• 제목/요약/키워드: Standard of Care

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중환자실 환자의 건강결과 예측을 위한 중증도 평가도구의 정확도 비교분석 (Comparative Analysis of the Accuracy of Severity Scoring Systems for the Prediction of Healthcare Outcomes of Intensive Care Unit Patients)

  • 성지숙;소희영
    • 중환자간호학회지
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    • 제8권1호
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    • pp.71-79
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    • 2015
  • Purpose: The purpose of this study was to compare the applicability of the Charlson Comorbidity Index (CCI) and Acute Physiology, Age, Chronic Health Evaluation III (APACHE III) to the prediction of the healthcare outcomes of intensive care unit (ICU) patients. Methods: This research was performed with 136 adult patients (age>18 years) who were admitted to the ICU between May and June 2012. Data were measured using the CCI score with a comorbidity index of 19 and the APACHE III score on the standard of the worst result with vital signs and laboratory results. Discrimination was evaluated using receiver operating characteristic (ROC) curves and area under an ROC curve (AUC). Calibration was performed using logistic regression. Results: The overall mortality was 25.7%. The mean CCI and APACHE III scores for survivors were found to be significantly lower than those of non-survivors. The AUC was 0.835 for the APACHE III score and remained high, at 0.688, for the CCI score. The rate of concordance according to the CCI and the APACHE III score was 69.1%. Conclusion: The route of admission, days in ICU, CCI, and APACHE III score are associated with an increased mortality risk in ICU patients.

호스피스 대상자의 돌봄 요구 유형에 관한 주관성 연구 (A Study on the Subjectivity of Care Needs for Hospice Patients)

  • 용진선;한성숙
    • 성인간호학회지
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    • 제16권4호
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    • pp.677-689
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    • 2004
  • Purpose: The purpose of the study was to identify types of care needs for hospice patients through Q- methodology. Method: Twenty three Q-statements were selected through in-depth interviews of hospice patients. Data were collected from 20 hospice patients by sorting 23 Q-statements into 9 points standard and then analyzed using PC QUANL program. Result: Type 1 was named 'the need for pain control type' and patients of this type had the greatest need of physical care to be free of pain and be comfortable. Type 2 was named 'the need for love and intimacy type' and patients of this type would like to share love and intimacy with their family members. Type 3 was named 'the needs for reliance on an Absolute Being type' and patients of this type would like to receive forgiveness from their God and prayers. Type 4 was named 'the need for accomplishment and service type' and patients of this type would like to complete their on going work and to give service to others. Conclusion: The study result could be basic data to perform effective nursing interventions for satisfying the care needs of hospice patients.

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조산사의 기본업무를 위한 핵심능력 개발 (Core Competency of Basic Practice of Nurse-Midwifery)

  • 이경혜;김경원
    • 여성건강간호학회지
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    • 제9권4호
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    • pp.410-421
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    • 2003
  • Purpose : The purpose of this study was to develop core competency of midwife practices to improve midwifery education, national examination and clinical practices. Method: Literature and. document review and internet search and survey were used. 127 registered in the Korean Midwifery Association midwives by structured instrument were surveyed to analyze midwife's practices and work situation. Result : Midwifery education program has to be either a post graduate or a graduate program for people with nursing license. Midwifery practice has to be extended to a lifelong health care of all women including non-pregnant women, not just a health care of pregnant women and newborns. Thus, a primary health care of women, laws/ethics, and management skills were included in the core competencies of midwifery practice considering the international trend of future-oriented and extended role of a midwife. Also, newborn care and ability to cope with emergency situations were emphasized based on the midwife´s opinion. Conclusion: This study has to be developed midwifery practices and education and the standard of midwifery practice has to be stated based on that result.

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시뮬레이션을 활용한 분만간호 실습교육의 효과 (Effects of High-fidelity Simulation-based Education on Maternity Nursing)

  • 정재원;김희숙;박영숙
    • Perspectives in Nursing Science
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    • 제8권2호
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    • pp.86-96
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    • 2011
  • Purpose: This study examined the effects of simulation-based education on knowledge about and self-confidence in maternity nursing care in senior students. Methods: One group, pre-post design, was utilized with 28 students. The simulation-based maternity nursing education that consisted of two sessions each 2 hours long for intrapartum and postpartum care was provided to 4 small groups. An expert panel of 3 maternity clinical instructors developed the module with a high-fidelity maternal simulator. Core items of knowledge about and self-confidence in maternity nursing care were measured with 13 items before and after the sessions. Results: The knowledge score did not increase significantly (z=-1.95, p=.05); however, self-confidence in maternity nursing care showed a significant change in the posttest (z=-2.82, p<.001). The subjective evaluation of the students indicated that the simulation-based education was helpful in preparing for clinical practicum as far as interaction with clients, psychological readiness to practice, and learning efficiencies. Conclusion: The simulation-based nursing education was useful in improving self-confidence in clinical performance for childbirth and postpartum care in nursing students. Along with the application of diverse scenarios in simulations, modules with standard patients and role-plays are also recommended for maternity nursing practicum to empower the competency of the students.

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도시ㆍ농촌 지역 어머니의 보육시설 질적 기준에 대한 인식 비교 (The Comparision of Mother′s Perception of the Importance of Selected Quality Criteria when Choosing a Day Care Center in Urban and Rural Community)

  • 박인전;안지연
    • 한국농촌생활과학회지
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    • 제6권2호
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    • pp.121-136
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    • 1995
  • The purposes of this research are to find out the standards which mothers consider seriously when choosing a day care center and mother's perception for the quality criteria of day care center, and to estimate the differences of these according to region. The sample consisted of 568 mothers with children using day care center located at the city of Taegu and Dalsung Gun. Collected data were analyzed by frequency, Percentage, chi-square, t-test, chronbach's $\alpha$. The results are summerized as follows : 1. In mother's perception for the quality criteria of day care center, the mothers living in the large city perceived more importantly in staff qualifications, administration - evaluation, staff- parent/staff- child interaction, curriculum, staffing, physical environment nutrition, health and safty than mothers in rural community. 2. In the importance classified by domains of the quality criteria of day care center, there were statistically significant differences according to the variable of region in staff qualifications, staff-parent/staff-child interaction, curriculum, staffing, physical environment 3. Given the present situations (income, transportation, location of workplace, etc.), when mothers choose a day care center, generally, staff-parent/staff-child interaction was the most important factor. And according to region, the distance to workplace or home was the most important factor in the case of mothers living in the large city, on the other hand, staff-parent/staff-chad interaction was the most important factor in the case of mothers living in rural community when mothers choose an ideal day care center, generally staff-parent/staff-chad interaction was the most important selection standard, and there were not remarkable differences according to region.

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간호수가 산정을 위한 간호행위의 규명 연구 (Identification of Nursing Activities for Determination of Nursing Cost)

  • 박정호;황보수자;이은숙
    • 대한간호학회지
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    • 제22권2호
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    • pp.185-206
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    • 1992
  • In this study nursing activities were examined to determine the nursing cost. A professional nursing group developed a tool for the investigation. 128 nursing activities were identified by the tool in 16 nursing care areas as referenced in the literature. Each activity was examined for four essential factors to define nursing cost ; time consumed for the care, level of professional skill, degree of independency and performer of the care. The activity was rated by a five point Likert scale. This investigation was conducted with the nursing staffing working in the 21 university hospitals in Korea and having more than four years experience especially in medical or surgical wards. The participating nursing staff were screened on the basic of the recommendation of the nursing director. The data were gathered from June 12th to August 12th, 1989. All the data were analyzed for mean, standard deviation, percent, and correlation coefficients between items. The results are summarized as follows : 1. Direct nursing care was classified into 16 large areas and 128 small activities. 2. No significant correlation was found between the study items of each activity. 3. Among 128 nursing activities, Those performed less than 50% of the time by a nurse were excluded from the nursing cost. Also excluded activities which were given less than 9 marks in all three items, time consumed, level of professional skill, and degree of independency. As a result, 83 activities in 14 nursing care areas were selected for the proposal to estimate nursing cost.

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보육시설급식소의 HACCP시스템 적용을 위한 미생물적 품질평가 II. 비가열조리 공정을 중심으로 (Microbiological Quality Evaluation for Implementation of a HACCP System in Day-Care Center Foodservice Operations II. Focus on Non-Heating Process)

  • 민지혜;이연경
    • Journal of Nutrition and Health
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    • 제37권8호
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    • pp.722-731
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    • 2004
  • The objective of this study was to evaluate the microbiological quality of non-heat-processed foods for implementation of a HACCP (Hazard Analysis and Critical Control Point) system in day-care center foodservice operations. The evaluating points were microbial assessment of foods, utensils, and employee's hands during preparation, cooking, and serving. The temperature of non-heated food being served was also measured. Microbiological quality was assessed using 3 M Petrifilm/syp TM/ to measure total plate count and coliforms for food and utensils and Staphylococcus aureus for hands in five Gumi day-care centers. Results showed low microbiological quality of non-heated foods. This was probably due to contaminated raw ingredients and cross-contamination that occurred during preparation and cooking (e.g., unsatisfactory washing and disinfection of raw materials and utensils). These results suggest that it is essential to educate employees on good personal hygiene (hand washing) , prevention of cross-contamination through use of properly washed and sanitized utensils, and proper washing and disinfection of raw vegetables. Establishing Sanitation Standard Operating Procedures (SSOPs) are an essential part of any RACCP system in day-care center foodservice operations.

일 상급종합병원 장기재원환자의 특성과 전원 결정 여부에 영향을 미치는 요인 (Characteristics of Long-term Care Patients at a Tertiary Referral Hospital and Factors Influencing the Decision of prolonged Care-giving)

  • 이미진
    • 가정간호학회지
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    • 제31권1호
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    • pp.56-65
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    • 2024
  • Purpose: This study aimed to explore the association between demographic characteristics, hospitalization-related characteristics, and the severity of long-term hospitalization in a high-level general hospital, and to analyze the factors influencing decisions of all patients. Methods: General and clinical characteristics of the participants were analyzed using frequency, percentage, mean, and standard deviation. Differences in these characteristics, contingent upon whether a power source was requested, were analyzed using independent t-Test and Chi-squared tests. Logistic regression analysis was used to identify the factors related to the presence or absence of power requests. Results: The factors impacting the decision to refer a dependent variable include medical treatment (neurosurgery) (B=2.118, SE=0.960, p-value=.027, OR=8.314, 95% CI=1.267-54.551), infection isolation (CRE) (B=1.336, SE=0.666, p-value=.045, OR=3.804, 95% CI=1.032-14.021), and the utilization of tertiary antibiotics (B=3.076, SE=1.362, p-value= .024, OR=21.663, 95% CI=1.502-312.530). Conclusion: This study found a significant association between medical treatment (neurosurgery), infection isolation (CRE), and the use of tertiary antibiotics as dependent variables. These findings indicate that continuous monitoring can contribute to a reduction in long-term financial burdens.

지역사회 노인의 건강정보이해능력과 미충족 의료가 건강증진행위에 미치는 영향 (Effects of Health Literacy and Unmet Health care Needs on Health Promotion Behavior among Elderly in the Community)

  • 이승주;심문숙
    • 한국보건간호학회지
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    • 제34권2호
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    • pp.238-250
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    • 2020
  • Purpose: The purpose of this study was to investigate the effect of health literacy and unmet health care needs on health promotion behaviors among elderly people receiving visiting health care services at community health centers. Methods: The subjects of this study were 180 elderly people over 65 years old who were receiving health care services at public health center The subjects fully understood the purpose of this study and voluntarily agreed to participate. The collected data were analyzed by frequency, percentage, mean, standard deviation, independent t-test, one-way ANOVA, Scheffé test and Hierarchical Regression Analysis using the SPSS 23.0 program. Results: Hierarchical regression analysis was used to identify factors influencing health promotion behaviors of the subjects. The results were as follows: presence of occupation (β=.26, p<.001), social activity status (β=.26, p=.001), and health literacy (β=.16, p=.023). Conclusion: Therefore, in order to improve health promotion behaviors, it is necessary for visiting nurses to administer health education and programs by considering the level of health care understanding.

Relationship between sonorheometry parameters and laboratory values in a critical care setting in Italy: a retrospective cohort study

  • Antonio Romanelli;Renato Gammaldi;Alessandro Calicchio;Salvatore Palmese;Antonio Siglioccolo
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.210-216
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    • 2023
  • Purpose: This preliminary retrospective cohort study analyzed the relationship between the parameters provided by sonorheometry device Quantra and the coagulation values obtained from standard venous blood samples in patients admitted in intensive care unit (ICU). Methods: We reviewed medical charts of 13 ICU adult patients in whom at least one coagulation study with Quantra was performed. The relationship between Quantra and laboratory data was analyzed with the Spearman rank correlation coefficient (rho). The 95% confidence interval (CI) was computed. A P-value <0.05 was considered statistically significant. Results: We collected 28 data pairs. Statistically significant moderate correlations were found for the following parameters: clot time (CT) and activated partial thromboplastin time (rho=0.516; 95% CI, 0.123-0.904; P=0.009; clot stiffness (CS) and the international normalized ratio (INR; rho=0.418; 95% CI, 0.042-0.787; P=0.039); INR and platelet contribution to CS (rho=0.459; 95% CI, 0.077-0.836; P=0.022); platelet count and platelet contribution to CS (PCS; rho=0.498; 95% CI, 0.166-0.825; P=0.008); and fibrinogen and fibrinogen contribution to CS (FCS; rho=0.620; 95% CI, 0.081-0.881; P=0.001). Conclusions: Quantra can provide useful information regarding coagulation status, showing modest correlations with the parameters obtained from laboratory tests. During diffuse bleeding, CT and FCS values can guide the proper administration of clotting factors and fibrinogens. However, the correlation of INR with CS and PCS can cause misinterpretation. Further studies are needed to clarify the relationship between Quantra parameters and laboratory tests in the critical care setting and the role of sonorheometry in guiding targeted therapies and improving outcomes.