• 제목/요약/키워드: Nursing care/classification

검색결과 230건 처리시간 0.021초

환자분류에 의한 일개 2차 의료기관의 간호업무량 조사;전산화를 위한 기초작업으로서 (Measurement of the Nursing Workload by Patient Classification System in a Secondary Hospital;As a Preliminary Step for Computerization of Nursing Staffing and Scheduling)

  • 박정호;조현;박현애;한혜라
    • 간호행정학회지
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    • 제1권1호
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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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병원중심 가정간호중재 분석: NIC 체계 적용 (Analysis of the Nursing Interventions Performed by Home Health Care Nurses in a Hospital : An Application of NIC)

  • 용진선;유인자;유지연
    • 성인간호학회지
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    • 제12권4호
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    • pp.606-618
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    • 2000
  • The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.

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중환자실 뇌혈관질환자에게 수행된 간호중재분석 (A study of the Nursing Interventions performed by the ICU nurses to the patients with Cerebrovascular disorders)

  • 박영례;최경숙
    • 재활간호학회지
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    • 제4권1호
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    • pp.94-104
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    • 2001
  • The purpose of this study was to analysis of nursing interventions performed by the ICU nurses to the patients with cerebrovascular disorder practically from one university hospital in Seoul. The data were collected from 15 nurses with 86 cerebrovascular disorder cases from one ICU with the questionaire to write frequency of nursing care done by the surveyee from May, 2, 2000 to July, 3, 2000 and the list of 66 nursing interventions selected out of 433 NIC(Nursing Interventions Classification) of Iowa University which were translated into Korean (44 items) and core nursing interventions by ICU nurses (22 items; KIm, Su-Jin, 1997). The data were analysed with SPSS program. The results are as follow : 1. The most frequently used nursing interventions were vital sign monitoring, fall prevention, cerebral edema management, dysreflexia management, neurologic monitoring, cardiac care, communication enhancement, technology management, bed rest care, respiratory monitoring in rank. 2. The most frequently used nursing intervention domains were 'Physiological : Complex', 'Physiological : basic', 'Behavior', 'Safty', 'Health system' in rank. In the domain of physiological : basic, the most frequently used nursing interventions were bed rest care, urinary elimination management, tube care : urinary, physical restraints in rank. In the domain of physiological : complex, the most frequently used nursing interventions were cerebral edema management, dysreflexia management, neurologic monitoring, cardiac care in rank. In the domain of behavior, the most frequently used nursing interventions were communication enhancement, touch, active listening in rank. In the domain of safty, the most frequently used nursing interventions were vital sign monitoring, fall prevention in rank. In the domain of health system, the most frequently used nursing interventions were technology management, specimen management in rank. 3. some difference of the frequency practicing the nursing interventions according to the shift of duties was found. For example, medication administration was common at day duty, touch was practiced at evening duty, temperature regulation was performed.

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간호중재분류(NIC)에 근거한 간호중재수행분석 II -한방병동과 일반병동 간호사를 중심으로- (Nursing Interventions Classification(NIC) Use in Korea : Oriental Medicine Hospitals and General Hospitals)

  • 염영희;김성실;김인숙;박원숙;김은주
    • 대한간호학회지
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    • 제29권4호
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    • pp.802-816
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    • 1999
  • The purposes of this research were to identify nursing interventions performed by Korean nurses and to compare the interventions performed by nurses working in the oriental medicine hospitals and with those performed by nurses working in the general hospitals. The samples consisted of 144 Korean nurses working in three hospitals, 70 nurses working in the oriental medicine hospitals and 74 nurses working in the general hospitals. The Nursing Interventions Classification (NIC) Use Questionnaire developed by the Iowa Intervention Project team was translated to Korean and verified using the method of back-translation. The questionnaire consists of 433 intervention labels and definition. Thirteen interventions were used at least daily by nurses working in the oriental medicine hospitals, while twenty-one interventions were used at least daily by nurses working in the general hospitals. The most frequently used interventions by nurses working in the oriental medicine hospitals were Documentation, Shift Report Vital Signs Monitoring, Pressure Ulcer Prevention, Positioning, Fall Prevention, Exercise Promotion, Intravenous (IV) Therapy, Pressure Ulcer care, and Bed Rest Care in that crder. For nurses working in the general hospitals the most frequent intervention was Analgesic Administration, followed by the interventions of Medication Administration : Parenteral and Intravenous Therapy (IV) Therapy, Documentation, Intravenous(IV) Insertion, Shift Report, Fall Prevention, Vital Signs Monitoring, Medication Adnninistraction : and, Fluid Monitoring, and Medication Maragement in that order. The interventions performed least often by nurses working in the oriental medicine hospitals were Hemodialysis Therapy and Bleeding Reduction : Antepartum Uterus, while the interventions performed least often by nurses working in the general hospitals were Rape Trauma Treatment and Contact Lens Care. The nurses working in the oriental medicine hospitals performed the interventions in the Physiological : Complex domain significantly more often than the nurses working in the general hospitals, while the nurses working in the general hospitals performed the intervention in the Behavior domain significantly more often than the nurses working in the oriental medicine hospitals. This study suggests that further study will be needed to developed and validate more interventions sensitive to Korean culture.

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Factors Affecting Adherence to Self-care Behaviors among Outpatients with Heart Failure in Korea

  • Ok, Jong Sun;Choi, Heejung
    • 성인간호학회지
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    • 제27권2호
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    • pp.242-250
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    • 2015
  • Purpose: To evaluate heart failure knowledge and adherence to self-care behaviors, and to identify factors affecting adherence to self-care behaviors among Korean patients with heart failure. Methods: Correlational research using the European Heart Failure Self-care Behavior Scale, the Duke Activity Status Index, the Dutch Heart Failure Knowledge Scale, the New York Heart Association Functional Classification, and the Medical Outcomes Study Social Support Survey was conducted. A total of 280 outpatients with heart failure responded to the five questionnaires. Results: The mean scores for self-care adherence and heart failure knowledge were $31.98{\pm}6.81$ and $8.78{\pm}2.53$, respectively, indicating lower adherence and knowledge than those previously reported. Subjects with lower functional status, more social supports, and greater knowledge of heart failure are more likely to adhere to prescribed regimens. Conclusion: Nurses should focus on patient education and support to improve their adherence to self-care behaviors.

일반외과 간호기록에서의 중재, 지각한 간호중재의 중요도 및 수행 빈도 (Comparison among with Nursing Records, Nursing Intervention Priority Perceived by Nurse and Nursing Intervention Frequency of General Surgery Department)

  • 최은희;서지영
    • 성인간호학회지
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    • 제21권3호
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    • pp.349-354
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    • 2009
  • Purpose: The purpose of this study was to determine core nursing intervention in nursing records and to compare perceived nursing intervention priority and nursing intervention frequency of general surgery department. Methods: Subjects were 70 nurses who work in the general surgery department. Data was collected using a nursing intervention classification and analyzed by frequency and mean. Results: The most frequent nursing interventions of nursing records were orderly risk management, coping assistance, tissue perfusion management, skin/wound management and nutrition support. Important nursing interventions were tissue perfusion management, respiratory management, electrolyte acid-base management, elimination, peri-operative care. The most frequent nursing interventions were drug management, peri-operative care, risk management, tissue perfusion management, patient education. Conclusion: This study found that nursing records were different from intervention priority and nursing frequency. So further study is needed for finding focused intervention of specific subjects and differences with priority of nursing and frequency of nursing.

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간접간호중재의 수행 및 위임에 관한 분석 (Identification and delegation of indirect care interventions)

  • 염영희;김소인;차보경
    • 간호행정학회지
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    • 제5권2호
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    • pp.197-207
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    • 1999
  • The purpose of this research was fourfold: (a) to identify the use rate of the indirect care interventions performed by nurses, (b) to estimate the time to perform each intervention, (c) to identify the indirect care interventions to be delegated to others, and (d) to determine the level of provider preparation needed to delegate indirect care interventions. The sample consisted of 199 nurses working in three hospitals. The Indirect Care Survey developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean and validated by nurse experts. Each of the 26 indirect care interventions were used several times a day. Four interventions (i.e.. Documentation, Shift Report, Specimen Management, and Transport) were performed several times a day by 50% or more of the nurses. The most frequently used intervention was Documentation, followed by the interventions Shift report. Environmental Management, Transport, and Examination Assistance. The least used intervention was Quality Monitoring, followed by the interventions Order Transcription, Referral, Health Care Information Exchange, Multidisciplinary Care Conference, and Product Evaluation. The intervention taking the most time to per-form was Technology Management (155.3 minutes), followed by the interventions Documentation, (122.2 minutes), Delegation (84.4 minutes), Supply management (83.4 minutes), and Preceptor: Student (79.9 minutes), Overall, the nurses reported that they would not delegate to others the majority of the interventions. More than 50% of the nurses would not delegate 21 interventions. Shift Report would not be delegated by 95% of the nurses and Documentation would not be delegated by 92% of the nurses. Caregiver Support would be delegated by 68% of the nurses to family. Three interventions (i.e.. Environmental Management, Examination Assistance, and Transport) would be delegated by more than 50% of the nurses to Nursing Assistant. This study will contributes to determining costs of nursing services and enhancing quality of nursing care. Replication study will be needed with large sample.

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간호진단 분류체계에 근거한 간호개념틀 개발 (Development of a Conceptual Framework of Nursing from Selected Concepts of Nursing Diagnoses)

  • 김조자
    • 대한간호학회지
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    • 제26권1호
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    • pp.177-193
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    • 1996
  • For the purpose of integrating nursing diagnosis into the nursing curriculum, a descriptive survey research was done using the inductive method with questionnaires and a literature review. Research subjects included nurse educators, textbooks of adult nursing published in Korea, and the course outline for adult nursing used in one college of nursing. The Results show that there was common agreement on 39 nursing diagnosis which should be in cluded in the adult nursing curriculum, textbooks of adult nursing, and patient care on the medical-surgical units. The two existing nursing diagnosis classification systems(NANDA and Gordon's Human Response Patterns) show different basic frameworks and difficulties were discovered in integration of nursing diagnosis into the curriculum. To develop a conceptual framework for a nursing diagnosis classification system, diagnosis were classified into three categories ; health promotion, high risk problem, and actual problem on the basis of the framework used in adult nursing textbooks and Gordon's 11 Functional Health Patterns. Subconcepts for actual problems were classified as ; activity and rest, nutrition and elimination, perception and coordination, stress and coping. Progress in this study supports further development of a conceptual framework of nursing based on a nursing diagnosis classification system, from which improvement in nursing education and clinical practice can be expected.

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국가지정 입원치료병상에 입실한 COVID-19 환자를 돌보는 간호사의 업무분석 (An Analysis of Tasks of Nurses Caring for Patients with COVID-19 in a Nationally-Designated Inpatient Treatment Unit)

  • 정민호;김문숙;이주연;이경이;박연환
    • 대한간호학회지
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    • 제52권4호
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    • pp.391-406
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    • 2022
  • Purpose: The purpose of this study was to provide foundational knowledge on nursing tasks performed on patients with COVID-19 in a nationally-designated inpatient treatment unit. Methods: This study employs both quantitative and qualitative approaches. The quantitative method investigated the content and frequency of nursing tasks for 460 patients (age ≥ 18 y, 57.4% men) from January 20, 2020, to September 30, 2021, by analyzing hospital information system records. Qualitative data were collected via focus group interviews. The study involved interviews with three focus groups comprising 18 nurses overall to assess their experiences and perspectives on nursing care during the pandemic from February 3, 2022, to February 15, 2022. The data were examined with thematic analysis. Results: Overall, 49 different areas of nursing tasks (n = 130,687) were identified based on the Korean Patient Classification System for nurses during the study period. Among the performed tasks, monitoring of oxygen saturation and measuring of vital signs were considered high-priority. From the focus group interview, three main themes and eleven sub-themes were generated. The three main themes are "Experiencing eventfulness in isolated settings," "All-around player," and "Reflections for solutions." Conclusion: During the COVID-19 pandemic, it is imperative to ensure adequate staffing levels, compensation, and educational support for nurses. The study further propose improving guidelines for emerging infectious diseases and patient classification systems to improve the overall quality of patient care.

Relationship between Nurse Staffing and Changes in Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes

  • Moon, Mi-Kyung
    • 재활간호학회지
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    • 제14권1호
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    • pp.62-69
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    • 2011
  • Purpose: The study assessed whether nurse staffing was associated with 3 nursing sensitive outcomes used in intensive care unit (ICU) nursing care plans. Methods: This study was a retrospective and descriptive study using clinical data extracted from the data warehouse of a large acute care hospital in the Midwest. One-way analysis of variance was used to analyze the records of 578 ICU patients admitted from March 25 to May 31, 2010. Results: 79 Nursing Outcomes Classification (NOC) outcomes were used in the nursing care plans. The 3 most commonly used NOC outcomes (Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes) were analyzed to determine their relationship to nurse staffing. As a nurse staffing ratio, the skill mix of nursing caregivers ranged from 0.74 to 1 with an average of 0.90. This skill mix of nursing caregivers significantly differed among the changes in Infection Severity scores. However, the mean difference was only 0.02. Conclusion: The results did not support that greater nurse staffing was associated with better outcomes. More research is still needed to determine the usefulness of Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes in evaluating the impact of nurse staffing.