• Korean Journal of Adult Nursing
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• v.26 no.3
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• pp.253-265
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• 2014

Purpose: This study was done to develop and evaluate a smartphone application for the medication confirmation of high-alert medications. Methods: A nonequivalent control group non-synchronized design was used for this study. Participants in the treatment group used the application for four weeks. Data were analyzed using descriptive analysis, ${\chi}^2$-test, and t-test for the homogeneity of participants, and a paired t-test for effectiveness in each group with the SPSS 18.0. Results: Stability of medication administration was estimated by knowledge and certainty, ranged from a score of one to three. A correct answer with high certainty was coded as high stability, low certainty regardless of correct answer was coded as a moderate stability, and incorrect answers with high certainty were rated as low stability. There were no differences in 'knowledge of high alert medication', 'Certainty of knowledge', 'stability of medication administration', 'confidence of single checking medication', and 'medication safety activities' between the treatment group and the comparison group. The treatment group reported a greater difference between pretest and post-test in 'certainty of medication knowledge' (t=3.51, p=.001) than the comparison group. Conclusion: Smartphone application for medication confirmation of high-alert medications will provide an important platform for reducing medication errors risk.

• Progress in Medical Physics
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• v.11 no.2
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• pp.141-146
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• 2000

Power spectrum analysis is a powerful noninvasive tool for quantifying autonomic nervous system activity. In this paper, We developed a measuring system for Autonomic Nervous Activity by using power spectrum analysis method to obtain the activities of autonomic nervous system. This system adopt a isolated power for patient's safety. In this system, Two output signal is obtained - R-R interval time variability and Respiration time variability. Time variability is use to find out some disease related to Autonomic Nervous System. Experimental tested range is 30 ～ 240 BPM for ECG and 15～80 BPM for Respiration.

• Clinical and Experimental Pediatrics
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• v.61 no.1
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• pp.1-5
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• 2018

We often overlook the importance of several safety issues such as identification of patients, timeout procedure, hand hygiene, handoff communication, and many others. This ignorance, along with many other issues, leads to medical error being ranked as a third leading cause of death in the U.S. Consequently, quality improvement (QI) has become one of the major subjects in healthcare despite a relatively short history. Improving quality is about making healthcare safe, effective, patient-centered, timely, efficient, and equitable. Understanding the need and methodology of QI as well as participation is now essential for physicians. Although basic QI methodology has not changed, one of the most fascinating changes in recent QI is conducting large-scale QI projects through multicenter networks. Prospective multicenter QI projects utilizing the Korean Neonatal Network are a substantial initiation of pediatric QI in Korea. The Korean Pediatric Society should set ambitious goals for QI activities for every primary care pediatrician and pediatric subspecialist.

• Journal of Korean Academy of Nursing
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• v.54 no.2
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• pp.237-249
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• 2024

Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

• Proceedings of the KAIS Fall Conference
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• 2012.05a
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• pp.22-24
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• 2012

The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$, .734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$, .612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

• Korean Journal of Adult Nursing
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• v.17 no.5
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• pp.697-708
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• 2005

Purpose: This study was to develop, implement, and evaluate an e-learning education program for improving practical knowledge and preventing nursing errors and adverse events of nurses working in the operating room (OR). Method: The e-learning program was developed and evaluated according to the following processes: 1) preparation phase 2) implementation phase 3) evaluation phase. In evaluation phase, the effectiveness was analyzed based on the Kirkpatrick's model. Results: The e-learning program consisted of OR basic nursing skills and techniques and nursing activities' manual based on the categories of nursing errors: surgical operation preparation, nursing skills and techniques, environment management, patient safety and comfort, and patient monitoring. The program was provided through on-line, http://cafe.daum.net/pnuhorn, for 4 weeks. The mean score(percent) of participants' satisfaction was $21.24{\pm}1.71$(68.2%). Their total knowledge level was significantly improved(Z=-3.00, p=.003) and specifically in the category of environment management(Z=-3.77, p<.001) and patient monitoring(Z=-2.46, p=.014). The occurrence of nursing errors or adverse events was a little decreased, but not statistically significant(Z=-3.10, p=.756). Conclusion: E-learning for nurses is one way of effective and efficient teaching-learning strategies. For better e-learning, it is important to develop the vital content of the education and objective measures for detecting nursing errors and adverse events.

• Proceedings of the Korea Institute of Fire Science and Engineering Conference
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• 2012.04a
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• pp.190-193
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• 2012

The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$,.734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$,.612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

• Journal of Korean Clinical Nursing Research
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• v.27 no.2
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• pp.199-209
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• 2021

Purpose: This study was conducted to investigate the nursing needs and workload of nurses according to nursing dependency for effective placement of nursing staff in the emergency department (ED). Methods: In June 2020, 256 adult patients who visited the ED were classified as two groups, suspected COVID-19 patients and general patients. The participants'electronic medical records were analyzed using descriptive statistics, t-test, 𝑥²-test, and Fisher's exact test using the SPSS. Results: The patient dependence score showed a significant difference between the two groups, with an average of 13.99±1.85 for the suspected COVID-19 patient group and 10.58±2.10 for the general patient group (t=12.42, p<.001). There were statistically significant differences in communication (t=3.28, p=.001), mobility (t=3.29, p=.001), nutrition, elimination, and personal care (t=7.34, p<.001) among the six domains of nursing dependency. In the domains of environment, safety, health, and social needs, the dependency score was 3 for all suspected COVID-19 patients and 1 for all general patients. Conclusion: The results of this study confirmed that infection control activities of emergency patients who need isolation affect the patients' nursing dependency on nursing care.

• Korean Journal of Clinical Pharmacy
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• v.33 no.2
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• pp.135-142
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• 2023

Background: Pharmacists communicate with a variety of healthcare experts to prevent medication errors. Situation-Background-Assessment-Recommendation (SBAR) is a tool used for concise and accurate communication. In 2018, we developed the pharmacy-SBAR (P-SBAR) to deliver pharmacists intervention more quickly and effectively through quality improvement activities. Objectives: This study evaluates the efficacy of P-SBAR on pharmacists' intervention activities before and after the implementation of P-SBAR applications. We assessed the impact of P-SBAR on reducing the burden of intervention work, promoting pharmacists' participation, and enhancing the acceptance rate. Methods: This is a retrospective study of the two groups before and after P-SBAR implementation. All pharmacists' intervention records during two periods (2016-2017 and 2019-2020) were extracted from the data warehouse system at Kyunghee University Hospital at Gangdong, Seoul. The outcome was the number of inpatients and pharmacists who participated in the prescription monitoring activity, the number of interventions, and the physicians' acceptance rate. Results: Although the total number of inpatients decreased (364,753 vs. 348,229), the number of pharmacists who participated in intervention activity increased (monthly mean: 15.8 vs. 18.0, p=0.001). The total number of interventions (2,767 vs. 4,389), the frequency of full acceptance (2,018 vs. 3,710), and the monthly acceptance rate increased significantly (73.8% vs. 83.8%, p<0.001). Conclusion: P-SBAR improved accessibility and convenience by digitalizing the intervention activities performed in an offline environment. Improvement in work burden and acceptance rate using P-SBAR is expected to contribute toward reducing medication errors.

• Journal of Korean Clinical Nursing Research
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• v.19 no.1
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• pp.20-32
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• 2013

Purpose: To present necessary data for improvement in communications between health professionals in as characterized by nurses' communications. Methods: This study was a descriptive survey research design with a survey of 1,510 registered nurses working in general hospitals (of at least 1,900 beds) in Seoul. A questionnaire on communication in the ICU, nurse-physician and nurse-nurse, was used. Data were collected from January 9 to 20, 2012, and the response rate was 85.0%. Results: Cronbach ${\alpha}$ values ranged from .75 to .89, except for .59 for accuracy (nurse-physician), with .89 overall. The highest mean score was for perception for timeliness [$3.83{\pm}.57$], followed by shift communication (nurse-nurse) [$3.64{\pm}.66$], openness (nurse-nurse) [$3.64{\pm}.65$], accuracy (nurse-nurse) [$3.14{\pm}.61$], openness (nurse-physician) [$2.90{\pm}.75$], understanding (nurse-physician) [$2.82{\pm}.65$], and accuracy (nurse-physician) [$2.70{\pm}.59$]. Subscales of openness, understanding, and shift communication were strongly associated with communication satisfaction. The general characteristics of nurses with different perceptions of communications included age, clinical experience, work pattern, and department. Conclusion: Proactive activities to improve accuracy, openness and mutual understanding between physicians and nurses are required for patient safety. Further studies are also needed to reassess communications and evaluate the relationship between patient outcomes and nurses' job satisfaction after application of strategies to improve communications.