• 대한간호학회지
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• 제54권2호
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• pp.237-249
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• 2024

Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

• Child Health Nursing Research
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• 제22권1호
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• pp.29-36
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• 2016

Purpose: The purpose of this study was to identify international students' use of university health centers by individual characteristics and seasons. Methods: This was a retrospective descriptive study using data obtained from the electronic record system of one university health center. The study participants were international undergraduate students who registered for any of two semesters between March 1, 2014 and February 28, 2015 and visited the university health center during their registration period. Results: The most common reasons for visits were problems of head, eye, nose and throat systems, followed by respiratory system. Their visits mostly occurred in the fall and spring. The most frequently used services were distribution of oral medication followed by wound treatment. The number of visits per individual was statistically different by gender (u=-3.307, p=.001), but not by their major (${\chi}^2$=.543, p=0.762) or nationality (${\chi}^2$=5.518, p=.271). Conclusion: Further study is necessary to better define health needs and related factors for this unique population. The electronic record system provides great opportunities in development and application of need based health services for international students and for research in this area.

• 임상간호연구
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• 제17권1호
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• pp.101-112
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• 2011

Purpose: The purpose of this study is to develop a detailed clinical model for recording initial nursing assessment items, and to test the applicability of the model to facilitate semantic interoperability for sharing and exchanging nursing information. Methods: First, the researchers extracted items by analyzing initial nursing assessment records. Second, defining characteristics were identified by analyzing nursing records and reviewing the literature. Third, value sets for defining characteristics were identified and types and cardinalities of defining characteristics were defined based on the value sets. Finally, the detailed clinical model was tested through evaluation by experts and comparison with the initial nursing assessment in a clinical setting. Results: Sixty-one detailed clinical models were developed with 178 defining characteristics and value sets. The experts evaluation and comparison with the initial nursing assessment in a clinical setting showed that the detailed clinical model developed in this study was valid. Conclusion: Use of this detailed clinical model can ensure that the Electronic Health Record contains meaningful and valid information and supports semantic interoperability of nursing information. This use will promote quality in the nursing records and eventually quality of nursing care.

• 한국융합학회논문지
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• 제12권10호
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• pp.365-372
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• 2021

본 연구의 목적은 자연어처리에 의해 생성된 욕창간호진술문의 특성을 파악하고, 욕창 단계판별 예측정확도를 평가하기 위함이다. 욕창관련 간호기록은 서술통계를 이용하여 분석하였고, 워드클라우드 생성기를 활용하여 욕창예방 간호기록에서 단어의 특성을 파악하였다. 딥러닝을 이용하여 욕창단계판별 정확도(accuracy ratio) 를 구하였다. 연구결과, 욕창의 단계에 대한 기록 중 2단계와 심부조직손상의심단계가 각각 23.1% 와 23.0 % 로 가장 많았고, 빈도수가 높은 핵심단어는 홍반, 수포, 가피, 부위, 크기 등으로 나타났다. 예측의 정확도가 높은 단계는 0단계, 심부조직손상의심단계, 2단계 순으로 나타났다. 따라서, 이를 활용하여 임상적 의사결정지지 시스템으로 개발된다면, 임상간호사의 욕창관리역량 향상 전략 개발에 기초가 될 수 있을 것이다.

• 한국의료질향상학회지
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• 제18권1호
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• pp.37-55
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• 2012

Objectives : This study was conducted to evaluate the effect of fixed critical pathway with emr (electronic medical record) on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a university hospital and to develop flexible critical pathway with emr which can be used excluded or drop-out patients. Methods : Thirty-eight patients with gastrectomy were included as case group and Thirty-four patients included as control group. The comparison between control and case with using fixed critical pathway were done. To develop and to evaluate usefulness of flexible critical pathway with flexible data base, simulation was done for flexible critical pathway with drop-out patients. Result : The major results of this study were as follows: There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. The length of hospital stay was 11 days in control group, 8 days in path group(P<0.01). The total costs during the hospital stay were reduced in path group. However the cost per day was significantly increased from reduction of hospital stay(554,352 won in control, 645,669 won in path group). One hundred percentage of drop out patients(60) in the simulation of flexible critical pathway was successful. Conclusion : Computerized critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care. The flexible critical pathway program can be used as one of the powerful management tools for reducing the practice variations and increasing the efficiency of care process and decreasing the workload of doctors and nurses in Korean hospital settings.

• 여성건강간호학회지
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• 제18권4호
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• pp.268-278
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• 2012

Purpose: This study aims to determine obstetric and gynecologic (OBGY) nurses' perception and performance propecting patients' privacy, and to contribute to develop educational program and improve the quality of nursing care. Methods: 206 OBGY nurses in 6 hospitals using an electronic medical record or an order communicating system were chosen by convenience sampling and agreed to participate in the study. The questionnaire, explored 4 domains of privacy: direct nursing, linked business, patient information management, communication with relatives. Results: Perception and performance of protecting patient privacy averaged 4.29 (of 5) and 3.55 (of 5), respectively. Most nurses (94.2%) recognized the importance of protecting patient privacy, 80.1% received patient privacy education. There was a distinct difference between the perception and performance of protecting patient privacy of nurses. Performance of protecting patient privacy had a positive correlation with perception. Conclusion: Proper performance of protecting privacy protection requires improving perception of each nurse on the patient privacy, and various efforts should be made to minimize the affect from external factors such as hospital environment. It is needed to educate nurses for patient privacy. It is also needed for medical organizations to improve their policies and facilities to ease the performance for privacy protection.

• Child Health Nursing Research
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• 제25권1호
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• pp.56-64
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• 2019

Purpose: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. Methods: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. Results: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. Conclusion: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.

• Journal of Korean Biological Nursing Science
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• 제20권4호
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• pp.236-243
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• 2018

Purpose: The purpose of this study was to identify the factors associated with the discontinuation of patient controlled analgesia (PCA) after surgery. Methods: The data of 1,092 adult patients that were over 20 years of age and underwent PCA after surgery in the Gachon University Hospital from May 1 to June 30, 2017, were collected through the patients' Electronic Medical Record (EMR). The collected data was analyzed via the use of the Chi-test, t-test and multivariate logistic regression analysis using SPSS 18.0 program. Results: The postoperative PCA discontinuation rate was 26.1%. It was associated with various symptoms, such as those of nausea, dizziness, and headache. The PCA discontinuation was also related with female (odds ratio, OR= 1.75; confidence interval, CI= 1.09-2.82), nausea (OR= 105.27; CI= 61.03-181.58), total intravenous anesthesia (TIVA) of the thyroidectomy (OR= 10.43; CI= 5.01-21.70). Conclusion: It is necessary to provide additional medication and nursing interventions to reduce nausea, which is the symptom associated with PCA discontinuation, especially in the operation of female subjects and thyroidectomy under TIVA. That is, those who are at a high risk for PCA discontinuation should be able to administer additional antiemetics or reduce non medication nursing interventions.

• 임상간호연구
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• 제19권3호
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• pp.357-368
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• 2013

Purpose: The purpose of this study was to investigate risk factors related to delirium and to develop screening model on delirium occurrence in MICU (Medical Intensive Care Unit) patients. Methods: For developing a preliminary tool for delirium, the data of 166 patients were collected and analyzed. In order to estimate the accuracy and discriminating power for the developed screening model, 98 patients were enrolled. The data used in this study were collected by EMR (Electronic Medical Record) review from January to September in 2012. The collected data were analyzed using SPSS/PC Win 18.0 program. Results: Screening model on delirium in MICU patients was developed using the results of logistic regression. The total score of screening model was 24 point and measuring point was 10 point. When the measuring point is over 10 point, it means that the risk of delirium occurrence is high. The discriminating power and the validity of screening model showed AUC .908 (p <.001) and .935 (p <.001) respectively. This result showed that the screening model on delirium which developed in this study was an appropriate model for screening the delirium risk group in MICU. The sensitivity of the screening model was 83%, specificity 89% and accuracy 84%. Conclusion: The developed screening model on delirium occurrence in MICU should be combined with EMR for screening and preventing delirium in a high risk group.

• 한국간호교육학회지
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• 제22권4호
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• pp.485-494
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• 2016

Purpose: The present research is a descriptive study aimed at understanding clinical nurses' Video display terminal (VDT) syndrome and identifying the factors that affect their VDT syndrome. Methods: Data were collected from 239 clinical nurses working in two metropolitan cities. Research tools included subject's VDT syndrome assessing musculoskeletal, ophthalmic, dermal, psychiatric, and whole body syndromes. The data were analyzed using frequency analysis, average and standard deviation, t-test, One-way ANOVA, and multiple regression analysis with the SPSS/WIN 20.0 program. Results: The subjects' VDT syndrome score was 1.34 out of 5. There were significant differences in participating subjects' VDT syndrome, hospital's size, working unit, health status, diagnosis of illness, having an Order Communication System (OCS), having an Electronic Medical Record (EMR) System, continuous VDT working for more than one hour, break time during VDT use, VDT use time, comfort of the chair, adjustability of the height of the chair, size of the VDT's desk, distance between the monitor and the user's eyes, resolution of the monitor, and frequency of eye exercise during VDT use. According to the research, influencing factors on VDT syndrome in clinical nurses included size of the VDT's desk, frequency of eye exercise during VDT use, having an EMR system, break time during VDT use, diagnosis illness, and having an OCS' system. Conclusion: The findings from this study can be used as a basis for future VDT syndrome prevention education and programs for clinical nurses.