• Journal of Korean Biological Nursing Science
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• 제24권2호
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• pp.95-103
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• 2022

Purpose: The purpose of this study was to provide multifaceted interventions for nurses and to confirm changes in their knowledge, perception, and actual practice on the adequate storage, conditions, and transportation of culture specimens. Methods: A one-group pretest-posttest experimental design was conducted with 41 nurses in two general wards of a tertiary acute care hospital in Seoul. Multifaceted interventions including education, feedback, posting guidelines and reminders, and improvement in specimen management accessibility were provided from May 2019 to January 2020. Outcomes were measured before and after the interventions. Knowledge and perception of the nurses were evaluated using self-reported questionnaires and actual practice by observation. Results: After the interventions, the average knowledge score on transportation time was significantly increased (Z= -4.89, p< .001). However, the knowledge score on storage methods was not significantly increased. The perception score was significantly increased (t= -3.19, p= .003). The proportion of specimen storage times, places, and conditions managed properly was significantly increased from 43.0% (46/107) to 77.1% (84/109) (p< .001). The average transportation time of blood samples to the laboratory significantly decreased from 3 hours 36 minutes (± 1 hour 52 minutes) to 3 hours 1 minute (± 1 hour 41 minutes) (t= 2.51, p= .013). The percentage of blood culture specimens arriving within 2 hours was increased significantly from 22.9% to 39.2% (χ²= 6.90, p= .009). Conclusion: The interventions were effective. However, some specimens remained in the ward longer than expected after the interventions. This requires further interventions.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제29권1호
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• pp.43-51
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• 2023

Purpose: To accommodate the increasing number of patients during the COVID-19 pandemic, numerous portable HEPA filter units (PHUs) were installed in the general wards of existing medical facilities(EMFs) to convert them into emergency conversion facilities (ECFs). The purpose of this study was to build a dataset in preparation for emerging infectious diseases in the post-COVID-19 era by analyzing the construction and operation of ECFs. Methods: Field investigations were conducted during ECF operation periods based on the analysis of heating, ventilation, and air conditioning (HAVC) system design documents for six ECFs across Korea. Interviews were conducted with facility managers during the field investigations. Results: When constructing an ECF within an EMF, the installation status and characteristics of the existing system should be considered. Field investigations and verifications of the operation of HAVC systems must be conducted beforehand for smooth ECF operations. If heating and cooling are required with indoor air circulation type equipment in an ECF zone, the implementation of a heating and cooling method that can satisfy the comfort requirements of the occupants while minimizing cross-contamination is essential. When using PHUs that do not meet the performance standards required by medical equipment, the noise level resulting from such equipment operation must be evaluated and improved. Implications: For EMFs, various guidelines that can be referred to for the construction and operation of ECFs must be developed to prepare for emerging infectious diseases in the future.

• 임상간호연구
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• 제16권1호
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• pp.167-175
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• 2010

Purpose: This study investigated nursing care delivery systems in 44 university affiliated hospitals and satisfactions with the systems perceived by 226 unit managers (head nurses) of general medical surgical wards. Methods: Data were collected with questionnaires consisting of checklists asking the unit managers their nursing care delivery systems and their satisfactions with the systems. Results: Four models of nursing care delivery systems (primary, modified primary, team, and functional models) were drawn from the participants' responses. Among the four key models 35% of the units adopted team model whereas 24.3% adopted primary model and 22.6% adopted modified primary model. In spite of 35% of team model being under use, 60.6% (n=137) of the unit managers answered the nursing delivery system of their units as team model and only 6.2% (n=14) answered their units having primary or modified primary models, instead of 46.9% combining both. In regard to the satisfaction, critical thinking ability of staff nurses (members in their units) was the most dissatisfactory area regardless of models of service delivery. Conclusion: Introducing team model supplemented with core concepts of primary model (primary team delivery model) into nursing practice will reform the workplace and therefore deliver safe health care services to patients.

• Journal of Korean Biological Nursing Science
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• 제25권4호
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• pp.285-294
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• 2023

Purpose: This study aimed to identify the colonization rate of carbapenem-resistant Enterobacteriaceae (CRE), the characteristics of CRE isolates, and risk factors for CRE colonization in patients transferred to the general wards of a small/medium-sized hospital. Methods: This retrospective study was conducted on patients who underwent CRE culture tests within 24 hours of admission among patients transferred to a small/medium-sized hospital. Forty-seven patients confirmed as positive for CRE were classified as belonging to the patient group. For the control group, 235 patients (five times the number of the patient group) were matched by sex, age, and diagnosis, and then selected at random. Data were analyzed using descriptive analysis and multiple logistic regression analysis. Results: The CRE colonization rate was 5% (47 out of 933 patients), and Klebsiella pneumoniae (68.0%) was the most common isolate of CRE. The positivity rate of carbapenemase-producing Enterobacteriaceae was 61.7%. The risk factors for CRE colonization included renal disease (odds ratio [OR]=4.93; 95% confidence interval [CI], 1.49-16.31), heart disease (OR=3.86; 95% CI, 1.35-11.01), indwelling urinary catheters (OR=4.43; 95% CI, 1.59-12.36), and cephalosporin antibiotic use (OR=8.57; 95% CI, 1.23-59.60). Conclusion: Having a comorbid renal or cardiac disease, an indwelling urinary catheter, or a history of exposure to cephalosporin antibiotics could be classified as risk factors for CRE colonization in patients transferred to small and medium-size hospitals. It is necessary to perform active infection control through proactive CRE culture testing of patients with risk factors.

• 한국의료질향상학회지
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• 제29권2호
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• pp.15-31
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• 2023

Purpose: This study aimed to identify the characteristics of patient safety incidents (PSIs) related to nursing and to provide primary data for preventing the recurrence of similar incidents. Methods: This secondary analysis study included damage claims rulings filed for clinical negligence from 2014 to 2018 that contained the keyword 'nurse'. It excluded judgments irrelevant to nursing care and in which clinical negligence or causal damages were overruled. A total of 93 cases were analyzed. The characteristics of PSIs were derived through descriptive statistics, and two instances of nursing-related PSIs were examined by qualitative content analysis focusing on root causes. Results: The analysis of PSIs related to nursing suggested that the medical institutions where the PSIs occurred most frequently were hospitals, and the most common types of PSIs were medication, surgery, and treatment/procedure, in that order. In addition, it indicated that nursing-related PSIs occurred most frequently in general wards during the day shift, with the most common related nursing practice being managing potential risk factors. The qualitative analysis showed that careless monitoring and institutional inertia were causes of PSIs. Conclusion: To prevent nursing-related PSIs, nurses need to individually monitor and assess patient conditions. In addition, support should be accompanied by the improvement in the systems in place aimed at preventing the recurrence of nursing-related PSIs at the institutional and national level, such as securing appropriate nursing personnel and improving labor conditions.

• 임상간호연구
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• 제30권1호
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• pp.35-44
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• 2024

Purpose: The purpose of this study is to compare the predictive validity of pressure injury risk assessment, Braden, Braden Q and Braden QD for pediatric patients. Methods: Prospective observational study included patients under the age of 19 who were hospitalized to general wards, intensive care units of a children's hospital. Characteristics related to pressure injury were collected, and predicted validity was compared by calculating the areas under the curve (AUC) of the Braden, Braden Q, and Braden QD scales. Results: A total of 689 patients were included in the study. A total of 13 (1.9%) patients had pressure injuries, and the number of pressure injuries was 17. Factors related to the occurrence of pressure injuries were 9 (52.9%) immobility-related and 8 (47.1%) medical device-related. The AUC for each scale was .91 (95% CI .89~.94) for Braden, .92 (95% CI .90~.95) for Braden Q, and .94(95% CI .92~.96) for Braden QD. The optimal cut-off points were identified as 16 for Braden (sensitivity=88.8%, specificity=86.4%), 17 for Braden Q(sensitivity=63.6%, specificity=94.9%), and 12 for Braden QD (sensitivity=94.4%, specificity=88.7%). Conclusion: The Braden QD scale demonstrated the highest predictive validity for pressure injuries in pediatric patients and is expected to be valuable tool in preventing pediatrics pressure injuries.

• 대한간호학회지
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• 제24권4호
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• pp.597-615
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• 1994

This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

• 간호행정학회지
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• 제2권1호
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• pp.125-139
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• 1996

Organizational commitment is characterized by a strong belief in and acceptance of the organization's goal and values ; a willingness to exert considerable effort on behalf of the organization ; a strong desire to maintain membership in the organization. The purpose of this study was to identify the variables which influence the organizational commitment and to test the relationship between the clinical nurses' organizational commitment and turnover intention. The subjects were 412 nurses who were working on general wards at three General Hospitals in Chounbuk. The data were collected by self-reporting questionnaire from Sept. 20 to Sept. 31, 1995. The instruments used in this study were Likert-type scale which were Organizational Commitment Scale by Mowday et al, and Turnover Intention Scale by Mobley et al. The questionnaire of organizational characteristics was made through reviewing literature. The data were analyzed by frequency, percentage, t-test, one-way ANOVA, Scheffe test, Pearson's correlation coefficient, and stepwise multiple regression with $SPSS-PC^+$ program. Major findings are as follows : 1. Mean scores for organizational commitment were 3.008 and turnover intention 3.167 on a 5 point scale. 2. Age and clinical experience were positively related to organizational commitment(r=.4806, p=.000; r=.4792, p=.000). 3. In the personal variables, hospital type(F=21.374, p=.000), education level(F=5.481, p=.001), position(F=30.867, P=.000), and marital status(t=-5.63, p=.000) of the nurses showed significant differences in organizational commitment. 4. The variables to the organizational characteristic were statistically significant in organizational commitment : formalization(r=.3458, p=.000), human-centered organizational characteristic(r=.4302, p=.000), performance- centered organizational characteristic(r=-.1502, p=.000), payment(r=.2234, p=.000), promotion(r=.2710, p=.000), benefit & service(r=.2325, p=.000), and resource inadequacy(r=-.2172, p=.000). 5. For the purpose of identifying the predicting variables in organizational commitment, stepwise multiple regression is conducted. The results show that age, human-centered organizational characteristic, formalization, hospital type, resource inadequacy, promotion, and benefit & service were significant variables and explained 46% of the variance. 6. Organizational commitment was significantly negatively correlated with turnover intention(r=-.6442, p=.000). As a result of stepwise multiple regression analysis, organizational commitment is the most powerful variable predicting turnover intention and explained 41.5% of the variance. In conclusion, this study shows that the higher the organizational commitment level, the lower the turnover intention. Therefore, for effective turnover management, it is important to improve the organizational commitment among clinical nurses. In order to enhance the organizational commitment by the clinical nurses, it will be useful to consider significant organizational characteristics variables identified in this study.

• Journal of Nutrition and Health
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• 제51권2호
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• pp.132-139
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• 2018

본 연구는 일반병동에 입원하여 3일 이상 경장영양을 시행한 성인 환자 95명을 대상으로 영양집중지원팀의 중재 효과를 평가하기 위해 영양중재를 받은 중재군과 받지 못한 군으로 분류하여 열량 및 단백질 지원율과 생화학적 지표를 비교 분석 하였다. 연구결과를 통해 환자의 입원초기부터 적절한 영양관리를 계획하고, 영양집중지원팀의 영양중재로 체계적인 관리를 실시하면 환자의 영양상태가 개선되는 것을 확인할 수 있었다. 결론적으로 영양불량 문제가 있는 환자에게 영양집중지원팀의 중재를 받아 문제를 개선할 수 있도록 절차를 마련한다면, 이는 환자의 임상적 치료에 긍정적인 영향을 줄 것으로 생각된다. 본 연구는 국내에서 경장영양을 시행한 일반병동 환자를 대상으로 영양집중 지원팀의 중재 효과에 대한 초기 연구이며, 집중영양치료료 수가 신설 이후 진행된 연구다. 추후 일반병동 환자를 대상으로 영양집중지원팀의 중재효과에 대한 연구가 다양하게 시행된다면 의료진의 관심이 증대 될 것이고, 나아가 영양집중지원팀의 중재를 통해 진료의 질을 높일 수 있을 것이다.

• 한국보건간호학회지
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• 제17권2호
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• pp.317-332
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• 2003

This study attempts to investigate the relations between the types of communication, the job satisfaction. and the nursing performance of the staff nurses. The subjects of this study were the 114 nurses working in general wards, intensive care units, and the emergency rooms of the general hospital in Kyongbuk province. They were asked to answer the questionnaires as regards the types of communication and job satisfaction, and their performance of nursing, and these were evaluated by the head nurses, and their direct seniors. The data were collected for 10 days from the September 17 to 26, 2002. According to the purpose of the study, descriptive analysis, ANOVA. Pearson correlation coefficient, and stepwise multiple regression were applied for the data analysis using SPSS 10.0. The results are as follows : 1. The types of communication of staff nurses showed that the upward communication was $3.12\pm0.56$. the downward communication was $3.56\pm0.42$. the horizontal communication was $2.98\pm0.44$. and the informal communication was $2.59\pm0.49$. It showed that the most frequent communication was the downward communication. 2. In terms of the job satisfaction, there was significant difference according to the length of the period working for one ward (F=5.95, p=0.003), 3. The performance of nursing was significantly different according to the age (F=23.52, p=0.000), the working duration as a nurses (F=21.9, p=0.000), the types of nursing unit (F=5.33, p=0.002), and the working duration in present nursing unit (F=15.87, p=0.000). 4. In terms of communication type, the job satisfaction was associated with quality of the upward communication (F=6.23, p=0.003), the downward communication (F=5.78, p=0.004), and the horizontal communication (F=11.73, p=0.000) There were no association between the types of communication and the performance of nursing. 5. There was a positive correlation between the communication and the job satisfaction. And the downward communication (r=0.398) showed the greatest correlation with the job satisfaction. There was no statistically significant correlation between the communication and the performance of nursing. And the upward communication (r=-0.058) showed a negative, though not significant correlation with performance of nursing. 5. There was a positive correlation between the communication and the job satisfaction. And the downward communication (r=0.398) showed the greatest correlation with the job satisfaction. There was no statistically significant correlation between the communication and the performance of nursing. And the upward communication (r=-0.058) showed a negative. though not significant correlation with performance of nursing. 6. The stepwise multiple regression result showed that the downward communication accounts for $15.8\%$ (p=0,000) of the job satisfaction.