• Quality Improvement in Health Care
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• v.7 no.2
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• pp.156-167
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• 2000

Background: Emphasis in healthcare during the 1990s has been to provide both optimal wellness and function with quality in a Cost-effective manner. Critical pathway was developed to meet the need to guide clients along the continunm of care and to achieve continuity of care. The purpose of this study is to review and analyze articles related to the critical pathway that had developed and applied in Korea and abroad from 1995 to 1999. Methods: Total 39 studies were analyzed in terms of group of application, need of development, horizontal axis: time frame, vertical axis : items of care, task force team, identification of preliminary critical pathway, validation of preliminary critical pathway, types of final critical pathway, a person who coordinates and effects on critical pathway. Results: In the aspect of group of application, there were various diseases in the overseas than in Korea. In domestic and overseas, the horizontal axis included mainly the time from the start of hospitalization to discharge and vertical axis of the critical pathway included commonly the following nine items : tests, diet, medications, consultations, activity, assessments, treatments, education, discharge planning. Preliminary critical pathway was mainly drawn up through chart review in both. Types of final critical pathway were mostly for medical team use in Korea and were for medical team and patient use in abroad. A person who coordinates critical pathway was mostly nurse in abroad. There was positive effects on critical pathway in both. Conclusion: Staff education and information about critical pathway are needed to use it effectively.

• Child Health Nursing Research
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• v.25 no.2
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• pp.103-111
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• 2019

Purpose: This study aimed to investigate incidence of delirium in the pediatric intensive care unit (PICU) and to analyze associated risk factors. Methods: The participants were 95 patients, newborn to 18 years, who were admitted to the PICU. The instruments used were the Richmond Agitation Sedation Scale (RASS), and the Cornell Assessment of Pediatric Delirium. Data analysis was performed using the descriptive, $x^2$ test, t-test, and logistic regression analyses. Results: The incidence of delirium in children admitted to the PICU was 42.1%. There were significant differences according to age ($x^2=14.10$, p=.007), admission type ($x^2=7.40$, p=.007), use of physical restraints ($x^2=26.11$, p<.001), RASS score ($x^2=14.80$, p=.001), need for oxygen ($x^2=5.31$, p=.021), use of a mechanical device ($x^2=9.97$, p=.041), feeding ($x^2=7.85$, p=.005), and the presence of familiar objects ($x^2=29.21$, p<.001). Factors associated with the diagnosis of delirium were the use of physical restraint (odds ratio [OR]=13.82, 95% confidence interval [CI]=4.16~45.95, p<.001) and the presence of familiar objects (OR=0.09, 95% CI=0.03~0.30, p=.002). Conclusion: Periodic delirium assessments and intervention should be actively performed. The use of restraints should be minimized if possible. The caregiver should surround the child with familiar objects and ensure a friendly hospital environment that is appropriate for the child.

• Research in Community and Public Health Nursing
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• v.7 no.2
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• pp.183-202
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• 1996

This study was designed out to develop a home health care service for nurses working in community care services. This study investigates actual conditions at welfare institutions related to health needs the demands of clients, and the state of home health care services we hope that this study will improve upon the current service system. In Korea home health care services are still developing and only new becoming a part of the health care supply system. The data was collected by recording the client home nursing assessments modified to the situation of UTMB home health agency. In this study 107 clients were selected for home care who needed care for physical and mental deficits. The study lasted from March to November of 1995 at one of the welfare service institutions in Chunchon city. The results show that those who most frequently needed care services were over 50 years old with a health deficit of 80.3%, followed by sex as women who needed care at 59.8%. 50.5% of the clients had very little education. 99.1% of the clients live with their family, and a medical diagnostic analysis reveals that 73.9% of the 5 year period of illnesses were the following : 38.8% - muscular -skeleton system disorder, 24.4% - hypertension and stroke, 25.7% sole disease of arthritis. For behavioral conditions 43.3% of the patients were without care services, 56.6% of the patients were taking treatment that 73.5% of those were taking medication. The most main complaint of patients were 22.4% of pain in the extremities, next were 16.8% of a limitation of body activities, 15.0% was lumbo-sacralgia. According to the investigator who was a senior student nurse, the following suggestions were made: 32.7% for curative medical services, 29.9% for physical exercise, 19.6% for emotional support. Consultation nursing services consisted of 67.2% for physical therapy, 11.2% for the maintaining healing, 9.4% for counseling. The patients at home, required assistance most frequently for muscular-skeleton problems under the category of physical systems (33.3%). But, on the other hand, 49.5% of the patients required care givers at home, 28.2% had a knowledge deficit, 21.0% had malnutrition, 18.4% had bad impaired communication. The character of health problems were devided into chronic disease(67.0%), accidents(I3.1%), and general disease(15.9%). 86% of the disabled client had an impairment of the physical system. Eating (86.9%) , Toileting(77.6%), and personal care showed much the same of ADL condition, the level and range of achievement of mobility, the most frequently self performed was 81.3% only in a room size area, and 40.2% were completely dependent when going out. Although there were a large number of home care services in th community at these welfare institutions, many clients needed a variety of curative services. As policy changes have gathered momentum, responsibility for the development of a more suitable program was demanded by the clients from the community.

• Health Communication
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• v.12 no.1
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• pp.97-110
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• 2017

Purpose: This study is an overview of the experiences of nurses who have participated in a communication education program which was designed to develop proper change-of-shift dialogues. The goal of this program was to improve the communication competencies of outgoing and incoming nurses during handover and takeover of their shifts. Methods: The materials used in this study to analyze the experiences qualitatively were transcripts from narrative interviews with seven nurse participants. The education program consisted of two rounds of change-of-shift simulations by pairs of nurses, planning of a forthcoming change-of-shift, three lectures on ideal dialogue patterns, and time for video feedback. Afterwards the participants' experiences of the program were evaluated generally, highlighting the positive and the negative aspects, and how this educational experiences might affect their future change-of-shift activities. Results: High practicability, originality, professionalism, and effectiveness were some of the positive assessments made by the nurse participants. In addition, they pointed out that the sample video in which two professors performed an ideal handover and takeover and the paper kardex were both quite unrealistic. The location of the change-of-shift simulation was also unfamiliar so it needed to be supplemented. However, most of the nurses took for granted that such a communication education program is necessary and that it will provide a substantial help in their future job performance. In this regard they recommended the program to all related hospitals and nursing schools. Conclusion: The results of this study could be applied to other forms of communication education programs regardless of the specific area where communication takes place.

• Journal of Korean Academy of Nursing
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• v.25 no.4
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• pp.709-728
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• 1995

The job related activities of sixty nine nurses, working in the emergency rooms of three university hospitals, were analyzed for six days according to preestablished checklist of nursing activities ; the frequency of these activities and the amount of time spent in each specific nursing activity. The established checklist was monitored every five minutes for the duration of the duty autu, thus producing 414 items of data. The data were not gathered on consecutive days but over the period of one month from May 6, 1994 to June 5, 1994. The following conclusions are derived from analysis of the data : 1. Twelve categories of nursing activities were obtained : The primary activity was communication related to the patient and all information pertaining to the patient. Other activities included maintaining the patient's record, observation and assessment of the patient, cooperation with other medical personnel, management of equipment and drugs, procedure and treatment, specimen collection, consultation and education for the patient, including drug management and personal hygiene and any other relevant education to the patient's condition. 2. The average frequency of categorized nursing activity can be classified as follows : communication related to patient was the highest at 17.6 times. The next was maintaining the patient's record at 17.3 times. The observation and assessment occurred 16.9 times. Consultation and education for patients and family, 8 times, medication, 5.7 times, and procedures and treatments, 6 times. 3. The average time required for each activity was as follows : 230.1 minutes (or maintaining the patient's record, 204.9 minutes for communication related to the patient, 199.2 minutes for observation and assessment, 71.2 minutes for medication, 66 minutes for consultation and education of the patient and family, and 51.8 minutes for procedures and treatment. 4. The most demanding nursing activity in the emergency room for the nurse was answering questions from the patient's family, maintaining communication between the medical staff, maintaining and reviewing the patient's charts, writing prescriptions and monitoring 1. V. infusion rates. 5. The most time consuming nursing activities for the emergency room nurse include maintaining and following the patient's charts, communication between the medical staff, answering questions from the patient's family, observation of the patient and relaying all of the appropriate patient information to the incoming nurses during a shift change. 6. The F-test was administered to measure the required time for the categorized nursing activities according to day, evening, and night-shift nurses. There were significant differences (p<.05) in specimen collection, observation and assessment, cooperation between medical staffs, personal hygiene, communication related to patient, education and re-search. Posterior multiple comparison test showed that specimen collection, cooperation between medical staffs and personal hygiene were mostly done by the evening-shift nurses. Also most observations and assessments were done by the night-shift nurses. Education and communication to patients were done by day-shift nurses. Thus there were significant difference between shifts for the main nursing activities. So there should considev a reallocation of the duty of nurses on each shift. 7. The F-test also indicated that there wes a similarity in time duration for procedures and treatments and for cooperation between medical staff and nurses in all three hospitals. However, the remaining categories of nursing activities also showed a significant difference between the three hospitals. This indicated that there were differences in each emergency room that influence time for each categorized nursing activities and this should be given more consideration. Recommendations : 1. A seasonal difference should be considered in the activities of nurses in the emergency room and a comparative analysis should be carried out to deter-mine seasonal differentiation. 2. A study on more objectively measurable nursing activities should be administered as well as one determining the subjective responds towards nursing activities in the emergency room.

• Journal of Korean Academy of Nursing
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• v.31 no.6
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• pp.1067-1076
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• 2001

This study was to developed to create a CD-ROM and an educational program for the prevention of sexual harassment and violence and to contribute to the perception and add to the coping of the victims of sexual harassment and violence as well as the child, parents, and teachers. Method: The study's methods were literature reviews, surveys, and assessments of the negotiation process for educational needs of sexual harassed and abused children. Result: The sexual harassment and violence prevention program will contain four subjects : 1) sexual development of a preschool child, 2) characteristics of sexual harassment and violence of a preschool child, 3) safe sex, early detection of sexual violence syndrome, and coping strategies. The CD-RON was composed from three sites. The first was a child site, the second was a parent/teacher site, and the third was a game site for evaluations. The child site consisted of 10 possible scenarios of sexual harassment and violence that a child could experience. The parent/teacher site consisted of knowledge and information for prevention and coping strategies for sexual harassment and violence. At the end of each situation question and answer sections that were used for formative evaluation. Also, the game site could be a summative evaluation. Conclusion: The effects of this program and the CD-ROM were based of the promotion of reverence for humanity and gender equality for preschool childen. Eventually, children, parents, and teachers will have prevention and coping ability that will reduce the occurrence of sexual harassment and violence in Korea

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.37-48
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• 2010

Purpose: The purpose of this study was to examine the frequency and the course of delirium, and identify risk factors for the development of delirium in surgical intensive care unit (SICU). Methods: Subjects older than 19 years admitted to the SICU were recruited. After informed written consent, enrolled subjects had baseline cognitive and functional assessments. Subjects were assessed daily for delirium using the Confusion Assessment Method-ICU (CAM-ICU). Results: During the study period, 110 patients were enrolled. The overall incidence of delirium was 20% (22/110). The average time to onset of delirium was 3.04(${\pm}1.25$) days. Several variables were associated with an increased risk of delirium including older age (p<.05), higher admission APACHE II score (p<.001), use of opioid and analgesics (p<.01), using physical restraints (p<.001), and intraoperative hypotension (p<.05). In a multivariate logistic regression model, using physical restraints (p<.001), intraoperative hypotension (p<.05), and older age (p<.05) remained significant predictors of the delirium development. Conclusion: Using physical restraints, intraoperative hypotension and older age was strongly associated with development of delirium in the SICU. Prevention measures need to focus on identifying patients at higher risk for delirium development.

• Safety and Health at Work
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• v.9 no.4
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• pp.381-387
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• 2018

Background: Physician behaviors that undermine a culture of safety have gained increasing attention as health-care organizations strive to create a culture of safety and reduce medical errors. We developed, implemented, and assessed a course to teach physicians skills regarding effective coping and interpersonal communication skills and present our results regarding outcomes. Methods: We examined a professional development program specifically designed to address unprofessional or distressed behaviors of physicians, and we evaluated the impact on burnout, quality of life, and emotional flooding scores of the physicians. Assessments of burnout, quality of life, and emotional flooding were assessed preintervention and postintervention. Results: Results demonstrated statistically significant reductions over time in physicians' emotional flooding and emotional exhaustion (EE). Specifically, using a Wilcoxon Signed-Rank test, results revealed that flooding scores at follow-up were statistically significantly lower than at baseline, V = 590, p < 0.05, and EE and personal accomplishment distributions were found to significantly deviate from normal as indicated by Shapiroe-Wilks tests (p < 0.05). A Wilcoxon signed-rank test indicated that EE scores were significantly higher at baseline compared to follow-up 1, V = 285, p < 0.05. Conclusion: We conclude that the physician participants who enrolled in the educational skills training program improved scores on emotional flooding and EE and that this may be indicative of improved skills related to their experiences and learning in the program. These improved skills in physicians may have a positive impact on the overall culture of safety in the health system setting.

• 한국노년학
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• v.36 no.3
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• pp.727-749
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• 2016

This systematic review was performed to investigate relationship between sarcopenia and cognitive function among community-dwelling older adults. Studies which reported prevalence rates of sarcopenia in community-dwelling older adults, relationships between sarcopenia and cognitive dysfunction, or effective interventions in alleviated symptoms of sarcopenia were selected. Of 43 studies reviewed, prevalence rate of sarcopenia ranged from 2.5-42.4% in 25 studies, and 4 studies revealed a significantly positive correlation between sarcopenia and cognitive dysfunction. Among 12 randomized-control trials (RCTs), exercise intervention was used in 2 studies; nutrition intervention in 6; and 4 studies included both the exercise and nutrition interventions. All interventional studies reported positive effects on muscle mass, muscle strength, or physical function. However, only 6 studies met the high quality criteria of Risk of Bias, and there was no study which evaluated cognitive function as an outcome measure. Therefore, this study draws attention to the lack of high-quality RCTs and exclusion of cognitive function as an outcome measure in the research of sarcopenia. A comprehensive and sustained system including standardized sarcopenia screening, assessments of cognitive functioning, and evidence-based intervention programs is needed in order to prevent and manage sarcopenia amongst older adults in the community.

• The Journal of the Convergence on Culture Technology
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• v.6 no.4
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• pp.583-590
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• 2020

This study examined the perceptions of health literacy on inpatient and outpatient patients among nurses currently in the field. The study participants consist of ten nurses working for general hospitals in Seoul and Busan. The data was collected from focus group interviews and all interviews were recorded and transcribed. Data were analyzed by using the content analysis method. Nurses recognized that there was a difference in the patient's health literacy level according to the patient's age, education, income level, underlying disease, and emotional state. This study suggests implementing 1) education programs to increase nurses' awareness of the importance of health literacy, to make accurate assessments of patent level of health literacy and communicate with them accordingly, and 2) support system for patients with poor health literacy.