• 한국직업건강간호학회지
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• 제32권1호
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• pp.9-19
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• 2023

Purpose: This study aimed to the investigate the relationship between nursing organizational culture, stress coping, bullying, and turnover intention among Korean hospital nurses; and to identify factors influencing turnover intention. Methods: The participants were 264 nurses working at three general hospitals in a metropolitan area in; South Korea. Data were collected using structured questionnaires from March 20 to June 21, 2021; and analyzed using the SPSS/WIN program. Results: Nurses' turnover intention was positively correlated with hierarchical -oriention (r=.28, p<.001), work -oriention (r=.14, p=.012), and bullying (r=.48, p<.001), whereas turnover intention was negatively correlated with relationship -oriention (r=-.41, p<.001), innovation -oriention (r=-.39, p<.001), and stress coping (r=-.09, p=.009). The factors influencing turnover intention were nursing organizational culture, bullying, age, position, and total working period; these had 44.0% explanatory power for turnover intention (F=14.00, p<.001). Conclusion: According to this study, addressing bullying and strengthening nursing organizational culture is essential to lower turnover intention among clinical nurses.

• 한국시뮬레이션학회논문지
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• 제25권2호
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• pp.51-61
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• 2016

최근 응급의료 서비스의 환자 만족도에 대한 관심이 높아지고 있는 가운데 사물인터넷(IoT: Internet of Things)을 활용한 프로세스 개선에 많은 노력을 기울이고 있다. 본 연구는 IoT기술을 응급실 운영에 활용한 스마트 응급실의 핵심 기술을 살펴보고, 의사와 간호사의 의사결정을 지원하는 진료테스크 우선순위 결정 알고리즘을 제시한다. 제시한 알고리즘은 진료테스크 선정에 따른 책임소재, 환자 불평, 위급환자 진료 지연, 체류시간 길어짐 등의 의사결정 리스크를 최소화한다. 이를 통해 의료진의 감정 육체 소진(Burn-out)을 줄이고 친절과 배려가 있는 환자 진료 케어를 가능하게 하여 환자 만족도와 응급실 의료진의 근무 만족도를 높이고 나아가 간호사의 정체성 제고에 도움을 줄 수 있다. 가상의 응급실을 대상으로 시뮬레이션을 수행한 결과 환자 체류시간 측면에서도 우수한 성능을 보였다.

• 중환자간호학회지
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• 제8권2호
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• pp.66-79
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• 2015

Purpose: This study aimed to derive the elements for effectively improving the management of emerging infectious diseases in the emergency room in large general hospitals. Methods: This research involved an analytic hierarchy process analysis of 10 experienced nurses working in a large general hospital located in the Seoul metropolitan area. The weighted values of the criteria for evaluating the importance of the management elements of patients with emerging infectious diseases in the emergency room of large general hospitals were derived using an analytic hierarchy process survey. Results: The results of the analytic hierarchy process analysis showed that experts considers responsiveness (0.291) as most important with respect to the criteria for the policy for isolation and control of infectious patients. The order of importance of the criteria for the policy for isolation and control of infectious patients were as follows: responsiveness (0.291), economical efficiency (0.257), feasibility (0.242), and sustainability (0.209). Subsequently, the weighted values of the management of the policy elements were determined based on the derived importance of the criteria mentioned above. These were, in order of priority, the construction of communication channels with the government authorities when dealing with emerging infectious diseases (15.9%), the equipment and provision of personal protective equipment to protect nurses from infection and dissemination of material (14.6%), and the operation of the isolation room and patient separation systems (14.1%). Conclusion: This study suggests critical strategies for infection control during a pandemic of emerging infectious disease.

• The Korean Journal of Pain
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• 제27권2호
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• pp.152-161
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• 2014

Background: According to the reports of the World Health Organization 20% of world population suffer from pain and 33% of them suffer to some extent that they cannot live independently. Methods: This is a cross-sectional study which was conducted in the emergency department (ED) of Valiasr Hospital of Arak, Iran, in order to determine the causes of delay in prescription of analgesics and to construct a model for prediction of circumstances that aggravate oligoanalgesia. Data were collected during a period of 7 days. Results: Totally, 952 patients participated in this study. In order to reduce their pain intensity, 392 patients (42%) were treated. Physicians and nurses recorded the intensity of pain for 66.3% and 41.37% of patients, respectively. The mean (SD) of pain intensity according to visual analogue scale (VAS) was 8.7 (1.5) which reached to 4.4 (2.3) thirty minutes after analgesics prescription. Median and mean (SD) of delay time in injection of analgesics after the physician's order were 60.0 and 45.6 (63.35) minutes, respectively. The linear regression model suggested that when the attending physician was male or intern and patient was from rural areas the delay was longer. Conclusions: We propose further studies about analgesics administration based on medical guidelines in the shortest possible time and also to train physicians and nurses about pain assessment methods and analgesic prescription.

• 한국응급구조학회지
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• 제19권2호
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• pp.7-17
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• 2015

Purpose: This study aimed to compare the effects of rescue ventilation maneuvers on the quality of two-rescuer cardiopulmonary resuscitation (CPR). Methods: We implemented mouth to mouth (MMV), mouth to pocket mask (MPV) and bag-valve mask ventilation (BMV) maneuvers. Each team of two-nurses was randomized to perform three consecutive sessions of two-rescuer CPR by using three artificial ventilation maneuvers. Results: The subjects were 26 teams of nurses (female: 96.2%, male: 3.8%, age: 26.6 years). Failed ventilation was more frequent in BMV ($2.23{\pm}2.21$, p <.001) than MMV ($0.31{\pm}0.74$) and MPV ($0.38{\pm}0.64$). BMV had more compressions per minute ($93.7{\pm}5.7$) than MMV ($87.0{\pm}7.2$, p = .001) and shorter total compression pause time ($46.1{\pm}5.8sec$) and compression pause fraction ($23.3{\pm}2.2%$) than MMV ($54.8{\pm}10.3sec$, p = .001, $25.5{\pm}3.5%$, p = .001, respectively) and MPV ($53.1{\pm}7.1sec$, p =. 006 and $25.8{\pm}2.6%$, p = .006, respectively). Conclusion: In our simulation study, BMV reduced the compression pause time and increased the number of compressions per minute, thus indicating CPR provided to patients was effective. However, considering the high rate of ventilation failure, we recommend periodic training.

• 가정∙방문간호학회지
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• 제25권3호
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• pp.153-163
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• 2018

Purpose: This study is know the home care nursing specialists' copying method for life-threatening emergency situation occurred while changing the tracheotomy tube in the patient's home through case-based learning. Methods: Two cases were analyzed using structured critical reflection while changing the tracheal tube. In the first case, the patient presented with dyspnea, cyanosis, and low oxygen saturation when connected to home mechanical ventilator after replacement of the tracheotomy tube. In the second case, replacement of the tracheal tube was difficult due to a narrowed airway from proliferated granulation tissue. Results: From the case-based learning. using a critical reflection instrument, home care nursing specialists indicated that it was important to explain the possibility of danger to the client and that nurses must check the operation of the ambu-bag to prepare for an emergency when replacing a tracheotomy tube. Moreover, they stated a need for two nurses during client visits when there is the possibility of an emergency. Conclusion: Case-based learning through critical reflection provides actual practice-focused knowledge that is helpful to home care nurse specialists who face emergency situations in a restricted environment. Therefore, we hope that home care nursing specialists will use this method to strengthen their professional knowledge.

• 임상간호연구
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• 제27권2호
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• pp.199-209
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• 2021

Purpose: This study was conducted to investigate the nursing needs and workload of nurses according to nursing dependency for effective placement of nursing staff in the emergency department (ED). Methods: In June 2020, 256 adult patients who visited the ED were classified as two groups, suspected COVID-19 patients and general patients. The participants'electronic medical records were analyzed using descriptive statistics, t-test, 𝑥²-test, and Fisher's exact test using the SPSS. Results: The patient dependence score showed a significant difference between the two groups, with an average of 13.99±1.85 for the suspected COVID-19 patient group and 10.58±2.10 for the general patient group (t=12.42, p<.001). There were statistically significant differences in communication (t=3.28, p=.001), mobility (t=3.29, p=.001), nutrition, elimination, and personal care (t=7.34, p<.001) among the six domains of nursing dependency. In the domains of environment, safety, health, and social needs, the dependency score was 3 for all suspected COVID-19 patients and 1 for all general patients. Conclusion: The results of this study confirmed that infection control activities of emergency patients who need isolation affect the patients' nursing dependency on nursing care.

• 임상간호연구
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• 제29권3호
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• pp.223-237
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• 2023

Purpose: This study aimed to investigate the impact of a nurse shift improvement pilot project on nurses' shift adjustment, work-life balance, and turnover intention, as well as nurses' experiences of participating in the pilot project. Methods: An explanatory sequential mixed-methods study was performed. Survey data was collected from a total of 1,051 nurses both in participant and non-participant groups. For the qualitative study, focus group interviews were conducted with 22 nurses who participated in the shift improvement pilot, including 12 staff nurses, 7 nurse managers, and 3 substitute nurses. Results: There were significant positive effects on the key variables of nurses' shift adjustment, work-life balance, and turnover intention in the group that participated in the nurse shift improvement pilot project. Based on the qualitative study, participants in the shift improvement pilot project indicated that it enabled nurses to recover their circadian rhythm, and achieve a better work-life balance, and they wanted to continue working as a nurse, and hoped expanded application of the pilot project. Conclusion: In order for expanded implementation of the pilot project and continued improvement in the shift system, we recommend establishing compensation standard, systematizing the use of substitute nurses, developing guidelines for shift schedules, and expanding the shift improvement pilot project to other departments such as the emergency room.

• 디지털융복합연구
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• 제13권12호
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• pp.303-311
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• 2015

본 연구의 목적은 환경문제 인식, 친환경 태도, 친환경 간호수행의 상관관계를 알고자 하는데 있다. 191명의 병원 간호사가 2012년 10월부터 11월까지 자기기입식 설문을 작성하였으며, 자료 분석은 t-test, one way ANOVA, Pearson 상관관계, multiple regression analysis를 사용하였다. 설문은 환경문제인식, 친환경태도, 친환경보건 관리로 구성되었고, 환경문제인식 (r=.46, p<.001), 친환경태도 (r=.36, p<.001), 친환경 보건관리 사이에 양의 상관관계가 있었다. 변수들에 대한 설명력은 35.0%였다. 본 연구를 통해 국내 병원 간호사의 환경문제와 친환경태도에 대한 인식도를 향상시킬 필요가 있음을 증명하였다. 본 연구 결과를 통해 병원 간호사의 친환경 간호수행을 향상시키기 위한 병원 내 친환경 프로그램 개발 연구를 제언한다.

• 산업경영시스템학회지
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• 제39권2호
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• pp.82-87
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• 2016

As contemporary society has become more complicated, specialized, and segmented, people are experiencing more diverse types of stress. In particular, while several factors associated with job stress have been examined among nurses, who belong to a professional group, the existing research has made no quantitative assessments of stress that reflect temporal differences in individuals. Therefore, the aim of this study is to understand the effects of job stress on alpha-amylase with regard to the working hours of nurses, to assess the variations in jobs stress over time, and provide basic data to improve the quality of nursing services. Ninety nurses working in three shifts in general, emergency, and intensive care wards of a university hospital in D City participated in this study. Salivary alpha-amylase (SAA) was extracted and analyzed at two-hour intervals from 07:00 to 15:00 from nurses on the day shift and from 23:00 to 07:00 from those working the night shift. The SAA level was highest between 23:00 and 01:00 for nurses in general wards ($mean{\pm}S.D.\;39.00{\pm}14.88$) and between 11:00 and 13:00 for those in both intensive care units and emergency wards ($mean{\pm}S.D.\;67.50{\pm}62.93$ and $mean{\pm}S.D.\;39.67{\pm}35.96$, respectively). The characteristic variation in SAA was significant between 23:00 and 01:00 (p < 0.01) and for those in their fifties or older (p < 0.01). The activation ratio of alpha-amylase, a stress reactant, showed an increase when the sympathetic nervous system was activated by mental stress; in addition, job stress was manifested with the effect of awakening at different time segments and at different ages among the nurses. With the aim of raising the level of service based on the nurses maintaining their mental health, it is necessary to focus sharply on the time segment for critical control and to conduct repetitive studies to determine the divisions of eustress critical values as well as to expand the population.