• 제목/요약/키워드: decision making of clinical nurses

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간호대학생의 윤리적 의사결정에 영향을 미치는 요인 (Factors Affecting Ethical decision-making of Nursing Students)

  • 유명숙;진주현
    • 가정∙방문간호학회지
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    • 제30권2호
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    • pp.163-173
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    • 2023
  • Purpose: The aim of this descriptive research study was to identify the factors affecting the ethical decision-making of nursing students. Methods: A convenience sample of 193 nursing students from three nursing colleges in D city who were engaged in clinical practice completed an online Google Forms questionnaire from September 9 to September 20, 2021. Using SPSS 23.0, data were analyzed with descriptive statistics, an independent t-test, a one-way ANOVA, Scheffé's test, Pearson's correlation coefficient, and a multiple regression analysis. Results: The influencing factors of ideal ethical decision-making were guilt (β=.38, p<.001), awareness of the nurses' Code of Ethics (β=.18, p=.023) and motivation for entering school, among general characteristics (β=-.18, p=.033). The explanatory power of the model was 22.2%. Further, the influencing factors of realistic ethical decision-making were ideal ethical decision-making (β=.26, p=.001) and grade (among general characteristics) (β=.15, p=.029); the explanatory power of the model was 17.9%. Conclusion: Various educational tools and programs pertaining to making ideal and ethical decisions must be enhanced to promote ethical choices in clinical areas and realistic ethical decision-making ability to actually make such choices. This focus may enable nurses to improve their nursing professionalism in the future.

일 종합병원 간호사의 간호수행능력 영향 요인 (Factors Influencing Clinical Competence for General Hospital Nurses)

  • 강경자;김은만;류세앙
    • 한국콘텐츠학회논문지
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    • 제11권1호
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    • pp.284-293
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    • 2011
  • 본 연구는 간호사의 간호수행능력을 파악하고, 그 영향요인을 규명하기 위하여 시도되었다. 자료는 2010년 5월 17일부터 6월 19일까지 경기도 소재의 종합병원 간호사 163명을 대상으로 구조화된 자가보고형 설문지로 조사하였다. 간호사의 학력, 근무부서, 프리셉터 경험, 향후 계획, 직무교육 참여도에 따라 간호 수행능력에 차이가 있었다. 간호수행능력과 근무경력, 비판적 사고성향, 임상 의사결정능력이 순 상관관계를 나타냈다. 일 종합병원 간호사의 간호수행능력의 영향요인은 비판적 사고성향, 근무부서, 근무 경력이었고 세 요인이 간호수행능력을 50.3% 예측설명하였다. 따라서 임상간호사의 간호수행능력을 향상시키기 위해 비판적 사고성향을 향상시킬 수 있는 교육과 지속적으로 근무하면서 교육을 받을 수 있도록 격려와 지원이 요구된다.

일 대학 병원 임상간호사의 의사결정상황과 대안에 관한 분석 (Analysis of Decision-Making Situations and Alternatives for Clinical Nurses in a University Hospital)

  • 김명희;최원희
    • 간호행정학회지
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    • 제10권4호
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    • pp.449-457
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    • 2004
  • Purpose: This study seeks to identify situations where nurses are required to consider alternatives, for the delivery of nursing care, appropriate to the needs of a medical care unit, surgical care unit, and intensive care unit in a university hospital. Method: Data was collected from 100 nurses using an open questionnaire, during a one week period in May, 2003. These nurses all had at least two years of experience within a medical care unit, surgical care unit, or intensive care unit at a university hospital. Results: The situations that nurses typically faced were categorized into 21 problems for nurses including : respiratory problems(26.8%), pain(23.6%), problems in relation to bowel habit(23.2%). In cases where nurses were faced with making decisions in relation to solving respiratory problems, the alternatives included ; applying oxygen(29.3%), physical assessment and monitoring(14.7%), refining and modifying order and suggestion order(9.3%). Ventilator care(9.3%), was chosen to solve pain problems ; doing pm orders(30.3%), placebo medication(27.3%), and to refine and modify orders and suggestions(18.2%). To solve problems in relation to bowel habits ; enemas accounted for 32.3%, and laxative medication 30.8%. Conclusion: To improve the quality of nursing, the outcome of nursing care associated with 21 problems for nurses including : respiratory problems, pain, and problems in relation to bowel habit, should be identified and the best alternative nursing care should be developed.

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임상간호사의 비판적 사고 (Critical Thinking of Clinical Nurses)

  • 장성옥;신나미;김순용
    • 기본간호학회지
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    • 제16권4호
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    • pp.459-471
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    • 2009
  • Introduction: Critical thinking involves identifying problem(s), assessing resources, and generating possible solutions and allows clinical nurses to decide which solution is the most reasonable under the given circumstances, taking into consideration the "hat ifs" and how they will affect the end result. This research was conducted to further understanding and identification of subjective factors in critical thinking in clinical nurses. Methods: The research design was a Q-Methodological Approach. Q-population was formulated from a non-structured questionnaire and interviews from 17 experienced clinical nurses. Thirty selected Q-statements were sorted by 30 experienced clinical nurses. Results: Four factors for critical thinking were identified: (1) Deductive reasoning based on causal relation, (2) Construction of an effective model based on patients' responses, (3) Formulating categories based on priorities for effective interventions, and (4) Judging validity of the situational significance on clinical performances. Conclusion: Critical thinking is an attitude and reasoning process. From this study, the frame of reference for clinical nurses in formulating critical thinking within the context of clinical settings is identified and indicates the way nurses utilize thinking skills when they care for patients and areas that need further exploration as nurses and faculty develop education systems to advance clinical performance competency.

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연명치료중단에 관한 중환자실간호사, 의사 및 중환자가족의 태도 및 인식 (Attitudes and Awareness towards the Withdrawal of Life-Sustaining Treatment among Nurses, Physicians, and Families of Intensive Care Unit Patients)

  • 이혜경;강현숙
    • 임상간호연구
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    • 제16권3호
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    • pp.85-98
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    • 2010
  • Purpose: This study was aimed to investigate the awareness and attitudes towards withdrawal of the life-sustaining treatment among nurses, physicians, and the families of intensive care unit (ICU) patients in general hospitals. Methods: The data were collected using a questionnaire from 80 ICU nurses, 80 physicians, and 80 families of ICU patients in general hospitals. Data were collected from February 22nd to May 31st, 2010. Rusults: ICU nurses, physicians, and families of ICU patients felt that objective and ethical guidelines were needed in making a decision to withdraw the life-sustaining treatment. The main reason for withdrawal of the life-sustaining treatment was found that the patients could not recovered despite many efforts. The role of nurses in decision making process on withdrawal of the life-sustaining treatment was considered very positive from the view of physicians and family members. The most important role of nurses for those patients in ICU was found to try their best to care for the patients. Conclusion: ICU nurses should play a major coordinating role in communication among patients, their families, and medical teams. Also, an appropriate roles of nurses in the process of the withdrawal of the life-sustaining treatment should be established.

한국어판 임상적 의사결정 (clinical decision making) 축약도구의 타당성 검정 (Validity of Korean Version of Clinical Decision Making Short Form Scale)

  • 김명수;정현경
    • 성인간호학회지
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    • 제26권4호
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    • pp.403-412
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    • 2014
  • Purpose: The purpose of this study was to validate the Korean version of shortened Nursing Decision-Making Instrument developed by Lauri & $Salanter{\ddot{a}}$(2002). Methods: The subjects were 247 nurses working in eight hospitals of Korea. Data were collected by questionnaires from June to July, 2012 and were analyzed by Principal Component Analysis for construct validity and Cronbach's ${\alpha}$ coefficient for reliability. Results: Factor loadings of the four subscales ranged from .32 to .73. The explained variance from the four factors was 48.54% of the total variance. The factors were named 'implementation of plan, monitoring and evaluation', 'plans of action', 'data collection', and 'data processing and identification'. The first factor consisted of 6 items which explained 13.21% of the total variance and the second factor contained 8 items. The Cronbach's ${\alpha}$ coefficients of the four subscales were from .64 to .81. Conclusion: The Korean version of the shortened Nursing Decision-Making Instrument has satisfactory construct validity and reliability. However, that the scores of the analytic items weren't reversed unlike the analysis method of the original tools is the biggest limitation of this study. In addition, based on the fact that there were several discrepancies for item interpretation of Korean comparing to the findings of the instrument development study, repetitive researches would be suggested.

말기의 의료적 의사결정에 관한 임상간호사의 갈등경험 (Nurse's Conflict Experience toward End-of-life Medical Decision-making)

  • 조계화
    • 성인간호학회지
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    • 제22권5호
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    • pp.488-498
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    • 2010
  • Purpose: The purpose of this study was to explore clinical nurse's reported conflict experience toward end-of-life medical decision making. Methods: Data were collected by in-depth interviews with eight nurses from three different wards of university hospital in D city of Korea. Conventional qualitative analysis was used to analyze the data. Results: Results were three major themes and twelve categories from the analysis. The three major themes were prioritization of treatment, non-disclosure of diagnosis, and hierarchical and power relations. Conclusion: The results of this study suggest that shared decision making in end of life among patient, family members, physician, and nurse may contribute to improve end-of-life care performance as well as dignified dying of patient in end of life.

간호조직특성 및 조직문화에 따른 간호사의 사건보고에 대한 지식과 태도 - 일 대학병원을 중심으로 - (Nurses' Knowledge and Attitude about Incidence Reporting according to Nursing Organizational Culture and Organizational Characteristics)

  • 김경자;오의금
    • 간호행정학회지
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    • 제15권4호
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    • pp.581-592
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    • 2009
  • Purpose: This study was designed to describe the nurses' knowledge and attitude about incidence reporting according to nursing organizational culture and organizational characteristics. Methods: The subjects of this study were 783 clinical nurses who were in A university hospital in Gyeonggi-Do. The data were collected from May, 20, 2009 to June, 2, 2009. The collected data were analyzed through descriptive methods, Pearson correlation coefficient, multiple regression in SPSS win(12.0). Results: Nurses' knowledge and attitude about incidence reporting were positively correlated with innovation oriented culture, relation oriented culture, and culture of patient safety. And among characteristics of nursing organization, communication, decision making, centralization were positively correlated with nurses' knowledge and attitude about incidence reporting. But the most correlated factor with nurses' knowledge and attitude about incidence reporting was culture of patient safety. Conclusions: The findings of this study suggest that to encourage reporting incidence, there must be a organizational approach, such as creating a culture of patient safety, active participating decision making, and communication.

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임상간호사의 낙태 태도, 산전기형아 검사 관련 지식도 및 정보요구도 (Clinical Nurses' Attitudes towards Termination of Pregnancy, Knowledge of, and Information Needs for, Prenatal Genetic Screening and Diagnosis)

  • 신계영;전명희;김혜경
    • 근관절건강학회지
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    • 제26권3호
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    • pp.184-194
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    • 2019
  • Purpose: There has been a considerable increase in the number of women giving birth at advanced age. The genetic screening of such women is highly desirable. Clinical nurses, however, are not adequately trained to assist such clients. This study aims at identifying the educational needs of nurses in order for them to provide better care and treatment for such women. Methods: 206 South Korean clinical nurses participated in this study. Study variables were measured by nurses' attitudes toward terminating pregnancy (ATP), knowledge of prenatal genetic screening and diagnosis (K-PGSD), and information needs for prenatal genetic screening and diagnosis (I-PGSD). The statistical analysis included T-test, analysis of variance and Pearson's Correlation Coefficient. Results: Mean scores were 34.57±5.73 for ATP, 16.44±3.04 for K-PGSD, and 78.81±10.95 for I-PGSD. The findings demonstrate that nurses have high information needs (I-PGSD) to take better care of women who have positive results from their amniocentesis tests. Conclusion: Information needs among clinical nurses are not currently being met. Education for nurses must include training in counseling to encourage patients' autonomous decision-making regarding their pregnancies.

중환자실과 응급실 초보간호사를 위한 맞춤형 시뮬레이션 학습프로그램 개발 및 효과 (The Development and Effects of a Tailored Simulation Learning Program for New Nursing Staffs in Intensive Care Units and Emergency Rooms)

  • 김은정;강희영
    • 한국간호교육학회지
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    • 제21권1호
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    • pp.95-107
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    • 2015
  • Purpose: The purpose of this study was to develop a tailored simulation learning (SL) program and to evaluate the effects of the program on the clinical competency, clinical decision-making competency, and communicative competency of new nursing staffs in intensive care units (ICU) and emergency rooms (ER). Methods: In this quasi-experimental study, fifteen nurses were assigned to the experimental group and fifteen to the control group. The experimental group was given the SL program of four sessions, whereas the lectures of four sessions were given to the control group. Data were analyzed using a $x^2$-test, Mann-Whitney U test, and Kruskal-Wallis test with an SPSS program. Analysis of covariance was used to treat the covariate of pre communicative competency between the experimental and control groups. Results: Based on the education needs of new nursing staffs in ICUs and ERs, three learning scenarios and one evaluating scenario were developed for the SL program. The score for clinical competency, clinical decision-making competency, and communicative competency were significantly higher in the experimental group compared with the control group. Conclusion: The SL program is an effective learning strategy for new nursing staffs in ICUs and ERs. These findings suggest that an SL program be offered as an alternative for new nurse orientation and continuing nurse education.