• 제목/요약/키워드: safety Nursing Activity

검색결과 106건 처리시간 0.023초

일 상급종합병원 병동간호사의 업무량 측정 및 간호사 배치수준의 적절성 연구: 혼합연구 설계 적용 (Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design)

  • 김현주;이선희;이재정;성선숙;양희;이향열
    • 대한간호학회지
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    • 제54권2호
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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.

일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정 (Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital)

  • 김경운
    • 간호행정학회지
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    • 제6권3호
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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입원 환자 낙상예방 간호중재 효과에 대한 메타분석 (Effects of Nursing Interventions for Fall Prevention in Hospitalized Patients: A Meta-analysis)

  • 김윤이;정석희
    • 대한간호학회지
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    • 제45권4호
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    • pp.469-482
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    • 2015
  • Purpose: The purpose of this study was to identify which nursing interventions are the most effective in fall prevention for hospitalized patients. Methods: From 3,675 papers searched, 34 were selected for inclusion in the meta-analysis. Number of fallers, falls, falls per 1,000 hospital-days, and injurious falls, fall protection activity, knowledge related to falls, and self-efficacy about falls were evaluated as outcome variables. Data were analyzed using the Comprehensive Meta Analysis (CMA) 2.2 Version program and the effect sizes were shown as the Odd Ratio (OR) and Hedges's g. Results: Overall effect size of nursing interventions for fall prevention was OR=0.64 (95% CI: 0.57~0.73, p <.05) and Hedges's g= - 0.24. The effect sizes (OR) of each intervention ranged from 0.34 to 0.93, and the most effective nursing intervention was the education & environment intervention (OR=0.34, 95% CI: 0.28~0.42, p<.001), followed by education intervention (OR=0.57, 95% CI: 0.50~0.67, p=.001). Subgroup analyses showed that multifaceted interventions (OR=0.76, 95% CI: 0.73~0.79, p<.001) were more effective than unifactorial interventions, and that activities for prevention of falls (OR=0.08, 95% CI: 0.05~0.15, p<.001) showed the largest effect size among outcome variables. Conclusion: Falls in hospitalized patients can be effectively prevented using the nursing interventions identified in this study. These findings provide scientific evidence for developing and using effective nursing interventions to improve the safety of hospitalized patients.

근로자의 삶의 질 예측모형 (A Predictive Model of Workers' Quality of Life)

  • 이복임;정혜선
    • 한국직업건강간호학회지
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    • 제20권1호
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    • pp.35-45
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    • 2011
  • Purpose: The purpose of this study was to propose and to test a predictive model that could explain the workers' quality of life. Methods: Data were collected using self-report questionnaires from 901 workers in Daejeon, Korea. The questionnaires included nine measured variables (safety culture, self-efficacy, activity of occupational health provider, knowledge in occupational health, age, health promotion behavior, workplace environment, health level, and quality of life), as revised PRECEDE model has suggested. The collected data were analyzed using SPSS/WIN 15 and AMOS 6.01 version. Results: Based on the constructed model, behavior, environment, and health were found to have significant direct effect on quality of life. Indirect factors were perceived biological, predisposing, reinforcing, and enabling. The proposed model was concise and extensive in predicting quality of life of the participants. The final modified model yielded GFI=.85, AGFI=.89, NFI=.79, and RMSEA=.11 and exhibited good fit indices. Conclusion: Findings of this study may contribute to development of effective nursing interventions for promoting quality of life in workers.

Social Support and its Predictors Among Iranian Cancer Survivors

  • Faghani, Safieh;Rahmani, Azad;Parizad, Naser;Mohajjel-Aghdam, Ali-Reza;Hassankhani, Hadi;Mohammadpoorasl, Asghar
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9767-9771
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    • 2014
  • Background: Social support is an important factor in psycho-social well-being of cancer survivors. There is little information about level of social support and its predictors among cancer survivors in Iran or other Middle Eastern countries. The aims of present study were to determine the social support and its prediction factors among Iranian cancer survivors. Materials and Methods: In this descriptive-correlational study 187 cancer patients in one educational center and one private oncology office in northwest of Iran participated using a convenient sampling method. The data collection tool consisted of a researcher-prepared checklist and the Multidimensional Scale of Perceived Social Support Assessment (MSPSS). Data analysis was performed using SPSS statistical software with descriptive statistics and multiple linear regression analysis. Results: The total score of MSPSS was 68 from a possible score between 7 and 84. Participants believed that they received a high level of support from their family members and significant others. Multiple linear regression analysis showed that single and depressed cancer survivors and participants with lower levels of physical activity believed that they received lower levels of social support. Conclusions: Iranian cancer survivors receive high levels of social support and family members are the most important source of this support. In planning any supportive care program for Iranian cancer survivors this strength should be considered. Especially, single and depressed and patients with lower levels of physical activity need more attention.

희망의 개념 분석 -항암화학요법을 받는 암환자를 대상으로- (The Concept Analysis of Hope : Among Cancer Patients Undergoing Chemotherapy)

  • 송미순;이은옥;박영숙;하양숙;심영숙;유수정
    • 대한간호학회지
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    • 제30권5호
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    • pp.1279-1291
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    • 2000
  • The main objectives of this study were to analyze the concept of hope, so to provide basic data to develop a valid instrument to measure hope, and to develop hope enhancing nursing intervention a program for cancer patients. The hybrid model approach was applied in three phases, the theoretical phase, the empirical phase, and the analytic phase. The study was developed on universal attributes explaining generalized hope and specific hope, which were revealed in a comprehensive review of the literature. In the empirical phase, eight cancer patients undergoing chemotherapy were interviewed to reveal causes, motivation, and their resource of hope according to The Hope Assessment Guide (Farren, Herth, & Popovich, 1995). In the analytical phase, the results of the two previous stages of the study were compared. The results were as follows : In the theoretical phase, six dimensions of hope emerged; affective, cognitive, behavioral, affiliative, temporal and contextual dimension. The antecedent of hope was loss, crisis, uncertainity, and stress. The consequences were renewal, development of new methods, safety, peace and transcendental competence. In the empirical phase, these six dimensions emerged as theoretical phases were verified and specified as these descriptive terms: feeling, intention, expectation, activity, relation, future- orientation, reality and goal-setting. The antecedent factor of hope was occurrence or recurrence of cancer. The consequence of hope was ability to cope with real condition, feeling of safety and comfort, peace, development of new strategy and recovery of disease. The major content of hope in this phase was related to specific hope, but it was also influenced on by general hope. In the analytic phase, general and specific hope was renamed as trait and state hope. All attributes emerged at the empirical phases, and also emerged at the theoretical phase. However, cognitive and contextual dimensions were revised and specified. In conclusion, the concept of hope is divided into trait hope and state hope, and state hope is an anticipatory expectation that occurs at the time of a stressful stimulus, such as being diagnosed with cancer. Hope is a multidimensional dynamic energized mental state which has the dimensions of affective, cognitive, behavioral, affiliative, temporal and contextual. There should be further studies to develope the state and trait hope scale according to definition and attributes of hope investigated in this study. In addition, considering results of the empirical phase, the family is very a important factor as a resource of hope, so it is necessary to consider family in implementing a nursing intervention program to enhance hope.

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근로자의 건강증진 생활양식 실천에 관한 연구 (Health Promoting Lifestyles of Korean Employees)

  • 조동란;박은옥
    • 한국직업건강간호학회지
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    • 제7권1호
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    • pp.33-46
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    • 1998
  • Introduction : In Korea, national attention to the workplace health promotion programs (HPP) for employees began in early 1990s. Governmental supports for the HPP and education programs have given to the employees. The purpose of this study is to find the performance degree of employees' health promoting lifestyle(HPL). Subjects and Methods : For this study, 615 employees who attended governmental educations were selected as research samples. The tool for measuring HPL used in this study was developed for Korean by In-Sook Park in 1995. It is composed of 4-point scaled 60 items and divided into 11 subcategories. The data were collected by self reporting questionnaires from June to December in 1997. Those data were analyzed percentile, mean, standard deviation, ANOVA, t-test with SAS program. Major findings are as follows; 1. The total mean score of the employees' HPL performance was 2.66. The average scores of 'harmonious relationships' category were the highest as 3.11, whereas the one of 'professional health maintenance' were the lowest as 2.02. The remains were 'sanitary life'(2.90), 'emotional support(2.85), 'regular diet'(2.84), 'self achievement'(2.78), 'healthy diet'(2.56), 'rest and sleep'(2.56), 'exercise and activity'(2.54), 'diet control'(2.53), 'self-control'(2.52). 2. The factors affecting HLP were category of industries and sex, age, marital status, education level, major, educational experience of health promotion, among personal characteristics. The employees of service industries, female, older age, married, nurse, educated for health promotion, graduated from junior college performed HLP more than the others. 3. The participation rates of employees for HPP were 12.4%, because of limited time and facilities and equipments. Recommendations; 1. The regulation for performing the health promotion programs in the industries is essential for activating industrial health promoting movement. 2. More governmental supports for educations and services for health promotion programs in the industries are needed. 3. For behavioral changes of the employees, the contents of educations have to consist of exercise and activity, rest and sleep, diet and smoking habits. 4. The evaluating studies for ready made health promotion programs in the industries are expected.

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간호사의 법적 책임에 관한 연구 (A Study on the Legal Responsibility of Nurse)

  • 범경철
    • 의료법학
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    • 제15권2호
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    • pp.285-316
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    • 2014
  • As the number of medical disputes regarding nurses has increased after medical disputes have increase, there is a need for a study on it. However, the legal relationship between nurses and patients has not yet been analyzed. Recently, the role and function of nurses are expanded according to the development of the science of nursing; moreover their activity and limitation of responsibility are also expanded. For this reason, the medical disputes regarding nurses have been increasing. However, the majority of these kind of dispute are just passed over because their practice is usually considered to be a mere action to assist doctor's role. In addition, nurse practice is not a secondary action of doctor's role, but forms part of a medical treatment. Of course, nurses handle many secondary tasks after doctors finish their medical treatment. But this is only part of the whole tasks of nurses. Furthermore, the general details of their medical treatment are not different from those of doctors because they also belong to the medical service personnel. Considering these features of nurse and the medical condition in South Korea, their task is becoming increasingly developed and specialized and they are also establishing their own field. With this stream of times, there is a growing interest in enacting a Nursing Practice Act, in other words, the independent law on nurse for the sake of patient safety and national health promotion. Then, their responsibility will distinctly be expanded as much more. That is, the time that nurses practice their medical care by following doctors' order and also pass over their responsibility to doctors is closed. Thus, this study examines the features and responsibilities of nursing practice, and discusses an institutional framework to efficiently cope with the legal disputes between nurses and patients. It aims to throw light on the decision making on nurse-patient disputes in future.

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요양시설과 재가의 요양보호사 직무비교 (Comparison of Frequency and Difficulty of Care Helper Jobs in Long Term Care Facilities and Client Homes)

  • 황은희;정덕유;김미정;김건희;신수진
    • 한국보건간호학회지
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    • 제26권1호
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    • pp.101-112
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    • 2012
  • Purpose: The purposes of this study were to identify differences of duties, tasks, and task elements of care helpers between long term care (LTC) facilities and client's home (CH), and to provide data for the development of educational programs and policies. Methods: This study was a descriptive investigation; the subjects of the study were 418 care helpers. Duties, tasks, and task elements were measured using the framework proposed by Shin et al. (2012). Data were analyzed by t-test using PASW 18.0. Results: All of the jobs were statistically significant differences between LTC and CH. Dietary assistance and Daily work assistance were more frequently in CH, and the frequency of other tasks was higher in LTC than CH. Tasks with higher-reported difficulty by those who worked in LTC were as follows: personal hygiene, position change and movement, exercise and activity assistance, safety care, communication assistance, dietary assistance, environment management, daily work assistance, emergency prevention, early detection and speedy reporting, and dementia patient care. Conclusion: These findings suggest that training for care helpers of each facility type will be differentiated. Tasks and task elements reported by care helpers were modified and added to the standard textbook.

청소년의 건강행위 측정을 위한 도구개발 및 평가 (Development and Psychometric Evaluation of a Scale to Measure Health Behaviors of Adolescents)

  • 신윤희
    • 대한간호학회지
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    • 제40권6호
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    • pp.820-830
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    • 2010
  • Purpose: The purpose was to develop a preliminary scale to measure Korean adolescents' health behaviors through a qualitative approach, to evaluate the scale psychometrically, and to develop a final scale. Methods: Participants were 61 adolescents for qualitative interviews and 1,687 adolescents for the psychometric evaluation. Procedure included content analysis of interviews to identify health behavior categories for Korean adolescents, pre-test to confirm that preliminary scale items were understandable, content validity by an expert panel, development of the web-based computer-assisted survey (CAS), and psychometric analysis to determine reliability and validity of the final scale. Results: A final scale was developed for both paper-and-pencil and CAS. It consisted of 14 health behaviors (72 items), including stress and mental health (10), sleep habits (5), dietary habits (12), weight control (4), physical activity (4), hygiene habits (5), tobacco use (5), substance use (2), alcohol consumption (4), safety (4), sexual behavior (9), computer use (3), health screening (4), and posture (1). Conclusion: The scale's strong points are: 1) Two thirds of the final scale items are Likert scale items, enabling calculation of a health behavior score. 2) The scale is appropriate to Korean culture. 3) The scale focuses on concrete health behaviors, not abstract concepts.