• Title/Summary/Keyword: Nursing Hours

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The Effect of Intracuff Pressure Adjustment on Postoperative Sore Throat and Hoarseness after Nitrous Oxide and Air Anesthesia (아산화질소(N2O)와 공기(Air)를 사용한 마취 수술의 기낭압 조정이 수술 후 인후통과 쉰목소리에 미치는 영향)

  • Gu, An Na;Yu, Mi
    • Journal of Korean Academy of Nursing
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    • v.49 no.2
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    • pp.215-224
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    • 2019
  • Purpose: To investigate the differences in postoperative sore throat and hoarseness by adjustment of endotracheal tube cuff pressure (CP) during nitrous oxide ($N_2O$) and air anesthesia. Methods: A one-equivalent control group pretest-posttest design was used. Data were collected from August 8 to October 19, 2017 and analyzed using the independent t-test and repeated measures ANOVA. Eighty-four participants were enrolled and divided into three groups: 28 in the Control Group (CP adjusted every 30 minutes using $N_2O$), 28 in Experimental Group 1 (CP adjusted every 10 minutes using $N_2O$), and 28 in Experimental Group 2 (non-adjusted CP using air), all of whom underwent urologic, gynecologic, and orthopedic surgeries at the G University hospital. Sore throat was assessed using a numeric rating scale; hoarseness was evaluate using the Stout classification at 1, 6, and 24 hours after surgery. Results: Scores for sore throat and hoarseness were significantly different between the groups at each measurement time, and scores were consistently higher in the control group. During subsequent measurements, sore throat and hoarseness scores were significantly lower at 6 hours. Cuff pressure changed significantly using air anesthesia (${\chi}^2=10.41$, p=.015) up to 2 hours after induction. Severe sore throat and hoarseness was observed for up to 6 hours after surgery. Conclusion: Cuff pressure adjustment at short time intervals would be helpful in reducing postoperative sore throat and hoarseness. Nursing intervention focused on prevention of sore throat and hoarseness should be required up to 6 hours postoperatively in patients undergoing endotracheal intubation.

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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Optimal Time Interval for Position Change for ICU Patients using Foam Mattress Against Pressure Ulcer Risk (폼매트리스 사용 중환자의 욕창발생위험군별 적정 체위변경시간)

  • Kim, Hyean Jeong;Jeong, Ihn Sook
    • Journal of Korean Academy of Nursing
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    • v.42 no.5
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    • pp.730-737
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    • 2012
  • Purpose: This study was done to identify the time interval to pressure ulcer and to determine the optimal time interval for position change depending on pressure ulcer risk in patients using foam mattress in intensive care units. Methods: The Braden scale score, occurrence of pressure ulcers and position change intervals were assessed with 56 patients admitted to an intensive care unit from April to November, 2011. The time to pressure ulcer occurrence by Braden scale risk group was analyzed with Kaplan-Meier survival analysis and log rank test. Then, the optimal time interval for position change was calculated with ROC curve. Results: The median time to pressure ulcer occurrence was 5 hours at mild or moderate risk, 3.5 hours at high risk and 3 hours at very high risk on the Braden scale. The optimal time interval for position change was 3 hours at mild and moderate risk, 2 hours at high and very high risk of Braden scale. Conclusion: When foam mattresses are used a slight extension of the time interval for position change can be considered for the patients with mild or moderate pressure ulcer risk but not for patients with high or very high pressure ulcer risk by Braden scale.

The Effects of Extended Family Visiting Hours in the Intensive Care Unit (중환자실 가족면회 시간 연장의 효과)

  • Lee, Young-Ock;Kang, Ji-Yeon
    • Journal of Korean Critical Care Nursing
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    • v.4 no.1
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    • pp.51-63
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    • 2011
  • Purpose: This study aimed to examine the effects of extended family visiting hours in the intensive care unit (ICU). Methods: The subjects were 168 ICU patients and their family members. Two 30-minute visits a day were allowed to the control group according to current policy, while four 30-minute visits a day were allowed to the experimental group. Patients' state anxiety was measured at the first day of ICU admission, and on the third day of ICU admission patients' anxiety and family satisfaction were measured. For the infection rate, comparison was made between the experimental and control data-collecting periods. Results: The patients' state anxiety significantly decreased in the experimental group. Family satisfaction of experimental group was significantly higher than that of control group. There was no significant difference in the infection rate. Nurses positively evaluated extension of visiting hours because it could stabilize patients, reduce the number of arrangements for additional visits, and help establish trust relationship with families. Conclusion: Extended family visiting hours in the ICU reduced patients' anxiety and improved family satisfaction but had no effect on the infection rate. Extended family visiting hours in the ICU is expected to improve the quality of critical care.

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The Effects of Shift Work and Hours of Sleep on Metabolic Syndrome in Korean Workers (교대근무와 수면시간이 우리나라 임금근로자의 대사증후군에 미치는 영향)

  • Park, Hyunju
    • Korean Journal of Occupational Health Nursing
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    • v.25 no.2
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    • pp.96-107
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    • 2016
  • Purpose: The purpose of this study was to investigate the effects of shift work and hours of sleep on metabolic syndrome in Korean workers. Methods: This study used the Korean National Health and Nutrition Examination Survey data of 2014. The study included 1,579 Korean workers aged over 20. $x^2$ test, t-test, and hierarchical multiple logistic regression were used for statistical analysis of data. Results: From the univariate analysis, hours of sleep, regular work, occupational group, sex, age, marital status, education, smoking, and self-rated health were significantly related to metabolic syndrome. After adjusting demographic, occupational, and health-related variables, workers with under 6 hours/day of sleep showed higher risk for metabolic syndrome (AOR: 1.56, 95% CI: 1.01~2.44), and shift work was not significantly related to metabolic syndrome. Male laborers and workers aged 40 or older also showed higher risk for metabolic syndrome. Conclusion: Results of this study suggest that workers with under 6 hours of sleep, male laborers and workers aged 40 or older are the risk groups of metabolic syndrome. Therefore, prevention and management program for metabolic syndrome should be implemented for this population.

The Relationship between Emotional Working Hour and Muscle Pain (감정노동 수행시간과 근육통의 관련성)

  • Lee, Bokim
    • Korean Journal of Occupational Health Nursing
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    • v.23 no.4
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    • pp.269-276
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    • 2014
  • Purpose: The purpose of this study was to investigate muscle pains of emotional laborers and determine whether there were differences in their muscle pains depending on the hours spent on emotional labor. Methods: This is a secondary analysis of the data collected from the 3rd (2011) Korean Working Conditions Survey. 50,032 participants responded to the study's questionnaire. Among them, 15,669 participants were emotional laborers who directly dealt with people such as customers, passengers, pupils, patients, etc. Results: Thirty three percent of subjects had reported muscle pains. Muscle pains of subjects were positively related to the hours spent on emotional labor (p<.001). According to the logistic regression analysis, the adjusted odd ratio of the subjects who spent about almost all of the work hours on emotional labor was 1.32 (95% CI: 1.15~1.52), compared to the subjects who spent about a quarter of their work hours on emotional labor, when other factors were controlled. Conclusion: The study's findings indicate that engaging in emotional labor for longer hours increases the risks of muscle pains. Occupational nurses must pay closer attention to the management of muscle pains of emotional laborers.

Estimation of nursing cost for selected special nursing services;operative nursing, emergency nursing, and ambulatory nursing (임상특수분야 간호원가 산정;응급실, 수술실, 외래를 중심으로)

  • Park, Jung-Ho;Sung, Young-Hee;Kim, Eul-Soon;Park, Kwang-Ok;Park, Jung-Sook;Sung, Il-Soon;Song, Mi-Sook;Cho, Moon-Soo
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.2
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    • pp.309-321
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    • 2002
  • Purpose: A cost analysis for nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing unit was performed using patient classification system by nursing intensity in order to determine an appropriate nursing fee schedule. Method: The data were collected from 4 secondary hospitals and 5 tertiary hospitals from November 14th 2000 to January 15th 2001. The study was conducted through four phases as follows: 1) Nursing hours of each nursing service in special nursing units were measured using three kinds of patient classification systems by nursing intensity. 2) The nursing cost of nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing units was estimated based on patient classification system by nursing intensity. Results: As a result, nursing hours by nursing intensity of each special nursing unit were measured, and every nursing cost by nursing intensity in operation room and emergency room was estimated, meanwhile, the cost of nursing services in ambulatory care units was estimated only per visit as shown in chapter 4. Conclusion: Future research on nursing cost should be extended to other special nursing units such as various intensive nursing care units, delivery room, and so on. In addition, the patient classification system should be refined for its appropriateness to apply all levels of medical institutions.

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Search of hemodialysis nursing behaviors and Estimation of hemodialysis nursing costs at a tertiary hospital (일개 3차 의료기관의 혈액투석 간호행위규명 및 간호원가 산정)

  • Sim, Won-Hee;Park, Jung-Ho
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.297-316
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    • 1999
  • The purpose of this study is searching for hemodialysis nursing bahaviors by hemodialysis room nurses and analyzing them. Then, it estimates hemodialysis nursing costs and obtains basic data for development of proper nursing costs. First, it searched for hemodialysis nursing behaviors at a tertiary hospital hemodialysis room in Seoul and classified them. After the content validity was verified by 6 experts, Tool of hemodialysis nursing behaviors was developed. patients who recived hemodialysis were classified by dialysis patient classification tool. The searcher observed hemodialysis nursing behaviors applied to classified patients per 5 minutes. Then hemodialysis nursing hours spent to classified patients were calculated respectively. The direct expenditures and indirect expenditures were estimated. Ultimately, hemodialysis nursing costs were estimated. The results of the study were as follows ; 1. hemodialysis nursing behaviors were grouped by the same knowledge and skills. then, the content validity of them was verified by evaluation tool of nursing intervention classification by expert groups. They consisted of 9 hemodialysis activity domains and 71 hemodialysis nursing behaviors. The predialysis activity domain included 15 nursing behaviors, the activity domain of start-dialysis included 12 nursing behaviors, the activity domain of during- dialysis included 9 nursing behaviors, the activity domain of finish-dialysis included 5 nursing behaviors, the activity domain of after-dialysis included 5 nursing behaviors, the nursing documentation & undertaking and transfering included 5 nursing behaviors, the supply, drug, equipment & environment management activity domain included 7 nursing behaviors, the patient emotional support & education activity domain included 4 nursing behaviors, the emergency activity domain included 9 nursing behaviors. 2. The acute hemodialysis nursing hours were 106.42 minutes per a dialysis and the chroni hemodialysis nursing hours were 72.23 minutes per a dialysis. 3. The direct expenditure was 11.971 won per hour and indirect expenditure was 288won. 4. Finally, the cost of acute hemodialysis was 21,745 won and that of chronic hemodialysis was 14,759 won. By search of hemodialysis nursing behaviors, they will be used as hemodialysis nursing care standard and will be tended toward high qualitative care. Estimation of hemodialysis nursing costs will be used as fundamental data for development of proper nursing costs.

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The Effect of Position Change on Discomfort and Bleeding after Liver Biopsy (체위변경이 간 조직검사 환자의 불편감과 출혈에 미치는 효과)

  • Yun, Mi-Jeong;Min, Hye Sook
    • Korean Journal of Adult Nursing
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    • v.27 no.2
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    • pp.233-241
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    • 2015
  • Purpose: This study examined the effects of e position change upon reported discomfort and bleeding complications during bed rest following a liver biopsy. Methods: The research design for this study was a non-equivalent control group quasi-experimental design. Twenty-nine participants were assigned to the treatment group and twenty seven participants were in the comparison group. Following the biopsy, the treatment group participants had a position change from the supine without compression for two hours followed by compressive right lateral position for two hours. The comparison group maintained continuously the compressive right lateral position with sandbag for four hours. Results: There were statistically significant differences in reported discomfort between the treatment and comparison groups following the intervention. No significant differences were found in bleeding complications between the two groups. Conclusion: The results of the study suggest that the positional change is an effective nursing intervention in reducing discomfort without risk of bleeding following a liver biopsy.

Effect of Positioning on Back Pain and Comfort of Bed Rest Patients after Transhepatic Arterial Chemoembolization (체위변경이 간동맥 화학색전술 후 침상안정기 환자의 요통과 안위에 미치는 효과)

  • Park Han-Jong;Sohng Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.12 no.3
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    • pp.317-324
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    • 2005
  • Purpose: The study was done to investigate whether positioning relieves the back pain and enhances comfort during bed rest after transhepatic arterial chemoembolization(TACE). Methods: A quasi-experimental design with non-equivalent control group non-synchronized design was used. The experimental group was placed semi Fowler's position for the first 2 hours. The following 4 hours the position was rotated hourly between 30 degrees laterally inclined position and a semi Fowler's position. The control group was maintained in a supine position for the 6 hours. Data were analyzed using t-test, $x^2$-test, Fisher's exact test and repeated measures ANOVA. Results: 1) Back pain intensity significantly decreased in the experimental group compared to the control group. 2) Comfort level significantly decreased in both groups, but there was no significant difference between the two groups. 3) There were no hematoma and bleeding complication in either group. In addition, there was no significant difference in urinary retention between the two groups. 4) Analgesics were less frequently taken by the experimental group. Conclusion: These results suggest that positioning relieves back pain without causing an increased incidence of hematoma and bleeding formation after TACE and this nursing intervention might help patients be more comfortable during the treatment of TACE.

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