• Title/Summary/Keyword: Emergency Nursing

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Path Analysis for Delirium on Patient Prognosis in Intensive Care Units (섬망이 중환자실 환자결과에 미치는 영향: 경로 분석)

  • Lee, Sunhee;Lee, Sun-Mi
    • Journal of Korean Academy of Nursing
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    • v.49 no.6
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    • pp.724-735
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    • 2019
  • Purpose: This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model. Methods: This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24. Results: In the final model, admission via emergency department (Β=.06, p=.019), age over 65 years (Β=.11, p=.001), unconsciousness (Β=.18, p=.001), dependent activities (Β=.12, p=.001), abnormal vital signs (Β=.12, p=.001), pressure ulcer risk (Β=.12, p=.001), enteral nutrition (Β=.12, p=.001), and use of restraint (Β=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (Β=.06, p=.038), hospital length of stay (Β=5.06, p=.010), and discharge to another facility (not home) (Β=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium. Conclusion: The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.

Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot (당뇨병성 족부질환자에 대한 가정간호서비스의 비용-효과분석)

  • Song, Chong Rye;Kim, Yong Soon;Kim, Jin Hyun
    • Journal of Korean Academy of Nursing Administration
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    • v.19 no.4
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    • pp.437-448
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    • 2013
  • Purpose: This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot. Methods: The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions. Results: Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients. Conclusion: Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.

The Degree of Injury Risk Perception in Preschool Children (학령전기 아동의 사고위험 지각 정도)

  • Kim, Shin-Jeong;Kang, Kyung-Ah;Kim, Sung-Hee;Lee, Jung-Eun
    • Child Health Nursing Research
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    • v.18 no.2
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    • pp.68-75
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    • 2012
  • Purpose: The purpose of this study was to measure (the degree of) injury risk perception in preschool children. Methods: The data were collected from child day care centers and kindergartens located in Seoul, and Gyeonggi and Kwangwon Province. A questionnaire consisted of 28 pictures was administered to 186 preschool children. Results: The mean score for the injury risk perception was 21.83 (${\pm}3.89$), and 77.98 converted into a 100-point scale. According to sub-categories, 'burn prevention' ($.96{\pm}.13$) was the highest, 'interpersonal safety' ($.44{\pm}.31$) was the lowest. There were significant differences in injury risk perception according to gender (t=-2.358, $p$=.019), age (t=-2.101, p=.037), experience of safety education (t=-3.719, $p$ <.001), area of residence (t=-3.445, $p$=.001), injury experience (t=3.212, $p$=.002), and mother's occupation (t=-4.858, $p$ <.001). The highest item in the percentage of correct answer item was 'making jump on the desk', the lowest item in the percentage of correct answer item was 'not wearing safety equipment when rollerblading'. Conclusion: Based on this study, studies should be continued to standardize the instrument. In addition, it is recommended that an injury prevention education program should be developed based on the results of this study to stimulate demand and interest.

Feasibility Evaluation of Korean Advance Directives (K-AD) (한국판 사전의료의향서(K-AD)의 가용성 평가)

  • Kim, Shin Mi;Hong, Sun Woo;Kim, Jin Shil;Kim, Ki Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.20 no.4
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    • pp.639-649
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    • 2014
  • Purpose: This study evaluates the feasibility of Korean Advance Directives (K-AD) developed earlier. Method: From January 1 to February 28, 2013, data were collected from 330 adults through a self-reported questionnaire established by the authors based on literature review and expert consultation. The feasibility of K-AD was multi-dimensionally evaluated through four criteria: cognitive, psychological, document making and socially expecting aspects. Data were analyzed using t tests, one-way ANOVA, and Scheffe post hoc tests via the SAS 9.1.3 program. Results: The feasibility of K-AD differed significantly by gender (p=.003), educational level (p<.001), religion (p=.002), and self-reported health status (p=.039). Differences in the level of easiness with K-AD by gender (p=.008) and education (p=.047) were significant. Perceived simplicity of AD differed significantly by religion (p=.005), and the necessity of AD differed significantly by gender (p=.025) and religion (p=.005). Conclusion: K-AD are sufficiently feasible to be tentatively utilized in practice. This is the first study to explore the feasibility of K-AD on the basis of multiple aspects. However, further studies involving diverse populations and methodologies to validate the usefulness of K-AD are warranted.

Current Status of Patient Safety Regulations, Guidelines and Support Mechanisms in Korean Hospitals

  • Lee, Jae Ho;Kim, Jeong Eun;Kim, Suk Wha;Lee, Sang Il;Jung, Yoen Yi;Kim, Moon Sook;Jang, Seon Mi
    • Perspectives in Nursing Science
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    • v.10 no.2
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    • pp.158-166
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    • 2013
  • Purpose: This study was conducted to investigate patient safety regulations and guidelines in order to understand their current status, and to examine support measures to improve patient safety in Korean hospitals. Methods: The participants were the safety officers from hospitals with 200 or more beds and 112 hospitals responded to the online survey. The questions covered patient safety regulations, the performance level of patient safety activities, patient safety incident reporting systems, the dedicated professional, training, support mechanisms, and expectations of reporting systems. Results: Among preventative measures, fall prevention and hand hygiene were reported to be most widely practiced (92% and 91%, respectively). Time-out for invasive procedures showed a relatively low practice rate at 70%. Among patient care activities, transfusion, surgery and sedation, medication, and infection management were performed by 84, 74, 93 and 93% of the hospitals, respectively. Patient safety activities included patient safety committee, patient safety cooperation between decision-making bodies, patient safety workshops, seminars, lectures, and training for employees. Conclusion: Patient safety regulations and guidelines have not yet been sufficiently prepared, and a public institution such as a certification authority is of crucial importance to enforce these guidelines.

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Comparison of Sleep Pattern, Factors of Sleep Disturbance and Sleep Enhancement Behaviors between Sleep Disturbance and Non-Sleep Disturbance Aged Patients (수면장애 노인 환자와 일반 노인 환자의 수면양상, 수면장애요인 및 수면증진행위)

  • Han, Suk-Jung;Lee, Eun-Young;Kim, Kyung-Mi;Park, Sun-Nam
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.1
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    • pp.62-71
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    • 2007
  • Purpose: This study was done to compare sleep patterns, factors of sleep disturbance and sleep enhancement behaviors between sleep disturbance and non-sleep disturbance elderly patients. Method: The participants were 117 patients over 65 years old who were hospitalized at 5 general hospitals in Seoul. There were 83 patients in the good sleeper group and 34 in the poor sleeper group. The survey questionnaires included questions on general characteristics, sleep patterns, sleep disturbing factors, and sleep enhancement behaviors of the patients. Results: For sleep patterns and environmental factors of sleep disturbance, the poor sleepers was significantly higher than that of the good sleepers. Significant differences between good sleepers and poor sleepers were also found on the following variables: Environmental factors of sleep disturbance -'Sound of other patient's or care-giver's', 'Discomfort of bed, linen, pillow and patient's gown', 'Light in the room', 'Emergency situations', 'Temperature of patients rooms too hot or too cold'. The significant physical factor of sleep disturbance was 'Hard to breath even without moving' and for sleep enhancement behaviors: 'Use of ear plugs or eye covers' Conclusion: Consequently it is necessary to develop positive and differentiated programs for sleep enhancement for the inactive and poor sleeper among the elderly patients.

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The Effects of Labor Support Behaviors (LSB) One-to-one Application and Partner's Delivery Participation on the Delivery Satisfaction and Delivery Results among Mothers Who Delivered Premature Birth and Low Birth Weight Infant (조산 및 저출생체중아를 분만한 산부의 Labor Support Behaviors의 일대일 적용 및 배우자의 분만참여에 따른 분만만족도와 분만결과 비교)

  • Park, Kwang Hee;Lee, Se Hwa;Jin, Bo Kyung;Won, Jin Suk
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.2
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    • pp.239-250
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    • 2011
  • Purpose: This study was aimed to evaluate the effects of Labor Support Behaviors (LSB) one-to-one application and partner's delivery participation on the delivery satisfaction and delivery results among mothers who delivered premature birth and low birth weight infant. Methods: The data were collected from 30 mothers in the experimental group and 27 in the control group from April 23, 2009 to April 22, 2010. The collected data were analyzed using percentage, mean, standard deviation, $x^2-test$ (Fisher's exact test) and t-test with SPSS. Results: The satisfaction levels of the experimental group and the control group women were $3.73{\pm}0.43$ and $3.72{\pm}0.34$ as mean values, respectively, showing not statistically different (t=0.07, p=.945). None showed less than 7 point of Apgar score at 1 minute in the experimental group while 5 out of 27 did (18.5%) in the control group, which was statistically meaningful. Also, the emergent cesarian section cases were 3 out of 33 (9.1%) in the experimental group and 5 out of 32 (15.6%) in the control group, demonstrating lower emergency cesarian section rate in the experimental group than the control group, but showing not statistically different ($x^2=0.643$, p=.475). Conclusion: The results of this study show that LSB one-to-one application and partner's participation has affirmative effects on 1 minute Apgar scores of newborns.

Effectiveness of Simulation Prctice Education on Emergency Using Debriefing for Meaningful Learning of Nursing Student (간호대학생의 DML(Debriefing for Meaning Learning)를 적용한 응급 시뮬레이션 실습의 효과)

  • Kim, So-Myeong;Kim, Su-Ol
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.6
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    • pp.1577-1586
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    • 2021
  • The purpose of this study was to evaluate the effects of debriefing for meaning learning on critical thinking ability, problem-solving ability, communication abilit of nursing students. A nonequivalent control group pretest-posttest design was used in this study. And the subjects were 73 students in D city, including 38 students in experimental group and 35 students in control group. The result critical thinking ability (t=-3.144, p=.002), problem-solving ability (t=-3.248, p=.002), and critical communication ability (t=-4.051, p=<.001) improved more significantly in the experimental group, compared with the control group. Therefor debriefing for meaning learning on nursing students' was effective education method on critical thinking skills, problem-solving skills, communication skills.

Factors influencing health-related quality of life for young single-person households: the mediating effect of resilience (청년 1인 가구의 건강 관련 삶의 질 영향요인: 회복탄력성의 매개효과를 중심으로)

  • Soo Jin Lee;Sujin Lee;Xianglan Jin
    • Journal of Korean Biological Nursing Science
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    • v.25 no.3
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    • pp.160-171
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    • 2023
  • Purpose: To identify factors influencing health-related quality of life for young single-person households, this study investigated physical and mental health status, health behavior, depression, resilience, and health-related quality of life. Methods: An online survey was administered to members of young single-person households from March 22 to 30, 2022. The data were analyzed using the chi-square test, independent t-test, one-way analysis of variance, Pearson correlation coefficients, multiple regression, and a simple mediation model applying the PROCESS macro model 4 with 95% bias-corrected bootstrapped confidence intervals. Results: The participants were 229 members of young single-person households. Health-related quality of life showed significant relationships with residence (t = 2.80, p = .006), month (F = 3.70, p = .026), mental health status (F = 20.33, p < . 001), and high-intensity exercise (F = 7.35, p = .001) among general and health-related characteristics. Health-related quality of life had significant correlations with depression (r = -.72, p < .001) and resilience (r = .58, p < .001). Multiple regression analysis showed that depression (β = -.57, p < .001) and resilience (β = .21, p < .001) influenced health-related quality of life. Moreover, resilience had a mediating effect between depression and health-related quality of life (indirect effect = -0.002, 95% bias-corrected bootstrapped confidence interval = -0.003 to -0.001). Conclusion: Members of young single-person households tended to be more vulnerable to emergency situations, such as during the coronavirus disease 2019 pandemic, when lockdowns and quarantines were frequent. To improve health-related quality of life in young single-person households, people with high levels of depression or low levels of resilience need special attention and support to promote mental health.

Content and quality of YouTube regarding women's health: a scoping review

  • Jin Hyeon Kim;Hyun Kyoung Kim
    • Women's Health Nursing
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    • v.29 no.3
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    • pp.179-189
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    • 2023
  • Purpose: This scoping review investigated the content and quality of YouTube videos on women's health. Methods: A literature search of the Cochrane Library, PubMed, Embase, CINAHL, ERIC, and RISS databases was performed using the keywords "('youtube'/exp OR youtube OR 'social media'/exp OR 'social media' OR (('social'/exp OR social) AND ('media'/exp OR media))) AND ('female health care' OR (('female'/exp OR female) AND ('health'/exp OR health) AND ('care'/exp OR care)))" from February 21 to 27, 2023. Peer-reviewed analytic studies in English or Korean that focused on women's health using YouTube were included. Results: The review identified 21 articles that covered various themes related to women's health, such as breast cancer, urinary disease, sexual health, pelvic organ prolapse, the human papillomavirus vaccine, Papanikolaou smears, contraception, women's health information during the coronavirus disease 2019 pandemic, obstetric epidural anesthesia, and placenta accreta. However, the overall quality of the content was low, inaccurate, unreliable, and misleading. Conclusion: This scoping review demonstrated that YouTube videos on women's health covered diverse topics, but the quality of the content needed improvement. More reliable and high-quality videos produced by academic institutes and healthcare professionals specializing in women's health are needed for social media to be usable as a reliable source of women's health information. The high number of views and shares received by the videos underscores the importance of providing accurate and reliable information on women's health.