Park, Sung Woo;Oh, Tae Suk;Choi, Jong Woo;Eom, Jin Sup;Hong, Joon Pio;Koh, Kyung S.;Lee, Taik Jong;Kim, Eun Key
Archives of Plastic Surgery
/
제42권1호
/
pp.28-33
/
2015
Background Topical anesthetics, such as eutectic mixture of local anesthetics (EMLA) cream, can be applied to reduce pain before minor procedure. This trial evaluated EMLA as pretreatment for facial lacerations and compared pain, discomfort and overall satisfaction. Methods This trial included consecutive emergency department patients ${\geq}16years$ of age who presented with simple facial lacerations. At triage, lacerations were allotted to either the routine processing group or EMLA pretreatment group according to date of admission. Initially, the emergency department doctors inspected each laceration, which were dressed with saline-soaked gauze. In the pretreatment group, EMLA cream was applied during wound inspection. The plastic surgeon then completed primary closure following the local injection of an anesthetic. After the procedure, all patients were given a questionnaire assessing pain using the 10-point visual analog scale (VAS) ("no pain" to "worst pain"). All questionnaires were collected by the emergency department nurse before discharge. Results Fifty patients were included in the routine processing group, and fifty patients were included in the EMLA pretreatment group. Median age was 39.9 years, 66% were male, and the average laceration was 2.67 cm in length. The EMLA pretreatment group reported lower pain scores in comparison with the routine processing group (2.4 vs. 4.5 on VAS, P<0.05), and lower discomfort scores during the procedure (2.0 vs. 3.3, P=0.60). Overall satisfaction was significantly higher in the EMLA pretreatment group (7.8 vs. 6.1, P<0.05). Conclusions Pretreating facial lacerations with EMLA topical cream aids patients by reducing pain and further enhancing overall satisfaction during laceration treatment.
Purpose: The aim of this study was to investigate the satisfaction of newly graduated nurses with educational programs and their experiences in role transition. Methods: Data were collected from November 1 to December 15, 2018 and 483 new graduate nurses working at 15 tertiary hospitals and 10 general hospitals participated. For data collection, self-report questionnaires including the Casey-Fink Graduate Nurse Experience Survey tool and satisfaction with education were used. Data were analyzed using descriptive statistics, t-test, and one-way analysis of variance. Results: Satisfaction with education ranged from 3.09 to 3.27, and satisfaction with preceptors was 3.45(maximum 4). The skill that new nurses ranked as most difficult during the first 3 months was charting/documentation, and throughout a whole year, the top 4 difficult skills were cardiopulmonary resuscitation/emergency response, ventilator care, end-of-life care, and prioritization/time management. In comfort/confidence, new graduates felt most comfortable with support and least comfortable with patient safety. More than 50 percent of new graduates experienced stress during role transition, and the most frequently experienced stressors were related to job performance and personal life. Levels of satisfaction with education and comfort/confidence differed according to the hospital type and number of preceptors for new nurses. Conclusion: In order to facilitate the transition of new graduate nurses to professional nurse, an extended period of education, systematic and standardized transition programs, and continuous support during the first year of practice are required.
Purpose: This phenomenological study is aimed at illuminating the lived experiences of newly-qualified nurses who working in general hospitals in C province. Method: The data was collected through unstructured, in-depth interviews with 10 new nurses from April to June 2001, and analysed by Colazzi' methodology. Results: Thematic content analysis identified 6 central themes in this experience-difficulties m making interpersonal relationship, negative feelings, fatigue and unskilled work performance, self-reflection, a sense of accomplishment, identity formation as a nurse. Also, this themes were constructed into 6 constructs explaining new nurses' experience. The results may contribute to a better understanding of what new nurses experienced and how their negative conflicts could be managed. Conclusion: New nurses need to get more education and supportive empowerment regarding diverse conflicts during training period. Educational programs like a preceptorship or individual counselling should be developed and adopted to all clinical settings.
Objectives: This study is to research delay time comparison for later defibrillation after hands off according to the changes in defibrillation electrodes. Study purpose: In defibrillation treatment that is the only way for cardiac arrest by arrhythmia, it is to find defibrillator device which can minimize late defibrillation delay time after important affect of hands off. Study object and method: After hands off according to the defibrillator device, we collected total 40 people for emergency medicine doctor, internal medicine doctor, general surgeon, nurse, emergency medical technician who are working at 2 CN, CS University hospitals in Gwangju Jeollanamdo district to find out hand off shock interval(HOSI). We then researched their general properties like occupation sector, experiences in clinic, gender, completion of AHA ACLS-P training and more. Then 40 participants continued ventricular fibrillation cardiac arrest simulation training (using human-model mannequin) designed by researcher and performed their roles as defibrillation operator. Each of participant used manual paddle and performed 4 times of defibrillation (150J) during 8 minutes of CPR and in 8day, the defibrillator devices were replaced from manual paddle to self-adhesive electrodes pads and 4 times of defibrillation (150J) under same simulation condition as manual paddle were performed. Study result: In comparison for delay time of later defibrillation after hands off of manual paddle and self adhesive electrodes pad, the self adhesive electrodes pad ($7.0{\pm}0.5sec$) seemed to reduce delay time of later defibrillation significantly (p<0.05) compared to manual paddle ($10.0{\pm}0.9sec$). The self adhesive electrodes pad, according to the general properties of participants, had no particular change in delay time after later defibrillation for the statistics (p>0.05) but the manual paddle had statistically significant differences for the occupation sector, experiences in clinic and gender (p<0.05). Conclusion: In defibrillation, the self adhesive electrodes pad($7.0{\pm}0.5sec$) showed short HOSI compared to manual paddle ($10.0{\pm}0.9sec$) significantly (p<0.05) and it applied identically for both existence and non-existence of ACLS-P training completion, experiences in clinic, gender and occupation sector. The manual paddle had also significant difference in experiences in clinic and occupation sector (p<0.05). which means the effect on HOSI according to the job mastery. Therefore, if the clinic experience is short or in case for the occupations without frequent defibrillation treatment has a danger of lowering success rate for the defibrillation using manual paddle. Therefore, it is true that using self adhesive electrodes pad for defibrillation electrodes when performing manual defibrillation in pre-hospital as well as in-hospital steps can generally minimize delay time of later defibrillation after hands off.
Purpose: The purpose of this study was to provide basic data to develop first aid education programs for elementary, middle and high school students. Method: Forty nine textbooks adopted by first to six grade elementary schools and first to third grade of both middle and high schools were analyzed for content on first aid. Results: 1) First aid content was covered only in courses on and 2) Content on first aid was included in the categories, "General of first aid", "Rescue & moving", "Fire & Burns", "Cardiopulmonary resuscitation", "Musculoskeletal injuries", "Thermal injuries", "Wounds", "Removing foreign bodies", "Disaster & Accidents" and "Others". Categories that were not included were "Poisoning" and "Bites". The content did not follow a progression related to the level of intellectual and physical development of the students. Conclusion: These results suggest that the content on first aid should be revised to be practical and rational for the benefits of student safety.
Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.
Purposes: The purposes of this study were to examine knowledge related to child abuse, attitudes toward child abuse, and intention to report child abuse and to identify the predictors of nurses' intention to report child abuse. Method: A descriptive-correlational study was conducted. Participants were 171 nurses who worked in the pediatric or emergency rooms in G city. Self-administered questionnaire was used for data collection. Descriptive statistics, t-test or ANOVA, Pearson correlation, and stepwise multiple regression analysis were used for data analysis. Results: Nurses had a limited knowledge related to child abuse. Nurses had negative attitudes toward child discipline, were inclined to punish the abuser, and had positive attitudes about professional responsibility for reporting child abuse. Nurses perceived difficulty in the actual behavior of reporting child abuse. Nurses' intention to report child abuse was predicted by nurses' attitudes to professional responsibility for reporting child abuse. Conclusions: Based on the findings of this study, educational programs need to be developed, implemented, and evaluated. The conclusion of this study is that supplementary education is needed for multidisciplinary decision making concerning the role of the nurses within the context of child abuse. Implications for nursing practice, education and research are discussed.
Purpose: This study was conducted in order to analyze the job of school health teacher in Korea. Methods: School health teachers' roles were analyzed by DACUM job analysis. Guide of DACUM methods and workshop were directed by a DACUM job analyst. The DACUM committee identified tasks associated with each duty and completed the DACUM chart. Results: Through DACUM job analysis, the roles of school health teachers were defined; one who manages health of students and staff, and conducts health education; 11 duties and 95 tasks were identified. The committee listed required knowledge and skills, working attitude, and future trends. Emergency and common disease care were the best critical duties, followed by health education, counseling, and self-development. Conclusion: School health teacher plays the roles of nurse and health care manager, and teacher. According to the expansion of health care needs and health education, school health teachers are placed in more essential and critical areas. Their duties and tasks are various and have changed significantly, thus the School Health Act should be changed practically. The results of this study can be used in development of training programs or evaluation of the job performance of school health teachers.
Purpose: The purpose of this study was to review articles, thesis and dissertation on turnover intention of hospital nurses in order to identify overall trends in turnover intention of nurses and suggest strategies for reducing turnover intention. Method: Thirty research papers on turnover intention of nurses were reviewed. Result: These papers were journal articles and thesis regarding nurses who worked in general wards, intensive nursing units, and emergency rooms in hospital. The tools used to measure turnover intention were Lawler (1983), Mobley (1982), and Lee (1995), and others. Most of tools were composed of 1-11 items, with 4-7 point Likert scales. Reported reliability was .55 to .91. The mean score for turnover intention was between 2.40 and 3.85. The important results revealed that job satisfaction, organizational commitment, and stress affected turnover intention of hospital nurses. Conclusion: The findings from this review indicate that to reduce turnover intention for hospital nurses, a nurse manager should increase job satisfaction, organizational commitment, and reduce stress by developing a good culture and work climate. Moreover it is necessary to assess stress and job satisfaction of nurses, and to manage nurses' welfare, including night duty policy, salary, and career ladder.
Purpose: To study aimed to examine the impact of the Nursing and Care=giving Integrated Service on nursing work performance, nurse' job satisfaction, and patient safety. Methods: A total of 66 nurses were selected as participants, comprising 30 nurses working in Nursing and Care=giving Integrated Service hospital ward, and 33 nurses working in a general hospital ward with a similar patient and disease group and distributed moderately. For data analysis, t-tests, ANOVA, and $X^2$ tests were conducted. Results: Nursing work performance in the Nursing and Care=giving Integrated Service ward was higher than that in the general hospital ward, but this difference was not statistically significant. Conversely, job satisfaction was lower among nurses in the Nursing and Care=giving Integrated Service ward, although again the difference was not significant. However, the Nursing and Care=giving Integrated Service ward had a significantly lower rate of safety-related accidents in patients compared to the general hospital ward. Conclusion: In order to expand and improve patient safety and other aspects of the Nursing and Care=giving Integrated Service, there is a need to establish a mediation strategy for increasing nurses' work performance and job satisfaction.
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