• Title/Summary/Keyword: diagnoses

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Nursing Problems in Oriental Nursing Practice Based on Nursing Documentation (간호기록을 이용한 한방 간호 실무에서의 간호 문제에 대한 조사 연구)

  • Hwang, Jee-In
    • Journal of East-West Nursing Research
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    • v.17 no.1
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    • pp.66-70
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    • 2011
  • Purpose: The aim of this study was to examine the types of nursing problems in oriental nursing practice. Methods: This study employed a descriptive survey design. Nursing documentation was retrospectively reviewed for patients discharged from an oriental medicine hospital during three months. Nursing diagnoses documented were mapped into the Clinical Care Classification System. Data were summarized using descriptive statistics. Results: Data were collected from 110 patients using nursing documentation. The number of nursing diagnoses documented was 204 with a mean of 1.9 per patient. The frequently occurring nursing diagnoses were 'risk for trauma' (48.0%), 'pain' (13.7%), and 'urinary elimination alteration' (7.8%). According to the Clinical Care Classification system, the safety component (51.5%) was the most common nursing problem in oriental nursing practice. Conclusion: The study finding suggested that major nursing problems in oriental nursing practice were related to patient safety. Therefore, oriental nursing education on patient safety should be emphasized to improve the quality of nursing care in oriental medicine hospitals.

Comorbidity Adjustment in Health Insurance Claim Database (건강보험청구자료에서 동반질환 보정방법)

  • Kim, Kyoung Hoon
    • Health Policy and Management
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    • v.26 no.1
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    • pp.71-78
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    • 2016
  • The value of using health insurance claim database is continuously rising in healthcare research. In studies where comorbidities act as a confounder, comorbidity adjustment holds importance. Yet researchers are faced with a myriad of options without sufficient information on how to appropriately adjust comorbidity. The purpose of this study is to assist in selecting an appropriate index, look back period, and data range for comorbidity adjustment. No consensus has been formed regarding the appropriate index, look back period and data range in comorbidity adjustment. This study recommends the Charlson comorbidity index be selected when predicting the outcome such as mortality, and the Elixhauser's comorbidity measures be selected when analyzing the relations between various comorbidities and outcomes. A longer look back period and inclusion of all diagnoses of both inpatient and outpatient data led to increased prevalence of comorbidities, but contributed little to model performance. Limited data range, such as the inclusion of primary diagnoses only, may complement limitations of the health insurance claim database, but could miss important comorbidities. This study suggests that all diagnoses of both inpatients and outpatients data, excluding rule-out diagnosis, be observed for at least 1 year look back period prior to the index date. The comorbidity index, look back period, and data range must be considered for comorbidity adjustment. To provide better guidance to researchers, follow-up studies should be conducted using the three factors based on specific diseases and surgeries.

Development of a Home Health Care Nursing Intervention List through Analysis of Home Health Care Nursing Records (가정간호대상자의 간호기록 분석을 통한 가정간호중재 목록구축)

  • Park Hyoun-Kyoung;Kim Cho-Ja;Kang Kyu-Suk;Shin Hye-Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.3
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    • pp.402-415
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    • 2001
  • The purpose of this study was to identify nursing diagnoses and nursing interventions that are found in the home health care patients, and to establish a basis for a standardized Nursing Intervention List that would help nurses doing home health care nursing. For this study, the records of 150 home health care clients who were discharged, from the Home Health Care Center at Yonsei Medical Center, between January to July. 2001 were analyzed. Of the 43 nursing diagnoses recorded for these clients are 43, the most frequent diagnoses were in the area of Exchanging. There were 2.814 nursing interventions which is a mean of 4.73 nursing interventions Per diagnosis. We confirmed that most of the interventions were related to 'education' and 'advice'. We present a Home Health Care Nursing Intervention List that was developed based on the results of this study. It has the five 5 criteria of the ICNP classification, Observing, Management, Performance, Caring, and Informing.

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Clinical characteristics and nursing diagnoses of pediatric patients hospitalized with inflammatory bowel disease: a single-center retrospective study in South Korea

  • Sung-Yoon Jo;Kyung-Sook Bang
    • Child Health Nursing Research
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    • v.29 no.3
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    • pp.218-228
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    • 2023
  • Purpose: This study aimed to identify clinical characteristics of South Korean pediatric inflammatory bowel disease (IBD) in a children's hospital over the past 5 years, with a specific focus on comparing the features observed between Crohn's disease (CD) and ulcerative colitis (UC). Additionally, it aimed to examine the nursing diagnoses given to patients. Methods: This retrospective study analyzed the medical records of Korean pediatric patients under 18 years of age who were diagnosed with IBD and hospitalized at a children's hospital in Seoul, South Korea, from January 2017 to December 2021. Results: The number of pediatric patients diagnosed with IBD steadily increased. This finding was particularly prominent for CD patients, the majority of whom were male. Pediatric patients with CD had significantly higher rates of abdominal pain and perianal lesions, while pediatric patients with UC had a higher rate of bloody stool. Laboratory findings indicated that CD patients had higher levels of inflammatory markers and lower albumin levels than UC patients. The nursing diagnoses given during hospitalization mostly related to safety and protection, physical comfort, and gastrointestinal function. Conclusion: This study provides insights into Korean pediatric IBD patients, enabling early detection and the development of nursing intervention strategies. From a comprehensive perspective, nursing care should not only address patients' physical needs but also their psychosocial needs.

The Validation of Standardized Nursing Care Plans Developed for Computerized Use in Clinical Practice (간호업무 전산화를 위해 개발된 표준화된 간호계획서의 타당성 검정)

  • 김용순
    • Journal of Korean Academy of Nursing
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    • v.21 no.3
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    • pp.349-364
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    • 1991
  • Recognition of the usefulness and the importance of the nursing diagnosis is increasing. There is a prevailing opinion that nursing diagnosis should be used to improve the quality of nursing care. Developing standardized nursing care palns based on nursing diagnoses is therefore considered one of the most essential projects for professional growth and improvement in the nursing world of Korea. Consequently, in the first stage of this research project, the ten nursing diagnses used most frequently with patients on medical and surgical wards were determined and related nursing care plans were developed, implemented and evaluated. The application of the standardized nursing care plans raised the nurses' confidence and proved to be effective in enhancing the quality of nursing care. This study was initiated as the next stage, to develop, test, and determine the validity of nursing care plans for the remaining nursing diagnoses. Nineteen medical and surgical wards were selected for the study ; the 176 staff nurses working on those wards and 1211 patients hospitalized there (603 patients during the nursing care plan use) took part in the project. The following summarizes the results of the study : 1. After listing all the nursing diagnoses up to the 20th in frequency from each ward except the ten used in the first study, 22 nursing diagnoses were selected. Two related to ‘self care deficit’, were combined into one. Standardized nursing care plans were established for these 21 nursing diagnoses. 2. The first page of each nursing care plan lists the related factors and defining characteristics as supporting data. The application rate distribution revealed that the majority were recorded less than 50% of the time. For each nursing diagnosis, only one to three related factors were recorded more than 50% of the time regardless of the number of suggested related factors, and similarly, only one to five defining characteristics were recorded more than 50% of the time regardless of the number of suggested defining characteristics. Therefore, these factors and defining characteristics were proposed as the common related factors and the typical signs and symptoms for each nursing diagnosis. 3. The application rate distribution for the expected outcomes, and the nursing orders that were the main data of each nursing care plan occurred more than 50% of the time, unlike the related factors and the characteristics that occurred less frequently. These findings supported the clinical validity. 4. In an effort to evaluate indirectly the effect of the use of the standardized nursing care plans, nurses' job satisfaction and perceptions of their ability in the use of the nursing process were measured and compared. Scores after the use of the plans were significantly higher than those before. The experience in actually using the standardized nursing care plans with patients increased the nurses' professional and emotional satisfaction and their confidence in using the nursing process. Also when the nurses who actually used the nursing care plans were asked to rate their effectiveness, the highest score was given to ‘the ease of establishing the nursing goal’, followed by ‘improved professional advice and care for patients’, ‘the efficiency and systemization of charting’, ‘the definite recognition of the nursing problem’, and ‘the selection of effective and appropriate nursing interventions’ in descending order. The results indicate the nurses were very positive about the effect of the real clinical application of standardized nursing care plans, and that the objective of this study to utilize the nursing diagnosis to strengthen the nursing process was attained.

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A Validation Study of Nursing Diagnosis in Emergency Care Unit (응급간호단위에 적용되는 간호진단의 타당도 연구)

  • Choi Kyung-Won;Oh Hae-Gyeong
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.145-153
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    • 2003
  • Purpose: Related factors for 24 nursing diagnoses frequently used in the emergency care unit were validated in this study. Method: A convenience sample of 65 registered nurses who had worked for 2 years or more in emergency care units and received instruction on nursing diagnosis was used for the study. The classification of nursing diagnoses was based on NANDA (1996) and validation, on Fehring (1987)'s DCV model. Result: Differences were found between emergency and general care units for related factors for nursing diagnosis. Newly reported related factors were not found for emergency care units. Conclusion: It is helpful for nurses who work in emergency care to be able to apply the nursing diagnosis validated in this study. These findings can be used as the database to provide a nursing diagnosis system appropriate to improving the emergency nursing practice.

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A Study of ECG Based Cardiac Diseases Diagnoses (심전도 신호를 이용한 심장 질환 진단에 관한 연구)

  • Kim, Hyun-Dong;Yoon, Jae-Bok;Kim, Hyun-Dong;Kim, Tae-Seon
    • Proceedings of the KIEE Conference
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    • 2004.11c
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    • pp.328-330
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    • 2004
  • In this paper, ECG based cardiac disease diagnosis models are developed. Conventionally, ECG monitoring equipments can only measure and store ECG signals and they always require medical doctor's diagnosis actions which are not desirable for continuous ambulatory monitoring and diagnosis healthcare systems. In this paper, two kinds of neural based self cardiac disease diagnosis engines are developed and tested for four kinds of diseases, sinus bradycardia, sinus tachycardia, left bundle branch block and right bundle branch block. For diagnosis engines, error backpropagation neural network (BP) and probabilistic neural network (PNN) were applied. Five signal features including heart rate, QRS interval, PR interval, QT interval, and T wave types were selected for diagnosis characteristics. To show the validity of proposed diagnosis engine, MIT-BIH database were used to test. Test results showed that BP based diagnosis engine has 71% of diagnosis accuracy which is superior to accuracy of PNN based diagnosis engine. However, PNN based diagnosis engine showed superior diagnosis accuracy for complex-disease diagnoses than BP based diagnosis engine.

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Feature Extraction of ECG Signal for Heart Diseases Diagnoses (심장질환진단을 위한 ECG파형의 특징추출)

  • Kim, Hyun-Dong;Min, Chul-Hong;Kim, Tae-Seon
    • Proceedings of the KIEE Conference
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    • 2004.11c
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    • pp.325-327
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    • 2004
  • ECG limb lead II signal widely used to diagnosis heart diseases and it is essential to detect ECG events (onsets, offsets and peaks of the QRS complex P wave and T wave) and extract them from ECG signal for heart diseases diagnoses. However, it is very difficult to develop standardized feature extraction formulas since ECG signals are varying on patients and disease types. In this paper, simple feature extraction method from normal and abnormal types of ECG signals is proposed. As a signal features, heart rate, PR interval, QRS interval, QT interval, interval between S wave and baseline, and T wave types are extracted. To show the validity of proposed method, Right Bundle Branch Block (RBBB), Left Bundle Branch Block (LBBB), Sinus Bradycardia, and Sinus Tachycardia data from MIT-BIH arrhythmia database are used for feature extraction and the extraction results showed higher extraction capability compare to conventional formula based extraction method.

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Construction of Linkage Database on Nursing Diagnoses, Interventions, Outcomes in Abdominal Surgery Patients (복부수술환자의 간호진단, 간호중재, 간호결과 연계 데이터베이스 구축)

  • Yoo, Hyung-Sook;Chi, Sung-Ai
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.3
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    • pp.425-437
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    • 2001
  • This reserch was to develop database software in order to handle a lot of clinical nursing data with nursing diagnoses, related factors, defining characteristics, nursing interventions, nursing activities and nursing outcomes. MS Access2000 and SQL was selected to use a general purpose database logic with an efficiency. MS Visual Basic 6.0 was used to construct the circumstance of Graphic User Interface. The Linkage Database of abdominal surgery patients was constructed from the clinical data and questionnaire. This database system could add related factors, defining characteristics, nursing activities in the database and analyze the statistical results through Access query. In the final stage, end-users satisfaction analysis using 5 points Likert scale was dong with the response of using the database system. The accuracy/trustworthiness of the database system was verified with the highest average scores as 4.42 and also, the efficiency as 4.21, user friendly function as 4.1.

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Histologic and Cytologic Follow-up in Atypical Squamous Cells of Undetermined Significance(ASCUS) on Cervical Smears (자궁경부도말에서 Atypical Squamous Cells of Undetermined Significance(ASCUS)의 조직학적 및 세포학적인 추적 관찰)

  • Shin, Mi-Kyung
    • The Korean Journal of Cytopathology
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    • v.9 no.1
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    • pp.29-35
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    • 1998
  • In 1988, The Bethesda System for reporting cervical and vaginal cytologic diagnoses was introduced and this was revised in 1991. The new diagnostic category "atypical squamous cells of undetermined significance(ASCUS)" introduced by The Bethesda System is an area of controversy about the diagnostic category, clinical significance and appropriate treatment. A retrospective 2 years and 9 months study(April, 1994-December, 1996) was performed to evaluate the significance of reporting ASCUS on cervical smears. Sixtyseven(1.17%) of 5,730 smears were diagnosed as ASCUS and 21 cases were followed by cervical biopsies and/or endocervical curettages in 4 cases(19%), and repeat cervical smears in 17 cases(81%). Tissue diagnoses were benign in 2 cases and squamous cell carcinoma in situ in 2 cases. Cytologic diagnosis of follow up smear were negative in 14 cases(82.4%) and persistent ASCUS in 3 cases(17.6%).

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