian principles of ethics, embedded deeply in the peoples' minds, form the idea that “heaven and human being are intimately united” based on concept that “heaven is, so to speak, reason”. Twoe Gae's theory of existential subjectivity develops the concept of self which is the basis of the spirit of reverence in modern Confucian philosophy. The human md is granted from heaven out of the idea of matter, and what control the mind is the spirit of reverence. Hence the idea of “The primacy of the mind" and provided that one should control one's own mind. The precepts of duty to parents, respect for elders and worship of ancestors, and moderation in all behavior put a restraint on life which directed that one live earnestly according to Nature's laws with their neighbors. Not only Confucianism, but also Buddism and Taoism have had an important effect upon these patterns of ideas. When compared with western culture, Korean health practices tend to be more inclusive, abstract and intuitive while westerner health practices found to be mere concrete, practical and personal. Values and beliefs based and pragmatism and existentialism infuence western civilization, Ethical values may be founded on utilitarianism, which considers what is good for the persons in their circumstances as the basis of conduct and takes a serious view of their practical lives including human aspirations rather than an absolute truth. These philosophical and ethical ideas are foundations for health practices related to active, practical and progressive attitudes. This study should be enable nursing not only to understand clients as reflections of the traditional culture when planning nursing practice, but to dovelop health education corresponding to cultural requiments for the purpose of protection against disease and improvement of health, and thus promote sound health practice. Eventually it is hoped that through these processes quality nursing care as the central idea of the science of nursing will be achieved.

  • PDF

자궁적출술 환자를 위한 critical pathway 개발과 적용효과 (Critical Pathway Development for the Hysterectomy Patients and its applied Effect)

  • 노기옥;박경숙
    • 여성건강간호학회지
    • /
    • 제6권2호
    • /
    • pp.234-257
    • /
    • 2000
  • At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

  • PDF

우리나라 어머니의 자녀 양육의 의미 - 거제지역을 대상으로 - (An Ethnography of Child-Rearing Experiences of Korean Mothers Living on Koje Island)

  • 이수연
    • 여성건강간호학회지
    • /
    • 제7권4호
    • /
    • pp.518-535
    • /
    • 2001
  • Nursing practices should be based on the understanding of human beings. In order to understand human beings, it is important to study the lifestyles and thoughts of people in their natural environment. In this sense, the cultural aspects of a society need to be studied for a culture-bound nursing service. Child care, which is an important element of nursing, is also strongly influenced by the culture of a society. Therefore, a cultural study is necessary to understand the child-rearing practices of any society. The major purpose of this dissertation is to provide basic foundations for developing a culture-based theory for nursing intervention through studying traditional cultural elements of child care in Korean society. The study examined child-rearing practices in a small village on Koje Island in the southern part of Korea. It utilized ethnographic methodologies including participatory observations and in-depth interviews. The study participants were 9 Korean mothers living on Koje Island. The average age was 52. The data were collected between July in 1998 and December in 1999. The average number of interviews per person was 7-8, and the duration of each interview was approximately 2 hours. The data were analyzed using the Spradley Analytical Method. The following 9 major child-rearing aspects of mothers on Koje Island were discovered as a result of the study: 1. Firstly, mothers on Koje Island were mostly concerned about the "Old Birth Goddess' Curse", especially during their child's early years. This concern was evidenced by their careful behavior when their child was very young and by their praying to the Old Birth Goddess not to be jealous of their babies. 2. Secondly, they wished their children to live a different and better life than themselves. It was represented by their strong motivation toward their children's education as well as their expectation for their children's success. In traditional Korean culture, Korean people think that the rise and fall of the household depend on their offsprings. Therefore, Korean mothers wish their children attain to a higher level of social status through education. 3. Third, mothers are concerned about their children's righteousness. Mothers on Koje island expect their children to live with discretion, justice, strength, respect, harmony, and to do their best in life. 4. Next was an 'anticipation of their children's happy marriage'. The attributes of this category were an 'anxiety about their children's married life', and 'an expectation of a good spouse for their children'. Because Korean people believe that only a son can continue the bloodline of a family, especially Korean mothers have a great concern of the possibility of their daughters not having a son after marriage. Also they have different expectations toward their daughter-in-laws than son-in-laws. 5. Korean mothers also derived their satisfaction from their son. It was characterized by 'excessive affection toward their son', 'dependency on their son', and 'being afraid of their married daughter having a girl like themselves'. Korean society has been a patriarchy. Therefore, a son is beloved as someone who will take care of his old parents, be in charge of ancestral rites, and provide a daughter-in-law who can conceive a son. 6. The sixth category concerned 'the differences in their expectations for their children'. The attributes in this category were 'different expectations depending on their children's gender', 'different expectations depending on their children's ability', and a 'great sympathy toward children with low abilities'. Korean mothers expect their son to become better than their daughter. 7. The seventh category was related to their 'roles in child-caring practices'. Traditionally a child was raised in an extended family system in Korea So it was not the sole duty of a mother to bring up the child. Korean mothers used to receive much help rasing children from their in-laws, and family members. On the other hand, many children grew up by themselves, because their mothers were very busy taking care of housework. Furthermore, many children also grew up in poverty. 8. Mothers also had issues related to 'conflicts in child rearing'. They were characterized by 'lack of understanding', 'rudeness of children', and 'giving vent to one's anger'. 9. Finally, mothers regretted not doing their best in child-rearing practices. It was characterized by a 'bitter feeling of repentance', 'feeling irritated', and 'feeling of unsatisfaction'.

  • PDF

병원감염 사건에서 증명책임 완화에 관한 입법적 고찰 - 개정 독일민법을 중심으로 - (Legislative Study on the Mitigation of the Burden of Proof in Hospital Infection Cases - Focusing on the revised Bürgerliches Gesetzbuch -)

  • 유현정
    • 의료법학
    • /
    • 제16권2호
    • /
    • pp.159-193
    • /
    • 2015
  • 병원감염 사례에 관한 판결의 주류적 태도는 병원감염 발생으로 인한 손해의 분담을 사실상 환자 측에 전가하는 문제가 있다고 판단되므로, 손해의 공평 타당한 분담을 그 지도 원리로 하는 손해배상제도의 이념에 비추어 환자 측의 증명책임을 대폭 완화하기 위한 방법을 강구할 필요성이 있다. 이와 관련하여 진료계약을 민법상 전형계약으로 규정하고, 병원감염과 같은 의료 측이 전적으로 지배할 수 있었던 경우에는 일반적 진료상 위험이 실현된 때 진료자의 오류가 추정된다고 명문으로 과실추정규정을 둔 독일민법을 검토하였다. 진료계약은 매우 빈번하고 광범위하게 일반 국민의 실생활에서 체결되고 있으며, 그로 인한 분쟁도 다양하게 발생하고 있으므로, 진료계약을 독일과 같이 민법의 전형계약으로 규정함으로써 계약 내용과 분쟁 발생 시 증명책임 등에 관해 규율할 필요성이 있다. 병원감염 사건의 경우 법률에 의해 과실을 추정하고, 병원감염 예방을 위한 노력을 철저히 시행한 기관에 한하여 병원감염 사고로 인한 손해가 발생한 경우 그 비용을 지원하도록 사회보험을 통한 제도적 보완이 필요하다고 생각되며, 향후 이에 관한 면밀한 연구와 검토가 요구된다.

  • PDF

최근국제항공보안대책(最近國際航空保安対策)의 제간제(諸間題) -특히 법적측면(法的測面)을 중심(中心)으로- (Some New Problems of International Aviation Security- Considerations Forcused on its Legal Aspects)

  • 최완식
    • 항공우주정책ㆍ법학회지
    • /
    • 제5권
    • /
    • pp.53-75
    • /
    • 1993
  • This article is concerned with the comment on "Some New Problems of International Aviation Security-Considerations Forcused on its Legal Aspects". Ever since 1970, in addition to the problem of failure to accept the Tokyo, Hague and Montreal Conventions, there has been also the problem of parties to them, failing to comply with their obligations under the respective treaties, in the form especially of nominal penalties or the lack of any effort to prosecute after blank refusals to extradite. There have also been cases of prolonged detention of aircraft, passengers and hostages. In this regard, all three conventions contain identical clauses which submit disputes between two or more contracting States concerning the interpretation or application of the respective conventions to arbitration or failing agreement on the organization of the arbitration, to the International Court of Justice. To the extent to which contracting States have not contracted out of this undertaking, as I fear they are expressly allowed to do, this promision can be used by contracting States to ensure compliance. But to date, this avenue does not appear to have been used. From this point of view, it may be worth mentioning that there appears to be an alarming trend towards the view that the defeat of terrorism is such an overriding imperative that all means of doing so become, in international law, automatically lawful. In addition, in as far as aviation security is concerned, as in fact it has long been suggested, what is required is the "application of the strictest security measures by all concerned."In this regard, mention should be made of Annex 17 to the Chicago Convention on Security-Safeguarding International Civil Aviation against Acts of Unlawful Intereference. ICAO has, moreover, compiled, for restricted distribution, a Security Manual for Safeguarding Civil Aviation Against Acts of Unlawful Interference, which is highly useful. In this regard, it may well be argued that, unless States members of ICAO notify the ICAO Council of their inability to comply with opecific standards in Annex 17 or any of the related Annexes in accordance with Article 38 of the 1944 Chicago Convention on International Civil Aviation, their failure to do so can involve State responsibility and, if damage were to insure, their liability. The same applies to breaches of any other treaty obligation. I hope to demonstrate that although modes of international violence may change, their underlying characteristics remain broadly similar, necessitating not simply the adoption of an adequate body of domestic legislation, firm in its content and fairly administered, but also an international network of communication, of cooperation and of coordination of policies. Afurther legal instrument is now being developed by the Legal Committee of ICAO with respect to unlawful acts at International airports. These instruments, however, are not very effective, because of the absence of universal acceptance and the deficiency I have already pointed out. Therefore, States, airports and international airlines have to concentrate on prevention. If the development of policies is important at the international level, it is equally important in the domestic setting. For example, the recent experiences of France have prompted many changes in the State's legislation and in its policies towards terrorism, with higher penalties for terrorist offences and incentives which encourage accused terrorists to pass informations to the authorities. And our government has to tighten furthermore security measures. Particularly, in the case an unarmed hijacker who boards having no instrument in his possession with which to promote the hoax, a plaintiff-passenger would be hard-pressed to show that the airline was negligent in screening the hijacker prior to boarding. In light of the airline's duty to exercise a high degree of care to provide for the safety of all the passengers on board, an acquiescence to a hijacker's demands on the part of the air carrier could constitute a breach of duty only when it is clearly shown that the carrier's employees knew or plainly should have known that the hijacker was unarmed. The general opinion is that the legal oystem could be sufficient, provided that the political will is there to use and apply it effectively. All agreed that the main responsibility for security has to be borne by the governments. A state that supports aviation terrorism is responsible for violation of International Aviation Law. Generally speaking, terrorism is a violation of international law. It violates the sovereign rights of states, and the human rights of the individuals. We have to contribute more to the creation of a general consensus amongst all states about the need to combat the threat of aviation terrorism. I think that aviation terrorism as becoming an ever more serious issue, has to be solved by internationally agreed and closely co - ordinated measures.

  • PDF

간호진단 프로토콜(Protocol)의 임상적용 효과에 관한 연구 (The Effects of Clinical Application of a Nursing Diagnosis Protocol)

  • 이향련;조미영;조결자;김윤희;김귀분;김광주;문희자;박신애;강현숙
    • 대한간호학회지
    • /
    • 제19권1호
    • /
    • pp.40-62
    • /
    • 1989
  • This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses(experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul. Data collection was done from August to October 12,1988. The results obtained in this study can be summarized as follows, 1, Effect of the clinical application of the nursing diagnosis protocol. 1) The first hypothesis ; “nurses who use the nursing diagnosis protocol will have higher degrees of satisfaction than those who use traditional methods” was rejected (t=.54, df=58, p=.59). 2) The second hypothesis ; “patients nursed by nurses using the nursing diagnosis protocol will have higher degrees of satisfaction than those nursed with traditional methods” was supported(t=1.93, df=154, p=.05). 3) The third hypothisis : Major hypothesis ; “the nursing records of the experimental group, who used the nursing diagnosis protocol, will be more detailed than those of the control group” was supported (t=6.40, df=79.90, p=.000). (1) The first subhypothesis ; “The recorded data collection of the experimental group will be more detailed than that of the control group” was rejected (t=1.79, df=118, p=.07). (2) The second subhypothesis ; “The recorded patient's problem statement of the experimental group will be more detailed than that of the control group”, was supported. (3) The third subhypothesis ; “The nursing record of the experimental group will be more convenient for implementation than that of the control group” was supported. 2. Factors related to the nurse's degree of satisfaction with protocol. 1) No general characteristics(age, religion, education level, duty career, present duty career) were related to the nurse's degree of satisfaction. 2) Variables related to the nurse's degree of satisfaction were “satisfaction as a nurse” and “consider nursing as lifelong job” (t=-2.6, df=13.22, p=.02, t=2.41, df=23.85, p=.02). 3. Factors related to the patient's degree of satisfaction. 1) General characteristics related to the patient's degree of satisfaction with nurses using the protocol were age, educational level, and being married.(F=5.17, df=3/153, p=.00, t= -2.39, df=154, p=,01, f=5.91, df=2/153, p=.00) 2) The variables previous hospitalization, duration of hospitalization, the hospital unit presence of a relative, medical insurance, or medical diagnosis were not related to the patient's degree of satisfaction. 1. The experimental group's nursing record was more detailed than the control group's record with regard to the physical and psychological state of the patients. As noted above, the experimental group nurses, who use a nursing diagnosis had protocol were less satisfied than the control group who used traditional methods of the recording, but experimental group patients had a higher degree of satisfaction than the control group patients. The nursing records of experimental group, using the nursing, diagnosis protocol was more detailed than that of the control group. If the nursing diagnosis protocol is used in clinical nursing practice, the quality of nursing care may be improved.

  • PDF

부산지역 목회자의 교구간호사업 요구조사 (The Demands on Parish Nursing Services by Pastors in Busan)

  • 손수경;강경자;이지현;이영은;박춘화
    • 지역사회간호학회지
    • /
    • 제13권1호
    • /
    • pp.182-196
    • /
    • 2002
  • The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

  • PDF