• Title/Summary/Keyword: Patient Care Management

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Effects of the Comprehensive Nursing Care Service Ward Nurses Occupational Stress on Safety Control and Patient Safety-related Nursing Activities (간호·간병 통합서비스 병동 간호사의 직무 스트레스가 안전통제감과 환자안전관리 활동에 미치는 영향)

  • Yang, Hee-Mo
    • The Journal of the Korea Contents Association
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    • v.19 no.7
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    • pp.444-455
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    • 2019
  • This study is a descriptive research study to identify the relevance of the occupational stress, safety control, and patient safety-related nursing activities of the nurses working in comprehensive nursing care service ward, and to check the effect of the occupational stress on safety control and patient safety-related nursing activities. From March 11 to April 17, 2019, 137 nurses who worked in comprehensive nursing care service ward at four general hospitals were studied. The results of this study suggest that occupational stress has a negative correlation with safety control and patient safety-related nursing activities, and occupational stress negatively affects safety control and patient safety-related nursing activities. Based on the results of this study, it is expected that the work environment will be improved to reduce the occupational stress in order to promote the safety control and patient safety-related nursing activities of nurses in comprehensive nursing care service ward, and the development of various programs for occupational stress management will be necessary.

Evaluating Nursing Needs in the Neonatal Intensive Care Unit with the Korean Patient Classification System for Neonatal Intensive Care Nurses (한국형 신생아중환자간호 분류도구를 이용한 간호요구도 평가)

  • An, Hyo nam;Ahn, Sukhee
    • Journal of Korean Critical Care Nursing
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    • v.13 no.2
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    • pp.24-35
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    • 2020
  • Purpose : This study aimed to determine whether the Korean Patient Classification System for Neonatal Care Nurses (KPCSN) properly measures neonatal intensive care needs and to compare the scale's results with those of the Workload Management System for Critical Care Nurses (WMSCN). Methods : Data were collected from the medical records of 157 patients who were admitted to the NICU of a university hospital, in D city. Two types of patient classification systems were applied to investigate the total points and distributions to investigate the total points and distributions by categories and compare relationships and classification groups between two scales. Finally, the score distribution among the classification groups was analyzed when the KPCSN was applied. Results : Scores on the KPCSN for the feeding, monitoring, and measure categories were 19.16±15.40, 16.88±3.52, and 9.13±4.78, respectively. Classification group distribution of the KPCSN was as follows : 1.9% for the first group, 24.2% for the second group, 58% for the third group, and 15.9% for the fourth group. The classification group distribution of the WMSCN was as follows: 35.7% for the third group, 61.1% for the fourth group, and 3.2% for the fifth group. Finally, the scores by categories were analyzed according to KPCSN classification group, and the characteristics of the patients' nursing needs were identified for each classification group. Conclusion : Results of this study indicate that the KPCSN effectively measures feeding needs, which account for many nursing activities in neonatal intensive care. Comparisons between the KPCSN and WMSCN classification group scores and distribution ratios verified the correlation and significance of nursing requirements.

A Study on the Area and Clearances around Patient Bed Space in Intensive Care Unit (중환자실 병상주변공간의 면적과 간격에 관한 연구)

  • Lee, Hyunjin;Kwon, Soonjung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.25 no.3
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    • pp.47-55
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    • 2019
  • Purpose: This study tries to propose the dimensions and area related to patient bed and surroundings in ICU considering nurses' observation and medical care. Methods: Literature survey, 11 Case studies, some Interviews with nurses and measuring of medical equipments' dimension in ICU have been mobilized in order to deepen the ICU bed area standards. Results: 0.3m clearance between head wall and patient bed is necessary for emergency cases. The minimum distance at the foot of the bed should not be less than 0.9m for EMR cart and medical tray. The clear floor area of one bed and surroundings in open ward is $10.2m^2(3m{\times}3.4m)$. In a single-bed patient room, the minimum clear floor area is $16.0m^2(4m{\times}4m)$. Considering the control of cross infection in ICU, Single bed patient room is recommended. Implications: The result of this study can be applied to the design of ICU and legislation of ICU standard.

Person-Centered Relational Care Experienced by Critical Care Nurses: An Interpretative Phenomenological Analysis Study (중환자실 간호사가 경험한 사람-중심의 관계 돌봄에 대한 해석 현상학적 분석 연구)

  • Jang, Myoung Sun;Kim, Sungjae
    • Journal of Korean Academy of Nursing
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    • v.49 no.4
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    • pp.423-436
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    • 2019
  • Purpose: The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. Methods: Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through indepth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. Results: Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced 'balancing emotions' and 'authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. Conclusion: The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

Successful Transition from Pediatric to Adult Care in Inflammatory Bowel Disease: What is the Key?

  • Kim, Jeongseok;Ye, Byong Duk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.1
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    • pp.28-40
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    • 2019
  • The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.

The Risk Factors Related to Early Readmission to the Intensive Care Unit. (중환자실 조기 재입실 관련 위험요인)

  • Jang, Jin Nyoung;Lee, Yun Mi;Park, Hyo Jin;Lee, Hyeon Ju
    • Journal of Korean Critical Care Nursing
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    • v.12 no.1
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    • pp.36-45
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    • 2019
  • Purpose : The purpose of this study was to identify status and characteristics of patients who have been readmitted to ICU, and to analyze risk factors associated with the readmission to ICU within 48hours. Method: Data were collected from patient's electronic medical reports from one hospital in B city. Participants were 2,937 patients aged 18 years old or older admitted to the ICU. Data were analyzed using odd ratios (ORs) from multivariate logistic regressions. Results: 2.2% of the 2,937 patients were early readmitted to ICU. Risk factors for early readmission to ICU were existence of respiratory disease, use of mechanical ventilator, and duration of hospitalization (longer). Conclusion: The assessment on the respiratory system of the patient who will be discharged from the ICU was identified as an important nursing activity. Therefore, the respiratory system management and education should be actively conducted. In addition, early ICU readmission may be prevented and decreased if a link was built to share the information on patient condition between the ICU and general wards.

Critical Success Factors for the Adoption of Health Management Information Systems in Public Hospitals in Zimbabwe

  • Caleb Manjeese;Indira Padayachee
    • Journal of Information Science Theory and Practice
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    • v.11 no.2
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    • pp.82-103
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    • 2023
  • The Zimbabwean healthcare sector faces huge challenges due to increased demands for improved services for a growing number of patients with fewer resources. The use of information and communications technologies, prevalent in many industries, but lacking in Zimbabwean healthcare, could increase productivity and innovation. The adoption of health management information systems (HMISs) can lead to improved patient safety and high-level patient care. These technologies can change delivery methods to be more patient focused by utilising integrated models and allowing for a continuum of care across healthcare providers. However, implementation of these technologies in the health care sector remains low. The purpose of this study is to demonstrate the advantages to be attained by using HMISs in healthcare delivery and to ascertain the factors that influence the uptake of such systems in the public healthcare sector. A conceptual model, extending the technology, organization, and environment framework by means of other adoption models, underpins the study of adoption behavior. A mixed method methodology was used to conduct the study. For the quantitative approach, questionnaires were used to allow for regression analysis. For the qualitative approach, thematic analysis was used to analyse interview data. The results showed that the critical success factors (namely, relative advantage, availability, complexity, compatibility, trialability, observability, management support, information and communication technology expertise, communication processes, government regulation, infrastructure support, organizational readiness, industry and competitive support, external support, perceived ease of use, perceived usefulness, attitude, and intention to use) influenced adoption of HMISs in public hospitals in Zimbabwe.

A Study on the Care Needs of Family-Caregivers and the Level of Self Care for Patients of Cerebral Vascular Accident(CVA) (뇌졸중환자의 자가간호 수준과 가족구성원의 간호요구)

  • Cho Young-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.239-255
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    • 2000
  • The purpose of this study was to explore the care needs of family-caregivers caring for patients with a CVA and the level of self care of the patients. The subjects for the study were 112 patients with a CVA and their caregivers. These patients were seen in a hospital or out-patient-department(OPD) at two oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL checklist for self care of patients and Kim's Likert-style checklist for care needs of family-caregivers to patient with CVA. The survey was conducted from July 4 to August 30, 1999. Internal validity by calculation of Cronbach's alpha was 0.95, which was regarded as high. The survey results were analyzed using the SPSS program, with percentages, means, t-test, ANOVA and Pearson's correlation coefficients. The results of this study are as follows : 1. The level of self care for patients with a CVA was : 1) complete dependence(M=14.9, 13.1%), 2) complete independence(M=23.6, 20.9%), 3) incomplete independence(M=23.9, 21.0%), 4) incomplete dependence(M=26.6, 25.0%), 5) dependence and independence(M=23.0, 20.0%). The items for which there was a high level of self care were : 1) drinking(M=3.62), 2) eating (M=3.25), 3) position returning(M=3.18) : and the items for which there was a low level of self care were : 1) ascending and descending stairs(M=2.08), 2) walking(M=2.47). 3) putting on and taking off trousers(M=2.55). 2. The mean score of the sum of the care needs of the family-caregivers was : 1) need for immediate care and help: 2) need of the way to communicate with patient: 3) need for education and assistance related to physical functional level: 4) need to be informed about the disease, treatment and care: 5) need for social support and consultation: 6) need for appreciation: 7) need for management of nursing problems related to immobility. The highest meed factor was the need for immediate care and help(M=3.47): and lowest need factor was the need for management of nursing problems related to immobility(M=2.80). 3. There were significant differences between the level of care need and general characteristic of the caregivers, there were family-caregivers age(P=0.001), marital status (P=0.276), occupation (P=0.006), monthly income(P=0.000), Patient's relationship to caregivers(P=0.004) and health(P=0.000). 4. There were significant differences between the level of self care and general characteristic of the patients, there were patient paralytic condition(P=0.01), blood pressure(P=0.01), and length of suffering(P=0.03). 5 There were significant differences between the level of care need and the general characteristic factors, which were CVA patient's blood pressure (P=0.05), problem of medical fee (P=0.05). 6. There was significantly correlation with the family-caregivers care need and the level of self care in the CVA patient(r=0.300, P=0.000). As a result, need to promote the level of self care in patients and to meet the care need of family-caregivers for more efficient nursing of CVA patients, is emphasized. Therefore more study is needed on an efficient way to provide rehabilitation and quality nursing interventions for family-caregivers and patients with CVA.

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Job Analysis of Nurse Care Coordinators for Chronic Illness Management in Primary Care Settings: Using Developing a Curriculum Process (데이컴 기법을 적용한 일차의료 만성질환관리 간호사 케어코디네이터 직무분석)

  • Hwang, Ju-Hee;Choi, Yong-Jun;Kim, Mi-Sook;Yi, Seng-Eun;Park, Yong-Soon;Kim, Ji-Hyang;Yoon, Ju-Young;Shin, Dong-Soo
    • Journal of Korean Academy of Nursing
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    • v.51 no.6
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    • pp.758-768
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    • 2021
  • Purpose: This study aimed to conduct a job analysis of nurse carecoordinators and to identify the frequency, importance and difficulty of each task of their job. Methods: A committee for developing a curriculum (DACUM) was formed and members of the committee defined nurse care coordinators' jobs and enumerated the duties, tasks and task elements by applying the DACUM technique. Then nurse care coordinators enrolled in the pilot project evaluated the frequency, importance and difficulty of each task. Results: From the job descriptions of nurse care coordinators, we identified 12 duties and 42 tasks. Each task comprised 1~5 task elements. Among tasks, 'assess the patient's general health status' was carried out most frequently. Nurse care coordinators perceived that 'check vital signs' and 'strengthen patient competence to promote health behaviors' were more important than all other tasks. The most difficult task was 'develop professionalism as a nurse care coordinator'. Conclusion: The nurse care coordinators' roles developed in this study will serve as the key guidelines for human resource management of care coordinators. Further, job specifications for nurse care coordinators need to be developed, which is necessary for designing education and training programs. We also need to integrate primary health care as an essential component in nursing education.

PROSTHETIC DENTISTRY PROCEDURES OF PERSONS WITH DISABILITIES UNDER GENERAL ANESTHESIA : A CASE REPORT (전신마취를 이용한 장애인의 보철치료 : 증례보고)

  • Lee, Jeong-Ok;Lee, Keung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.1
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    • pp.146-150
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    • 2000
  • Dental caries and periodontal disease continue to present unique problems in the dental management of the persons with disabilities because the chronicity of oral diseases complicates the primary physical or mental disability. The increased prevalence of dental disease in most persons with disabilities is probably not due to any inherent proclivity for dental disease but more likely evolves because dental care receives less attention. Prosthetic dentistry procedures are not contraindicated for most patients with physical and mental disabilities. Fixed bridges may be feasible if the patient or care provider can maintain adequate oral hygiene and the patient's disability dose not preclude this type of prosthesis. Removable partial or full dentures may be indicated if the patient or care provider can easily remove the prosthesis and care for it. Although most persons with disabilities need no additional behavior management modalities to complete dental care, some persons require professionally recognized behavior management techniques during treatment, such as physical restraint, pharmacologic agents, or general anesthesia. Hospitalization and the use of general anesthesia are sometimes required to deal effectively with the extreme management problem patient. This patient with mild mental retardation was fearful of dental treatment. Routine restorative, surgical and prosthetic dentistry procedures were performed under general anesthesia.

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