• 대한간호학회지
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• 제49권5호
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• pp.575-585
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• 2019

Purpose: The purpose of this study was to develop predictive models for pressure ulcer incidence using electronic health record (EHR) data and to compare their predictive validity performance indicators with that of the Braden Scale used in the study hospital. Methods: A retrospective case-control study was conducted in a tertiary teaching hospital in Korea. Data of 202 pressure ulcer patients and 14,705 non-pressure ulcer patients admitted between January 2015 and May 2016 were extracted from the EHRs. Three predictive models for pressure ulcer incidence were developed using logistic regression, Cox proportional hazards regression, and decision tree modeling. The predictive validity performance indicators of the three models were compared with those of the Braden Scale. Results: The logistic regression model was most efficient with a high area under the receiver operating characteristics curve (AUC) estimate of 0.97, followed by the decision tree model (AUC 0.95), Cox proportional hazards regression model (AUC 0.95), and the Braden Scale (AUC 0.82). Decreased mobility was the most significant factor in the logistic regression and Cox proportional hazards models, and the endotracheal tube was the most important factor in the decision tree model. Conclusion: Predictive validity performance indicators of the Braden Scale were lower than those of the logistic regression, Cox proportional hazards regression, and decision tree models. The models developed in this study can be used to develop a clinical decision support system that automatically assesses risk for pressure ulcers to aid nurses.

• 대한간호학회지
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• 제33권6호
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• pp.772-783
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• 2003

Purpose: This study was performed to measure the nursing service perceived value by consumer and providers, and to investigate the relationship among nursing service, general satisfaction and hospital revisiting intent, and to examinate the tools that measures nursing service's reliability, construct validity and usefulness. Method: The questionnaire was developed and distributed to 300 patients and 210 nurses at three general hospitals. For data analysis, SPSS/PC program was used. Result: The nursing service perceived value by providers is higher than that by consumers. There are distinctive difference in the expectation, and importance and performance values of the nursing service perceived. In examination of the relationship among nursing service, general satisfaction and hospital revisiting intent, nursing service has a deep relationship with general satisfaction, but doesn't have relationship with hospital revisiting intent. The tool that measures nursing service has a good reliability and construct validity. In analysis on the usefulness between the tools, SERVPERF tool is more useful than SERVQUAL tool. conclusion: The nursing service perceived value by consumer is different that by providers, and the tool that measures nursing service has a good reliability and construct validity. The SERVPERF tool is more useful than SERVQUAL tool.

• 간호행정학회지
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• 제11권3호
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• pp.335-345
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• 2005

Purpose: This study was designed to develop a computerized program for patient classification and record of basic nursing care. Method: The study was carried out from February to May 2004 at the four general wards in A university hospital using three steps; investigation of needs for program development, program design and development, and program application and evaluation. Result: Results of this study showed that users were mostly satisfied with the program and set a high value on the usefulness and performance of this program. Accordingly it was found that this program could be of help to assist nurses in classifying the patients and taking records of their nursing service. Conclusion: The program is likely to contribute to enhance the efficiency in providing appropriate and effective nursing service to the patients by easily identifying the overall particulars of patients and improving repeated manual works. And Record of basic nursing care is a part of several nursing records. As such the continual development on the computerized program for various fields of nursing service is needed.

• 동서간호학연구지
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• 제10권1호
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• pp.11-26
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• 2004

The purpose of this study is to investigate the present conditions of nursing investment contents, its conversion process, and output in Oriental University Medical Center, Korea to get good qualified Oriental nursing result which is the ultimate purpose of the Oriental nursing management, and to develope a matrix of Oriental nursing management system on the basis of that project. The subjects for nursing investment and output contents were eighteen nursing directors in eleven Oriental University Medical Center and two hundred thirty-nine nurses with three years and over experience in Oriental medical center. The subjects for Oriental nursing organization, human affair management, and control function were nineteen Oriental medical center in Oriental University Medical Center, Korea. Data were collected from November, 2002 to February, 2003 with questionnaire. Data analysis was done by SPSS PC+ 12 program. Frequency, percentage, and minimum/maximum values were used for investment contents, and frequency and percentage were used for conversion process and output contents. 1. The input factors of oriental nursing management system The objective's western hospital career was over five years of one hundred and seventy-five(73.2%) persons. Nursing in-service education was performed in fourteen hospitals(77.8%). Two hundreds(83.7%) were pro to oriental nurse system. Only four hospitals(22.2%) had independent budget in nursing division. Nursing staff allocation to the bed was from 2.8:1 to 9.06:1 respectively, with a big gap of the rate following the hospitals. 2. The conversion factors of oriental nursing system 1) Oriental nursing system Oriental hospital nursing system was organized independently in ten hospitals among eighteen hospitals. The recruitment of nurses which was a vital role of the nursing division of the hospital was mostly(79%) opened. The education to develope nursing personnels was through in-service one in 97.4%. Education for oriental nursing and management was performed in 42.1%(eight hospitals) and that for reserves was done in 36.8%(seven hospitals). Administration for nursing education by nursing division was 68.5%(thirteen hospitals). The post education evaluation was performed by report submission in 36.8%(seven hospitals), by written examination in 26.3%, by questionnaires in 21.1%, and by lecture presentation in 15.8% subsequently. The directorial meeting for the nursing directors was attended by 84.2%(sixteen hospitals), and the meeting type was the medical executive and support division executive meeting in 55.6%(ten hospitals) and the personnel management in 39.6%(seven hospitals). 2) The actual conditions of oriental nursing personnel management The reason of working in oriental hospital was by voluntary in 67.1%(a hundred and sixty persons), by nursing department order in 28.0%(sixty-seven persons), and by others in 5.0%(twelve persons) respectively. The shift form was a three-shifts one in 94.7%(eighteen hospitals), a two-shift one in only one hospital. Duty assignment was functional in 52.6%(ten hospitals), team and functional in 26.3%(five hospitals) and no team alone. Promotion manual was present at 68.4%(thirteen hospitals) and the competency essentials comprised of performance evaluation in 79%, interview, written examination, training result, study result subsequently. No labor union existed in 79%(fifteen hospitals) 3) Oriental nursing preceptor system There were five oriental hospitals(27.7%) administering the preceptor utilization model, which showed lower rate than the twenty-two medical university hospitals in Seoul in which fifteen hospitals (72.7%) were having the system. To the question of necessity of oriental nurse system asked to the objectives of two hundred and thirty-nine with more than three year-experience in oriental hospital, two hundred persons(83.7%) answered positively. 4) The control of oriental nursing The evaluation results from the target hospitals were mostly not opened in 89.4% of oriental hospitals. Thirteen hospitals(68.3%) had evaluation system of direct managers and the next were three hospitals(15.8%) of direct managers and selves. There was one hospital(5.3% each) where fellows and superiors, fellows, and inferiors' evaluation was performed and no hospital where superiors, fellows, inferiors and selves, and superiors, fellows and selves' evaluation was performed. The QI activity of nursing was 42.1%(eight hospitals) for nursing service evaluation, 36.8% for survey of ECSI, 26.3% for survey of ICSI, 15.8% for medical visit rate, 10% for hospital standardization inspection in sequence. 3. The output factors of oriental nursing management system The job satisfaction appeared good in general, indicating very good in thirty-seven persons (15.7%), good in one hundred and fourteen persons (48.3%) and fair in eighty-five persons(36.0%).

• 한국간호교육학회지
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• 제17권1호
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• pp.14-24
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• 2011

Purpose: The purpose of this study was to investigate the learning effect of a standardized patient managed instruction program for a clinical maternity nursing course. Methods: The SP managed instruction was made for clinical cases in intrapartum and postpartum nursing care. The SP managed instruction was evaluated by using a quasi-experimental, nonequivalent control group post-test design with separate classes of students attending clinical maternity nursing classes at a nursing school in Incheon. Control groups were taught by traditional lecture/model method and experimental groups were taught by SP managed instruction. Data was collected from September 2009 to February 2010. Results: 1. There was no significant difference between the experimental group and control group in identifying relevant data (z=-1.418, p=.156) and necessary nursing skills performance (z=-.643, p=.520) for intrapartum nursing care. In addition, there was no significant difference between the two groups in identifying relevant data (z=-.264, p=.782) and necessary nursing skill (z=-.342, p=.732) for postpartum nursing care. 2. In clinical nursing skill performances the total score was statistically significantly higher in the experimental group than the control group (intrapartum care z=-4.181, p=.000, postpartum care z=-4.279, p=.000). 3. There was a statistically significant difference between the two groups (intrapartum care z=-3.731, p=.000, postpartum care z=-4.066, p=.000). Conclusion: In conclusion, the SP methodis effective in teaching clinical maternity nursing for student nurses and it is necessary to develop SP instruction courses for many areas in the clinical nursing education field.

• 디지털융복합연구
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• 제14권7호
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• pp.201-211
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• 2016

본 연구는 병원간호사의 환자안전문화 인식과 안전통제감 및 안전이행 정도를 확인하고 안전이행에 미치는 요인을 파악하기 위한 서술적 조사연구이다. 연구방법은 종합병원간호사 342명에게 자가기입식 웹 설문조사방법으로 2014년 5월 9일부터 13일까지 환자안전문화인식과 안전통제감, 안전이행 등을 조사하였다. 수집된 자료는 SPSS/WIN 21.0을 이용하여 분석하였으며, 분석결과는 환자안전문화 인식 3.34점, 안전통제감 3.50점, 안전이행 정도는 3.53점으로 보통보다 높은 수준으로 나타났다. 안전이행은 환자안전문화인식과 안전통제감과 유의한 정적 상관관계를 보였으며(r=.463~.645, p<.001), 안전이행에 영향을 미치는 요인으로는 대상자의 일반적인 특성 중 결혼상태, 환자안전문화 인식 중 사건보고의 빈도와 전반적인 환자안전도에 대한 인식, 그리고 안전통제감이 긍정적인 영향을 주는 요인으로 나타났다. 본 연구에서 사용한 변수들의 안전이행에 대한 설명력은 52.0%로 나타났다(F=4.252, p=.004). 이에 병원에서 간호사가 안전이행을 증진시킬 수 있는 긍정적인 영향요인임을 확인하여 추후 안전이행 증진을 위한 간호중재 전략의 기초자료로 활용할 수 있을 것이다.

• 한국전문물리치료학회지
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• 제8권1호
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• pp.35-50
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• 2001

The purposes of this study were to investigate the therapeutic effects of an early exercise program after mastectomy and to provide the early exercise program protocol for patients who had undergone mastectomy. The subjects were seventy women who were diagnosed with breast cancer. They were randomly as signed either to a experimental group (n=35) that received early postoperative exercise program or to a control group (n=35) that received only education by nurses. Data were obtained for each patient from goniometric measurements of shoulder flexion, abduction, external rotation, 10 elements of functional performance, and subjective pain evaluation using visual analogue scale (VAS). All variables were measured preoperatively, three days postoperatively, and one month postoperatively. Data were compared by groups using independent t-test and Mann-Whitney U test for parametric or non-parametric data, respectively. There were no significant differences between the groups for all variables preoperatively and at three days postoperatively. But there were significant differences at one month postoperatively. The experimental group showed a statistically significant increases in shoulder flexion, abduction, and external rotation and in the pain VAS at one month postoperatively (p<.05). Also, at one month postoperatively, the experimental group had less difficulty with three elements of functional performance-doing up a 'back' zippered article of clothing, reaching the ipsilateral scapula, and contralateral scapula with the fingers on the operated side-than the control group (p<.05). The results of this study suggest that, after mastectomy, the early exercise program conducted by a well-trained physical therapist can make a significant contribution to the return of more normal shoulder function and activities of daily living and to an increased quality of life.

• 기본간호학회지
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• 제19권1호
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• pp.87-97
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• 2012

Purpose: This study was done to evaluate nursing guidelines for patients with acute stroke, developed by adapting the guidelines of Registered Nurses Association of Ontario, Canada to clinical settings on a large scale and evaluating the effectiveness as a research study. Method: The general characteristics of the 319 patients and the effectiveness of guideline application were evaluated in terms of structure, process, and outcome using questionnaires on the guidelines application with reference to the medical records of patients with acute stroke hospitalized on a ward of the stroke center of S General Hospital in Seoul. Results: Structures as a guidance system for assessment were consistent with the recommendations. With respect to the process of the guidelines, for items on nursing assessment, improved performance was found to be statistically significant. For outcomes of the guidelines, complications occurred in 8 patients (5.3%) prior to application of the guidelines and 11 patients (6.5%) after application of the guidelines, but this result was not statistically significant (p=.841). Conclusion: The results of the study indicate that for the effectiveness of the guidelines, accessibility to the guidelines and effectiveness of quality improvement need to be evaluated, in addition to complications of a stroke.

• 중환자간호학회지
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• 제9권2호
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• pp.1-12
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• 2016

Purpose: This study aimed to develop a nursing handoff protocol for intensive care units and test its relevance. Methods: This is a methodological research to develop a protocol. A preliminary protocol was developed by composing items and testing content validity through literature review and experts' review. We revised and complemented the preliminary protocol following practical relevance assessment of 38 intensive care unit nurses at a university hospital to test content validity and to assess practical relevance of the final protocol. Results: On the basis of the content validity test for the final protocol, 40 items were adopted. The scores for the practical relevance of the final protocol increased significantly for items such as accuracy of handoff, reduction of handoff-related errors, convenience in using the protocol, reduction in handoff time, and simplification of handoff. Conclusions: The nursing handoff protocol for intensive care units in this study is expected to improve nursing performance with a standardized handoff in intensive care units, promote patient safety, and improve communication among the medical staff.

• 성인간호학회지
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• 제20권5호
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• pp.778-790
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• 2008

Purpose: This study was conducted to develop Web-based multimedia contents for supporting student nurses' clinical practice on critical care, and to evaluate learners' responses. Methods: Based on the steps of Assessment, Design, Development, Implementation, & Evaluation(ADDIE) model, a total of 13 self-directed learning modules including live lectures and real video clips were developed through faculty collaboration of nine nursing colleges in Gwangju and Chonnam province. The finally developed multimedia contents were published on the Web of the learning management system at a local e-learning center. Results: The Web contents were evaluated after self-learning by 81 junior college nursing students who were encouraged to study it at their own pace during their two-week clinical practice at a medical or surgical intensive care unit of a university hospital and two hospitals. The knowledge (t = -27.66, p < .001) and self-evaluated clinical performance level(t = 7.54, p < .001) were significantly increased after learning of the Web contents and clinical practice, and satisfaction level that measured post-test only was 4.0 out of 5 point. Conclusion: The use of Web contents for critical care need to be extended as a complimentary material in a class room lecture or clinical practice of students to increase their self-learning ability and understandings of clinical knowledge and situation.