• Title/Summary/Keyword: Nursing assessment

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Analysis of Church based parish nursing activities in Teagu city (목회간호사의 업무활동분석)

  • Kim, Chung-Nam;Park, Jeong-Sook;Kwon, Young-Sook
    • Research in Community and Public Health Nursing
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    • v.7 no.2
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    • pp.384-399
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    • 1996
  • The concept of parish nursing began in the late 1960s in the United States when increasing numbers of churches employed registered nurses (RNs) to provide holistic, preventive health care to the members of their congregations. Parish nursing role was developed in 1983 by Lutheran chaplain Granger Westberg, and provides care to a variety of church congregation of various denominations. The parish nurse functions as health educator, counselor, group facilitator, client advocate, and liaison to community resources. Since these activities are complementary to the population-focused practice of community health' CNSs, parish nurses either have a strong public health background or work directly with both baccalaureate-prepared public health nurses and CNSs. In a Midwest community in U.S.A., the Healthy People 2000(1991) objectives are being addressed in health ministries through a coalition between public health nurses and parish nurses. Parish nursing is in the beginning state in Korea and up untill now, there has been no research was conducted on concrete role of korean parish nurses. The main purpose of this study was to identify, classify and analyze activities of parish nurses. The other important objective of this study was to establish an effective approach and direction for parish nursing and provide a database for korean parish nursing model through analysis and' classification of the content of the nursing record which included nursing activities. This study was a descriptive survey research. The parish nurses were working in churches where the demonstration project developed on parish nursing. The study was done on all nursing records which were working in churches where the demonstration project developed on parish nursing. The study was done on all nursing records which were documented by parish nurses in three churches from March, 1995 to February, 1996. Namsan, Taegu Jeei and Nedang presbyterian churches in Taegu and Keimyung nursing college incooperated together for the parish nursing demonstration project. The data analysis procedure was as follows: First, a record analysis tool was developed and second, the data was collected, coded and analyzed, the classification for nursing activities was developed through a literature review, from which the basic analysis tool was produced and cotent validity review was also done. The classification of the activities of parish nurses showed 7 activitity categories. 7 activity categories consisted of visitation nursing, health check-ups, health education, referring, attending staff meetings, attending inservices and seminar, volunteers coordinating. The percentage of activities were as follows: Visitation nursing(A: 51.6%, B: 55%, C: 42.6%) Health check-ups(A: 13.5%, B: 12.1%, C: 22.3%) Health education(A: 13.5%, B: 13.2%, C: 18.2%) Referring(A: 1.4%, B: 4.2%, C: 2.4%) Attending staff meeting(A: 18.8%, B: 13.0%, C: 12.2%) Attending inservices and seminar(A: 1.5%, B: 2.2%, C: 2.1%) Volunteers coordinating(A: 0.3%, B: 0.4%, C: 0.0%) To establish and develope parish nursing delivery network in Korea, parish nurses role, activities and boundaries of practice should be continuously monitored and refined every 2 years. Also, It is needed to develope effective nursing recording system based on the need assessment research data of various congregation members. role, activities and boundaries of practice and arrangement of the working structure, continuing education, cooperation with community resources and structuring and organizing parish nursing delivery network. Also, It is needed to develope effective nursing recording system based on the need assessment research data of various congregation members.

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Identifying Usability Level and Factors Affecting Electronic Nursing Record Systems: A Multi-institutional Time-motion Approach (전자간호기록 시스템의 사용성 수준 및 관련 요인 분석: Time-motion 방법 적용을 통한 다기관 접근)

  • Cho, Insook;Choi, Won-Ja;Choi, WoanHeui;Hyun, Misuk;Park, Yeonok;Lee, Yoona;Cho, Euiyoung;Hwang, Okhee
    • Journal of Korean Academy of Nursing
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    • v.45 no.4
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    • pp.523-532
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    • 2015
  • Purpose: The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated. Methods: This mixed-method research was performed as a time-motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed. Results: The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p<.001, F=53.08 and p<.001, and F=29.13 and p<.001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics-educational background, practice period, and experience of using paper records-significantly affected the system usability and satisfaction scores. Conclusion: The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.

Nursing Activities and Outcomes Related to Indwelling Urinary Catheterization from a Review of Medical Records and Interviews (의무기록지 분석과 간호사 면담을 통한유치도뇨관 관리에 관한 간호활동 및 환자결과)

  • Jang, Keum-Seong;Chung, Kyung-Hee;Choi, Ja-Yun;Yang, Jin-Ju;Park, Soon-Joo;Ryu, Se-An;Kim, Nam-Young;Sim, Jae-Youn
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.4
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    • pp.438-448
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    • 2008
  • Purpose: The purpose of this study was to identify nursing activities and to analyze patient outcomes related to indwelling urinary catheterization. Method: A review was done of 628 medical records from five units for patients admitted between January 1 and June 30, 2006. Twelve nurses who worked in the same units were interviewed. Results: In the interviews, nurses reported considering several non-invasive interventions prior to catheterization but there were no medical records of this activity. Results from the in-depth interviews showed that infection control activities such as urinary bag management were conducted but again there were no medical records. Seventy-five percent of the catheters were removed without prescription. In the medical records there were no notes for approximately 15%, on the time of first voiding and 80%, on volume of first voiding after removal of catheter. There was a significant difference in hospitalization days between the group catheterized for 5 days or less and the group catheterized for 6 days or more. Conclusion: Results indicate a need to close the gap between recorded and described activities and between current and best evidence based practice. Further study is needed to develop a standard recording system and guidelines related indwelling catheterization to decrease the gaps identified in this research.

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Nursing outcomes of inpatient on level of nursing staffing in long term care hospitals (요양병원 간호인력 확보수준에 따른 입원환자의 간호결과)

  • Kim, Eun Hee;Lee, Eunjoo
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.3
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    • pp.715-727
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    • 2015
  • This study was conducted to explore the impact of nursing staffing on inpatient nursing outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals. Patients per RN was a significant indicator of foley catheter ratio in high risk group and low risk group. Patients per RN&NA was a significant indicator of decline in ADL for patients with dementia, non dementia, urinary incontinence and new pressure ulcer development in the high risk group. The average nursing outcome of inpatient in high grade was higher than that low grade in long care hospital. This higher level of nursing staffing and the higher the grade shown a positive effect on the nursing outcomes of the inpatient. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving nursing outcomes.

Job Competencies and Educational Needs Perceived by New Community Health Practitioners (신규 보건진료전담공무원이 인식한 직무역량과 교육요구)

  • Kim, Hyun Kyung;Eun, Young;June, Kyung Ja;So, Ae Young;Kim, Hee Gerl;Eom, Mi Ran;Song, Yeon Yi;Choi, Eun Suk;Park, Ji Yeon;Kim, Hyoung Suk
    • Research in Community and Public Health Nursing
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    • v.25 no.2
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    • pp.85-96
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    • 2014
  • Purpose: This study was performed to identify job competencies and needs for job education perceived by new community health practitioners. Methods: This study used a qualitative research design. Eight new community health practitioners participated in this study. Data were collected through in-depth interviews and analyzed using content analysis. Results: Five job competencies were identified in this study, including primary care, public health management, interpersonal relationship, teaching and counseling, and leadership. The contents of job education that they needed were management of major symptoms and chronic diseases, understanding and prescription of medications, emergency responses and care, management of endemic diseases, planning and management of public health programs, writing official documentsand computer works, and leadership training. The learning methods they preferred were connecting theory and practice, situation- or case-based learning, skill- or practice-based learning, and increased opportunities of clinical practice. Conclusion: The findings of this study provided the direction of job education for new community health practitioners. Job education for new community health practitioners needs to consider the job competencies and educational needs identified in this study.

Development of a Health Behavior Assessment Scale of Patients with Rheumatoid Arthritis (류마티스 관절염 환자의 건강 행위 사정 척도 개발)

  • Jo, Gye-Hwa;O, Won-Ok;Choe, Jeong-Yun
    • Journal of Korean Academy of Nursing
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    • v.30 no.5
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    • pp.1333-1346
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    • 2000
  • This study is a methodical research to develop a health behavior assessment scale for patients with rheumatoid arthritis, and to test the validity and reliability of the instrument. The research procedure was as follows; 1) The first step was to develop conceptual framework based on a comprehensive review of the literature, in-depth interviews patients with rheumatoid arthritis. This conceptual framework was organized in eight dimensions; pain management, exercise, rest, diet control, active committment, self-management, positive thinking, interpersonal maintenance. Initially 56 items were selected from 164 statement. 2) These items were reviewed by panel of eight specialists and the Index of Content validity (CVI) was calculated, and forty six items were selected which met more than 70% on the CVI. 3) 174 rheumatoid arthritis pateints were interviewed, and data was gathered from Jan. 25 to Feb. 18, 1999 for test reliabilities and validities of the scale. The item analysis was carried out and 40 items were selected. Factor analysis by varimax rotation was carried out to test construct validity. The internal consistency by chronbach's $\alpha$ was calculated. The findings were as follows; 1) Item analysis and factor analysis were carried out to test the validity of the health behavior assessment scale. The item analysis was based on the corrected item`s to total correlation coefficient (.30 or more), and information about the alpha estimate. However, this was only if this item was deleted from the scale. As a result of the item analysis, forty items were selected. Thirty items were selected by a initial factor analysis by varimax rotation, and ten items were deleted because of factor complexity. In the secondary factor analysis, eight factors were labled as 'positive thinking', 'exercise', 'rest', 'pain management', 'active committment', 'self-management', 'diet control', and 'interpersonal maintenance', each similar with the conceptual framework. 2) Chronbach's $\alpha$ coefficient to test reliability of the scale was. 903 for total the thirty items. The Scale for assessing health behavior developed in this study was identified to be a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for assessment in the health behaviors of the patients with rheumatoid arthritis.

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Development of Needs Assessment Instrument for the Patients with Cancer (암환자의 요구 조사 도구 개발)

  • Kim, Gi-Yon;Choi, Sang-Soon;Pak, So-Mi;Song, Hee-Young;Hur, Hea-Kung
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.136-145
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    • 2002
  • Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.

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Job Analysis of Korean Medicine Nurses Using the Developing a Curriculum(DACUM) Process (DACUM기법을 이용한 한방간호사의 직무분석)

  • Jeong, Younhee;Jang, Mi Heui;Yun, Eun Kyoung;Jeong, Eun Sook;Park, Jun Hee
    • Journal of East-West Nursing Research
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    • v.23 no.1
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    • pp.63-74
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    • 2017
  • Aims: This study aimed to analyze the tasks of Korean Medicine (KM) nurses. Methods: The definition and job description of KM nurses were developed through a "developing a curriculum" (DACUM) workshop. DACUM committee consisted of nine nurses from eleven Korean medicine hospitals, two DACUM facilitators and four DACUM coordinators. Twenty five nurses from nine Korean medicine hospitals validated job description established through the workshop. 235 KM nurses from 9 traditional Korean medicine hospitals participated in evaluating frequency, importance and difficulty of the duties and tasks. Questionnaires were sent to those nurses and 225 responses were included for final analysis due to missing data. The data were analyzed using descriptive statistics. Results: The jobs of a KM nurse were analyzed into 11 duties and 86 tasks on the DACUM chart. The 11 duties were KM nursing assessment, KM nursing intervention, fundamental nursing intervention, KM therapy management, support for KM therapy, KM nursing education, nursing administration, material management, environment management, professional development, and collaborative role between Korean medicine and Western medicine. Conclusion: We identified various roles of KM nurses and developed a DACUM chart based on their duties and tasks. Phased education programs for KM nurses should be developed by considering frequency, importance and difficulty. In addition, it is necessary to promote unique KM nursing interventions for expanding the roles of KM nurses in the future.

Financial Projection of the Nursing Fee Differentiation Policy Improvement Proposal in the National Health Insurance: Using a Break-even Analysis Model for the Optimal Nursing Fee (적정 간호인력 등급별 입원료 추정 모델을 이용한 간호관리료 차등제 정책개선 재정부담 추계)

  • Kim, Sungjae;Kim, Jinhyun
    • Journal of Korean Academy of Nursing Administration
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    • v.19 no.5
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    • pp.565-577
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    • 2013
  • Purpose: This study was done to propose an improvement in the Nursing Fee Differentiation Policy to alleviate polarization of nursing staffing level among hospitals and to rectify the confusion of legally mandated standards between the Korean Medical Law and National Health Insurance Act. Methods: The policy regulation was reconstructed related to nurse staffing standards and nurse-to-patients ratios. Data on nurse staffing grades were obtained from database of the Health Insurance Review & Assessment Service (HIRA) for the third quarter of 2010 for 44 tertiary hospitals, 274 general hospitals, and 1,262 hospitals. A break-even analysis was used to estimate financial burden of the revised policy improvement proposal. An industrial engineering method was used to calculate Nurse-to-Patients ratios per shift. Results: Twelve tertiary hospitals were downgraded. 74 general hospitals and 102 hospitals were upgraded after application of the regulation. Finances for total hospitalization expenditures changed from -3.55% to +3.14%. Conclusion: The results indicate that the proposed policy would decrease polarization between tertiary hospitals and small hospitals, and would not put a major strain on the finances of the Korean National Health Insurance. Therefore, it is suggested that government stake-holders and many interest groups consider this policy proposal and build a consensus.

Development of Oral Care Nursing Practice Guideline using the Guideline Adaptation Process (간호분야 실무지침의 수용개작 방법론에 따른 구강간호 실무지침의 개발)

  • Cho, Yong Ae;Eun, Young;Gu, Mee Ock;Kim, Kyung Sook;Kwak, Mi Kyong;Kim, Jeong Hye;Lee, Seon Heui;Park, Dong-Ah;Noh, Hwakyung
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.154-168
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    • 2015
  • Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.