• 제목/요약/키워드: Emergency Nursing

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가정간호행위 업무량의 상대적 가치 측정에 관한 연구 (Workload Measurement of Home Health Care Nurses상 Services using Relative Value Units)

  • 이태화;박정숙;김인숙
    • 대한간호학회지
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    • 제30권6호
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    • pp.1543-1555
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    • 2000
  • Home health care is moving into a set of new realities. An era of competition and cost containment has arrived. Before nurses are able to contain costs or describe the relationship between nursing activities, cost must be accurately measured based on the nurse's workload. Nurses in home health care usually desire to measure expenses for one of three reasons : reimbursement, management, or research. The purpose of the study was to investigate the work input by Registered Nurse in each of the home health care activities by relative value units and identify the factors affecting the nurses' total work input in health care services. To measure the work input by nurses, work was defined by four dimensions: time, physical effort, mental effort, and stress. This study used a descriptive-correlational design. Data collection consisted of two phases. In phase I, data on home health activities performed by nurses were collected. In phase II, data on nurses' time, physical effort, mental effort, and stress in each of home health care activities discovered phase I were collected. In this method, the respondent was asked to rate a service in relation to a reference service using a ratio scale. The sample included 39 home health care nurses. The results of the study indicated that home health care activities performed by the nurses were in 10 categories and 69 items. Measuring the relative work inputs in each of home health care activities, and foley catheterization was selected as the reference to service. In terms of time and physical effort dimensions, full bath service was rated as the most strenuous among 69 activities by the respondents, and intramuscular injection was rated as least. It was found that emergency treatment required the highest mental effort and the highest stress, while blood sugar tests required the lowest mental effort. Approximately 91.3% of the variance in total work input was accounted for by the linear combination of time, physical effort, mental effort judgement, and stress. Examining the regression coefficients of those variables, physical effort, time, and stress were found as the predictors which were significantly associated with the total work of nurses in home health care. Professional nursing's next step in the conundrum of economic volatility is to develop a tool to reflect the interaction of functional deficiency and direct professional nursing care. And this will be a more accurate predictor of nursing resource use and ultimately a great forcaeter cost.

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일 도시 초·중등 학생의 보건실 이용률과 건강문제 및 보건교사의 간호수행도 (Utilization of School Health Room and Health Problems among Elementary and Secondary School Students, and Nursing Performance of School Health Teachers in a City)

  • 김진희;소향숙
    • 한국콘텐츠학회논문지
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    • 제16권5호
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    • pp.180-193
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    • 2016
  • 본 연구의 목적은 초 중등학교 학생들의 성별 및 소재지별 보건실 이용률 및 건강문제의 연도별 변화를 파악하고, 학생들의 건강문제를 해결하기 위해 보건교사가 제공하였던 간호중재수행 빈도 및 난이도를 분석함에 있다. 자료분석은 경력 3년 이상의 보건교사 59명이 응답한 조사지였다. 분석결과, 연도별 재적 총학생수는 매년 감소한 반면에 보건실 이용률은 점차 증가하였으며, 보건실 이용률은 여학생이 남학생보다 200% 정도 상위를 보였다. 초등학교 도심지역 여학생들의 보건실 이용률이 가장 높았으며 중등학교 도심지역 남학생들이 가장 낮았다. 남학생은 피부 피하계, 근골격계, 소화기계 건강문제 순으로, 여학생은 피부 피하계, 소화기계, 근골격계 건강문제 순으로 이용률을 보였다. 도심지역이 변두리 농촌형보다특정 건강문제에서 보건실 이용률이 높았다. 간호중재수행은 자기건강관리교육과 상담 영역에서 빈도가 가장 높았으며, 자해, 발작, 순환기계 건강문제에서 난이도가 가장 높았다. 결론적으로 보건실 이용률은 점차 증가하여 보건교사의 업무는 가중되었으며, 특별하고 위급한 건강문제를 보건실에서 전문적이고 효과적으로 응급처치를 수행하기 위해서는 자질 있는 보건교사의 인력확충과 표준화된 업무지침이 요청되며 나아가 전문가적 역량을 강화하는 보수교육 프로그램이 필요하다.

정맥내 주사요법시 수액세트에 연결된 3 way-stopcock의 오염정도에 관한 실태조사 (Degree of contamination in 3-way stopcock connected to infusion set on the intravenous therapy)

  • 홍해숙;김윤경;나연경;이경란;곽경숙
    • Journal of Korean Biological Nursing Science
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    • 제4권2호
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    • pp.113-125
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    • 2002
  • This study is to evaluate contamination of the 3-way stopcocks connected to infusion set, which is used to the patients admitted to emergency room in a general hospital in D city. The data were collected from Oct. 1, 2001 to Feb. 25, 2002. First of all, in order to select microorganisms, From the 50 patients were randomized, Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus, Pseudomonas aeruginosa, Acinetobacter detected. Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus were determined to be evaluated in this study. As a result, 8 of the patients were Coagulase Negative Staphylococcus positive(>15 colonies), 4 were Staphylococcus aureus positive(>15 colonies). 1 was micrococcus positive(>15 colonies). Among the patients who were Coagulase Negative Staphylococcus positive 112(average) colonies were detected on the first day, 429 were on the second day, and 563 were on the third day. In case of patients of Staphylococcus aureus positive, 85(average) colonies were detected on the first day, 151 were on the second day, and the 203 were on the third day. CNS was cultured using API kit for the 8 patients who were in CNS positive. One case was detected Staphylococcus capitis, another one case was Staphylococcus chromogenes. Two cases were Staphylococcus xylosus, another two were Staphylococcus hominis, and the remainer were Staphylococcus epidermidis. As a result, the API codes of two Staphylococcus epidermidis had shown the same pattern, and the resistance patterns of the them were the same, too. As a result of resistance test among 5 patients who have shown that the same resistance pattern in 02SAK1, 02SAK5, 02SAK2, 02SAK4. As a result of this study, aseptic technique of 3-way stopcock intravenous therapy can protect infections, and it is needed the sterilization of the 3-way stopcock just before injection using disinfectants. It needs to improve the 3 way stopcock change intervals from 48 hours.

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수술환자를 위한 회복유니트의 건축계획에 관한 연구 - 독일의 종합병원을 대상으로 - (A Study on the Architectural Planning of the Patient's Recovery Unit - Focused on the General Hospital in Germany -)

  • 채철균
    • 한국실내디자인학회논문집
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    • 제40호
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    • pp.109-116
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    • 2003
  • The space planning and interior layout of recovery unit should be determined carefully for patient's nursing and observation which is considered to prevent infection and to cope quickly with emergency situation after surgical operation. Recently, the recovery unit in medical facilities is planned and managed without consideration of operating system, sanitary facilities and prior condition of space. Therefore, there is required to the logical criterion of architectural planning for patient's recovery unit which is concerned about opinion of medical team, anesthetist, sanitarian, architect and patient as a user. As the result, this study would apply to design guideline for the architectural planning of patient's recovery unit.

대학생의 체형지각 유형이 건강관심, 우울, 식이제한 및 운동실천에 미치는 영향 (Effect of Type of Body Shape Perception on Health Concern, Depression, Dietary Restriction, and Exercise Practice among University Students)

  • 함영림;박미정
    • 근관절건강학회지
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    • 제20권2호
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    • pp.151-160
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    • 2013
  • Purpose: The purpose of this study was to identify the effect of type of body shape perception on health concern, depression, dietary restriction and exercise practice in university students. Methods: A descriptive design was used. Data were collected from 308 university students by using structured questionnaires. Results: The results showed that 65.6% of the students believe that they are overweight. There are no differences in health concern, depression, and exercise practice among the skinny perception group, satisfaction group, and obesity perception group. However, there was a significant difference in dietary restriction among the three groups (p<.001). The type of body shape perception was significantly associated with dietary restriction (p=.007). Conclusion: Integrated and effective interventions are necessary for university students to establish healthy body image and learn healthy weight control.

A Study on Job Stress and Emotional Burnout of Clinical Nurses

  • Park, Junghee;Han, Woosok;Lee, Mihyang;Kim, Jinkyung
    • International Journal of Advanced Culture Technology
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    • 제10권3호
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    • pp.18-24
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    • 2022
  • This study attempts to provide basic data for the development of manpower maintenance programs by checking the degree of job stress and emotional burnout for nurses working in a university hospital and identifying factors affecting emotional burnout. Data were obtained through a structured questionnaire survey conducted on 187 nurses. The average score for job stress of nurses was 2.50 (range 1 to 4) and emotional burnout was 3.29 (range 1 to 5). The factors affecting emotional burnout were occupational climate, job demand, job insecurity, and lack of reward, which accounted for 44% of explanatory power. In order to reduce the emotional burnout of nurses, the management of medical institutions needs administrative and financial support. Further, it is necessary to improve the organizational culture regarding job assignment through job analysis, employment security, and a performance-based reward system.

허혈성 뇌졸중 환자의 재원적절성 평가 (Appropriateness Evaluation of Hospitalization for the Cerebral Ischemia Patients)

  • 염효영;김순례
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.80-92
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    • 1999
  • The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

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지식결과에 대한 타당성 검증;간호결과분류(NOC)에 기초하여 (Validation of Nursing-sensitive Patient Outcomes;Focused on Knowledge outcomes)

  • 염영희;이규은
    • 간호행정학회지
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    • 제6권3호
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    • pp.357-374
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    • 2000
  • The purpose of this study was to validate knowledge outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 71 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1(indicator is not all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follow: 1. All indicators were considered to be 'supporting' and no indicators were considered to be 'nonsupporting'. 2. 'Knowledge: Treatment Regimen' attained and OCV score of 0.816 and was the highest OCV score among outcomes. 3. 'Knowledge: Energy Conservation' attained an OCV score of 0.748 and was the lowest OCV score among abuse outcomes. 4. 'Knowledge: Breastfeeding' attained an OCV score of 0.790 and was the highest indicator was 'description of benefits of breastfeeding'. 5. 'Knowledge: Child Safety' attained an OCV score of 0.778 and was the highest indicator was 'demonstration of first aids techniques'. 6. 'Knowledge: Diet' attained an OCV score of 0.779 and was the highest indicator was 'performance of self-monitoring activities'. 7. 'Knowledge: Disease Process' attained an OCV score of 0.815 and was the highest indicator was 'description of signs and symptoms'. 8. 'Knowledge: Health Behaviors' attained an OCV score of 0.800 and was the highest indicator was 'description of safe use of prescription drugs'. 9. 'Knowledge: Health Resources' attained an OCV score of 0.794 and was the highest indicator was 'description of need for follow-up care'. 10. 'Knowledge: Infection Control' attained an OCV score of 0.793 and was the highest indicator was 'description of signs and symptoms'. 11. 'Knowledge: Medication' attained an OCV score of 0.789 and was the highest indicator was 'description of correct administration of medication'. 12. 'Knowledge: Personal Safety' attained an OCV score of 0.804 and was the highest indicator was 'description of measures to reduce risk of accidental injury'. 13. 'Knowledge: Prescribed Activity' attained an OCV score of 0.810 and was the highest indicator was 'proper performance of exercise'. 14. 'Knowledge: Substance Use Control' attained an OCV score of 0.809 and was the highest indicator was 'description of signs of dependence during substance withdrawl'. 15. 'Knowledge: Treatment Procedure(s)' attained an OCV score of 0.795 and was the highest indicator was 'description of appropriate action for complications'. 16. 'Knowledge: Treatment Regimen' attained an OCV score of 0.816 and was the highest indicator was 'description of self-care responsibilities for emergency situations'. More outcomes need to be validated and outcomes sensitive to Korean culture need to be developed.

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뇌졸중 환자의 자가 선택에 의한 한·양방 병행 치료 경험 (Experiences of Stroke Patients With Combined Treatment of Self-selected Oriental and Western Medicine)

  • 한진숙;김양신;문영숙;한수정;박인숙;이상훈;김애란
    • 디지털융복합연구
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    • 제12권6호
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    • pp.375-384
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    • 2014
  • 본 연구는 뇌졸중 환자가 한방과 양방을 병행하여 치료를 받으면서 겪는 회복 경험이 어떤 의미인지에 관한 본질을 추구하고 현상을 심층적으로 이해하고자 질적 연구방법으로 진행하였다. 연구 참여자는 주로 D시에 거주하는 뇌졸중 환자로 한방과 양방을 병행 치료하되 본인의 의지에 의한 자가 선택 하에 한방치료를 받은 25명을 대상으로 하였다. 자료 수집은 심층 면담을 하여 녹취하였다. 자료 분석은 Colaizzi의 현상학적 방법에 의해 분석하였으며, 연구 결과 뇌졸중 환자의 한 양방치료 경험은 21개의 주제모음과 6개의 범주로 도출되었다. 6개의 범주는 '갑작스런 발병으로 충격이 큼', '재활과 함께 우울감이 밀려옴', '응급상황에서는 양방치료가 효과적임', '양방치료에서 한계를 느낌', '한방치료를 스스로 선택함', '한방치료에서 재활의 의미를 찾음'이다. 이러한 연구결과를 바탕으로 뇌졸중 환자의 발병을 예방하고, 회복과 재활을 도울 수 있는 체계적인 한방 재활프로그램 개발에 필요한 자료로 활용되고자 하였다.

임종 다빈도 부서 간호사의 죽음에 대한 태도 및 대처정도와 생애 말기환자 간호와의 관계 - 응급실, 중환자실, 종양내과 병동 간호사를 중심으로 (Nurses Attitudes toward Death, Coping with Death and Understanding and Performance Regarding EOL Care: Focus on Nurses at ED, ICU and Oncology Department)

  • 서민정;김정연;김상희;이태화
    • Journal of Hospice and Palliative Care
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    • 제16권2호
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    • pp.108-117
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    • 2013
  • 목적: 본 연구의 목적은 1) 죽음에 대한 태도와 대처정도, 생애 말기환자 간호인식 및 간호수행 정도를 파악하고, 2) 그들 간의 상관관계를 살펴보고, 3) 생애 말기환자 간호수행에 영향을 미치는 요인을 파악하고자 함이다. 방법: 3개 대학병원의 임종 다빈도 부서인 종양내과병동, 중환자실, 응급실에 근무하는 187명의 간호사를 대상으로 하였다. 연구 도구로는 '다차원 죽음에 대한 태도 척도', '죽음에 대한 대처정도 척도', '생애 말기환자 간호에 대한 인식 척도', '생애 말기환자 간호에 대한 수행 척도'를 사용하였다. 자료는 기술 통계, 상관관계, 다중 회귀분석을 수행하였다. 결과: 첫째, 생애 말기환자 간호수행은 결혼 유무, 종교, 근무 부서, 말기환자 간호에 대한 교육 참여 여부에 따라 의미 있는 차이를 보였다. 둘째, 생애 말기환자 간호수행은 죽음에 대한 태도(P=0.014), 죽음에 대한 대처(P=0.003), 생애 말기환자 간호인식(P<0.001)과 양의 상관관계를 보였다. 셋째, 생애 말기환자 간호수행이 근무부서(P<0.001), 생애 말기환자 간호인식(P<0.001)에 영향을 받는 것으로 나타났다. 결론: 생애 말기환자 간호수행이 근무 부서, 생애 말기환자 간호인식에 영향을 받으므로, 근무 부서에 따라 차별화된 생애 말기환자 간호인식을 향상시킬 수 있는 교육이 필요하다.