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Measurement of the Nursing Workload by Patient Classification System in a Secondary Hospital;As a Preliminary Step for Computerization of Nursing Staffing and Scheduling (환자분류에 의한 일개 2차 의료기관의 간호업무량 조사;전산화를 위한 기초작업으로서)

  • Park, Jung-Ho;Joe, Hyon;Park, Hyeoun-Ae;Han, Hye-Rah
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.132-146
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    • 1995
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

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An Application Effect of Rhythmic Movement Program for the Health Promotion in the Elderly (노인의 건강증진을 위한 율동적 운동프로그램의 적용효과)

  • 이숙자
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.776-790
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    • 2000
  • Every year the number of the elderly increases in Korea thanks to the improvemen of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups:33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

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A Study on the Characteristics of Each Section Based on Visitor's Satisfactions of the Dulegil in Bukhansan National Park (북한산국립공원 둘레길 탐방객 만족도에 따른 구간별 특성화 연구)

  • Han, Bong-Ho;Choi, Jin-Woo;Hur, Ji-Yeon;Kim, Sun-Hee;An, Kyung-Jin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.2
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    • pp.69-82
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    • 2013
  • The purpose of this study is to evaluate the effect of Dulegil in Bukhansan National Park in dispersing peak climbing hikers, characterize each section of Dulegil and suggest ideas of improvement. This study was conducted based on the survey completed by visitors in all 21 sections of Dulegil. After the construction of Dulegil, the number of visit to Dulegil grew and it was analyzed that Dulegil attracted new visitors given that the rate of young people(aged 19~30) who visited for the first time was quite high. Regarding the frequency of peak climbing, 7.6% of the respondents said "decreased" and 46.2% said "increased", showing that Dulegil's effect to disperse peak climbing hikers is nominal. Seven qualities were evaluated regarding Dulegil's level of satisfaction. Out of those seven, the quality of recreational place and taking a walk achieved high scores of 3.74 and 3.61 respectively. The quality of culture and history scored the lowest with 3.09. The analysis on the characteristic of each section of Dulegil, reason of visit, and the visitors' level of satisfaction showed that Dulegil is now regarded as a place where they can improve their health through light exercise and walking. In addition, a positive effect can be expected for a long time since there are different ways of utilizing the resources of the National Park, such as getting in touch with nature, preserving ecology, learning history and enjoying beautiful landscapes. If infrastructure and programs specific to each section of Dulegil were improved in a long-term perspective, it would be effective to encourage peak climbers and enjoy the lower parts of the mountain.

A Study on the Establishment Process and Spatial Composition of TaiSho Park in Modern Busan (근대 부산에서 대정공원의 성립 과정과 공간 구성에 관한 연구)

  • Kang, Young-Jo
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.31 no.2
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    • pp.92-102
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    • 2013
  • This study aimed to reveal the establishment process and spatial composition of TaiSho park in modern Busan. The TaiSho park is an athletic park which combines a playground and a rest facilities. The arguments on construction of playground commenced for commemorating Kameyama, Busan director official, when he moved to Taiwan in 1910. First Proposers which construct to sport park were businessman in that time. However, construction of playground was progress as a commemoration business of accession of Taisho Tenno. Playground construction got into stride by the proposal of the Busan mayor Wakamatsu in 1917. When it looks into process of discussion about a site selection candidate, norms of playground site selection are the paly ground which appropriate with effective site area and distance between park and a section of a city, in other hand, those are accessibility and budget. As a result of several arguments and actual site investigation, it was decide to select a site which enters to elementary school, after the isolation hospital relocates. The cost of construction of the TaiSho park is prepared by donation of the Busan civil. The donation fund raising committee was constituted by local commerce and industry people, a company, government, municipal offices and area, and funds was raised systematically. As a result, total amount of construction cost was made from the donation of local civil. The TaiSho park is broadly into two sectors; exercise area and rest and pleasure space. Entrance was set up in three aspects of the park and the subcontract planted. The baseball field took the seat in the central part of the park, and also prepared two tennis courts. Japanese Sumo field was also prepared for the north side of the park. The significance of the TaiSho park in Korea Park history can be summarized in South Korea's first sports park and which was made from the donation of local civil. The remained subjects from this study are to clarify the disappearance process of TaiSho park and a reason why modern Busan people want to get playground.

Prevalence of Orthostatic Dysregulation in Elementary School Students and Frequency of Individual Symptoms (학동기 아동의 Orthostatic Dysregulation의 유병률과 임상증상의 빈도에 대한 연구)

  • Yang, Eun Seok;Kim, Eun-Young;Moon, Kyoung-Rae;Park, Sang Kee;Park, Young Bong;Rho, Young Il
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.138-142
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    • 2005
  • Purpose : The purpose of the present study was to access the prevalence of orthostatic dysregulation(OD) and the frequency of each category for major and minor criteria among elementary school students using the OD questionnaire. Methods : We carried out inquiry by questionnaire as to the frequency of OD among two elementary schools with 725 students, 10 to 12 years of age, residing in Gwangju, Korea. The questionnaire was made according to criteria proposed by the Japan OD Study Group. Results : Of the 725 students(male 390; female 335) questioned, the OD was found in 338 students (53.5 percent). Prevalence of OD in males(59.2 percent) was significantly higher than in females(46.8 percent)(P<0.05). Palpitation with slight exercise(95.9 percent) was the most frequent major symptom. Headaches(85.8 percent) were the most frequent minor symptom among cases of OD. Conclusion : The prevalence of OD in elementary school students in this study(53.5 percent) was higher than in other studies. Contrary to studies from other countries, the male to female ratio was reversed. Because the diagnostic criteria seem to be dependent on subjective reporting of the symptoms, a newer diagnostic system based on more objective findings should be established.

A Study on Awareness and Knowledge of Obesity, Life Style, and Eating Habits According to Body Mass Index in High School Students (고등학생에서 체질량지수에 따른 비만에 대한 인식과 생활습관의 차이에 관한 조사)

  • Kim, Mi Jung;Choi, Kwang Hae;Lee, Kyeong Soo
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1491-1496
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    • 2002
  • Purpose : This study was performed to investigate the level of obesity awareness and to help to prevent and to treat obesity by examining the relationship between knowledge of obesity and life style. Methods : Of the students who were surveyed, 1514 answered seriously and were accepted as subjects for the study. The questionaire was anonymous and was filled in by the students themselves. Body mass index was used to compare and analyze the subjects according to gender and age, with 85 percentiles or lower as group one, 86-94 percentiles as group two, and 95 percentiles or higher as group three. Results : Among the boys, level of obesity-awareness was significantly higher(P<0.01) in the obese group than in the normal-weight group. Among the girls, there was no difference in the level of obesity-awareness among the groups(P=0.332). The knowledge of obesity between the groups was not significantly different in either boys or girls. As for the relationship between healthy eating habits and knowledge of obesity, there were no significant differences in either boys or girls. There was no significant difference between the habit of regular exercise and the knowledge level of obesity in either boys or girls. Conclusion : Although this was a localized study and the students were aware of the seriousness of obesity to a certain extent, there was no difference in knowledge of obesity between normal-weight students and obese students. Also, there was no relationship between knowledge of obesity and healthy eating habits or the presence/absence of regular exercises.

College Students' Attitude toward Body Weight Control, Health-related Lifestyle and Dietary Behavior by Self-perception on Body Image and Obesity Index (대학생의 체형인식과 비만도에 따른 체중조절 태도, 건강관련 생활습관 및 식행동)

  • Chin, Jeong-Hee;Chang, Kyung-Ja
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.10
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    • pp.1559-1565
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    • 2005
  • The Purpose of this study was to investigate college students' attitude toward body weight control, health-related lifestyle and dietary behavior by their perception on body image and obesity index. The subjects were 871 nation- wide college students (330 male and 541 female students) participating in a nutritional education program via internet- A cross-sectional survey was conducted using a self-administered questionnaire via internet. The data were analyzed by a SPSS 10.0 program. Height and weight (p < 0.05), and the distribution of obesity index (p < 0.001) showed significant differences between male and female college students. As for self perception on body image, the necessity of body weight control and the experience of efforts to change the body weight, there were significant differences between male and female college students (p < 0.001). There were significant differences among groups by obesity index in the hours of exercise (p < 0.01), drinking (p < 0.01) and smoking (P < 0.001). As for methods of body weight control, all the groups by obesity index thought that program of body weight control by diet company is the most desirable method. Therefore, we must recognize that it is hard to correct health problems resulting from wrong lifestyle and dietary behavior fixed during college life and prepare a system for college students to obtain correct lifestyle and dietary behavior.

Food Habits and Nutrition Knowledge of College Students Residing in the Dormitory in Ulsan Area (울산지역 기숙사 거주 대학생의 식생활 습관과 영양지식)

  • Kim, Hye-Kyung;Kim, Jin-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.9
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    • pp.1388-1397
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    • 2005
  • This study has been carried out to obtain information regarding to the food habits including health-related behaviors, the nutrition knowledge and the satisfaction on the dormitory food service. The subjects of this study were 758 college students (580 male and 178 female) residing in the dormitory in Ulsan. The data were obtained through questionnaire and interview, and were analyzed using the SPSS package program. the results of this study are as follows: The average age of the subjects was $20.7\pm2.3$ years old. The average height and weight of male were $175.2\pm5.0\;cm\;and\;69.4\pm9.6\;kg$, respectively. Those of female were $162.6\pm4.1\;cm\;and\;51.8\pm5.9\;kg$, respectively. The BMI value of male was $22.6\pm0.1$ which ranged within normal level, but that of female was $19.6\pm0.2$ which ranged underweight level. In the case of food habits, $26.0\%$ of total subjects always skipped a meal (especially breakfast). The main reasons for skipping meals were no time to eat, no appetite, and weight control. Most of subjects ($69.3\%$) have usually eaten snack after dinner, their most favorite food was noodle (ramen), and the next was pizza. With regard to the health care, there was a significant difference between male and female respect to smoking (p<0.001), drinking (p<0.01) and exercise level (p< 0.001). The mean food habit score of the subjects was $59.9\pm11.1$. Male students had a higher food habit score than female students (male: $60.6\pm10.9$, female: $57.7\pm11.4$), and the group residing longer period had a higher food habit score than the one residing shorter period. Average nutrition knowledge score of subjects was $7.8\pm1.8$. Gender, residing periods, monthly pocket money influenced on the nutrition knowledge score. Female had a higher score than that of male (P<0.001), and the group residing longer period had a higher score than the one residing shorter period (p<0.01), and the group who had more monthly pocket money had a higher score than the one who had less. No significant correlation was found between food habit score and nutrition knowledge score. In the case of dormitory food service, the total subjects showed high satisfaction scores for the sanitation and the atmosphere, while low scores for the menu and the quality of food service. This study may provide basic information on the eating habits and health-related behaviors of college students in dormitory. However, further studies and nutrition counseling are needed to improve food habits and nutrition knowledge.

The Survey for Improvement in Clinical Practice Curriculum of Physiotherapy (물리치료 임상실습 교과내용 개선을 위한 조사연구)

  • Jang, Su-Gyeong
    • Journal of Korean Physical Therapy Science
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    • v.5 no.3
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    • pp.659-674
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    • 1998
  • This Study was to investigate elaborated research themes and direction through specifying the problems of clinical practice education and looking for the direction of improvement. It was in the basis of the viewpoint of the educators that professors and therapists who were the subjects of this study. Perform this study, the 15 colleges' professors and the 55 hospitals' therapists was made up questionnaire, and the data was analysing by Chi-square test and percentage. The results were as follow : ${\cdot}$ In a personal history among the general qualities, professors have little clinical practice history(l-5 years, 53.3%), and therapists have little lecture career(1-5 years, 43.6%, have no 49.0%), ${\cdot}$ The 78.6% subjects were unsatisfied of clinical practice systems. ${\cdot}$ The correlation between clinical history, school career and lecture career and the satisfaction level of clinical practice systems has no(P<.005), ${\cdot}$ The subjects were agreed to that clinical practice curriculum should be changed(67.1%), reinforced(82.9%), and specified(90.0%). ${\cdot}$ The clinical practice credits are 11 points averagely. ${\cdot}$ In the clinical practice curriculum, it made no difference in the practicum of diseases, modality, and the therapeutic techniques between professors and therapists. ${\cdot}$ The 100% professors said that the practicum of the patients' assessment is necessary, and the 63.6% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the clinical psychology is necessary, and only the 20.0% therapists were training for that. ${\cdot}$ The 93.3% professors said that the practicum of the patients' management is necessary, and the 50.9% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the medical ethics is necessary, and the 34.5% therapists were training for that. ${\cdot}$ The 46.7% professors said that the practicum of the hospital administration is necessary, but the 54.5% therapists have not training. ${\cdot}$ The 33.3% professors said that the practicum of the pharmacology is necessary, but the 81.8% therapists have not training. ${\cdot}$ The 86.7% professors said that the practicum of the patient's education is necessary, and the 43.6% therapists have training. ${\cdot}$ The 66.7% professors said that the practicum of the prosthesis and brace is necessary, but the 14.5% therapists have not training. ${\cdot}$ The 60.0% professors said that the practicum of the exercise prescription is necessary, but the 25.5% therapists have not training. ${\cdot}$ The 53.5% professors said that the practicum of the emergency treatment is necessary, but the 52.7% therapists have not training. ${\cdot}$ Drawing up the plan about the curriculum of clinical practice, the professors (46.7%) were agreed to national master plan framing by an expert advisor, but the therapists (58.2%) said that the plan that make the most of hospitals' characteristics should be specified. ${\cdot}$ It was found that a clinical special therapists(54.5%) was good as a person in charge of clinical practice education, in that each therapist's own good time (34.5%) was. ${\cdot}$ It made use of the form framing by college(40.0%) as the clinical practice textbook, the form framing by hospital (42.9%) and each therapist(22.9%) as the plan, and the form framing by college (74.3%) as the measurement. ${\cdot}$ The most difficult point in clinical practice education was the lacks of the theory-praciticum linkage(78.2%). ${\cdot}$ It was found that the period of clinical practice was in the second semester-third grade (40.0%) and the desirable period was in the first semester-third grade(50.0%). ${\cdot}$ Professors (53.3%) were agreed that the desirable clinical practice duration was from four months to six months(60.0%), and the therapists (60.0%) were agreed that from one month to three months. ${\cdot}$ This study presented the lacks of rearing the experts, the lacks of cultural education, and the lacks of the theory-clinical practice linkage. There were need to develop the systematic programs, clinical practice textbooks, the measurements and the special hospital for clinical practice. And it was need to reduce the gab between of the hospitals for clinical practice, to cut down the costs. and to improve the labour conditions of leaders. In view of this findings, it takes notice of that both professor and therapist were dissatisfied at the present clinical practice systems. These results point out the problems of clinical practice systems, and do not make expect to us the successive and positive clinical practice. The general, specific and intensive plan about the problems and the direction of improvement that establishing the level of hospital for clinical practice and physiotherapy can be elaborated.

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Repair of Acute Aortic Arch Dissection with Hypothermic Circulatory Arrest and Retrograde Cerebral Perfusion (저체온순환정지와 역행성 뇌관류에 의한 대동맥궁을 침범한 급성 대동맥 박리증의 수술결과)

  • 이삼윤
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.43-49
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    • 2004
  • Background: Acute thoracic aortic dissections involving the aortic arch differ in diagnosis, surgical procedures, and operative results compared to those that do not involve the aortic arch. In general cerebral perfusion under deep hypothermic circulatory arrest (HCA) is performed during the repair of the aortic arch dissection. Here, we report our surgical results of the aortic arch dissection repair using retrograde cerebral perfusion (RCP) and its safety. Material and Method: Between January 1996 and June 2002, 22 consecutive patients with aortic arch dissection underwent aortic arch repair. In 20 of them RCP was performed under HCA. RCP was done through superior vena cava in 19 patients and by systemic retrograde venous perfusion in 1, in whom it was difficult to reach the SVC. When the patient's rectal temperature reached 16 to 18$^{\circ}C$, systemic circulation was arrested, and the amount of RCP amount was 481.1 $\pm$292.9 $m\ell$/min with perfusion pressure of 20∼30 mmHg. Result: There were two in-hospital deaths (4.5%) and one late death (9.1%). Mean circulatory arrest time (RCP time) was 54.0$\pm$ 13.4 minutes (range, 7 to 145 minutes). RCP time has no correlation with the appearance of consciousness, recovery of orientation, or ventilator weaning time (p=0.35, 0.86, and 0.92, respectively). Ventilator weaning was faster in patients with earlier recovery of consciousness and orientation (r=0.850, r=926; p=0.000, respectively). RCP of more than 70 minutes did not affect the appearance of consciousness, recovery of orientation, ventilator weaning time, exercise time, or hospital stay (p=0.42, 0.57, 0.60, 0.83, and 0.51, respectively). Conclusion: Retrograde cerebral perfusion time under hypothermic circulatory arrest during repair of aortic arch dissection may not affect recovery of orientation, ventilator weaning time, neurologic complications, and postoperative recovery.