Primary function of health record is that as tool of communication between the health processionals with the mutual goal, the promotion of health care standard. Studies have been carried out world over oil tile subject, among those, Weed's Problem-Oriented Health Record is considered a paramount achievement. This study was designed to assess tile possibility of implementing tile problem-oriented health record system through ail experiment in order to provide data for nurse administrators infiltrating reformation of recording system and format. Record of 29 patients admitted at Korea University Hospital, Seoul, from March through June, 1976 for 4 to 14 days were sampled. Nursing notes were recorded by research assistants; senior nursing student trailed extensively by the researcher oil Problem-Oriented Records, oil Problem Oriented Nursing Record format (experimental group) and analysis were carried out comparative, with that of traditional nursing records noted by other nursing personnel (control group) on the same patient. Attitude towards Problem Oriented Nursing Record system and format were attained through questionaries responded by the 51 research assistants. Results are as fellows: Comparative analysis revealed that: 1. Assessment of patients' health problems recorded significantly more in traditional records. 2. Focus of health Problem differed; traditional records slowed significantly higher frequency in medical and procedure as focus while problem oriented records on nursing focus problems. 3. Problem- Oriented records were better organized, Mean value scores of attitude towards Problem- Oriented Records revealed that: Positive value scores on all 4 categories: 1) Assessment of nursing needs, 2) Nursing care planning 3) Patient progress assessment and 4) Tool of teaching and learning revealed that the Problem-Oriented Nursing Record is positively accepted by tile respondents. Recommendation Further experiments on implementation of Problem- Oriented Health Record are recommended: experiment involving all health professionals, in larger scope and longitudinal.
Purpose: Ineffective communication between healthcare professionals leads to medical errors and puts patients at risk of harm. The aim of this study was to examine the effects of interdisciplinary communication training in simulated settings on self-confidence in communication, observed communication behavior, and technical skill performances of nursing students. Methods: A repeated measures design with one group was conducted. Data was collected from 92 nursing students through a self-administered questionnaire and an observed behavior checklist. Data analysis was performed using descriptive statistics, a paired t-test, the Wilcoxon signed rank test, the Friedmann test, a Repeated Measures ANOVA, and the Spearman correlation coefficient. Results: Self-confidence in communication, observed Identification-Situation-Background-Assessment-Recommendation-Read Back communication behavior, and technical skill performances of nursing students were significantly improved. In observed communication behavior, the performance of Assessment and Read Back communication significantly improved. However, communication of Background, Assessment, and Recommendation did not improve to a satisfactory level. Observed communication behavior was not correlated with the overall technical skill performance. Conclusion: These results indicate that interdisciplinary communication training in simulated settings was effective in improving nursing students' confidence and communication skills with physicians. Longitudinal studies with larger samples are recommended in order to verify the effects of interdisciplinary communication training on clinical outcomes as well as communication competence.
This study was Performed to understand Pediatric Pain management status and nurses' knowledge and attitudes toward it. In addition. it aimed to provide basic data in order to establish effective nursing intervention strategies by confirming the barriers of effective pain management in practice. The subjects were 195 nurses working in pediatric units(general pediatric unit. oncology unit, neonatal unit. neonatal ICU, Pediatric ICU) of 8 university hospitals and one general hospital. Data was collected by the questionnaire from the 3rd of August to the 20th of September in 1999. The instrument developed by Sanna(1999) to measure nurses' knowledge and their attitudes and the other tool by Cleeland(1984) to evaluate barriers in effective Pain management was used. Results of this study are summarized as follows 1. Most nurses learn about the pain management knowledges from through regular curriculum of nursing school(62.0%) And almost nurses(90.8%) don't used to utilize pain assessment tool, but the 'Faces Rating Scale' is the most frequently used by nurses. 2. The use of pain medication(65.6%) is most frequently taken by nurses as pain management and is followed by massage (55.9%) , distraction(27.7%). 3. Nurses' knowledge level is moderate (Mn=3.07). Nurses don't seem to understand pediatric Physical development (Mn = 2.86), psychological development(Mn=2.94) well, meanwhile they seem relatively Quite knowledgeable about the way pain emerges. 4. Nurses' attitudes toward pain is based on behavioral and physiological responses to Pain. They believe 'changes in behavior are a way of assessing pain in child' and 'acute pain increases the number of respiration' Nurses are ready to accept pediatric pain, but are not positive in adopting pain intervention in practice. 5. The barriers of effective pain management are inadequate assessment of pain and pain relief(81.5%), ineffective incorporation among health professionals(80%), and lack of equipment or skills(80.0%).
Purpose: This study aimed at the effectiveness to investigate the performance of evidence-based pain assessment and management guidelines. Methods: Participants were 140 nurses at the med-surgical units. Data were collected in early July, 2014 using Registered Nurses Association of Ontario (RNAO) guideline (2007) revised and validated by Hong and Lee (2012) and analyzed by descriptive statistics, t-test, ANOVA using SPSS/WIN18.0. Results: The score of performance of pain assessment guideline was higher than the score of pain management. Categories with high score were pain screening, parameter of pain assessment, documentation, assessment of opioids side-effects, and record of pain caused intervention. Categories with low score were comprehensive pain assessment, multidisciplinary communication, establishing a plan for pain management, consultation and education for patients and their families, and education for nurse. Non-pharmacological management was the lowest one. Conclusion: Assessing and managing pain is a complex phenomenon. It might be useful if institutions host training programs to ensure that nurse are better able to understand and implement pain assessment and management. Since non-pharmacological management is less likely to be used by nurses it may be helpful to include these methods in a training program.
Purpose: This study was performed to identify the pre-and post-transplant nutritional assessment for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Methods: The subjects of this study were 25 patients undergoing allogeneic HSCT. The data collection was performed from January 31st to March 31st, 2011. The Patient-Generated Subjective Global Assessment (PG-SGA), anthropometrics and biochemical test were collected from the time they entered the isolation unit until they left. Results: Pre-transplant nutritional assessment status indicated moderate malnutrition which scored $7.32{\pm}1.68$ in PG-SGA. There were 22 patients (88.0%) with moderate malnutrition and 3 patients (12.0%) with severe malnutrition. Post-transplant nutritional assessment indicated severe malnutrition status which scored $11.92{\pm}3.26$ in PG-SGA. Pre-and post-transplant nutritional assessment displayed significant differences (p<.001) in PG-SGA score. Hematopoietic stem cell transplantation led to a deterioration of patients' nutritional status. Pre-transplant patients were already in malnutrition status and patients undergoing allogeneic HSCT were at risk for malnutrition. Conclusion: Pre-and post-transplant patients were categorized as having undernutritional and malnutritional status. Pre-transplant nutrition status impacted on post-transplant nutritional status. Health care personnel should pay attention to patient's nutrition status when undergoing allogeneic HSCT with appropriate nutritional assessment tools.
Background: Nursing service is a nonroutine work with an excessive physical load and diverse tasks. This study derived representative common tasks based on the frequently occurring tasks with a high physical load in the nursing workers' daily work and developed indicators to evaluate the work risk by reflecting the characteristics of nonroutine work. Methods: Common tasks were classified through the following stages: literature review, first focus group interview (FGI) with experts, first classification of common tasks, second FGI with hospital health managers, a survey of nursing service workers, and the final classification of common tasks for each task type. To develop an objective risk index for physical load assessment, we investigated the frequency and duration of the derived common tasks via survey. Results: Nursing common tasks were categorized into six task types and 56 subtasks. To evaluate the risks of various tasks in nonroutine works, three frequencies and three working time levels were defined by examining the task frequency and working hours. Exposure time was defined to reflect the characteristics of a nonroutine job. The final risk assessment was the product of the exposure time level and job intensity level. From this, four risk action levels were derived. Conclusion: This study has the advantage of solving the problem of focusing on some tasks in evaluating the physical load. It was meaningful in that a new risk assessment index based on exposure time was proposed based on the development of an evaluation scale for frequency and time by reflecting the characteristics of nonroutine work.
Purpose: The aims of study were; (1) to evaluate the validity and sensitivity of a fall-risk assessment tool, and (2) to establish continuous quality improvement (CQI) methods to monitor the effective use of the risk assessment tool. Methods: A retrospective case-control cohort design was used. Analysis was conducted for 90 admissions as cases and 3,716 as controls during the 2006 and 2007 calendar years was conducted. Fallers were identified from the hospital’s Accident Reporting System, and non-fallers were selected by randomized selection. Accuracy estimates, sensitivity analysis and logistic regression were used. Results: At the lower cutoff score of one, sensitivity, specificity, and positive and negative predictive values were 82.2%, 19.3%, 0.03%, and 96.9%, respectively. The area under the ROC was 0.60 implying poor prediction. Logistic regression analysis showed that five out of nine constitutional items; age, history of falls, gait problems, and confusion were significantly associated with falls. Based on these results, we suggested a tailored falls CQI process with specific indexes. Conclusion: The fall-risk assessment tool was found to need considerable reviews for its validity and usage problems in practice. It is also necessary to develop protocols for use and identify strategies that reflect changes in patient conditions during hospital stay.
Purpose: The purpose of this study is to provide a comprehensive overview of the various measures available for assessment of oxaliplatin-induced peripheral neuropathy (OXLIPN) and to evaluate the measurement properties of each assessment tool. Methods: A systematic review was conducted to identify existing measures for OXLIPN found in the databases of PubMed, Cochrane Library, Embase, RISS and KoreaMed. The quality of the 24 identified tools was evaluated based on their properties of measurement including content validity, internal consistency, criterion validity, construct validity, reproducibility, responsiveness, floor-ceiling effects and interpretability. Results: Ten (41.7%) of the 24 tools were identified as specific measures for assessing OXLIPN and the most popular type of measures were clinical grading systems by clinicians (58.3%) and only 29.2% of measures were identified as patient reported outcomes. The most frequently used tool was National Cancer Institute-Common Toxicity Criteria (NCI-CTC), but the validity of NCI-CTC has not been reported appropriately. Overall, the Neuropathic Pain Symptom Inventory (NPSI) received the best psychometric scores, and the Chemotherapy-induced Peripheral Neuropathy Assessment Tool (CIPNAT) and Functional Assessment of Cancer Therapy/Gynaecologic Oncology Group-neurotoxicity-12 (FACT/GOG-Ntx-12) followed NPSI. Conclusion: To select appropriate measure, evidences should be accumulated through the clinical use of tools. Therefore, practitioner and researchers are urged to report relevant statistics required for the validation of the currently used measures for assessment of OXLIPN.
Purpose: This descriptive research was conducted to identify educational needs in pediatric nursing handoff training to improve students' handoff skills. Methods: Data were collected using a survey with 188 senior nursing students and 48 pediatric nursing professors and clinical nurses. The survey included items on general information as well as experiences in handoff training, necessity, training content, and items for a handoff training program in pediatric nursing. Results: Of the nursing students, 30.5% reported receiving handoff training during their clinical hours. After their handoff training, the students' confidence index was only 3.78 out of 10. Significantly, 98.3% of the respondents said that pediatric handoff training is necessary. In addition, participants reported that simulation practice (26.5%) is an appropriate educational method, and the time required for handoff training should be 8.16 hrs. Admission process was placed first as the most critical circumstance for handoff (56.8%). High demands were observed for the necessity of training content for patients with respiratory problems. Conclusion: The results of this study show the various educational needs for developing a patient safety pediatric handoff training program to promote nursing students' skills in handoff.
The author investigated pain experiences of 90 cancer patients and the adequacy of pain treatment they have received during their stay at a large medical center in T city between October 1994 and August 1995. Pain was assessed by the Shortened BPQ and results are summarized as follows: As for ratings of “worst pain” during the 24 hour period, 70% of the patients reported they had “severe” pain. As for ratings on “pain now,” 43% of the cancer patients reported “moderate to severe” pain. Over 46% of the patients reported a pain relief score of 0(not at all) or 1(somewhat) even after receiving pain medication. Adequacy of analgesic treatment was evaluated by comparing the patient's reported level of pain and the analgesic use, namely, the pain management index(PMI). The PMI indicated that 58% of the patients were undertreated for the pain control. In review of nurse's notes. systematic pain assessment was scarcely recorded, although pain documentation appeared in 70% of the notes; and the contents were mostly simple description. In conclusion, the results of patient's pain ratings, the PMI and poor pain documentation in the nurse's notes implied poor pain assessment and management.
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