• 제목/요약/키워드: process of care

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서비스 청사진을 이용한 병원서비스 개선방안에 관한 연구 (A Study on the Improvement of Hospital Service Using Service Blueprint)

  • 박근완;박광태
    • 한국IT서비스학회지
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    • 제7권2호
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    • pp.223-242
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    • 2008
  • We assess service delivery system for outpatients of general hospital(A) using service blueprint. Service blueprint for outpatients' service process currently being implemented in general hospital(A) is analysed to improve hospital services and define hospital service delivery system more accurately. In addition, comparative analysis of service blueprint between before and after improvement is conducted to find that health care services Is now more customer-oriented and hospital employees can link their duties to service delivery system. Dealing with the efficiency of health care service delivery system based on service blueprint analysis is expected to pave the way for continual service quality improvement of general hospitals in the future. The analysis of service blueprint of outpatients' service process suggested in this study is useful for setting strategies for health care service. It also helps service process design and service digitalization of other general hospitals in the future.

수술 전 심리간호가 회복에 미치는 효과에 관한 실험적 연구 (Effects of Preoperative Psychological fare on Postoperative Recovery - An Exploratory Experiment -)

  • 김조자
    • 대한간호학회지
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    • 제2권1호
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    • pp.97-113
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    • 1971
  • The purpose of this study was to investigate the preoperative anxiety of surgical patients and to observe the effects of an experimental nursing process on the incidence of vomiting, the number of analgesics used and the voiding ability of surgical patients within a 48 hour postoperative period and also the number of postoperative days in the hospital. This study me based on a sample of 51 patients who were scheduled for abdominal surgery. They were assigned alternately to experimental and control groups. Patients assigned to the experimental group were given nursing care by the writer, using an experimental nursing process. This is a process directed toward helping the patient obtain a suitable psychological state for surgery. This process was performed by use of the following steps: 1. The nurse approached the patient with interest and concern, and observed the patient's behavior to determine the presence of anxiety. 2. The nurse explored further to find out what was causing the anxiety and what was needed too relieve it. 3. The nurse listened carefully lo the patient. 4. The nurse gave an opportunity for expression of individuality. 5. The nurse showed friendliness and reassured the patient 6. The nurse gave instruction about deep berating, turing and coughing and gave an explanation of routine preoperative preparation which decreased the unknown and so decreased the patient's anxiety- The findings of this study are as follows: 7. The investigation of preoperative anxiety through observing and interviewing revealed patients were concerned about the following: a. Length of stay in the hospital 69.7% (31 cases) b. Condition unimproved o. worse 48.,8% (30 cases) c. Postoperative pain and discomfort .56.8% (29 cases) 2. The results of the study regarding the four hypothesis were as follows: a. Preoperative psychological care not reduce the number of analysis needed during the 48 hour period following surgery. b. Preoperative psychological care did not reduce the Postoperative incidence of vomiting c. Preoperative psychological care had no influence on voiding ability following surgery. d. Preoperative psychological care significantly reduced the number of postoperative days in tile hospital. The experimental nursing process proved to be successful in decreasing the length of postoperative hospitalization (improving rate of healing). This study has demonstrated further that the relief of anxiety (emotional distress) is part of the nurse's professional role. In order to be sure psychological care is given it is important to make a nursing care plan which .includes a plan for the psychological care needed by the patient. As this care is given it can be charted off by each nurse just as medication and treatments are checked after they are given.

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간호분야 실무지침의 수용개작 방법론에 따른 구강간호 실무지침의 개발 (Development of Oral Care Nursing Practice Guideline using the Guideline Adaptation Process)

  • 조용애;은영;구미옥;김경숙;곽미경;김정혜;이선희;박동아;노화경
    • 임상간호연구
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    • 제21권2호
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    • pp.154-168
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    • 2015
  • Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.

치위생과정에 근거를 둔 임상치위생학의 교육 실태 (Current Status of Clinical Dental Hygiene Education Based on Dental Hygiene Process of Care)

  • 한선영;김남희;유재하;김철신;정원균
    • 치위생과학회지
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    • 제9권3호
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    • pp.271-278
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    • 2009
  • 이 연구는 치위생과정에 근거한 임상치위생학 교육과정을 도입하기 위하여 현재 운영 중인 임상치위생학의 교육의 실태를 조사한 연구이다. 50개 대학의 (학)과장을 대상으로 구조화된 설문지를 이용하여 면접조사 및 전자우편 조사를 실시하였으며, 그 결과는 다음과 같다. 1. 설문에 응답한 대학의 53.1%는 1999년 이전 (1977-1999년)에 개설되었고, 46.9%는 2000년 이후(2000-2006년)에 개설되었다 학제는 3년제 치위생과가 28개교(87.5%)이었고 4년제 치위생학과가 4개교(12.5%)이었다. 입학정원은 40명 이하(37.4%)가 가장 많았다. 2. 임상치위생학 실습에서 교수 한 명이 지도하는 학생의 수는 평균 22명이었고, 응답 대학의 62.5%가 포괄치위생과정에 관한 교육을 하고 있었다. 실습 시 평균적으로 한 명의 환자가 실습실을 내원하는 횟수는 특별히 정해놓지 않는다(32.3%)가 가장 많았고, 그 다음으로 1회 (29.0%), 3회(16.1%), 2회 (12.9%), 4회(9.7%) 순이었다. 3. 치위생과정의 다섯 단계에 관한 강의여부에서 사정과 수행단계는 대부분의 대학에서 실시하고 있었으며, 치위생판단(68.8%), 계획수립 (65.6%), 평가(68.8%)는 비교적 낮았다. 4. 실제로 강의 시간에 치위생과정의 개념에 관한 교육이 있는지 조사한 결과, 56.7%의 대학에서 강의가 이루어지고 있었다. 강의에서 사용하는 주 교재는 'Clinical practice of the dental hygienist (Wilkins) 또는 임상치위생학 (김숙향 역)'이 40.0%로 가장 많았다. 이를 종합해 볼 때, 치위생과정을 임상치위생학 교육과정에 도입하기 위해서는 치위생판단올 위한 진단 모형, 계획수립의 절차, 평가 방법에 관한 교육을 보강해야 할 것이다.

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전실 스트레스[relocation stress]의 개념분석 - 중환자실에서 일반 병실로 전실하는 환자를 중심으로 - (Concept Analysis of Relocation Stress - Focusing on Patients Transferred from Intensive Care Unit to General Ward -)

  • 손연정;홍성경;전은영
    • 대한간호학회지
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    • 제38권3호
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    • pp.353-362
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    • 2008
  • Purpose: This study was conducted to analyze and clarify the meaning of the concept for relocation stress -focusing on patients transferred from an intensive care unit to a general ward. Methods: This study used Walker and Avant's process of concept analysis. Results: Relocation stress can be defined by these attributes as follows: 1) involuntary decision about relocation, 2) moving from a familiar and safe environment to an unfamiliar one, 3) broken relationship of safety and familiarity, 4) physiological and psychosocial change after relocation. The antecedents of relocation stress consisted of these facts: 1) preparation degrees of transfer from the intensive care unit to a general ward, 2) pertinence of the information related to the transfer process, 3) change of major caregivers, 4) change in numbers of monitoring devices, 5) change in the level of self-care. There are consequences occurring as a result of relocation stress: 1) decrease in patients' quality of life, 2) decrease in coping capacity, 3) loss of control. Conclusion: Relocation stress is a core concept in intensive nursing care. Using this concept will contribute to continuity of intensive nursing care.

일부 무의농촌 지역 노인의 건강관리경험: 신체적 변화를 스스로 견뎌내기 (Grounded Theory Approach to Health Care of Older Adults at a Doctorless Farm Village)

  • 한영란;김영희
    • 대한간호학회지
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    • 제34권5호
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    • pp.771-780
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    • 2004
  • Purpose: The purpose of this study was to explore how older adults kept their health good at a doctorless farm village. Method: Data was collected through in-depth interviews with 32 participants who were over 65 years old and analyzed in terms of Strauss and Corbin's (1990) grounded theory methodology. Result: The Core Category of health care of older adults was identified as 'enduring physical changes by themselves'. The process of this could be divided into 4 stages: the stage of bearing, the stage of managing daily living activities, the stage of passively collecting information and the stage of minimally utilizing health care services. Older adults accepted the aging process positively but health sources limitation passively, so they managed daily living activities and used natural food for health. In addition, they collected information related to health care and used health care services minimally. Conclusion: We found that participants managed their health passively because of negative attitudes toward active health behaviors of older adults by themselves and the difficulty of access to health care services. Therefore, various community health services for older adults need to be developed to empower older adults in the community.

미숙아를 위한 지역중심 건강관리사업의 모델개발 (Development of the Model for Community-based Health Care Program for Premature Infants and Family)

  • 안영미
    • Child Health Nursing Research
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    • 제8권2호
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    • pp.129-140
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    • 2002
  • The article reports the process, contents and strategies in the development of community based-heath care management program for high-risk infants and family, which was based on literature review, empirical needs assessment from pilot study. The program was divided into two emphasis areas: (1) identification and home visiting nursing care program, and (2) the construction of self-supporting group. The contents of home visiting nursing care were developed from the pilot study of the direct home visiting to premature infants after discharge. The documentation form for home care was standardized, including the demographic data, birth history, home care services, education and counsels, and visiting schedules. The integrated education protocol was elaborated to enhance the body of knowledge as well as clinical competency in caring high-risk infants and family by the supports of neonatologists, nursing scholar, and clinical specialists. In addition, the process and strategies in developing self-supporting group, consisting the high-risk infants and family, and any significant others were addressed. Emphases were given to the role of public health center and the recycling health care referral system to maximize the growth and development of high-risk infants on the community-base, which in turn, contributing to decrease the postneonatal mortality rate.

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호스피스 환자와 가족을 위한 임종교육 시청각 자료 개발 (Development of Audio-visual Aids of Death Education for Hospice Patients and Their Families)

  • 서미숙;강유정;윤지윤;김태연;조혜준;박소연;이시연;장지혜;김유진;강믿음
    • Journal of Hospice and Palliative Care
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    • 제19권3호
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    • pp.240-248
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    • 2016
  • 목적: 호스피스완화의료의 목적은 환자와 가족의 고통을 줄이고 삶과 죽음의 질을 향상시키는데 있다. 편안한 임종을 맞이하는 것은 죽음의 질을 향상시키는데 역할을 한다. 이를 위해 환자와 보호자는 남은 삶 동안 임종을 준비할 수 있도록 임종과정 중 발생하는 다양한 문제와 요구에 대한 이해가 필요하다. 따라서 호스피스 환자와 가족을 위한 매뉴얼화된 임종교육 시청각 자료를 개발하고자 한다. 방법: 시청각 자료 개발을 위해서는 문헌고찰을 토대로 접근하기 쉬운 파워포인트 유인물로 초기 교육자료 개발하였고 다섯 차례에 걸친 전문의의 자문과 수정 및 보완, 평가 과정을 거쳐 완성하였다. 결과: 호스피스 환자와 가족들을 대상으로 한 시청각 교육자료는 3차시 5단계로 분류하였으며 교육 소요시간은 총 26분 34초이다. 최종 교육프로그램은 시청각 교육실 협력 하에 촬영하였으며 시청각 자료를 완성하였다. 결론: 본 연구는 완화의료병동의 구축과 전문성 증대를 위해 개발된 매뉴얼화 된 임종교육 시청각 자료로써 큰 의의가 있으며, 호스피스 환자와 가족뿐 아니라 호스피스 영역 전문 종사자들이 호스피스 환자와 가족을 대상으로 효율적인 임종교육 자료로 적극 활용되길 기대한다.

케어매니저 양성을 위한 교육과정 개발 (Development of a curriculum for Care Manager Education)

  • 정민영;손명동;박천규
    • 한국콘텐츠학회:학술대회논문집
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    • 한국콘텐츠학회 2009년도 춘계 종합학술대회 논문집
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    • pp.1064-1069
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    • 2009
  • 고령화 사회에서 급격히 증가하는 노인문제를 해결하기 위한 노인장기요양보험제도는 노인, 가족, 사회 전체에 큰 영향을 미치는 주요한 과제이다. 따라서 노인장기요양보험제도의 실천에 있어 중요한 역할을 수행하게 될 케어인력 양성과 그 중에서도 특히 케어매니저(Care Manager) 양성과 이를 위한 교육과정 개발은 매우 중요하다고 할 수 있다. 이는 케어매니저(care manager)는 노인장기요양보험제도의 전 과정에 개입하여 대상자들에게 적절한 서비스가 제공될 수 있도록 관리하는 중심적인 인력이기 때문이다. 이에 본 논문에서는 먼저 케어매니저 교육대상자를 신규 교육대상자, 기존 경력자로 분류하고, 교육과정을 각각 이론, 실기 및 현장실습으로 세분화하고, 각각의 경우에 합당한 교육 과목 및 시간을 배정하여 교육한 후, 필기시험을 거쳐 인증하는 과정을 밟는 캐어매니저 교육과정을 제시한다.

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