Purpose: The purpose of this study was to identify the influencing effects of job stress, professional autonomy, and reciprocity on the job embeddedness among comprehensive nursing care unit nurses. Methods: The participants in this study were 147 nurses who have worked for over 6 months in Comprehensive Nursing Care Unit. Data were collected from January 3 to January 31, 2022 from six general hospitals with more than 300 beds in three cities in G, G and P. Results: As the results of hierarchical regression analysis, job embeddedness was lower when nurses had clinical experiences for 1 to under 5 years (β=-.49, p<.001), 5 to under 10 years (β=-.27, p=.035), 10 to under 20 years (β=-.54, p<.001) compared to those who had clinical experiences for more than 20 years. Also, job embeddedness was higher when there was greater balance within team caregiving of reciprocality (β=.27, p<.001) and intrinsic reward (β=.22, p=.003), and lower role conflict (β =-.27, p<.001). Conclusion: The results of the study showed that job embededness would increase if the role conflict of comprehensive nursing care unit nurses reduces, if there was a culture that the members can make cooperative relationship with other health care professionals and, if there was an appropriate intrinsic reward depending on their work experience.
Purpose : This study aimed to investigate the characteristics and risk factors associated with pressure injuries related to medical devices among patients admitted to the intensive care unit (ICU). Method : A retrospective study analyzed data from 462 ICU patients. Statistical analyses, including independent t-tests, Fisher's exact tests, and logistic regression were performed to analyze the data. Results : Among the 154 subjects, there were a total of 198 medical device-related pressure injuries (MDRPI). Stage 2 and deep tissue pressure injuries were the most frequent. MDRPI occurred most frequently on the face, with nasogastric tubes being its leading cause, followed by endotracheal tubes. The risk factors for MDRPI included male sex (odds ratio [OR]=1.78, 95% confidence interval [CI]=1.12-2.83), department at the time of ICU admission (OR=4.29, 95% CI=2.01-9.15), post-surgery ICU admission (OR=0.43, 95% CI=0.25-0.73), application of extracorporeal membrane oxygenation machines (OR=2.72, 95% CI=1.06-6.95), number of medical devices (OR=1.16, 95% CI=1.05-1.30), inotropic drug administration (OR=2.33, 95% CI=1.19-4.60), and sedative use (OR=2.53, 95% CI=1.17-5.45). Conclusion : These results enable the determination of the characteristics and risk factors associated with MDRPI. It is crucial to acknowledge the risk factors for MDRPI in ICU patients and establish a prevention strategy.
The need of oriental nursing role is recently increasing. The implication of this trend is enormous not only for the need of independent of independent oriental nursing intervention. Hence, this study was designed to describe the characteristics of oriental nursing activity and identify the meaning of nursing activity in oriental hospital. A total of 24 nurses were selected by convenience sampling from eight units at one oriental hospital. A total of 168 data were collected using minute-by-minute recording during nurse s work shift. The data were analyzed using nova and scheffe method as post-hoc test The results of this study are as follows; 1. the category of nursing activity in oriental hospital 74.4% of nursing activity was the patient-oriented nursing care. The nursing activity included others (18.28%), the function-oriented nursing care (7.07%), and staff-oriented care (0.2%). 29.1 % of the patient-oriented nursing care was the direct care, and 24. 5 % of the patient-oriented nursing care was the indirect care. There was a lack of patient education and the communication patient. 2. Nursing activity in oriental hospital by characteristics 1) Nursing activity by unit For patient-oriented nursing care, there was a statistically significant difference among 8 units. In the critical care unit, the patient-oriented nursing care was mostly performed. For function-oriented nursing care, there was statistically significant difference among 8 units. In the physical therapy unit, the function-oriented nursing care was mostly performed. 2) Nursing activity in oriental hospital For all kinds of nursing activity, there was a statistically significant difference between shifts. In night shift patient-oriented nursing care, function-oriented nursing care, and other kinds of nursing care was mostly performed. Patient-oriented nursing care included indirect care, treatment set management, and the breaktime. In day shift, staff-oriented nursing care was performed. 3) Nursing activity in oriental hospital For all kinds of nursing activity, there was not a statistically significant difference by day. The day has not impact on nursing activity. 3. the meaning of activity in oriental hospital The results of this study show that the patient-oriented care was vital check, input! output check, medication, bedsore prevention, nasogastric feeding, oral care, catheterization care, perinatal care, nursing care associated with acupuncture and moxacautery, observation (fever, sweating), heat and cold application communication with patent and family, and patient room management In conclusion, two issues associated with the findings of the research appeated to be involved in the difficulty of nursing activity in hospital. The first issue was the nursing care in oriental hospital provided by nurses who have a limited understading of the principles of oriental medicine. The second issue was the deficiency of systematic guideling for oriental nursing activity. The findings suggest the need to develop the systematic guideline for oriental nursing activity. The need of continuing education for nurses who work in the oriental hospital, and the need of nursing education including oriental nursing are critical.
A teaching hospital is a place where both patient care and learning occur together. To identify the role of the teaching hospital in an effective clerkship, we first determined the features of workplace learning and the factors that affect learning in the workplace, and then we proposed a role for the teaching hospital in the clinical clerkship. Features of learning in a clerkship include learning in context, and learning from patients, supervising doctors, others in the team, and colleagues. During the clerkship, medical students learn in three-way learner-patient-teacher relationships, and students' participation in the tasks of patient care is crucial for learning. Factors that influence learning in the workplace are associated with tasks, context, and learner. Tying the three factors together, we proposed a role for the teaching hospital in the three categories: involvement in the tasks of patient care, engagement in the medical team, and engagement in the learning environment and system. Supervising doctors and team members in a teaching hospital support students' deep participation in patient care, while improving the learning environment through organizational guidelines and systems. Gathering both qualitative and quantitative data for the evaluation of a teaching hospital is important.
Bosco, F;Cidin, S;Maceri, F;Ghilli, M;Roncella, M;De Simone, L
대한약침학회지
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제21권2호
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pp.126-131
/
2018
This study investigates the effect of a combination of homeopathic medicine and electro- acupuncture in two patients with breast cancer and severe liver disease who could not receive standard anaesthesia therapy due to liver problems. Specifically, measurable and quantifiable parameters were used to evaluate whether an integrated approach-consisting of electro- acupuncture and a homeopathic medicine diluted above Avogadro's limit (that is, above a potency of 12CH) during the pre-surgical, surgical and post-surgical phases -can improve general well-being of a patient undergoing breast cancer surgery. In breast cancer surgery, we employed an integrated approach consisting of induction with hypnotics and muscle relaxants, followed by maintenance with anaesthetic gas, combined with a homeopathic treatment (Arnica montana 15CH and Apis mellifica 15CH) before and after surgery and an electro- acupuncture treatment performed in the pre- and post-surgical phases without any analgesic/pain relieving medications. Both of the patients treated with the integrated approach improved their overall condition without need for other common pain relieving medicines. Additionally, thanks to their rapid awakening, the patients were not relocated to a protected area and the hospitalization was shorter. A multidisciplinary approach incorporating homeopathic medicine and electro-acupuncture can be a solution for patients who need or ask about a different and/or safer alternative to the standard treatment. This approach can offer a safe, much less expensive, non-invasive and viable alternative for such cases. Moreover it can be useful for an opioids free anesthesia.
The shortage of nursing personnel was become one of the most serious problems in operating pediatric oncology nursing unit which was the first pediatric oncology nursing unit in Korea. The purpose of this study was to estimate the optimal number of nursing personnel by calculating nursing care hours. The subjects were 13 staff nurses and inpatients of pediatric oncology nursing unit at Seoul National University Hospital during the period of May 20, 1996, to June 2, 1996. The number of nurses' duty was 132, the number of patients treated was 1288 for these 2 weeks. The tools used for this study were pediatric patient classification indexes and direct & indirect care indexes. Each nurse measured the time that they spent for their activities by self record under the supervision of their nurse manager. The method used to calculate the number of nursing personnel was multiplication of the average number of nursing care hours per patient per day with the number of patients. Percentage, average, t-test, F-test were used for data analysis. The results of this study were as follows : 1) The distribution of patient class : Class I & II none, Class III 86.8%. Class IV 12.9% 2) Direct nursing care hours for a patient per shift according to patient classification: Class III : 27.64 minutes, Class IV : 54.64 minutes The average direct nursing service hours for a patient per shift(3 shift) was 31.54 minutes(94.62 m/day). The average indirect nursing service hours for each patient per duty(3 shift) is 21.3 minutes (63. 91 m/day). 3) The average nursing hours for a patient per duty was 52.80 minutes(2.64h/day). 4) The group of administering medications in direct care activities showed the highest percentage (38.9%). Checking vital signs among observation took the most time am.ong each direct care activity (6.88 minutes for a patient per duty). 5) Charting took the most time of each indirect care activity(52.53 minutes/ duty/nurse). 6) The average personal time per duty is 29.40 minutes, which 'was below 30 minutes of this hospital regulations. 7) The average nursing hours that a nurse provided for a duty was 8.60 hours, which meant that a nurse worked 1.10 hours overtime. 8) Standardizing to a 33 bed to a unit, 17 nurses were needed at the present nursing level.
Background : As an empirical study, current research about the quality of social services carried out in general and teaching hospitals across the country. In the flux of health care reforms and market transformation, the quality of social services in the hospital becomes increasingly significant. Methods : A sample of total 80 hospitals, including general hospitals with one social worker at least and single-department hospital with two social workers or more, were identified nationwide through the registry of Korean Association of Medical Social Workers and Korean Association of Hospitals. The subjects of this survey were 80 leaders of social service units. The survey data from each subjects were measured to evaluate level of quality that service provider perceived of sample hospitals. Under the method of one-way ANOVA and multiple regression, the level of quality in social work service was analyzed. Results : The major findings were as following ; First, the level of quality perceived showed less score, especially the lowest was the score of quality of outcome. Second, the key variables of each hospital which turned out significantly different in quality of social work service were the departmental form of social work unit, unit leader's age, educational level, field experience, and job rank. Third, the level of quality of social work service correlated positively with the field experience of unit leader, the size of social work unit, the job rank of the unit leader. Conclusion : The most influential variables to the quality of social work service proved departmental form of social work unit, leader of social work unit. Therefore, to assure the proper level of quality, social work unit in hospital must be structured single, independent department in which entitled social worker is supposed to supervise and manage. And a leadership-development program for leaders in social work unit are strongly recommended.
The purpose of this study was to investigate the spatial characteristics of residential and nursing units in large skilled nursing facilities for the elderly that were located in city areas, and to discuss the way for efficient unit care. For collecting the data, the researcher visited 6 facilities to make explorations and to interview the staff concerned. Most of the research facilities had systematic residential units that each unit basically had elderly private rooms and the spaces for small group. The number of elderly residents per unit was appropriate for the limit which was suggested by Kwon(2002), but the sizes of small group spaces were smaller than the standard limit($1.62m^{2}$ per resident). The nursing units were made up of nursing station, 2-4 residential units, spaces for large group of residents, hair dressing, nurse, living assistants, bathing, storage and etc. Some of them had problem in efficiency of space use because they did not have distinct usage. In conclusion, this study suggests that each floor has one nursing unit including 40 residents maximum and each nursing unit consists of 2-3 residential units that have 20 residents maximum per unit. In each residential unit, the furniture and spaces for efficient unit-care should be arranged, such as TV, dining table, kitchenette, bathroom, and rooms for living assistants. The hall type is better for the small group so that it has a transitional characteristic leading to the public spaces. The large group space needs to have clear usage such as conducting program differentiated from small group, and various furniture such as sofa, TV, table, and etc which encourage the elderly voluntary use.
Purpose: The purpose of this study was to explore the subjective experience of life-sustaining treatment care among nurses in intensive care units. Method: A phenomenology was used for the study. Data were collected from October to December, 2015 using open-ended questions during in-depth interviews. Participants were nurses working in intensive care units and were contacted through purposive techniques. Eight nurses participated in this study. Results: Four categories emerged from the analysis using Colaizzi's method: (a) difficulties due to life-sustaining treatment care, (b) dilemma of extension or cessation of life-sustaining treatment, (c) repressed feelings and emotional exhaustion, and (d) forming values for life-sustaining treatment from nursing experience. Conclusion: Provision of clearer guidelines on life-sustaining treatment which reflect a family-oriented culture is important for nurses in ICU and will promote nurses involvement in the decision-making process of life-sustaining treatment of patients.
Purpose: This study was conducted to investigate the factors influencing the competence in intensive and critical care nursing of senior nursing students. Methods: A descriptive survey was used to examine the factors that influence competence in intensive and critical care nursing. The data were collected using self-administered questionnaires; 237 senior nursing students were asked about general characteristics, critical thinking, communication competence, self-esteem, self-resilience, and self-leadership. Results: Multiple regression analysis indicated that self-leadership, self-esteem, and confidence in intensive care unit practice predicted the competence in intensive and critical care nursing (37.8% of explanatory power). Critical thinking, communication competence, and self-resilience were not shown to be significant predictors of, but were positively correlated with, the competence in intensive and critical care nursing. Conclusion: Based on the results, it is suggested that self-leadership, self-esteem, and confidence in intensive care unit practice should be considered in nursing education in order to improve nursing students' level of competence in intensive and critical care nursing.
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