• Title/Summary/Keyword: Emergency Nursing

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The Effect of Simulation Training applying SBAR for Nursing Students on Communication Clarity, Self-Confidence in Communication, and Clinical Decision-Making Ability (SBAR를 적용한 시뮬레이션 교육이 간호대학생의 의사소통명확성, 의사소통자신감, 임상의사결정능력에 미치는 효과)

  • Cho, Hun-Ha;Nam, Keum-hee;Park, Jung-Suk;Jeong, Hyo-Eun;Jung, Yu-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.73-81
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    • 2020
  • This study is a single-group study to check the effectiveness of nursing students on their communication credibility, communication confidence and clinical decision-making ability by implementing SBAR-applied simulation training to improve the difficulty of delivering clear information to medical personnel during transition. By combining simulation practices and SBAR training based on emergency situations of mothers and newborns, programs were developed and applied to communicate clearly and briefly to the medical staff about emergencies and to enhance communication skills. The subjects were 91 fourth-year nursing college students from one university in B metropolitan city. The data were collected from Feb. 18, 2019 to Feb. 28, 2019 and were analyzed using the SPSS/WIN 18.0 program as a paired t-test. The results revealed that the communication clarity measured after the simulation exercise (t=-3.99, p<.001), Communication Confidence (t=-8.60, p<.001), Clinical Decision Capacity (t=-4.66, p<.001) Statistically, it has increased significantly. Therefore, the purpose of this research is significant in that it seeks to promote the expertise of nursing college students by developing and applying simulation practical education programs to enhance the communication skills and clinical decision-making skills of nursing college students as prospective medical personnel.

An Analysis of Nursing Decision Tasks, Characteristics, and Problems with Decision Making (환자 간호에 대한 간호사의 의사결정 내용과 특성 및 의사결정 장애요인에 관한 분석)

  • 최희정
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.880-891
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    • 1999
  • The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.

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An Operations Study on the Home Care Nursing Delivery System (지역사회 중심 가정간호사업 운영연구(가정간호사업 운영을 위한 정보전달체계 개발Ⅱ))

  • Park, Jung-Ho;Kim, Mae-Ja;Hong, Kyung-Ja;Han, Kyung-Ja;Park, Sung-Ae;Yun, Soon-Nyoung;Lee, In-Sook;Cho, Hyun;Bang, Kyung-Sook
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.5
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    • pp.20-31
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    • 1998
  • The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

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The Incidence and risk factors of delirium in elderly surgical patients (외과계 병동 노인 수술 환자의 섬망 발생률과 위험요인)

  • Lee, Eun Ju;Jang, Mi;Kim, Myung Hwa;Yun, Hye Jun;Kim, Eun Mi;Chung, Young In;Kim, Bo Kyung;Im, Eun Su;Hong, Kyoung Soon
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.2
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    • pp.137-145
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    • 2022
  • Purpose: This retrospective chart review study was conducted to examine the frequency of delirium and to identify the risk factors of delirium in elderly surgical patients. Methods: The subjects of this study were 394 patients aged 65 years or older who underwent surgery. The diagnosis of delirium was based on the nursing assessment records with scores from the day of surgery to the 4th day after surgery. The collected data were analyzed by binary logistic regression analysis. Results: The incidence of delirium was 4.3%, and delirium occurred most frequently on the first day of surgery and lasted for 2.16 days on average. Of delirium patients, 76.5% underwent gastrointestinal surgery, and the most common delirium pattern was disorientation. In terms of the characteristics of the subjects, the occurrence of delirium was statistically different by age (𝝌2=10.79, p=.005), systemic-specific disease (𝝌2=9.63, p=.047), use of delirium-inducing drug(benzodiazepine) before surgery (𝝌2=15.90, p<.001), walking ability before surgery (𝝌2=7.65, p=.006), history of delirium (𝝌2=35.92, p<.001), and emergency surgery (𝝌2=16.40, p<.001). As risk factors of delirium, gastrointestinal surgery was found to increase the risk of delirium by 12.57 times (95% CI=2.45~64.46, p=.002), and the use of benzodiazepines before surgery was shown to increase delirium by 10.07 times (95% CI=2.21~45.87, p=.003). Conclusion: It is necessary for nurses to actively evaluate delirium using screening tools for early detection and prevention of delirium in elderly surgical patients with delirium risk factors.

A Study on the Development of a Measuring Instrument for Korean Nursing Student' Evaluation of the Effect of Simulation Education. (시뮬레이션 교육의 효과 평가를 위한 한국형 간호학생 팀워크 측정도구개발)

  • Nam, Ho-Hee;Song, Hyun-Young;Lee, Bo-Ram
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.3
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    • pp.381-390
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    • 2017
  • The aim of this study is to develop a teamwork self-assessment tool for Korean nursing students (K-self assessment of teamwork) to evaluate the effects of simulation education, and to test the validity of the tool. As the research method, data were collected from 185 third- and fourth-year nursing students who had completed emergency simulation practice courses while attending nursing schools at two universities in K region. The collected data were analyzed using such statistical programs as SPSS/WIN 22.0 and AMOS 17.0. A test of the construct validity was conducted using confirmatory factor analysis and explanatory factor analysis. To test the criterion validity of the K-self assessment of teamwork, its correlation with the Mayo High Performance Teamwork Scale (MHPTS) was analyzed using Pearson's correlation coefficients. In addition, of the reliability items, the internal consistency was tested using Chronbach's ${\alpha}$. The results of the study are as follows: The construct validity was demonstrated through the confirmatory factor analysis and explanatory factor analysis. As regards the test of reliability, there was one item for which the reliability of its validity was increased to .937 when a (single/particular) question was removed. However, in the end, no questions were removed, because the correlation coefficient between the questions and the total score was greater than .4. The overall reliability of the K-self assessment tool of teamwork was found to be .934, confirming its reliability. The translated version of the K-self assessment of teamwork developed in this study was also demonstrated to be applicable to domestic settings, in which the teamwork of nursing students can be assessed during simulation education. The results of the use of this tool in the future will be used to assess the effects of simulation education at nursing colleges, and will become the basis of various types of educational programs aimed at improving teamwork in emergency situations.

A Study on the Nursing Needs and Satisfactions of Early Postpartum Women (초기 산욕부의 간호요구도와 만족도에 관한 연구)

  • Yoo, Youn-Ja;Lee, Eun-Ju
    • Women's Health Nursing
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    • v.5 no.3
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    • pp.389-409
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    • 1999
  • This study was carried out to identify the differences between nursing needs and levels of satisfaction of postpartum women during the early postpartum period. The goal of this study was to obtain needed to develope the nursing quality for postpartum women. The subjects were 87 postpartum women who had vaginal delivery at 2 general hospital and 2 maternity hospital in the Ulsan City. The period for the data collection was from June 1 to 29, 1999. The data was gathered using an 98 items questionnaire which was a modified version of a questionnaire the developed by Y. J. Chun. Results found are as follows : 1. The general characteristics of the subjects : The majority of subjects were 25-29 yrs. (57.5%), high school and college graduates(96.5%), unemployed(75.9%), middle ranged economics(93.1%), had no religion(43.7%), male baby(52.9%), birth weight 3-3.5Kg(49.4%), wanted pregnancy(96.6%), no abortion history(50.6%), had antenatal care(89.7%), had prenatal education(32.2%), postnatal education(42.5%), intended breast feeding (46.0%), had resonable self confidence about self(20.7%), infant care(36.8%) and nuclear family pattern(82.3%). 2. The level of nursing needs of overall nursing care(3.93) and the levels of satisfaction(3.86) was relatively high. The nursing needs by category of nursing care, the highest need was in the emotional and psychological care(4.09), and the lowest need was in physical need(3.73). The satisfactions by category of nursing care, the highest satisfaction was in emotional and psychological care(4.11) and the lowest satisfaction was in education in self care(3.64). The significant differences between nursing needs and satisfactions were found on education in infant care(p=.005), and education in self care(p=.020). 3. Among items of physical care, 'accurate medication and treatment(4.21)', 'control of postpartum hemorrhage(4.13)', 'pain control and care of episiotomy wound (4.12)' and 'regular observation of postpartum conditions(4.09)' showed high nursing needs. 'Accurate medication and treatment(4.31)', 'regular observation of postpartum condition(4.24)', 'control of postpartum hemorrhage(4.22)' and 'pain control and care of episiotomy wound(4.12)' showed high satisfaction levels. 4. Among items of emotional and psychological care, 'personal treatment(4.32)', kind and faithful care(4.30)', 'detailed explanation on the treatment or nursing care(4.25)', 'adequate draping during the care and treatment(4.23)' and detailed explanation on a doubt(4.13)', showed high nursing needs, 'personal treatment(4.52)', 'kind and faithful care(4.45)', 'detailed explanation on a doubt(4.24)', 'detailed explanation on the treatment or nursing care(4.21)' and 'adequate draping during the care and treatment(4.18)' showed high satisfaction of nursing care. Difference between the level of nursing needs and satisfaction was significant except item of 'early contacts with their baby and breast feeding'. 5. Among items of environmental care, the highest level of need and satisfaction were on the items of 'neat bedding and clothes(4.05, 4.21)' and 'room cleansing or care of room(4.01, 4.28)'. Differences between the level of nursing care and satisfaction were 'room cleansing of care of room'. 6. Among items of educational needs on self care, 'sitz bath method(4.22)', 'high risk symptoms to immediate clinic visits(4.13)', 'the timing of tub bath(4.05)' and 'good secretion of breast milk(4.03)', showed high nursing needs, 'sitz bath method(4.22)' showed high satisfaction of nursing care. Differences between the level of nursing care and satisfaction were 'the timing of hair shampoo', 'the timing of tub bath', ' the method of pad change', 'postpartum exercise', 'good secretion of breast milk', 'maintenance of breast figure', 'contraindicated drugs in postpartum women', 'kegel exercise' and 'breast self examination'. 7. Among items of educational needs on infant care, 'immunization of infants(4.36)', 'symptoms of sickness to immediate clinic visits(4.28)'. 'safety and emergency care(4.28)', 'umbilical care(4.26)', 'feeding times and intervals(4.24)', 'normal growth and development of infant(4.24)' and 'infection control(4.22)', showed high level of nursing care, 'immunization of infants(4.21)', 'feeding times and intervals(4.17)', were high satisfaction items showed significant differences between the level of nursing care and satisfaction. 8. Relationship between nursing needs and levels of satisfaction among postpartum women were as follows : 1) Physical area : There were no significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'working mothers', 'baby's weights', 'baby's sex', 'planning of feeding' and 'routes of receiving postpartum informations'. 2) Emotional and psychological area : The level of nursing needs were significantly different in the area of 'confidence in self care'. Satisfaction levels were significantly different among 'baby's sex', 'baby's weights', 'the confidence of infant care' and 'working mother'. 3) Environment area : There were on significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'maternal age' and 'baby's weights'. 4) Education in self care : The level of nursing needs were significantly different among 'parity history' and 'type of family formation'. Satisfaction levels were significantly different among 'working mother', 'baby's sex', 'antenatal care', 'postpartum education', 'planning of feeding', 'routes of receiving postpartum informations'. 5) Education in infant care area : The level of nursing needs were significantly different among 'parity history'. Satisfaction levels were significantly different among 'baby's sex', 'receiving postpartum education or not' and 'working mother'.

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Awareness of Early Symptoms and Emergency Responses to Myocardial Infarction and Stroke in People with Diabetes Mellitus Compared to Non-diabetic Population in the Community: A Propensity Score-Matched Analysis (지역사회 당뇨병 유병자와 비유병자의 심근경색증 및 뇌졸중 조기증상과 대처방안 인지도 비교: 성향점수매칭 분석)

  • Kim, Mina;Lee, Young-Hoon;Kim, Nam-Ho
    • Health Policy and Management
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    • v.30 no.3
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    • pp.386-398
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    • 2020
  • Background: We determined the differences in awareness of myocardial infarction and stroke according to the presence or absence of diabetes mellitus in the community. Methods: The 2018 Community Health Survey identified 20,812 people with diabetes mellitus aged 40-79 years. Using 1:1 matching by propensity score, 20,812 people without diabetes mellitus but with similar sociodemographic characteristics were selected as a comparison. Outcome variables were awareness of early symptoms of myocardial infarction and stroke and awareness of coping strategies in case of occurrence. Results: There was no significant difference between nondiabetic and diabetic people in terms of recognizing all early symptoms of myocardial infarction (nondiabetic, 42.7%; diabetic, 43.0%; p=0.43) and stroke (nondiabetic, 49.4%; diabetic, 49.4%; p=0.91). In addition, no significant difference was found between nondiabetic and diabetic people in the proportion of knowing correct emergency response to myocardial infarction (nondiabetic, 84.6%; diabetic, 84.4%; p=0.56) and stroke (nondiabetic, 81.3%; diabetic, 81.4%; p=0.77). Conclusion: Since people with diabetes are at greater risk of cardiovascular disease than the general public, it is important to lower the risk of disability and death by improving their awareness of early symptoms and correct emergency response to myocardial infarction and stroke.

Comparative study of Needs about First Aid Education between Elementary school students & Middle school students (초등학생과 중학생의 응급처치 교육 요구도 비교)

  • Lee, Jung-Eun;Kim, Shin-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.6
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    • pp.2107-2117
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    • 2010
  • The purpose of this study was to provide basic data in order develop first aid education programs for elementary & middle school students. The data were collected 1203 elementary school students and middle school students using self-administered questionnaire. The results showed : In the mean score of 11 categories, "poisoning"was high($2.76{\pm}.49$). There was significant difference in the needs of first aid education according to subject's gender(t=-7.618, p=.000), judgement ability of emergency situation(F=3.336, p=.036), and education needs for emergency situation or not(t=6.509, p=.000). It is necessary to develop effective first aid education program for elementary & middle school students according to their needs.

Maternal Behavior to Preventing Childhood Accident in the Home (아동사고에 대한 어머니의 예방행위 영향요인)

  • Kim, Kwuy-Bun;Son, In-A
    • The Korean Journal of Emergency Medical Services
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    • v.6 no.1
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    • pp.87-102
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    • 2002
  • Injury has now replaced disease as the biggest single cause of death in children after their first birthday. Each day child dies from preventable, unintentional injury and the medical cost of these injury is increasing remarkably. It is necessary to develope injury prevention models to explain, predict, manage, evaluate and analyze the information about accident. The purpose of this paper is, firstly, to investigate parent's actions regarding safety measures at home and secondly, to identify the influencing factors of parents' safety behaviors. The selection of such factors is guided by the theoretical framework of the Pender's Health Promotion Model. Method ; The questionnaire was developed on the basis of other investigations, through pilot testing, peer review, and review by field health workers. The questionnaire was completed by 231 mothers of young children. Data was collected between April and May 2002. Variable Use of three different domains of safety behavior, safety habits, supervision and perception of safety devices, were listed. Mothers were self reported on internal locus of control, mother & child relationships, and marital intimacy. Also the elements of the Health Promotion Model: perceived benefit, barrier, threat, and self-efficacy, were surveyed. Results & discussion The results indicate that most parents take considerable action to reduce household hazards. The constructs derived from the Model were statistically significant differences for a small part of the variables on parental behavior to reduce hazards in the home, such as age, education, economic status, self-efficacy, perceived benefit, internal locus of control. Future studies ought to include social influences, such as expectations, perceived norms, knowledge, and child-related variables, relevant to parental safety measures in their home.

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Study on Laws related to the Scope of Both Medical Doctors' Practice in Korea (한의사와 의사의 업무 범위와 관련된 법령 고찰)

  • Park, Yu Lee;Kang, Yeonseok;Baek, Kyung Hee;Ra, Sewhan
    • Journal of Society of Preventive Korean Medicine
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    • v.18 no.3
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    • pp.91-104
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    • 2014
  • Objective : This study aims to compare the scope of practice of Korean Medicine doctors and western medicine doctors based on laws related to medical practice Method : We searched for laws related to medical practice using terminologies such as "Korean Medical practice", "Korean Medicine", "Principles of Korean Medicine", "western medicine", "Korean Medicine doctor", "western medicine doctor" at the national law information center(http://law.go.kr/main.html). Results : We categorized the laws we found into four categories: diagnosis, treatment, prescription, and all the other areas including public health. In diagnosis, both Korean Medicine doctors and western medicine doctors have a right to issue medical certificates including birth and death. However, diagnosis of a few specific diseases is allowed only to western medicine doctors. In treatment, laws related to emergency medicine and nursing at home were searched. Korean Medicine doctors and western medicine doctors are emergency care providers; however, most of emergency medicine can be done by western medicine doctors. In prescription, the scope of practice is divided by herbal medicine and western medicine. Finally, as public health professionals, both of them need to do lots of public health works. However, in some area such as vaccination, maternal and child health care, and industrial health, only western medicine doctors can practice. Conclusion : This study suggests that, in diagnosis, treatment, prescription, and all the other areas including public health, the scope of practice of Korean Medicine doctors and western medicine doctors has huge difference. There is also lack of consistency in current law, and some laws do not reflect current health care system and health care services.