Purpose: The purpose of this study was to determine the meaning of the adaptation experiences of new ICU nurses who were working in a newly established university hospital. The study was based on phenomenological research methodology. Method: Data were collected over 3 months through in depth interview with 6 new nurses who had worked less than 1 year in a newly established ICU of university hospital of less than 1 year located in Y city. The Colaizzi analysis method was used for data analysis. Results: The themes were classified into 13 themes clusters. The 13 themes clusters were finally grouped into 6 categories, 'The endlessness of a new beginning', 'Pressure of work due to lack of senior nurses', 'Wanting to quit', 'Attachment for the complete hospital and ICU', 'Preciousness of colleagues', 'Pride in self-growth'. Conclusion: New ICU nurses have a difficult time due to pressures of work and lack of expert knowledge, and anxiety adds to these problems making the situation more difficult. The study results indicate that professional knowledge and skills learned through repetition of difficult work, pride through self growth, recognition from others and good-fellowship are driving forces to overcome obstacles and with stand difficult daily work.
Purpose : The purpose of this study was to explore and describe the meanings of hands among clinical nurses. Methods : A descriptive qualitative study design was used. Participants were 1,048 nurses working in a tertiary hospital in G city. From April to May 2018, an open-ended survey on how nurses felt about their hands and what their hands meant to them was conducted. The collected data were analyzed using MAXQDA 2018 version as well as content analysis. Results : A total of 1,048 pieces of data were analyzed, and 2,094 units of analysis were categorized based on their attributes, resulting in physical, emotional, and social domains. The data in the social domain were reported in a narrative format; thus, they were analyzed using content analysis. Three themes and eight sub-themes were elicited. The three themes included "meaning as an instrument," "meaning of infection control," and "meaning of caring." Conclusion : Nurses imbue essential meanings of caring on their hands even though they face negative skin symptoms. Furthermore, nurses understand the importance of hand hygiene on infection control. The findings of this study provide an in-depth look into nurses' perceptions of their hands.
Purpose : The purpose of this study was to identify factors influencing the professional self-concept of nurses working in intensive care units (ICUs). Methods : Data were collected from July 1 to August 15, 2014. The subjects were 206 ICU nurses working in four university hospitals in B and U cities, Korea. Their professional self-concept was measured using Arthur's Scale revised by Yoon (2012), and professional quality of life (QOL) was measured using Pro QOL Korean Ver. 5 developed by Stamm (2010). Data were analyzed with SPSS Ver. 18, using a t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis. Results : Professional self-concept was significantly correlated with compassion satisfaction (r=.61, p<.001), and burn out (r=-.57, p<.001). The factors influencing professional self-concept were compassion satisfaction (${\beta}=.46$, p<.001), burn out (${\beta}=-.27$, p<.001), and education level (${\beta}=.14$, p =.014). The explanatory power of this model was 46.5%. Conclusion : The results suggest that the influencing factors found in this study should be considered when planning nursing intervention programs for improving the professional self-concept of ICU nurses.
Purpose : This study sought to investigate novice nurses' communication education needs in the intensive care unit (ICU) using Importance-Performance Analysis (IPA) and Borich's need assessment model. This study identified communication challenges in clinical settings to develop a simulation program that enhances communication competencies based on educational requirements. Methods : A descriptive research design and a self-report questionnaire were used. The latter was developed and administered to 121 novice nurses with less than one year of experience in the ICU at various university hospitals in Korea. Data were collected via the online open chatroom from June 24th to July 28th, 2023. The communication education needs were identified using descriptive statistics, t-tests, IPA, and Borich's needs assessment model. Text analysis was used to categorize the participants' communication experience. Results : The results revealed that "communication with physicians," "communication with patients," and "communication with nurse on another shift" domains contained the most substantial educational needs for novice nurses working in the intensive care units. Conclusion : The results provide fundamental data for developing and enhancing customized communication education programs for novice ICU nurses. This valuable information could help ICU nurses and educators improve new nurses' communication skills, which would ultimately contribute to the advancement of nursing education and clinical practice.
Purpose: This study was done to verify validity and reliability of a neonatal patient classification system (NeoPCS-1). Methods: An expert group of 8 nurse managers and 40 nurses from 8 Neonatal Intensive Care Units in Korea, verified content validity of the measurement using item level content validity index (I-CVI). The participants were nurses caring for 469 neonates. Data were collected from November 11 to December 14, 2011 and analyzed using descriptive statistics, ANOVA, intraclass correlation coefficient, and K-cluster analysis with PASW 18.0 program. Results: Nursing domains and activities included 8 items with 91 activities. I-CVI was above .80 in all areas. Interrater reliability was significant between two raters (r=.95, p<.001). Classification scores for participants according to patient types and nurses' intuition were significantly higher for the following patients; gestational age (${\leq}29$ weeks), body weight (<1,000 gm), and transfer from hospital. Six groups were classified using cluster analysis method based on nursing needs. Patient classification scores were significantly different for the groups. Conclusion: These results show adequate validity and reliability for the NeoPCS-1 based on nursing needs. Study is needed to refine the measurement and develop index scores to estimate number of nurses needed for adequate neonatal care.
Purpose: The aim of this study was to explore the patients' perspectives on nursing students' clinical practices in the wards, and to investigate their willingness for allowing students to practice on them. Methods: This was a descriptive study. 116 inpatients were recruited from the S University Hospital. A 60-item questionnaire was applied to collect the data. The participants were 19 years and older with sound judgement, and were not in special or intensive care units. Data analysis was done in SPSS/WIN 22.0 using descriptive statistics, Fishers exact test, and the ANOVA test. the participant answered to questionnaire from April 29th 2016 to May 10th. Results: 40 participants (34.5%) stated they would allow students' practice, while 72 (61.2%) said they would allow only under staff supervision. 5 participants (4.3%) stated they would not allow whatsoever. The 3 most allowed were emotional support, oral care, and vital signs measurement while the 3 least allowed were gastric feeding, intravenous catheterization, and urinary catheterization. Conclusion: Patients were more inclined to allow students to practice on them when a member of the medical team was present. A fair number of participants said they would be more inclined to allow students' practice if they felt the student was competent; hence, reinforcing simulation sessions is vital in enhancing students' competency and ultimately practice allowance.
Purpose: This study was to identify topics for evidence-based clinical nursing practice guidelines in Korea. Methods: Data were collected from 330 staff nurses from 10 general hospitals and 53 nurses in charge of nursing education in 110 hospitals with over 500 beds. Using open questions, the nurses identified activities which could not be verified, which lacked consistency among nurses, clinical units and/or hospitals, which were not based on the up-to-date knowledge and which needed reform. The data were analysed by content analysis using a qualitative methodology. Results: Collected data consisted of 1882 clinical topics, which were classified into 50 topics, 207 mid-categories, and 456 sub-categories. The most frequent topics in order of frequency were medications, central line management, intravenous injections, urinary catheterization, perioperative nursing care, skin tests, pressure ulcer care, blood transfusions, laboratory examination-culture, respiratory care which were performed routinely in clinical setting by staff nurses. Conclusion: The research findings indicate the urgent need to develop evidence-based clinical nursing practice guidelines related to these research findings. Further research is needed to identify topics related to health promotion, and symptom/management of health problem.
Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.
Purpose: The purpose of this study was to apply patient-engaged bedside handoffs in comprehensive care units, and to evaluate the effects of bedsides to nurses and patients. Methods: This study employed a cluster randomized cross-over design.Electrical Medical Record (EMR)-based handoffs and patient-engaged bedside handoffs were alternatively applied to 104 patients, who were assigned to a total of 30 clusters (nursing handoff teams) in 4 comprehensive care units at the S medical center in Seoul, and the patients evaluated each type of handoffs. A total of 139 nurses were also participated in the same units and evaluated each type of handoffs. Data were analyzed using t-test, Wilcoxon rank sum test, ANOVA, and Kruskal-Walls test. Results: The patient's satisfaction of the patient-engaged bedside handoffs was higher than that of the EMR-based handoffs (Z=-5.16, p<.001). On the other hand, the nurse's satisfaction of the patient-engaged bedside handoffs was significantly lower than that of the EMR-based handoffs (t=13.21, p<.001). There were no differences in length of the reporting time between two types of handoffs (t=-0.48, p=.634). Conclusion: Patient satisfaction with the patient-engaged bedside handoffs was higher than that of EMR-based handoffs, and nurses' satisfaction with the patient-engaged bedside handoffs was significantly lower than that of EMR-based handoffs. Future studies are needed regarding the impacts of patient-engaged bedside handoffs on the quality of healthcare by identifying the benefits of the handoffs.
Purpose: The aim of this project was to develop a patient safety-focused inservice education program for surgical nurse and to test the effects of this program. Methods: Methodological designs for instruments development, a pretest-posttest and a posttest design were employed. After the education, nurses' satisfaction, confidence, usefulness and application of 137 nurses were evaluated at 15 surgical units of a tertiary teaching hospital in Seoul, Korea. The education contents are 6 skill areas (infusion pump use, suction, chest tube drainage, oxygen administration, nebulizer use, insulin administration) and medication knowledge. Teaching methods were lecture, instructor demonstration, and 1:1 skill test. Descriptive statistics, Wilcoxon test, Spearman's correlation and Stepwise regression were used. Results: Satisfaction scores for skills and medication education were 4.00-4.21 (out of 5), The more performance frequency in 6 skills, the higher score in confidence as well as in usefulness and application, and the higher satisfaction with the program, the higher score in usefulness, application, confidence, and medication knowledge. Medication knowledge improved after the education (Z=-7,757, p<.001). Significant predictors of skill confidence were application of skills in job performance, medication confidence, and career in present unit. Conclusion: The results of this study suggest that systematic and continuous inservice education will improve patient safety by promoting nursing quality.
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