• Title/Summary/Keyword: Quality nursing care

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A Comparative Study of the Stress Level between Military Wives and Civilian Wies (군인부인과 일반부인의 스트레스 비교)

  • Park, Young-Suk
    • Women's Health Nursing
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    • v.1 no.1
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    • pp.68-80
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    • 1995
  • Housewife plays a significant role in maintaining a health family life. If she can not function adequately due to high stress, it will affect quality of life of the household members. It also interferes with the normal process of family development. Futhermore, dysfunctional family will have effects on morale of the servicemen in military. This is a descriptive study. The main purpose of this study is to compare the level and types of stress between a group of military wives and a group of civilian wives and provide a data which can be used to develop a stress management program. Sample consist with 250 military wives and 250 civilian wives residing in metro Seoul area. Data collection was done during October 4, 1994-November 30, 1994. Stress was measured with the instrument developed by the researcher. The cronbach's ${\alpha}$ score of the instrument was .91. The data was analyzed by using SPSS-PC. The results of this study are : 1. The stress score was 47.09 for military wives, 36.56 for civilian wives. The range of score was 0-192. The stress level of military wives was greater than civilian wives. (t=4.80, P<.000) 2. The rank order of stressors of military wives were 1) move 2) residential environment 3) purchase of house 4) holidays. The rank order of stressors of civilian wives were 1) husband late return after work 2) arguments with husband 3) holidays 4) husband's drinking problem. The result shows that the main stressors of military wives are frequent moves, residential environment, uncertainty of the future, unsafe work environment of husband, and the lack of private life which are all associated with the military. Therefore, it is urgently needed to distribute this facts through military journal to understand the characteristic of the stress of military wives, and to develope appropriate health care program to lessen the stress.

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Effects of Aromatherapy on Stress, Sleep, Nausea and Vomiting during Patient Controlled Analgesia Treatment of Patients with Hysterectomy (자가통증조절장치 (PCA) 사용자에서 향기흡입법이 자궁적출술 후 스트레스, 수면 및 오심과 구토에 미치는 효과)

  • Choi, JungHee;Kim, Yun Mi
    • Women's Health Nursing
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    • v.19 no.4
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    • pp.211-218
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    • 2013
  • Purpose: The purpose of study was to examine effects of aromatherapy on stress, sleep, nausea and vomiting of women after laparoscopic hysterectomy. Methods: The participants were 60 women who had laparoscopic hysterectomy: experiment group for aromatherapy (n=30) and control group for routine care (n=30). The experimental group received inhalation aromatherapy for 5 minutes, twice; the first was done right after the operation, the second was at 9 pm before sleep on the same day-while the control group had no inhalation. Data were collected from July to September, 2012 at G hospital. Results: The degree of psychological stress was not significantly different between two groups (t=-1.96, p=.054). Yet, there were significant differences between two groups for degree of physiological stress (t=-3.20, p=.002), the level of cortisol (t=-2.01, p=.049), the score of sleep status (t=2.47, p=.016), the score of sleep satisfaction (t=2.43, p=.018), and the score for nausea and vomiting (t=-2.58, p=.012). Conclusion: Inhalation aromatherapy using the mixed oil of lavender, mandarin, and marjoram was effective in decreasing the level of physiological stress, cortisol, and the score for nausea and vomiting, and also allowed the participants to have a better sleep. Therefore, inhalation aromatherapy could be effective in improving the quality of life of these women during recovery.

Outcomes for Employment of a Trauma Clinical Nurse Specialist in the Treatment of Trauma Patients (외상환자의 치료에서 외상 전문간호사 도입 결과)

  • Jung, Yooun Joong;Kim, Young Hwan;Kim, Tae Hyun;Keum, Min Ae;Ma, Dae Sung;Kyoung, Kyu Hyouck;Kim, Jung Jae;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.254-260
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    • 2012
  • Purpose: Ongoing treatment and care, as well as initial stabilization, are required for trauma patients. With increasing number of sickest trauma patients and shortage of surgeons, the need for advanced practice nurse to provide and coordinate trauma care has been greater. The purpose of this study is to analyze the effect of hiring a trauma clinical nurse specialist and its influence on the treatment of trauma patients. Methods: Based on the employment of the clinical nurse specialist in December 2010, the patients were divided into two groups: patients admitted from January 1, 2010 to November 30, 2010 and patients admitted from December 1, 2010 to December 31, 2011. Retrospectively, data were collected using electronic medical records. The general characteristics, clinical courses, and ICU re-admission rates, collaboration (transfers to other departments and collaborative surgery) were compared. Results: To have a clinical nurse specialist on the trauma team resulted in a statistically significant reductions in the length of general ward hospital stay (p<0.05), the ICU re-admission rate, (p<0.03), the lead-time before transfer to other departments (p<0.05). Conclusion: The clinical nurse specialist, as a professional practitioner, improved the quality of treatment through early detection and management of problems. In addition, as a coordinator, the clinical nurse specialist maintained a cooperative relationship with multi-disciplinary medical personnel. The trauma clinical nurse specialist contributed to the treatment of trauma patients positively through a decrease in ICU re-admission rate and length of hospital stay.

Experience of Aging Simulation Clothes among Undergraduate Nursing Students (간호대학생의 노인체험복 착용경험에 관한 연구)

  • Jeong, Hyesun;Kim, Eungjong;Kim, Junghee
    • 한국노년학
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    • v.30 no.1
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    • pp.141-157
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    • 2010
  • This quasi-experimental study examined the experience of simulation clothes and its effects among undergraduate nursing students. Method: The experimental group consisted of 44 sophomore students in a diploma nursing program, while 41 students comprised the comparison group. Only the experimental group experienced the functional decline of aging after taking on simulation clothes. Homogeneity between the groups was analyzed using t-test, and Fisher's exact test. Paired t-test and t-test were adopted for testing changes of attitudes and awareness of supporting elders. In addition, contents of students' reports of the aging simulation experience were analyzed. Results: No significant quantitative effect was observed in attitudes toward elders and awareness of supporting elders. However, the simulation experience seemed to have enhanced students' understanding of elders and of basic elder care as well. Furthermore, the students could think of preparing for their later lives. Conclusion: The experience of simulation clothes is a meaningful learning opportunity in gerontological nursing curriculum. Students' experiences need to be shared and reinforced in a discussion session. Safety should be secured in the process of the experience. The simulation experience can be further developed to raise its quality.

A Study on Patients' Satisfaction and Service Utilization in the DRG Based Payment System - Patients who Experienced Cesarean Section Before and After the Demonstration Program - (DRG 지불제도에서 환자의 의료서비스 만족도와 제공량에 관한 연구 - 시범사업 전.후 제왕절개 분만 경험 산모를 대상으로 -)

  • Kim, Ji Sook;Park, Hayoung
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.190-202
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    • 2000
  • Background : The objectives of this study were to examine patients' satisfaction with the DRG based payment method and its association with their awareness of the method, to examine patient reported changes in doctors' caring attitude, level of their out-of-pocket payments, providers' acceptance of patients' request for additional services after the program, and to examine changes in service utilization recorded in medical records. Method : One hundred-four patients who had cesarean sections before and after the demonstration program at two hospitals located in Seoul participated in the study. Patients were surveyed before discharges when their charges were finalized. Their medical records were reviewed as well to collect data for service utilization during hospital stays. The association between patients' satisfaction with the payment method and their awareness of the method was analyzed by ${\chi}^2$-test, and the significance of changes in providers' acceptance of patients' request for additional services and service utilization after the program were examined by ${\chi}^2$-test and t-test, respectively. Results : A large proportion of patients did not know of the DRG based payment method at the time of survey and a significantly larger proportion of patients who came to the hospitals with the knowledge satisfied with the method. About the same proportion of patients reported improvement and deterioration in doctors' caring attitude compare to the previous hospitalizations and a similar result was found concerning out-of-pocket payments. Providers' acceptance of patients' request for medication, PCA and painless delivery decreased significantly after the program whereas the acceptance for additional hospital days and laboratory and radiology tests did not. Length of stay, the numbers of days on antibiotics and antianemic medication, and the number of blood tests decreased significantly after the program, however, decreases in the rate of antianemic medication and the number of urine analyses were not statistically significant. Re-operation, in-hospital death, and complications were not observed before and after the program. Conclusion : The study findings indicated a need for better patient education and publicity about the newly introduced payment method to improve their satisfaction with the system. Other study findings concerning service utilization and quality of care indicators were consistent with the government funded evaluation studies.

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Perceptions of Hospital Health Information Managers Regarding Present on Admission Indicators in Korea: A Qualitative Study (입원 시 상병의 수집 및 활용에 관한 보건의료정보관리사의 관점: 질적 연구)

  • Pyo, Jee-Hee;Choi, Eun-Young;Oh, Hae-Mi;Lee, Won;Kim, Ju-Young;Ock, Min-Su;Kim, So-Yoon;Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.26 no.1
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    • pp.23-34
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    • 2020
  • Purpose: This qualitative study was conducted to examine the current status and problems concerning the collection of present on admission (POA) indicators and determine how to use these indicators for evaluating the quality of care and degree of patient safety. Methods: A total of 11 health information managers were divided into two groups according to the size of their hospitals. Two focus group discussions (FGDs) were conducted, one for each group, which followed a pre-developed semi-structured guideline. The verbatim transcriptions of the FGDs were analyzed. Results: The majority of participants were concerned about entering POA flags honestly because they did not know how future POA indicators would be used. In particular, for some participants, POA N was a burden that could imply a signal of mismanagement within the medical institution. In addition, the lack of awareness and indifference of physicians regarding POA indicators were some of the difficulties for POA flag entry. Although medical institutions are making efforts to improve the accuracy of POA flagging, many participants mentioned the need to develop real case-oriented POA entry guidelines to improve the accuracy of POA flagging. Conclusion: To increase the validity of POA indicators, it is necessary to increase the level of awareness of POA indicators in physicians and other medical professionals. Furthermore, efforts related to POA indicators by individual medical institutions need to be reflected in the process evaluation.

A Study on Evaluation of the Appropriateness of Hospitalization for Patients with Stroke (뇌졸중 환자의 재원 적절성 평가에 관한 연구)

  • Choi, Eun-Mi;Yoo, In-Sook
    • Journal of Digital Convergence
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    • v.10 no.3
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    • pp.233-240
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    • 2012
  • This study aimed to clarify any factors that may have effect on the appropriateness of hospital admission and hospitalization with the intention of facilitating more efficient occupancy of hospital beds and better medical services in the aspect of their quality, minimizing unnecessary occupancy of beds, and ultimately helping patients requiring acute treatments to use immediately hospitals. This paper selected 154 Stroke patients who left neurology department of one general hospital from March, 1, 2006 to September, 31, 2010 as targets to meet the rate according to medical care security and to see the trend of recent 4 years. As study method, this paper analized medical treatment record with AEP to evaluate the appropriateness of hospital admission and stay and the collected data was computerized through SPSS 12.0. Based upon the results above, the conclusion was drawn that the higher appropriateness of hospital admission and the shorter length of hospital stay will lead to the higher appropriateness of hospitalization. In other words, it is required to provide hospitalized patients with all kinds of behaviors including medical treatments and nursing care service, management of pharmaceuticals, tests, rehabilitation and symptoms, as well as instructions and information for patients. Meanwhile, as it was found that the length of hospital stay may affect the appropriateness of hospitalization, the longer length of hospital stay may result in reduced bed turnover rate. In this light, it is necessary to organize a task force team responsible for evaluation and control of the appropriateness of hospitalization and hospital stay length to improve the quality of medical service in a medical center, so that patients can leave the center timely. Ultimately, governmental supports such as expansion of long-term care facilities will reduce the necessary length of hospital stay so that patients with stroke can receive rehabilitative treatments and long-term care service shortly after completion of acute treatments.

Policy Measures for Improving Health Care Services in Rural Areas (농촌보건의료서비스 향상을 위한 제도 개선방안)

  • Moon, O.R.;Lee, L.S.;Park, J.Y.;Ko, D.H.;Lee, K.H.
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.97-119
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    • 1991
  • Korea has made a rapid economic development since the last three decades. This has helped Korea narrow the gap in health service differences in resource availability and in quality of care. However urban and rural differentials are still remarkable. This study has maintained that health status of rural residents is inferior to that of urban dwellers. Therefore, this study was carried out to develop policy measures for improving health services in rural areas. In order to achieve the objective of this study the authors collaborated closely and made field visits, interviews and conducted an extensive literature review regarding rural health services. The following policy options are recommended as a summary ; First, the quality of rural health personnel is a single most important factor influencing the level of rural health services. An innovative program for public health doctors to the internship and/or residency training program such as specialty board program of family medicine. Second, dissatisfaction regarding employment of public health doctors is problematic. More rational employment and deployment programs are needed to meet their personal desire. One way to do this is to make it wide open and competitive. Third this study shows how to increase physician productivity in the rural public health sector. Incentive system needs to be elaborated for the career development of rural health workers. University linked job opportunity as clinical professor is an example. Fourth, without straightening the function of health centers and subcenters, the future of rural health services is doomed to failure. Straightening primary health care is one way to enrich the program of public health facilities and reactivating the operation of health center/hospital is another. A close linkage of public facilities with private hospitals is a minimum requirement for the operation of health delivery system within a health district. Fifth, some measures are urgently required to enhance hospital services in medically underserved areas. Financial subsidy, tax exemption, long-term public loans and higher priority of health manpower deployment are some of them. Sixth, new health programs should be in tiated to meet changing needs of peoples in rural areas. Home health care program, hospice program, nursing home, residential program for the elderly are recommended.

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A Comparative Study regarding Health Condition and Work Stress of Nurses Working in Cancer Ward and General Ward (암병동간호사와 일반병동간호사의 건강상태와 직무스트레스 비교 연구)

  • Kim, Hyun-Sook
    • Asian Oncology Nursing
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    • v.1 no.2
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    • pp.191-203
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    • 2001
  • The health of a nurse is very important because her mental and physical health can influence toward nursing patients directly, Especially, Cancer patients are growing annually. Also, terminal cancer patients' nursing and dead place are increasingly using hospital and the period of nursing for cancer patients are increasing. Nursing for cancer patients are different with acute disease. Therefore, I analysed comparing nurses' health working in cancer and general ward so that nurses working at cancer ward could be developed as a professional nurse, and I wanted to establish the foundation of nursing administration and reasonable manpower management to supply good quality of nursing to patients. In my research, I selected 117 nurses working in cancer ward and 134 nurses working in general word to analyse the stress rate and nurse's health comparing nurses working in general ward and cancer ward. The survey was conducted of nurses working in cancer ward nurses in 2 university hospitals, nurses working in a cancer hospital, and general ward nurses working in 3 public hospital. Also, the data was collected from Sep. 13, 2001 to Sep. 28, 2001. As health measuring tool, I used Cornell Medical Index(CMI) which are developed to fit Koreans by Ko Ungrin and Park Hang-bas (1980) using Cornell Medical Services which were designed by Weiser, Brosman, Mittelman, Wechler, Wolff in Cornell University(1945). As working stress measuring tool, I used Questionaries which were designed by Kim Mae-ja and Ku Mi-ok(1984) and then developed by Bae In-sook(1996). For managing the data, I used frequency, percentage, ${\chi}^2$ verification, t-test, and F-test (ANOVA). And in the case of significant data(p<.05). I did Duncan's test for post verification. The mutual relation between health condition and working stress rate have been conducted using Pearson's Correlation Coefficient. Followings are the results of my research. 1. Two groups showed significant differency at age after testing homogeneous character between two groups (${\chi}^2$ =9.919, p=.007). 2. Comparing two group's health condition, cancer ward(average 19.35${\pm}$18.34) were higher than general ward(14.42${\pm}$10.59) and showed statistical significant differency(p=.009). And, comparing two group's mental condition, cancer ward(9.00${\pm}$9.79) were higher than general ward(7.13${\pm}$6.35) and statistically no differency. 3. After comparing two group's working stress rate, the rate of cancer ward nurse's working stress(3.36${\pm}$.50) is higher than general ward nurse (3.32${\pm}$.48). There are no significant differency. However, in the detailed verification test, there were significant differency at inappropriate compensation (t=3.254, p=.001) and medication issue (t=2.170, p=.031). 4. After comparing health condition at general points, physical health condition showed significant differency at age(p=.020), the number of children (p=.015), religion (p=.015), position(p=.005), career(p=.008), working satisfaction(p=.003), activity after office hour(p=.045); and mental health condition showed significant differency at position(p=.010), career (p=.017), working satisfaction (p=.003). 5. After comparing the working stress rate according to general points, there were significant differency at working satisfaction (F=5.285, p=.006), predicted nursing(F=3.822, p=.023). 6. At the relation of health condition and working stress rate between two groups. physical and mental condition showed significant relation with working stress rate. i.e, if a nurse's health condition is not good, she are feeling much more stress than others. After considering all the factors in my research, I found that the health condition and stress rate of cancer ward nurses is much higher than general ward nurses. Considering that cancer ward nurses is necessary to care for increasing cancer patients with mental and physical nursing, the less stress for cancer ward nurses is very important to develop nursing quality and working efficiency by keeping good health condition, specializing cancer ward nurses. Therefore, we need following studies to find the factors which are effecting to cancer ward nurses' health and specialization. Also, we need to improve managing working condition to decrease working stress by improving working condition.

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Sleep Quality and Sleep Patterns of Patients Treated by the Hemopoietic Stem Cell Transplantation (조혈모세포 이식환자의 입원 후 수면의 질과 수면양상의 변화)

  • Choi, So-Eun;Park, Hae-Ryung;Park, Ho-Ran
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.37-44
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    • 2005
  • Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.

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