Purpose This study aimed to examine the relationship between nursing care needs and nurse staffing in pulmonology units. Methods This was a descriptive study that used a retrospective design. In total, 2,622 patient medical records from a tertiary hospital were analyzed. Variables were collected from Clinical Data Warehouse and Electronic Medical Records. Results The study found a difference in nursing care needs and nurse staffing by shift among units. In unit A (general unit), nurses were assigned according to nursing care needs and the proportion of severe patients. However, in unit B (general unit), higher nursing needs could lead to an increase in the number of patients per nurse on night duty (r=.23, p<.001). In unit C (comprehensive nursing care service unit), the number of patients per nurse during the day increased as nursing needs increased. The higher the proportion of “greater than two points in nursing activities”, the higher the number of patients per nurse during the day (r=.13, p=.010) and evening (r=.12, p=.018). However, the higher the proportion of “greater than three points in activities of daily living”, the lower the number of patients per nurse during the night shift (r=-.28, p<.001). Conclusion Patients’ nursing care needs should be considered in the management of nurse staffing. We should develop a nurse staffing program that considers variation in daily nursing care needs to establish efficient staffing guidelines.
PURPOSE This study was conducted to test criterion-related validity of the Critical Patients' Severity Classification System (CPSCS) developed by the Hospital Nurses' Association by examining relationships with brain injury severity measured by Glasgow Coma Scale (GCS), recovery state measured by Glasgow Outcome Scale (GOS), and days of stay in ICU of brain injury patients. METHODS Prospective correlational research design was adopted by including 194 brain injury patients admitted to ICU of one university hospital. RESULTS The score of CPSCS appeared to significantly discriminate the severity of brain injury. Among nursing activities in CPSCS, Respiratory therapy, IV Infusion and Medication, Monitoring, Activities of Daily Living (ADL), Treatment and Procedure were significant to discriminate the severity of brain injury. Respiratory therapy, Vital Signs, and Monitoring appeared to significantly discriminate the recovery states of 1- and 3-months. Nursing activities significantly contributed to predict the days of ICU stay were Respiratory therapy, ADL, and Teaching and Emotional Support. CONCLUSION CPSCS developed by the Hospital Nurses Association appeared to be valid to discriminate or predict brain injury severity, recovery states, and days of stay in ICU for brain injury patients.
PURPOSE The purpose of this study was to assess the importance and contribution of 9 nursing outcomes and their indicators that could be applied to cerebrovascular patients. METHODS: Data were collected from 175 neurosurgical nurses working at two university affiliated hospitals and five secondary hospitals located in Gwang-ju. The Fehring method was used to estimate outcome content validity(OCV) and outcome sensitivity validity(OSV) of nursing outcomes and their indicators. Stepwise regression was used to evaluate relationship between outcome and its indicators. RESULTS: The core outcomes identified by the OCV were Tissue Perfusion: Cerebral, Nutritional Status, Neurological Status, and Wound Healing: Primary Intention, whereas highly supportive outcomes identified by the OSV were Oral Health, Self-Care: ADL, and Nutritional Status. All the critical indicators selected for Fehring method were not included in stepwise regression model. By stepwise regression analysis, the indicators explained outcomes from 19% to 52% in importance and from 21% to 45% in contribution. CONCLUSION: This study identified core and supportive outcomes and their indicators which could be useful to assess the physical status of cerebrovascular patients. Further research is needed for the revision and development of nursing outcomes and their indicators at neurological nursing area.
PURPOSE The purpose of this study was to compare the importance and performance of nursing interventions linked to five nursing diagnoses in CVA patients. METHODS First, total 37 nursing diagnoses were identified from the analysis of 78 nursing records of CVA patients, and then top 5 diagnoses were mapped with nursing interventions. Second, each intervention was compared in terms of importance and performance by 80 nurses working at neurosurgical units from 5 general hospitals. Data were analyzed using mean, SD, and t-test using the SPSS program. RESULTS Selected the top five nursing diagnoses were Acute Pain, Risk for Disuse Syndrome, Decreased Intracranial Adaptive Capacity, Ineffective Cerebral Tissue Perfusion and Acute Confusion. In general, most of the interventions were scored higher in importance than performance and most of independent interventions were not performed as frequently as it perceived in importance. The interventions which scored high in performance were the interventions ordered by physician or interventions related to medication behavior. CONCLUSION We identified which nursing interventions should be performed more frequently and more critically important to nursing diagnoses. We recommend further research that enhances the performance of nursing interventions to provide better quality of nursing services to the patients in practice.
PURPOSE this study was to examine the differences of the level of pain, depression and self-efficacy according to the classifications of pain among chronic pain patients. METHOD: The data were collected by means of self-reported questionnaire from 164 patients with chronic pain visited in one university hospital and one local pain clinic in Busan, from October 7 to November 16, 2002. Analysis was done by ANOVA, and Scheffe test using SPSS program. RESULT: The subjects were divided into five classifications of chronic pain : 26.2% low back and extremity pain, 23.2% neck, shoulder and upper extremity pain, 19.5% postherpetic neuralgia, 15.9% complex regional pain syndrome and 15.2% peripheral neuralgia. There were significant differences in pain (p=.000), depression (p=.000) and self-efficacy (p=.003) according to the 5 kinds of chronic pain. With the results of the Scheffe test, the patients with peripheral neuralgia experienced pain and depression higher than those with the other kinds of chronic pain. The patients with neck, shoulder and upper extremity pain experienced self-efficacy higher than those with peripheral neuralgia. CONCLUSION: Chronic pain patients should be provided effective individualized intervention depending on the classifications of chronic pain. Therefore the development of interventions for pain management according to the classifications of pain in chronic pain patients is needed.
PURPOSE The purpose of the study was to compare symptoms, medical therapies, and nursing interventions with terminal cancer patients during the last four weeks of their lives in a hospice unit and general units. METHOD For the descriptive survey study, data were collected by reviewing the medical records of 243 patients who died of terminal cancer at K hospital in Seoul. The data was analyzed by using Chi-square test and t-test. RESULT The study findings are summarized as follows: There were higher frequencies in physical symptoms of constipation, itching sensation, pain, sleeping disturbance, soreness and dysuria for those patients in the hospice unit than those patient in general units. All emotional symptoms were recorded significantly higher for those patients in the hospice unit than those in general units. Regarding the major medical interventions, pain management was used more significantly for those patients in the hospice unit, but antibiotic therapy and resuscitation were used more significantly for those patients in general units. CONCLUSION The hospice unit provided more comprehensive nursing interventions including psychological, spiritual, and family cares as well as physiological care for terminal cancer patients. The facts showed that those patients who would need hospice care in general units should be referred to the hospice unit at an appropriate time.
PURPOSE The purpose of this study was to evaluate the selected nursing interventions and to describe the most common nursing interventions used by neurosurgery unit nurses. METHOD The data was collected from 65 nurses of 5 general hospitals from Jan. 8, 2001 to Feb. 28, 2001. The instrument for this study was the Korean translation of 486 nursing intervention classifications, developed by MacClosky and Bluecheck in 2000. In the 486 nursing interventions 310 nursing interventions were selected, 8 from among the 10 professional nurses group in the neurosurgery care unit. The 310 nursing interventions were used in a secondary questionnaire. In the secondary questionnaire, all 310 intervention lables and definitions were listed. The data was analysed with SPSS program. RESULT The results of this study are as follows. 1.The most frequently used nursing intervention domains were "physiological: complex", "physiological: basic", "Health system", "Behavior", "Safety", "Family". 2.Neurosurgery care unit core nursing interventions were performed several times a day by 50% or more of the Neurosurgery care unit. Neurosurgery core nursing intervention, 5 domain ("physiological: complex", "physiological: basic", "Health system", "Safety", "Behavior"), 16 class, 48 core nursing intervention. The most frequently used Neurosurgery core nursing interventions were Intravenous Therapy, Pressure ulcer prevention, Documentation, Airway suctioning, Medication: intravenous, Pain management, Medication: intramuscular, Shift report, Intravenous insertion, Positioning, Aspiration precaution, Pressure management, Physician support, Pressure ulcer care. 3.Compared with carrier and age of nurses, the more effective nursing interventions were "Family", Compared with the nursing place and the use of nursing interventions of nurses the most effective nursing interventions were "Health system" performed by nurse in university hospital. CONCLUSION The purpose of this study was to analysis the nursing intervention performed by neurosurgery unit nurses. This study analyses nursing intervention and core nursing interventions performed by neurosurgery unit nurses. Basis on this study result, neurosurgery nursing interventions will be systematized, and progression of qualitative nursing, data of computerized nusing information system will be utilized.
The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.
The purpose of this study was to develop and test the validity of the standardized Korean nomenclature of Nursing Outcomes Classification (NOC), developed by Johnson &Maas at the University of Iowa. The four phases of the study were: (1) translation of the NOC into Korean by the research team, (2) four nursing professors and eight nurses with various clinical backgrounds reviewed each nomenclature taking into consideration definitions and nursing activities. The modified Delphi method was used to determine the most appropriate nomenclature for each term; (3) Twenty four academic and clinical experts in nursing were given a questionnaire to rate each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate; (4) the team determined the most appropriate Korean nomenclature for each class of the NOC. The mean validity score of 190 items was 4.54, but several nursing outcome had a score lower than 4.0. They included 'adherence behavior(3.3)', 'ambulation : walking(3.57)', 'transfer performance (3.57)', 'caregiving endurance potential(3.57)'.
The purpose of this study was to develop and test the validity of standardized Korean nomenclature of the International Classification for Nursing Practice (ICNP), developed by the International Council of Nursing (ICN). The four phases of the study were: (1) Two professors and 15 graduate students translated who were taking a nursing intervention course, translated nursing phenomena and nursing action of the ICNP into Korean; (2) 12 nurses with various clinical backgrounds reviewed the nomenclature taking into consideration of the definition, and contents for each Korean nursing terminology, and the Delphi method was used to determine the best appropriate nomenclature for each terminology; (3) 20 academic and clinical experts in nursing were given a questionnaire to rate the validity of each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate; (4) five members of the Korean Nurses Association Research Committee reviewed the survey results and determined the most appropriate Korean nomenclature for each nursing phenomena and activity of the ICNP. Most nomenclature of the ICNP had a score of more than 4.0, but four nursing phenomena had a score between 3.5 and 4.0: Unilateral neglect(3.86), Care Giver strain (3.86), Health denial(3.86), Health Adjustment (3.86) and draining(2.63) . In nursing activity 726 items, except for twelve items, had a score of over 4.0: Drainage(2.63) Weaning(3.13), Caring(3.75), Cold Wrapping(3.63), distraction Technique(3.57), drawing(3.88), Establishing Report with(3.5), Heating Wrapping(3.5), Manipulating(3.75), Performing(3.88), Reading material(3.75) and Restricting(3.75).