• Title/Summary/Keyword: decision making of clinical nurses

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Nurses' Perception of the Performance and Necessity of Nursing Services for Patients Engagement (간호사의 환자참여 간호서비스 수행정도와 필요성 인식)

  • Lee, Tae Wha;Jang, Yeon Soo;Ji, Yoon Jung;Do, Hyun Ok;Oh, Kyoung Hwan;Kim, Chang Kyung;Chun, Ja Hye;Shin, Hae Kyung;Cho, Mee Young;Bae, Jung Im
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.2
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    • pp.120-132
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    • 2019
  • Purpose: This study aimed to investigate the performance of patient engagement nursing services perceived by nurses and necessity in Korea. Methods: This study was a descriptive research. A total of 205 nurses participated in the study. The Smart Patient Engagement Assessment Checklist was developed by the investigators to assess patient engagement nursing services performance and necessity. The data were collected using online survey. Descriptive analysis and $x^2$ analysis were performed using SPSS 25.0 program. Results: The mean age of participants was $36.6{\pm}8.5years$ and the mean working experience was $12.92{\pm}9.23years$. Seventy eight percent of participants reported that patients and family participated in care as advisors through customer's suggestion or patient satisfaction assessment. The rate of patients' and family's engagement in care as advisors was significantly higher in tertiary hospitals ($x^2=28.54$, p<.001). About 89% of participants communicated with patients and family to make clinical decisions with a multidisciplinary approach. The rate of communication for multidisciplinary decision making was significantly higher in tertiary hospitals ($x^2=6.30$, p=.012). With regards to nurses' bedside patient handoff, 22.0% of participants reported that they were performing bedside patient handoff, and there was no significant difference between type of hospitals. About discharge planning, 72.2% of participants reported utilizing discharge checklist. Conclusion: Currently, patient engagement nursing services are applied partially in Korea. It seems that care protocols to be applied for patient engagement nursing services are insufficient. Therefore, patient engagement care protocols need to be developed to improve patient's health outcome and safety.

Nursing Core Competencies Needed in the Fields of Nursing Practice for Graduates in Nursing (간호실무현장에서 요구하는 간호대학 졸업생들의 간호핵심역량)

  • Lee, Sun-Kyoung;Park, Sun Nam;Jeong, Seok Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.18 no.4
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    • pp.460-473
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    • 2012
  • Purpose: This study was done to provide information on issues of nursing core competencies needed in the fields of nursing practice for graduates in nursing, from the perspective of nursing managers, and to make suggestion for improving nursing education programs. Methods: Ten nursing managers participated in this study. They were in charge of clinical nursing education in the fields of nursing practice. Data were collected using focus group interviews and analyzed with the content analysis methodology of Downe - Wamboldt's. Results: Six types of nursing core competency - therapeutic nursing competency, professional nursing competency, administrative nursing competency, humanistic nursing competency, relational nursing competency, and personal nursing competency - were identified as nursing core competencies needed in the fields of nursing practice for graduates in nursing. Conclusion: Results of the study show important evidence for decision-making about nursing curriculum revision based on nursing core competency, both in the classroom and in nursing practice areas. These results should contribute to the development of evaluation indicators for nursing students or new nurses. Further research is required to measure degree of nursing core competency in graduates of nursing and to identify the effect of competency-based education for improving nursing core competency.

A Fundamental Study for a System Establishment of Advanced Practice Nursing for Gynecological Cancer Patients (부인암 전문간호사 제도 확립을 위한 기초조사)

  • Park, Chai-Soon
    • Women's Health Nursing
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    • v.12 no.2
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    • pp.87-96
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    • 2006
  • Purpose: This study was conducted to provide fundamental information for a system establishment of advanced practice nursing for gynecological cancer patients (APN-GCP). Method: Data was collected by focus group and individual interviews and analyzed in the framework of the Grounded theory method mapped by Strauss and Corbin (1990). There were 13 subjects in this study (nurses, doctors, patient and her family). Result: We identified 87 concepts, 22 sub-categories, and 10 categories. Categories for role expectation were arrangement of diagnosis and treatment process, giving information of treatment course, support of treatment process, patients' right toward making a decision of treatment, counseling and teaching after discharge from hospital, medical insurance and financial problems, counseling about sexual problems and use of family and community resources. All subjects perceived the necessity of an APN-GCP. An APN-GCP requires over 2$\sim$7 years clinical experience and a master's degree. Services would be performed from initial registration to termination of treatment or death, and accomplished on an outpatient clinic basis. Conclusion: The nursing delivery system and curriculum should be developed for a women's health nurse practitioner including APN-GCP. As a further step, cost-effectiveness and projected estimation of manpower of APN-GCP should be studied in the future.

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Comparative Effects and Ranks of Repositioning for Pressure Ulcer Prevention in Adults: A Network Meta-analysis (욕창예방을 위한 체위변경 중재 효과의 비교순위: 네트워크 메타분석)

  • Ko, Ji Woon
    • Journal of muscle and joint health
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    • v.29 no.1
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    • pp.18-27
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    • 2022
  • Purpose: A network meta-analysis was conducted to assess the comparative effects and ranks of repositioning for pressure ulcer prevention in adults. Methods: A network meta-analysis was performed in a frequency method, using the "netmeta" package of R software version 4.1. The effects of repositioning intervention were confirmed by the odds ratio. The comparative ranking of the repositioning effects was confirmed using the cumulative probability (P-score). Results: Seven intervention studies were included in this study. Based on the P-score, the use of the repositioning system was ranked as the most effective among all interventions (P-score 78.7%). Next was 3~4-hour repositioning combined with memory foam mattress use (P-score 77.2%), use of wearable sensor (P-Score 61.4%), 2-hour repositioning combined with memory foam mattress use (P-score 59.1%), 2-hour repositioning combined with powered air pressure redistribution mattress use (P-score 18.0%), and 4-hour repositioning combined with powered air pressure redistribution mattress use (P-score 18.0%). Conclusion: This study provides information on the relative comparative value of various repositioning interventions to prevent pressure ulcers using network meta-analysis. This is expected to be useful for nurses' decision-making when applying repositioning interventions in clinical practice

Recovery Outcomes Following Laparoscopic Surgery in Overweight Rectal Cancer Patients (과체중 직장암 환자의 복강경 수술 회복성과)

  • Woo, Sang Jun;Lee, Eun Sook;Kim, Hyeong Rok
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.3
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    • pp.17-26
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    • 2009
  • Purpose: The purpose of this study was to compare the recovery outcomes between a normal weight group (BMI<25) and an overweight group ($$BMI{\geq_-}25$$), who received laparoscopic surgery for rectal cancer, to provide information for effective decision making. Methods: Data from 76 patients who received laparoscopic surgery for rectal cancer in a university hospital were reviewed retrospectively from September 2004 to March 2007. Collected data were analyzed using Win SPSS 12.0. The recovery outcomes related to the operation were the length of the operation, the amount of bleeding during the operation, the length of stay in the recovery room, first bowel movement, the length of hospital stay, and complications. Results: There was no statistical difference between the two groups with regard to the recovery outcomes. Conclusion: From the above results, nursing information can be offered to help make effective decisions before the operation for overweight patients with rectal cancer who prefer laparoscopic surgery.

Associated Factors in Pediatric Nurse Parent Partnership (아동간호사의 환아 부모와의 파트너십 영향요인)

  • Choi, Miyoung;Kim, Jisoo
    • Child Health Nursing Research
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    • v.20 no.3
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    • pp.176-184
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    • 2014
  • Purpose: The purpose of this study was to investigate pediatric nurse parent partnership and factors associated with this partnership. Methods: A survey was conducted with 158 nurses working in pediatric practice at one of 7 hospitals in Seoul, Incheon, and Chungcheongbuk Province. Data were collected from September to December 2013, and analyzed with SPSS Windows 21.0. Results: In hierarchial multiple regression analysis, self-efficacy (${\beta}$=.19, p=.016), clinical decision making (${\beta}$=.15, p=.046), and empowerment (${\beta}$=.29, p=.001) were associated with pediatric nurse parent partnership, after adjusting for marital status, children, education, position and satisfaction with work unit. These factors accounted for 44.0% of the variance in the pediatric nurse parent relationship. Conclusion: These results suggest that pediatric nurse parent partnership could be influenced by the predictors. Ultimately, intervention programs focusing on these factors should be effective in helping pediatric nurses improve partnership with parents.

Development of Community Health Nursing Service Model: - Based on the Visiting Nurses Project in Seoul, Kyonggi, and Kang-won Area- (지역사회 간호 서비스 전달 체계 모형 개발 -가정방문서비스를 중심으로-)

  • Kim, Sung-Sil
    • Research in Community and Public Health Nursing
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    • v.12 no.2
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    • pp.361-374
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    • 2001
  • This study was done to identify a status of home visiting project as a community health nursing system, that was the organization. personal who have age, educational background, marital status, position, experience of the home visiting in the public sectors in part of Seoul. Kyonggi, Kang-won area, It was done to provide basis data for the development of effective visiting nurses project in the health sectors, where was Health Centers in urban and rural. Branch of Health Center in rural and Health posts. The question airs were distributed 352 public health workers who working place was 118 health workers in 12 health centers in Seoul. 56 public health workers among 39 health center and other public health sectors in Kyonggi and 178 public health workers among health center and health care sectors. Data collected from October to December. 2000. The analysis by SAS system with F test, percentage and frequency. The major result were as follows. The general characteristics of the respondent show that most of them were graduates from community college and RN-BS with broadcast that they had not completed CPHN course but only two health workers have trained for the visiting nurses project. As for their grade in the position, the most of health workers have seventh level and the other CHP were above sixth level in the health care post that in the government structure. This indicates that workers do not have great authority in decision making, the most period of works in the position was one and two years indicating that they change jobs frequently. On an average their clinical experience was 4.11 years which is ideal for the total service. As for preparation of staff for home visiting workers education on visiting nurses program have to receive short term or longer term training course for strong emphasis. The analysis showed that public health visiting workers responds about active job performance that based on an area, approach of acting by districts, education and position are shown statistically significant difference between acceptance of the visiting nursing job show the same as well as visiting nurses project. Special concerns for visiting Nursing care spread came to burden, many of activity carry out main solution is covered the health problem connective support system needs of quality and quantity which out health problem. As 71.1% of visiting health service held on the poor population was under the guardianship of the law, but people who health insurance wide application under law shown a tendency to increase gradually. The general characteristics of the patients showed 56.2% of female on average of age was 66.1 years old, they have health problem was the most of 47.6% of high blood pressure and stroke, the other and as a problem that economics, which is complex welfare with out health problem. Community health care service should be combined health and social work program. The form of delivery of visiting health care given the most guide and education with counselling and support. (33.6%) Among the six category of visiting care service shown statistically significant difference and next is fundamental care, remedy care with priority.

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Demand-supply of Advanced Practice Nurse (APN) and Alternative Benefit Strategies in the National Health Insurance (전문간호사의 수급 현황과 건강보험 급여화 방안)

  • Kim, Jin-Hyun
    • Perspectives in Nursing Science
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    • v.7 no.1
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    • pp.23-35
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    • 2010
  • Purpose: The purpose of this paper is to analyze the demand and supply of advanced practice nurses and suggest alternative benefit strategies in the Korean national health insurance. Methods: A revised demand & supply model was used to estimate the excess supply of APNs, and policy making process and key actors in the Korean health insurance were considered to develop a political approach to the APN issue. Results: The social demand for APNs is currently estimated to be less than 50% of its supply and the APN education program fell into difficulties in recruits. No reimbursement mechanism for APN's services in the national health insurance has given no economic incentive to hospital managers who have monopsony power in nursing labor market, which has caused the demand shortage of APNs in hospital industry. Payment for APN's services recognized as one of the most significant strategies to booster the social demand for APN's services should be carefully designed and implemented in the national health insurance. In line with this, key actors in health insurance policy decision-making include government, national assembly, labor unions, NGOs, civic groups, medical associations, and academia. Conclusion: The basic researches for APN's activities and cost-effectiveness analysis in clinical settings are required to support the strategies aforementioned. Constructing a policy network among key actors is able to make the payment strategy feasible, which will increase the socal demand for APNs.

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A Q-methodological Study on Nursing Students' Attitudes toward Nursing Ethics

  • Yeun Eun-Ja;Kwon Young-Mi;Kim Hung-Kyu
    • Journal of Korean Academy of Nursing
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    • v.34 no.8
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    • pp.1434-1442
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    • 2004
  • Purpose. Professional nursing ethics is a living, dynamic set of standards for nurses' professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decision-making that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients' care. Methods. Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software. Results. Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes. Conclusion. This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.

Updates of Nursing Evidence-Based Practice Guideline for Indwelling Urinary Catheterization (근거기반 유치도뇨간호 실무지침 개정)

  • Park, Kyung Hee;Choo, Hee Jung;Seo, Hyun Ju;Hong, Hae Kyung;Lee, Joohyun;Lim, Kyung Choon
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.3
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    • pp.211-222
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    • 2023
  • Purpose: This study was conducted to update the existing evidence-based nursing clinical practice guideline for indwelling urinary catheterization (IUC). Methods: The guideline have been revised in 22 steps based on international standards. The quality of the practice guidelines to be used for revision was evaluated using the Appraisal of Guidelines for Research and Evaluation II. The evaluation of the content appropriateness and applicability of the draft recommendations of the revised practice guidelines was performed using the RAND/UCLA Appropriateness Method, a decision-making method developed by the RAND Corporation. Four guidelines were used for the revision. Results: The updated nursing practice guideline for IUC consisted of 9 domains and 134 recommendations. The numbers of recommendations in each domain were: 4 Assessment, 20 Equipment, 11 Catheter insertion, 52 Catheter maintenance, 4 Catheter and drainage bag change, 9 Catheter removal, 22 Complications management, 5 Education and consult, and 7 Hospital support. The recommended grade was 8.2% for A, 38.1% for B, and 53.7% for C. Among these, the major revision was done in 11 recommendations (8.2%). A total of 29 recommendations (21.6%) were newly added. 30 (22.4%) recommendations had minor revisions such as changes or addition for some words or sentences, and 13 (9.7%) recommendations were deleted. Conclusion: Revised nursing practice guideline is expected to serve as an evidence-based practice guideline for IUC in Korea. This guideline will provide health care providers, patients, and caregivers with information to help manage IUC, leading to improved patient outcomes.