• Title/Summary/Keyword: Nursing approach

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Analysis of Nursing Care Activities of Nursing Students in Clinical Experience (간호학생의 임상실습 간호활동시간 분석)

  • Lee Chung-Hee;Sung Young-Hee;Jung Yoen-Yi;Kim Jung-Suk
    • The Journal of Korean Academic Society of Nursing Education
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    • v.4 no.2
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    • pp.249-263
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    • 1998
  • The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

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An Approach of the Eastern-Western Nursing Sciences for the Management of Hypertensive Patients (고혈압환자관리를 위한 동서간호학적 접근)

  • Kim, Kwuy-Boon;Kim, Ce-Ran;Chae, Jeong-Sook
    • Journal of East-West Nursing Research
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    • v.3 no.1
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    • pp.27-38
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    • 1998
  • This study was carried out to understand the general conditions about management of hypertension and the differences in opinions between the Eastern-Western Nursing Sciences. In this context, this study was aimed to find out a possible integration of the Eastern-Western Nursing Sciences for the management of hypertension and to suggest a distinct frame of Korean nursing intervention method which is unique for the hypertensive patients by combining two hypertensive management systems originated from the Western type, "mainly classified by stage", and the Eastern type, "typically classified by form" as they are identified in the literature. From the research literature including both domestic and foreign, this study identified that exuberance of Yang of the Liver form mainly appeared to the patient who is at a border hypertension or the first stage of hypertension, Deficiency of Yin of the Liver and Kidneys form mostly appeared to the first stage and the second stage of Hypertension and Deficiency of the both of Yin and Yang form appeared to the third stage of Hypertension. These unifications of the types of Hypertension classified by stages and forms suggest the possibility not only of integration of the Eastern-western Medicine but also of establishment for the intervention of specific nursing management which is the united Eastern-western Nursing Science for the Hypertension. Hence, the new frame for the nursing management of Hypertensive patient is suggested as follows : 1) In case of the exuberance of Yang of the Liver form, as classified by form which is categorized to the border Hypertension or the first stage of Hypertension, nursing intervention should include general therapy, cooking meal and neutral care to restrain the condition of the exuberance of Yang of the liver. 2) In case of the deficiency of Yin of the liver and the Kidneys form, as classified by form which is categorized to the second stage of Hypertension, nursing intervention should include both the general and drug therapy and their use in combination with cooking meal and neural care to restrain the condition of the deficiency of Yin of the Li ver and Kidneys. 3) In case of the deficiency of both of Yin and Yang form, as classified by form which is categorized to he third stage of Hypertension should include both the general therapy and drug therapy and their use in combination with cooking meal and neural care to restrain the condition of deficiency of the both of Yin and Yang. In addition, using this basic frame of Hypertensive management, a specific way of nursing intervention, which is suitable for exuberance of Yang of the Liver form, deficiency of Yin of the Liver and Kidneys form, and deficiency of both of the Yin and Yang form and classified by Korean herbal medicine related to hypertension, should be pursued continuously in the future.

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Parish Nursing : A New Challenge for Primary Health Care (지역교회간호(Parish Nursing) - 일차건강간호를 위한 새로운 도약)

  • No, Yu-Ja;Baek, Yeong-Mi
    • The Korean Nurse
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    • v.37 no.2
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    • pp.53-62
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    • 1998
  • ursing as a profession is characterized by its holistic, mind-body-spirit approach to the patient. Also, nurses have historically been the leaders in health education and promotion. Parish nursing has a great potential for providing primary preventive health care. services as well as assisting people to access the health care system. While working in the community, parish nurses see the church as the new arena for delivering health care services. The parish nurse program was introduced by Granger Westberg in 1984. The concept of parish nursing is based on several beliefs; health is multidimensional and affects all aspects of an individual-physical, psychological, social, and spiritaul being. Parish nursing is one model in which churches can cooperatively work with health care institutions to address the needs of their parishioners. The role of the parish nurse is emphasized in four basic area: a) health education, b) health counseling, c) referal services, and d) facilitation and organization of support groups within the congregation. The parish nurse programs work chiefly in congregation or commuity where a certain language of faith is ready at hand. This means that the parish nurse works in an ecology of meanings and care which encourages the drawing on the message of God's grace, the practices and habits it encourages. The parish nurse may be involved in the church's health ministries and may work on either paid or volunteer basis; however, one of the most important qualification of the parish nurse is to have the nursing knowledge and skills to practice within the standards of Nursing Practice Act. The completion of standards of practice for professional nurses practicing as parish nurses had been identified as a priority by the HMA Executive Board (1996, HMA). In conclusion, parish nursing promotes health and healing by empowering the faith community, family, or individual to incorporate health and healing practices. There are several preconditions that should proceed to establish the foundation for successful development of the parish nursing program in Korea. First, reciprocal relationship with home health nursing should be considered. Second, correct terms and concepts of parish nursing should be studied and understood. Third, systematic study and investigation should be followed for further development of parish nursing. Fourth, strengths and weaknesses of different models should be studied to develop proper model of parish nursing for Korean situation. Finally, consensus of standardized education program and corporation with various religious communities as well as health institutions should be established. When these preconditions are met, the role of parish nursing as a new program for the promotion of holistic health will be established.

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Model for Unplanned Self Extubation of ICU Patients Using System Dynamics Approach (시스템다이내믹스를 활용한 중환자실 환자의 비계획적 자가 발관 모델)

  • Song, Yu Gil;Yun, Eun Kyoung
    • Journal of Korean Academy of Nursing
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    • v.45 no.2
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    • pp.280-292
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    • 2015
  • Purpose: In this study a system dynamics methodology was used to identify correlation and nonlinear feedback structure among factors affecting unplanned extubation (UE) of ICU patients and to construct and verify a simulation model. Methods: Factors affecting UE were identified through a theoretical background established by reviewing literature and preceding studies and referencing various statistical data. Related variables were decided through verification of content validity by an expert group. A causal loop diagram (CLD) was made based on the variables. Stock & Flow modeling using Vensim PLE Plus Version 6.0b was performed to establish a model for UE. Results: Based on the literature review and expert verification, 18 variables associated with UE were identified and CLD was prepared. From the prepared CLD, a model was developed by converting to the Stock & Flow Diagram. Results of the simulation showed that patient stress, patient in an agitated state, restraint application, patient movability, and individual intensive nursing were variables giving the greatest effect to UE probability. To verify agreement of the UE model with real situations, simulation with 5 cases was performed. Equation check and sensitivity analysis on TIME STEP were executed to validate model integrity. Conclusion: Results show that identification of a proper model enables prediction of UE probability. This prediction allows for adjustment of related factors, and provides basic data do develop nursing interventions to decrease UE.

Determining Nursing Student Knowledge, Behavior and Beliefs for Breast Cancer and Breast Self-examination Receiving Courses with Two Different Approaches

  • Karadag, Mevlude;Iseri, Ozge;Etikan, Ilker
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.3885-3890
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    • 2014
  • Background: This study aimed to determine nursing student knowledge, behavior and beliefs for breast cancer and breast self-examination receiving courses with a traditional lecturing method (TLM) and the Six Thinking Hats method (STHM). Materials and Methods: The population of the study included a total of 69 second year nursing students, 34 of whom received courses with traditional lecturing and 35 of whom received training with the STHM, an active learning approach. The data of the study were collected pre-training and 15 days and 3 months post-training. The data collection tools were a questionnaire form questioning socio-demographic features, and breast cancer and breast self-examination (BSE) knowledge and the Champion's Health Belief Model Scale. The tests used in data analysis were chi-square, independent samples t-test and paired t-test. Results: The mean knowledge score following traditional lecturing method increased from $9.32{\pm}1.82$ to $14.41{\pm}1.94$ (P<0.001) and it increased from $9.20{\pm}2.33$ to $14.73{\pm}2.91$ after training with the Six Thinking Hats Method (P<0.001). It was determined that there was a significant increase in pre and post-training perceptions of perceived confidence in both groups. There was a statistically significant difference between pre-training, and 15 days and 3 months post-training frequency of BSE in the students trained according to STHM (p<0.05). On the other hand, there was a statistically significant difference between pre-training and 3 months post-training frequency of BSE in the students trained according to TLM. Conclusions: In both training groups, the knowledge of breast cancer and BSE, and the perception of confidence increased similarly. In order to raise nursing student awareness in breast cancer, either of the traditional lecturing method or the Six Thinking Hats Method can be chosen according to the suitability of the teaching material and resources.

Demand-supply of Advanced Practice Nurse (APN) and Alternative Benefit Strategies in the National Health Insurance (전문간호사의 수급 현황과 건강보험 급여화 방안)

  • Kim, Jin-Hyun
    • Perspectives in Nursing Science
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    • v.7 no.1
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    • pp.23-35
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    • 2010
  • Purpose: The purpose of this paper is to analyze the demand and supply of advanced practice nurses and suggest alternative benefit strategies in the Korean national health insurance. Methods: A revised demand & supply model was used to estimate the excess supply of APNs, and policy making process and key actors in the Korean health insurance were considered to develop a political approach to the APN issue. Results: The social demand for APNs is currently estimated to be less than 50% of its supply and the APN education program fell into difficulties in recruits. No reimbursement mechanism for APN's services in the national health insurance has given no economic incentive to hospital managers who have monopsony power in nursing labor market, which has caused the demand shortage of APNs in hospital industry. Payment for APN's services recognized as one of the most significant strategies to booster the social demand for APN's services should be carefully designed and implemented in the national health insurance. In line with this, key actors in health insurance policy decision-making include government, national assembly, labor unions, NGOs, civic groups, medical associations, and academia. Conclusion: The basic researches for APN's activities and cost-effectiveness analysis in clinical settings are required to support the strategies aforementioned. Constructing a policy network among key actors is able to make the payment strategy feasible, which will increase the socal demand for APNs.

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A Study on the Nutritional Status, Symptoms, and Information Needs in Stroke Patients with Dysphagia (연하장애가 있는 뇌졸중 환자의 영양상태, 자각증상 및 정보요구도)

  • Kim, Na-Hyun;Kwon, Young-Sook;Kim, Myung-Ae;Lee, Keung-Hee;Kwak, Hye-Weon
    • Journal of Korean Biological Nursing Science
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    • v.13 no.1
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    • pp.72-80
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    • 2011
  • Purpose: The purposes of this study were to reveal the nutritional status and symptoms related to dysphagia and to identify the information needs of the patient with post-stroke dysphagia for self care. Methods: Fifty one subjects were selected among patients being admitted from 3 tertiary hospitals. Data were collected using questionnaires, interview, and medical record. Data analysis was done using descriptive statistics with SPSS. Results: 1) The mean hemoglobin, serum albumin, and hematocrit level of the subjects were $11.2{\pm}1.8g/dL$, $3.2{\pm}0.6g/dL$, and $33.5{\pm}2.3%$, respectively. 2) The most common symptom due to dysphagia was 'slurred speech (86.3%)', followed by 'less flexible in tongue and mouth movement (80.4%)', 'difficulty chewing and swallowing (74.5%)'. 3) The highest score of information needs for patients/caregivers was to know which foods are suitable for dysphagic patients or not ($2.67{\pm}0.48$ of 3.0 score). They also want to know how to swallow safely ($2.65{\pm}0.59$), to administer medication safely ($2.63{\pm}0.59$), and to learn rehabilitative techniques ($2.61{\pm}0.57$). Conclusion: These findings would be useful information for staffs to do multidisciplinary approach and they would be necessary for stroke patients to manage their symptoms.

Nursing approach to energy (Qi) flow (에너지 흐름(기(氣))의 간호학적 접근)

  • Kim, Myung-Ja;Lee, Myung-Suk
    • Journal of East-West Nursing Research
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    • v.3 no.1
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    • pp.7-16
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    • 1998
  • This paper reviewed the concept of the energy flow in east and west. The differences in the views of the energy flow between oriental and western thought were compaired according to the ontological point of view. Human body take up energy and material on open system which maintains homeostasis. Human and environment are continuously interacting in a state of co-existence. Human has energy field called "aura" and seven chakra in energy outflow moving came as meridian. Qi is an invisible cosmic energy helping the fundamental human activity and changes. The basic action of Qi is helping the human growth and development, maintain the body temperature and preventing the intrusion of microorganism. In the normal healthy organism, all are maintained in balance and in a continuous circulation of Qi, while illness is the result of the disturbed Qi flow in the aspect of Qi-theory. Although there are differences between oriental and western medicine in approaches to clients, the basic point of view and philosophy have many similarities on fundamental level. An understanding of the basic thought of energy flow and oriental concept of energy flow implies a more comprehensive meaning than the perspective of unitary transformation discussed in modern western thought of energy flow. Now we should avoid narrow view of energy concept and regard energy flow as an integrated concept with Korean culture. Regarding Qi-theory which provides a comprehensive and humanistic and ethical foundation for nursing philisophy through this overview, it is hoped that a contribution will be made to the development of nursing intervention which is suitable to Korean context.

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Existential Philosophic at Approach to Nursing Science (간호학의 실존철학적 접근-서양의 실존주의와 동양의 불교사상을 중심으로-)

  • 최연자
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.759-767
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    • 1996
  • This study was done to provide an understanding of nursing in relation to the existential philosophy of the West and Buddhistic philosophy, It examined how human beings and death are interpreted and understood in existential philosophy as well as in Buddhistic philosophy. Then the study suggested that nursing should focus on helping the sufferer to find meaning and a sense of responsibility in his or her existence. When people have the opportunity to realize certain important but painful truths about their existence, they develop internal strength and control of their lives. Just as people learn to face their being, so can they come to terms with their non-being. According to the causal process in Buddhism, Human Being is not always annihilation of self. Therefore, birth, aging, disease and death go through the process of natural change and it is the appearance of human existence which is inherent in the health of every human being. To promote our health we must gain an insight about this phenomenon. This study viewed nurses' clients as 〈good friend〉 rather than 〈patient〉 which focuses on a disease-oriented concept. The concept of 〈good friend〉 views nurses' clients as active participants to create their life and as responsible persons in a constantly changing life. The study also examined the concept of recovery which means to come back to the previous healthy state and it suggested that the concept of recovery should be changed to 〈good change〉, because in existential philosophy, human beings are viewed as never going back to the past but moving on to the future by creating their existence. This study also suggested that nursing should help 〈good friend〉enlighten their existence to be free from pain and death and to get control over their existence.

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The observation experience of nursing students toward delivery (간호학생의 분만관찰 경험 : Q 방법론을 중심으로)

  • Lee, Kyung-Sook;Oh, Jin-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.3
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    • pp.1278-1288
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    • 2011
  • The purpose of this study was to classify subjective structure of observation experience toward delivery on nursing students. A Q-methodological approach that gives information about the way of analyzing the subjectivity of each item was used. Q population was performed for analyzing through interview and literature review. From this, ultimately, a final Q sample of 35 statements was obtained. The P sample sorted the Q sample for observation experience toward delivery. The collected data was analyzing using PC QUANL program, which revealed three distinctive types of delivery experience about nursing students. Type 1 is a sympathy towards delivery woman, type 2 is a requirement of care. And type 3 is a future of analogical inference of delivery type. In conclusion, it is needed not only to give high quality of nursing service but also to have a right job value based on proper understanding of patient. Also, it is recommended about education of nursing students for making right view of value based on the three types of delivery experience.