• Journal of Korean Clinical Nursing Research
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• v.20 no.2
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• pp.162-176
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• 2014

Purpose: The purpose of this study was to perform an operating room nursing activities analysis and estimate nursing intensity of each nursing activity based on the Relative Value Scale (RVS). Methods: The methodology for this study of RVS was based on the work of Hsiao et al. The first stage was to identify nursing activities and the second to measure intensity of nursing activities including technical skill, mental effort, and stress. Results: Calculation of the RVS for 99 nursing practices showed a score range from 300.00 to 1337.78. CS operation assistant, OS operation assistant, and obtaining certification had high nursing intensity. Surgical hand washing, putting on surgical gowns, surgical gloves and surgical caps and mask had low nursing intensity. Conclusion: The activities of operating room are not compensated separately but reimbursement is usually included in physician fees. In the future, an estimation of nursing cost should show the nursing contribution rate to total operation revenue.

• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.63-71
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• 2010

Purpose: This study was conducted to evaluate the incidence and risk factors for surgical glove perforation during operation. Methods: During the month of december 2008, a total of 1,400 pairs of surgical gloves used in major operations was collected in a tertiary hospital. All gloves were examined immediately after operation using the standardized water-leak method to detect any perforation. Incidence of the glove perforation was counted according to the type of operation, operation time, the number of involved personnel, perforation sites, and the manufacturing companies. Results: Out of 2,800 gloves examined, 312 perforations were detected comprising 11.1% of samples. In terms of the type of operation, the perforation incidence varied from 5% to 20%, and the perforation rates in CS (20%) and NS (18%) (p<.001) were significantly higher than those in other departments. The 1st assistant or scrub nurse got glove perforation more frequently than the 2nd assistant or operator (p<.001). Longer operation time was associated with higher incidence of perforation evidently (p<.001). In terms of the sites, the thumb and index finger were more frequently perforated than other sites (4.1% and 3.4% respectively) without any differences between left and right side. Conclusion: Risk factors for glove perforation including the department of operation, operation time, participating personnel, and location of perforation should be taken into account to improve surgical safety.

• Journal of Korean Academy of Nursing
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• v.47 no.1
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• pp.49-59
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• 2017

Purpose: The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness. Methods: Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. Results: General medical-surgical nurses experienced difficulties in 3 categories, 9 subcategories, 27 codes. The three categories were 'nurse' related factors, 'patient' related factors, 'resource' related factors. The nine categories were 'unpreparedness', 'nursing barriers due to stigma', 'undervaluing and avoidance of psychiatric nursing', 'eroding into the trap of a vicious cycle', 'facing unapproachable patients', 'dealing with unhelpful family members', 'burdening already overburdened staff', 'obstructive environment', and 'isolation of staff with heavy responsibilities'. Conclusion: The results of this study indicate the need to develop psychiatric mental health education programs for non-psychiatric nurses. Education about psychiatric mental health and support from institutions for non-psychiatric nurses can reduce their negative attitude toward psychiatric patients and difficulties in caring for psychiatric patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9307-9312
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• 2014

Background: Hope is an important coping resource for cancer patients. Types and sources of hope and hope-inspiring strategies are not well investigated among Iranian cancer patients. The aims of present study were therefore to investigate the nature of hope and some demographic predictors of hope among Iranian cancer patients. Materials and Methods: This descriptive-correlational study was undertaken among 200 cancer patients admitted to an educational center affiliated to Ardabil University of Medical Sciences, Iran. Participants were selected using a convenience sampling method. The Herth Hope Index and other validated questionnaires were used to investigate level of hope and types and sources of hope, as well as hope-inspiring strategies. Data were analyzed using SPSS statistical software. Results: The overall score for hope was 31 from total scores ranging between 12 and 48. Some 94% of patients mentioned 'return to normal life' and 'complete healing of disease by drugs and physicians' as their main hopes. The most important sources of hope reported by patients include spiritual resources, family members, healthcare workers, and medicines and treatments available for the disease. Relationship with God, praying/blessing, controlling the signs and symptoms of the disease, and family/health care workers' support were the main hope-inspiring strategies. Patients who had a history of metastasis, or who were older, illiterate, divorced/widowed and lived with their children reported lower levels of hope. On the other hand, employed patients and those with good support from their families had higher levels of hope. Conclusions: The study findings showed moderate to high levels of hope among Iranian cancer patients. Accordingly, the role of spiritual/religion, family members and health care workers should be considered in developing care plans for these patients.

• Journal of Korean Academy of Nursing Administration
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• v.13 no.2
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• pp.199-207
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• 2007

Purpose: Clinical characteristics and medical cost were analyzed according to the surgical procedures for intertrochanteric fracture in aged patients to assess the appropriateness of treatment expense and to find possibility of reducing the medical cost. Method: Variable for the statistical analysis were; the clinical characteristics, medical cost according to the surgical procedures, the treatment success rate, the total medical expense, and the average expense per case. SAS Package Version 8.02. was used to analyze the relevant data. Results: Operative procedures differ significantly according to the gender and by the location of institution. Only significant clinical variables according to the operative procedure were duration of general anesthesia and amount of blood transfusion. Average cost per treatment was the highest in the bipolar hemiarthroplasty followed by the gamma nail and hip compressing screw. Average cost for bipolar hemiarthroplasty was significantly higher than other surgical procedures. Conclusions: The difference in hospital costs for treatment of intertrochanteric fracture originates from the utilized surgical procedures, mostly by the materials used. The method of surgical treatment should be carefully determined by the purpose of the surgery, in order to improve the quality of medical care and also to reduce the hospital cost.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.2
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• pp.151-161
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• 2014

Purpose: The purpose of this study was to identify the risk factors that influence surgical site infections after surgery. Methods: This study was a retrospective research utilizing Electronic Medical Records. Data collection targeted 4,510 adult patients who had 8 different kinds of surgery (gastric surgery, colon surgery, laparoscopic cholecystectomy, hip & knee replacement, hysterectomy, cesarean section, cardiac surgery) in 4 medical care departments, at one general hospital between January 2006 and December 2011. Multivariate logistic regression analyses were used to identify the risk factors affecting surgical site infections after surgery. Results: Risk factors for increased surgical site infection following surgery were confirmed to be age (OR=1.59, p<.001), BMI (Body Mass Index)(OR=1.25, p=.034), year of operation (OR=2.45, p<.001), length of operation (OR=3.06, p<.001), ASA (American Society of Anesthesiology) score (OR=1.36, p=.025), classification of antibiotic used (OR=2.77, p<.001), duration of the prophylactic antibiotics use (OR=1.85, p<.001), and interaction between classification of antibiotic used and duration of the prophylactic antibiotics use (OR=1.90, p=.016). Conclusions: Results suggest that risk factors affecting surgical site infections should be monitored before surgery. The results of this study should contribute to establishing effective infection management measures and implementing surveillance systems for patients who have actual risk factors.

• Journal of Korean Critical Care Nursing
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• v.9 no.1
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• pp.27-39
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• 2016

Purpose: The purpose of this study lies in investigating nursing and medical staff perceptions on the importance of surgical patient safety protocol, teamwork, and patient safety culture, and how their grasp of the factors affects the degree of their performance of the protocol. Methods: A survey was conducted on 249 nurses and medical staff participating in the operating rooms of one higher general hospital in Seoul, using a 5-point scale self-reported questionnaire. Logistic regression analyses were used. Results: Operating room nurses yielded the highest scores on both the importance of the patient safety protocol and its performance. In patient safety culture, the operating medical staff yielded significantly higher scores than those of operating room nurses. Perception of the importance of the patient safety protocol and teamwork had a significant effect on the nurses' complete performance of the protocol. Conclusion: It is important to create a safety culture, where all the staff can actively and freely communicate with one another through team-based training programs. By enhancing teamwork and patient safety culture, it will be possible to establish the surgical patient safety protocol and to improve the performance of the protocol by health professionals.

• Korean Journal of Adult Nursing
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• v.25 no.4
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• pp.365-376
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• 2013

Purpose: The purpose of this study was to construct, develop, and apply a nursing information system (NIS) using NANDA-NOC-NIC linkage in medical-surgical nursing units. Methods: This study consisted of three phases which were the construction of the database, development of the NIS, and application of the NIS. To construct the database, a questionnaire and nursing record review by an expert group were used. Collected data were analyzed by the SPSS/WIN 13.0 program. Results: In first phase, the database was made up of 50 nursing diagnoses, 127 nursing outcomes and 300 nursing interventions. In the second phase, NIS was developed according to its flow diagram and then tested. In the third phase, the developed NIS was applied to 130 inpatients. Nursing diagnoses frequently used were acute pain, delayed surgical recovery, and deficient knowledge (specify). Nursing outcomes for a nursing diagnosis of 'acute pain' were identified as pain control, pain level and comfort level. Nursing interventions for the nursing outcome 'pain control' were pain management, patient controlled analgesia assistance and medication management. Conclusion: The results of this study will facilitate the use of the newly proposed NIS in nursing practice and provide a guideline for evidence-based nursing.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2141-2144
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• 2016

Background: Many cancer patients still experience pain worldwide. There are many barriers for effective control of cancer pain and many of these are related to health care providers. There is a need for further investigation of these barriers. The aim of this study was to investigate nurse-related barriers to control of cancer pain among Iranian nurses. Materials and Methods: In this descriptive study 49 nurses from two hospitals affiliated to Tabriz and Ardebil Universities of Medical Sciences participated using a census sampling method. A demographic and profession related checklist and Barriers Questionnaire II (BQ-II) were used for data collection. Results: The results showed negative attitudes of participants regarding control of cancer pain. Participants believed that cancer pain medications do not manage cancer pain at acceptable levels; patients may become addicted by using these drugs; cancer pain medications have many uncontrollable effects; and controlling cancer pain may distract the physicians from treating disease. Conclusions: Iranian nurses have negative attitudes toward pain control in cancer patients especially about effectiveness of pain medication and their side effects. Educational intervention to reduce these misconceptions is needed.

• Korean Journal of Adult Nursing
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• v.20 no.2
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• pp.353-363
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• 2008

Purpose: This study was conducted to develop a timeout protocol as the process of patients verification in the operating room, and to evaluate its effects. Methods: The timeout protocol was developed based on the experience of practices and the universal protocol of JCAHO 2004. The subjects of this study were 192 surgical members working in the operating room at an university hospital in Daegu, Korea. Results: The timeout protocol was developed in six steps; participants verification, encouragement of compliance, verification of right 3 PSP, agreement of surgical team members, verification of the parties to a patient, patient agreement. The data which have been resulted from the experimental group show significantly higher than those of control group as follows; cognition(t = -6.580, p = .000), contents of performance; progress of anesthesiologist as leader(${\chi}^2$ = 29.029, p = .000), verification of right patient, right site and right procedure(${\chi}^2$ = 40.663, p = .000), participation of surgical team(${\chi}^2$ = 68.412, p = .000), and the number of cases of performance(${\chi}^2$ = 242.900, p = .000). Conclusion: It suggests that medical accidents caused by failures in a preoperative verification process can be prevented if a timeout is conducted active involvement and effective communication among surgical team members for a final verification of the correct patient, procedure, and site.