• Title/Summary/Keyword: critical difference

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Effects of a Critical Thinking Course for Korean Nurses in RN-BSN Program

  • Je, Nam-Joo;Lee, Shin-Young;Lee, Seonah
    • Journal of Integrative Natural Science
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    • v.12 no.2
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    • pp.58-68
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    • 2019
  • Critical thinking is essential to implementing the nursing process requiring timely decision making. The study examined the effects of a critical thinking course for nurses in the RN-BSN program. The study used a pre- and post-test design with a control group. The experimental group was a convenience sample of 24 working nurses attending a health college. The control group was 24 fellow nurses. The nursing process-based critical thinking course was provided to the experimental group two and half hours a week for 8 weeks. Teaching methods included lectures followed by a summary and quiz, brainstorming and action learning, and lecturer feedback. A pamphlet about views of professional occupation was provided to the control group. The data were collected using self-report questionnaires and analyzed to examine differences in the test scores before and after the intervention. The scores of critical thinking disposition, problem-solving process, and clinical competence increased significantly in the experimental group but did not in the control group. The difference between the two groups was also statistically significant in critical thinking disposition, problem-solving process, and clinical competence. It is necessary that a robust educational program or training to enhance critical thinking ability of nurses are provided in clinical settings and that nurses keep going on thinking critically in their practice.

Critical Pathway Development for the Hysterectomy Patients and its applied Effect (자궁적출술 환자를 위한 critical pathway 개발과 적용효과)

  • Noh, Gi-Ok;Park, Kyung-Sook
    • Women's Health Nursing
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    • v.6 no.2
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    • pp.234-257
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    • 2000
  • At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

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A Study on Job Stress and the Health Status of ICU Nurses (중환자실 간호사의 직무스트레스와 건강상태에 관한 연구)

  • Park, Hyoung-Sook;Cho, Gyoo-Yeong;Gang, Eun-Hee
    • Journal of Korean Critical Care Nursing
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    • v.3 no.1
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    • pp.29-40
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    • 2010
  • Purpose: This study was to investigate Job Stress and the Health status of ICU Nurses. Methods: Data was accumulated from 230 ICU nurses serving at least more than one year in 500 bed order hospitals during the period of three months from June 1 to August 31, 2009. Results: The average job stress was $3.14{\pm}.59$ points, which was relatively high, The average health status was $1.52{\pm}.19$ points, There was significant difference according to religion and subjective health status in Job Stress, There was significant difference according to age, religion and subjective health status in Health Status, There was significant difference according to satisfaction of work, satisfaction of personal relations, impulse to give up duty and in service education in Job Stress, There was significant difference according to satisfaction of work. satisfaction of personal relations, and expectant nursing job in Health Status, There was significantly negative relationship between job stress and health status. Conclusion: Job stress has the most important impact on health status of ICU nurses, Based on the finding, we could conclude that job stress management of ICU nurses should be required to improve health status.

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Development and Effectiveness of the Critical Pathway for Laparoscopic Cholecystectomy Patients (복강경 담낭 절제술 환자의 표준관리지침 개발 및 적용 효과)

  • Jun, Seong-Sook;Park, Young-Ju
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.1
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    • pp.123-135
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    • 2002
  • Purpose: In this study, the critical pathway for laparoscopic cholecystectomy patients was developed and applied for clinical study. The effectiveness of the critical pathway was analyzed. Method: The subjects with no critical pathway services of this study were 30 laparoscopic cholecystectomy operation patients, who were hospitalized in B General Hospital in Busan from Nov. 28. 2000 to May 2. 2001. The subjects with critical pathway services of this study were 30 laparoscopic cholecystectomy operation patients, who were hospitalized in B General Hospital in Busan from June. 11. 2001 to Oct. 31. 2001. Results: 1. Development for critical pathway Preliminary critical pathway for the laparoscopic cholecystectomy patients was developed though analysis of the reference and 34 case of medical record. The items on the y-axis were assessment, test, treatment, diet, fluid, consult, medication, activity and education and the items on the x-axis were till 3days after operation. The developed critical pathway was applied in clinical field. 2. Effectiveness of application on developed critical pathwayPost operational complication was not found in neither the critical pathway using Group nor Non-using Group. Hospitalization period mean was 4.63 days for the using Group and 5.93 days for the Non-using Group(P=.001). The mean cost for medical examination and treatment for the using Group was 786,270 won, 117,454 won(12.9%) less than that of the Non-using Group, 903,724 won(P=.000). The degree of satisfaction for the using group was 3.7 points, for the Non-using Group, 3.15 points. The degree of satisfaction for the used Group was 0.55 points higher than that for the Non-using Group and there was a statistically significant difference(P=.000). Concousion: From results of this study, Using the critical pathway in the laparoscopic cholecystectomy operational patients was effective in decreasing the hospitalization period and cost, and increasing the satisfaction about the medical service.

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Role of Catheter's Position for Final Results in Intrathecal Drug Delivery. Analysis Based on CSF Dynamics and Specific Drugs Profiles

  • De Andres, Jose;Perotti, Luciano;Villanueva, Vicente;Asensio Samper, Juan Marcos;Fabregat-Cid, Gustavo
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.336-346
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    • 2013
  • Intrathecal drug delivery is an effective and safe option for the treatment of chronic pathology refractory to conventional pain therapies. Typical intrathecal administered drugs are opioids, baclofen, local anesthetics and adjuvant medications. Although knowledge about mechanisms of action of intrathecal drugs are every day more clear many doubt remain respect the correct location of intrathecal catheter in order to achieve the best therapeutic result. We analyze the factors that can affect drug distribution within the cerebrospinal fluid. Three categories of variables were identified: drug features, cerebrospinal fluid (CSF) dynamics and patients features. First category includes physicochemical properties and pharmacological features of intrathecal administered drugs with special attention to drug lipophilicity. In the second category, the variables in CSF flow, are considered that can modify the drug distribution within the CSF with special attention to the new theories of liquoral circulation. Last category try to explain inter-individual difference in baclofen response with difference that are specific for each patients such as the anatomical area to treat, patient posture or reaction to inflammatory stimulus. We conclude that a comprehensive evaluation of the patients, including imaging techniques to study the anatomy and physiology of intrathecal environment and CSF dynamics, could become essential in the future to the purpose of optimize the clinical outcome of intrathecal therapy.

The Effects of Reflection Rubric on Critical Thinking and Collaboration Argumentation in CSCA environment (CSCA 환경에서 성찰루브릭이 비판적 사고와 협력적 논증에 미치는 영향)

  • Kim, Soo Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.11
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    • pp.5559-5569
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    • 2013
  • The purpose of this study was to examine the effect of the reflection rubric on frequency and content of critical thinking in CSCA. The researcher carried out research during 4 weeks, on 60 students taking the course of 'educational methods and educational technology' in K collage. As the result of this study, The reflection rubric frequency could not be significant difference in critical thinking, but could be significant difference in critical thinking content and collaboration argumentation. The reflection rubric could prevent learner form giving one side reasoning, considered both side opinion and grounds. Also the reflection rubric could trigger learner to construct collaborative knowledge building more strongly. This study showed that the reflection rubric have significant impacts on the argumentation collaboration learning in CSCA.

A Study on Critical Reynolds Numbers of Two-Dimensional Closed Cavity by CFD (CFD에 의한 2차원 밀폐캐비티의 임계레이놀즈수에 관한 연구)

  • 김진구;조대환;이영호
    • Journal of Ocean Engineering and Technology
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    • v.11 no.4
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    • pp.122-129
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    • 1997
  • Flow characteristics of two-dimensional closed square cavities near unsteady critical Reynolds numbers were studied numerically at five Reynolds numbers : 8${\times}10^3$, 8.5${\times}10^3$, 9${\times}10^3$, 9.5${\times}10^3$ and $10^4$ were investigated. A convection conservative difference scheme based upon SOLA to maintain the nearly 2nd-order spatial accuracy was adopted on irregular grid formation. Irregular grid number is 80${\times}$80 and its minimum size is about 1/400 of the cavity height(H) and its maximum is about 1/53 H. The result shows that the critical Reynolds number indicating the emergence of flow unsteadiness exists near Re=8.5${\times}10^3$ and their flow patterns reveal periodic fluctuation during transient and fully-developed stages.

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Effects of Problem Based Learning on Critical Thinking Disposition and Problem Solving Process of Nursing Students (문제중심학습이 간호학생의 비판적 사고성향과 문제해결과정에 미치는 효과)

  • Yang, Jin-Ju
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.2
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    • pp.287-294
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    • 2006
  • Purpose: The purpose of this study was to identify the change of critical thinking disposition and problem solving process in students who experienced problem-based learning. Method: This research design was one group pre-post test design. Twenty-five nursing students who participated in ‘'Nursing Process' course with two PBL packages for a semester in 2004 were the subjects of this study. The data were analyzed by repeated measures of ANOVA, and content analysis. Result: The problem defining in problem solving process was improved significantly, but there was no significant difference in the critical thinking disposition. Conclusion: The results of this study suggest that PBL has a positive effect on nursing students' problem solving process, But for a more significant effect on a continuous base for critical thinking of nursing students, faculties should use web based and simulation-based education for self directed learning along with clinical situation-based scenarios.

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Development of Safety Criteria for Railway Safety Critical Software (철도 안전필수 소프트웨어를 위한 안전기준 도출)

  • Joung, Eui-Jin;Shin, Kyung-Ho
    • Proceedings of the KIEE Conference
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    • 2007.07a
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    • pp.1201-1202
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    • 2007
  • Safety critical systems are those in which a failure can have serious and irreversible consequences. Nowadays digital technology has been rapidly applied to critical system such as railways, airplanes, nuclear power plants, vehicles. The main difference between analog system and digital system is that the software is the key component of the digital system. The digital system performs more varying and highly complex functions efficiently compared to the existing analog system because software can be flexibly designed and implemented. The flexible design make it difficult to predict the software failures. This paper reviews safety standard and criteria for safety critical system such as railway system and introduces the framework for the software lifecycle. The licensing procedure for the railway software is also reviewed.

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Fluidelastic instability of a curved tube array in single phase cross flow

  • Kang-Hee Lee;Heung-Seok Kang;Du-Ho Hong;Jong-In Kim
    • Nuclear Engineering and Technology
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    • v.55 no.3
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    • pp.1118-1124
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    • 2023
  • Experimental study on the fluidelastic instability (FEI) of a curved tube bundle in single phase downward cross flow is investigated for the design qualification and analysis input preparation of helical coiled steam generator tubing. A 6×9 normal square curved tube array with equal and different vertical/horizontal pitch-to-diameter ratio was under-tested up to 6 m/s in term of gap flow velocity to measure the critical velocity for FEI. The critical velocity for FEI was measured at the turning point from the vibration amplitude plot along the gap flow velocity. Our test results were compared with straight tube results and published data in the design guideline. The applicability of the current design guidelines to a curved tube bundle is also assessed. We found that introducing frequency difference in a curved tube array increases the critical velocity for fluidelastic instability.