Purpose This study aimed to suggest directions for legislation regarding medical support tasks in the Nursing Act to promote the advancement of nursing.
Methods This study reviewed the history of medical support nurses in South Korea and the educational programs for advanced practice providers, both domestically and internationally.
Results Nurses have performed medical support tasks traditionally carried out by physicians, but legal controversies have persisted. As a result of the escalation of conflicts surrounding policies aiming to increase the physician workforce, training doctors left hospitals. This prompted the initiation of pilot programs allowing nurses to legally engage in medical support tasks, culminating in the enactment of the Nursing Act in September 2024. Internationally, advanced practice providers such as advanced practice nurses (APNs) and physician assistants (PAs) undergo graduate-level education and certification. Since Korea lacks a PA system, integrating medical support tasks within the APN framework would be preferable. Achieving this will require absorbing clinical practice nurses (referred to as PA nurses) into the APN system, implementing government-supported education programs to address regional disparities, and establishing reimbursement policies for APNs.
Conclusion With the implementation of the Nursing Act, a long-term approach is needed to establish professional qualifications, accreditation, education, training, examination, and regulatory systems. A comprehensive discussion should be undertaken to develop an optimal workforce, ensuring the delivery of safe and high-quality healthcare services to patients and the public.
Purpose The purpose of this study was to describe clinical practice nurse’s role experience working in a university hospital. Clinical practice nurses are a mix of certified and non-certified nurses. They perform some of the duties of physicians in addition to the work they do as nurses. In the future, such nurses may become advanced practice registered nurses.
Methods Focus group interviews were conducted with three groups, each consisting of eight participants. The interview lasted two and a half hours per group. Data were analyzed using a thematic analysis method.
Results The analysis yielded four categories and 14 themes. The four categories were “seeking an escape from the repeated routines as a nurse”, “pioneering and developing new roles as a clinical practice nurse”, “confusion about professional identity due to ambiguity in role boundaries”, and “securing oneself as a team member and establishing a role as a clinical practice nurse”.
Conclusion The scope of advanced practice registered nurses’ roles was meant to have been established in 2020, but this was not achieved. Thus, studying the role experience of clinical practice nurses and their experiences is worthwhile and the results can inform legislation. The results of the study will also help establish a customized curriculum for advanced practice nurses and ultimately improve the quality of nursing services for patients.
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Purpose Nurses are at the forefront of the battle against the Coronavirus Disease 2019 (COVID-19) pandemic.Nurses’ expertise, attitude, and practice of prevention and control are important to provide a good quality of care for patients and to protect themselves from COVID-19 infection. This study aimed to investigate the attitudes and practices toward droplet and airborne universal precaution among nurses during the COVID-19 outbreak and to identify factors associated with nursing practices.
Methods: A cross-sectional online survey was conducted among nurses who had been involved in COVID-19 prevention and control and were able to join in the research from referral hospitals from Bandung, West Java, Indonesia from May 1 to 20, 2020. The questionnaire comprised three parts: demographic characteristics, attitude toward droplet and airborne universal precaution, and practice toward droplet and airborne universal precaution.
Results: The response rate was 91.7% (550 of 600 nurses). The majority were women (75.5%), aged 31.26±7.19 years (range: 22~55). Attitude (β=.51, p=.036) and perception of risk of contracting COVID-19 (β=.66, p=.045) were factors found to be associated with practices toward droplet and airborne universal precaution during the COVID-19 outbreak.
Conclusion: The Indonesian government needs to improve health services by enhancing and expanding tailored training programs for nurses on routine infection prevention and provide policies to better control the spread of the COVID-19 pandemic.
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PURPOSE This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. METHODS This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. RESULTS The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. CONCLUSION This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.
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PURPOSE This study was to provide baseline data about nurses' Influenza A (H1N1) knowledge, awareness, andpractice of infection control and to identify the significant factor affecting the level of practice. METHODS The subjects of this study were 144 nurses who worked at Influenza A (H1N1) regional base Hospital in D city. Data were collected by self-reported questionnaires during September 2009. The collected data were analyzed using SPSS/WIN 12.0 program. RESULTS The knowledge of Influenza A (H1N1) was statistically different according to age, unit, career and experience of seasonal influenza vaccination during the last year. The awareness of infection control was statistically different according to age, career, experience of seasonal influenza vaccination for last year and intention to get seasonal influenza vaccination for this year. The practice of infection control was statistically different according to unit, experience of seasonal influenza vaccination for last year, intention to get seasonal influenza vaccination for this year and intention to get Influenza A (H1N1) vaccination for this year. There was positive correlation among knowledge, awareness and practice (p < .05). Awareness was the significant factor affecting the level of practice. CONCLUSION An educational program focusing on strategy to change nurse's awareness can be effective for infection control of Influenza A (H1N1) in regional base hospitals.
PURPOSE To describe the lived experience of nursing students when faced with clinical judgment in a nursing practicum at the hospital. METHODS A descriptive research design was utilized. Participants were 79 students in the clinical practicum. Participant consent was obtained for ethical protection. Data were collected from August to December 2007 using a semi-structured questionnaire. Content analysis was utilized for data analysis. RESULTS Two categories and 5 themes were extracted from the data for 'difficult' and 'easy' clinical judgments. For the student category, the two themes were 'knowledge' and 'skill', while the three themes for the clinical education environment category were, 'judgment of clinical symptoms and signs', 'differences between theory and practice' and 'human relationships'. For coping, 2 categories and 5 themes were extracted for the difficult clinical judgment situation, while one category and one theme were found for the easy clinical judgment situation. CONCLUSION To develop students' clinical judgment, there is need to develop the method of clinical skills using simulation in clinical teaching. For future research, a study on factors affecting clinical judgment of nursing students in hospitals is needed.
PURPOSE This study was to identify the perceptions of nursing student on the clinical practice environment and related variables. METHODS The subjects of this study were 180 nursing students from a college participated in clinical practice at four regional hospitals. Data was collected with the questionnaire tool for the perceptions of clinical practice environment. RESULTS The students highly satisfied in the major had significantly high perception in innovation, personalization, student involvement, and clinical practice satisfaction. The students with a low level of stress and a clearly named guidance nurse were significantly high in the perceptions of task orientation, innovation, personalization, student involvement, and practice satisfaction. Clinical practice environment variables such as task orientation, innovation, individualization, personalization, student involvement, and practice satisfaction were significantly correlated with each other. In student characteristics, the main variables directly influencing the perceptions of clinical practice environment were religion, the level of stress, and the method of guidance. CONCLUSION Understanding the students' perspective would be valuable for promoting a positive clinical practice environment. Developing a cooperative system between the college and educational hospitals is necessary for effective clinical practice education
PURPOSE This study was to provide baseline data to arrange systematic management for the infectious waste. METHODS This data was collected by self-reported questionnaires from a total of 419 subjects, ie nurses, nurse's aides and laboratory technicians working at a university hospital located in G city. The collected data were analyzed by t-test or ANOVA, Tukey test, Pearson's correlation, and multiple regression analysis using SPSS/WIN 12.0. RESULTS The knowledge of the infectious waste was statistically significant in type of staff and level of education. Attitude was statistically significant in type of staff, age group, level of education, working period, and marital status. And also the practice of the subject was statistically significant in type of staff, age group, education level, the working periods, and marital status. There was positive association between attitude and practice(r=.63, p< 001). By means of multiple stepwise regression analysis, total variance explained by the attitude towards infectious wastes, single employee, and the working periods less than ten years was 44% of the practice of infectious wastes. CONCLUSION An educational program focusing on strategy to change employee's attitude can be effective for building a well-organized management system.
PURPOSE The purpose of this study was to develop an e-learning orientation program for nursing students(junior), to evaluate the program, and to find out its effects on adapting to clinical practicum. METHODS The e-learning orientation program was developed according to ADDIE model(analysis, design, develop, implement, evaluate) using an Active Tutor Program. Twelve nursing professionals and 31 nursing students(learners) evaluated the e-learning orientation program. Thirty one nursing students participated in the e-learning orientation program both on-line and off-line. RESULTS The e-learning orientation program consisted of 5 parts including 'Taking a lesson in gastrointestinal tract', 'Fundamental nursing skill and reading a medical chart', 'Taking a ward orientation by head nurse', 'Clinical practice with preceptors', and 'Writing for case report'. Adapting scores to clinical practicum were significantly different between pre-test and post-test(t=-5.76, p=.000). CONCLUSION The e-learning orientation program of on-line and off-line has an effect on adapting to clinical practicum for nursing students.
PURPOSE This study elicited Korean students' experiences of nursing practice at geriatric hospitals. METHOD A purposive sample of 26 Korean nursing students was recruited from K College of Nursing located in Daegu, Korea. Inclusion criteria were nursing students who: 1) finished nursing practice at geriatric hospitals, 2) were oriented and communicable, and 3) understood research purpose and agreed to participate in this study. Individuals were interviewed using Q-methodology. RESULTS The majority of the participants had experience of living with the elderly and volunteering related to elder care. Data analysis showed that participants' experiences of nursing practices were consisted of three types: skill acquiring-oriented, relationship-oriented, and practice system-oriented. CONCLUSION Nursing practices at geriatric hospitals provided opportunities of having positive attitude toward the elderly for nursing students. Nursing students' experiences were divided into at least three different types. Nursing educators need to develop curriculum for gerontological nursing practice tailoring to theses differences.
PURPOSE The purpose of this study was to offer the baseline data for developing a systematic and high quality of clinical practice guideline by exploring how nurses utilize clinical guidelines and what they need for. METHOD This study has been done with 242 nurses of a university hospital in Daegu using a self-administered questionnaire. The instrument used in this study was developed by researchers based on the results of the previous studies. Data analysis was done with SPSS 11.0 Program. RESULTS Nurses felt that clinical guidelines were not sufficiently disseminated to update their clinical knowledge education. Nurses showed the strong demand for developing clinical practice guidelines with the newest and systematic evidence. However, a relatively low number of nurses knew evidence-based nursing and evidence-based clinical guidelines. CONCLUSION It is necessary to develop an educational program for evidence-based nursing and an evidence-based nursing clinical practice guideline for nurses and to explore the strategies for development and dissemination of evidence-based clinical practice guidelines to solve the urgent and frequent clinical problems.
PURPOSE Behavioral symptoms in dementia (BSD) are one of the most disturbing behaviors to caregivers and a major reason for nursing home placement. Behavioral symptoms are often treated with psychotropic drugs (PD), however, the effect of such drugs for the frail elderly dementia patient is not certain because of their critical adverse effects. Theoretical model applicable to nursing practice for BSD in nursing homes, which is essential in guiding and evaluating such interventions, is absent. This article presents the process of developing a theoretical model of BSD in nursing homes. METHOD Using Walker and Avants' theory synthesis method, three behavior models and two system models were incorporated into the proposed model to provide the theoretical and analytical explanation of the relationships between PD usage, its determinants, and BSD. RESULTS Resident variables and nursing home variables related to the two focal concepts (i.e., PD usage and BSD) were identified. Resident variables include demographical characteristics such as age and gender, and dementia-compromised functions such as cognitive and functional impairment. Nursing home variables include facility characteristics such as ownership type and size, and physical and psychosocial environment. CONCLUSION The proposed model suggests that fulfillment of resident unmet needs through improvement of physical and psychosocial environment may produce better health outcomes of nursing home residents with BSD. Assessment and intervening environmental triggers of such behaviors are also suggested to be prior to the PD usage.
PURPOSE The purpose of this study was to identify the effect of web-based learning for ventilator practice on the knowledge and clinical competence of nursing students. METHOD The research design was a non-equivalent control group pre-post non-synchronized design. Twenty five nursing students were collected for the experimental group from August 23 to November 26, 2004 and nineteen nursing students for the control group from August 22 to November 25, 2005. All subjects experienced clinical practices in an intensive care unit of a hospital in G city for 2 weeks. The web-based learning for ventilator practice was conducted in the experimental group only. The data were analyzed with t-test and ANCOVA using SPSS 10.1 program. RESULT The 2 week web-based clinical practice learning significantly improved the knowledge scores for the experimental group, however, there was no significant differences in the score for the clinical competence between experimental and control group. CONCLUSION These findings suggest that a self-directed web-based learning for ventilator practice of nursing students can facilitate the knowledge of care for a ventilated patient. Therefore, faculties should develop a variety of web-based multimedia content programs for clinical instruction based on clinical situation.
PURPOSE The purpose of this study was to investigate foot ulcer risk factors, foot care knowledge, and foot care practice in patients with type 2 diabetes. METHOD One hundred fifty type 2 diabetic patients were in and out-patients in a large urban hospital. The data were collected using a self-report questionnaire, chart review and foot examination. The questionnaires were developed by the researchers through the experts consultation and literature review. High risk for foot ulcer was evaluated by peripheral neuropathy(PN), peripheral vascular disease(PVD), and prior foot ulcer. Foot risk scores(FRS) means numbers of present risk factors. RESULTS 31.3% of subjects show 1 FRS, and 13.3% showed 2 FRS. Mean foot care frequency was 3.5 times per week. There were significant differences in foot care knowledge according to DM education (t=2.96, p=.004) and foot care education (t=3.65, p=.001). There were significant differences in the foot care practice activities according to duration of DM (t=3.48, p=.010) and educational levels. CONCLUSION There were high proportion of foot ulcer risk among the patients. It is necessary to screen high risk foot ulcer patients and provide practical education for foot care practice of diabetic patients.
OBJECTIVE The study was conducted by the Association of Korean College of Nursing in order to survey and analyze the current state of clinical practicum for adult health nursing at four-year nursing college in Korea and to suggest improvements in the contents and methods of clinical practicum and its future direction. METHOD: Data were collected using a survey by mail from July to November 2004 using a structured questionnaire on the general state of clinical practicum for adult health nursing. The questionnaires were sent to 53 nursing colleges throughout the country, and 47 recovered questionnaires were analyzed. RESULTS: The number of credits for adult health nursing practicum was 7~10(average range), and various nursing fields were used in clinical practicum. The number of students per team was 5~6 at general wards and 3~4 at intensive care units. Students also experienced practicum during daytime and in the evening. Clinical practicum for adult health nursing was led by full-time professors and field practicum directors. In clinical practicum for adult health nursing, almost every college evaluated students' attitude, skills, leadership, etc. in various forms. CONCLUSIONS: It is urgent to develope a standardized evaluation tool for clinical practicum.
PURPOSE The purpose of this study is to investigate the perception of nursing students' on-site clinical experience at intensive care unit(ICU), which will help on developing fundamental tool to enhance the effect of their clinical practice. METHOD Van Manens hermeneutic-phenomenological method has been used to analyze the data. Participants consisted of 74 third-year nursing students who performed the clinical practice at an ICU in C university hospital. The students got the group interviews and kept the clinical diaries. Data was collected from series of group interviews and contents of the students clinical diaries. RESULT Major concerns related to students clinical practice were found as follows: [being nervous about unfamiliar machines and situations], [being frustrated about the patients], [feeling of helplessness], [being stupefied from witnessing a death], [realizing the importance of health], [realizing individual patient's precious value through family's love], [realizing the importance of treating a patient as human being], [realizing the differences between theory and practice], [modelizing two aspects of nursing: professional and personal], [readiness to become a capable nurse]. CONCLUSION We are able to obtain in-depth understandings about the nursing students lived experience of clinical practice at the ICU. Based upon this, there is a need to develop a better nursing intervention enhance the effectiveness of the nursing students clinical practice.
PURPOSE To describe the status of the laboratory facilities, equipment and expenses for practice in a four-year nursing schools and to analyze mandatory requirements for laboratory facilities and equipment. METHOD A descriptive survey research design was used. The participants were 49 of the 4-year nursing schools across the nation. The data were collected by e-mail. The return rate for questionnaires was 63.3% (n=31). RESULT In 2001 the total expenses for laboratory practice were 21,865,230 won and the average per student was 102,418 won. Types of laboratories included single and complex. The mean size for laboratories was 318.7 m2 and mean size for laboratories for fundamental nursing was 161.1 m2. The range for number of students in a laboratory class was 20-30 for eight universities (30.8%). Among required laboratory equipment, items that were deficient in 50% in the universities were mercury and aneroid sphygmomanometers for children, electronic sphygmomanometers, Bell type fetal stetho- scopes, sheepskin, beds for children, for gynecology, and electronic hilo beds. Among the elective equipment, items that were deficient in 50% of the universities were O2 tents, Blackmore tubes, retractors, hot-water supply, and incentive spirometers. The number of items that needed to add to the equipment were 10 for required equipment and 22 for elective equipment. CONCLUSION A standardized mandatory list of equipment for laboratory facilities and expenses for practice in 4-year nursing schools needs to be developed.
PUPPOSE: The purpose of this study was to compare the effect of breast self-examination (BSE) education between at education and three months. METHOD The study subjects were consisted of 30 women chosen from those in a Catholic church in Seoul. The data was collected by using questionnare at two different times: immediately after the BSE education and 3 momths after. RESULT At three months, women who performed BSE was 50.0% and the number of BSE practce was 2.53. There was statistically significant change on the score of the knowledge, barrier and practice between at education and three months later. Susceptibility was increased after three month, but wasn't significant different. Confidence, motivation after three months were decreased from the time of initial BSE education and wasn't significantly changed. It was found that motivation about BSE explained 44.2% of variance. CONCLUSION The findings showed that the knowledge of BSE, and attitudes and practice were change between at the time of the first survey and at three months. Therefore, the intensive education about BSE can be effective to enhance women's health belief and practice to perform BSE for early detection of breast cancer.
PURPOSE This study was conducted to describe qualitatively the entities of nurse's experiences in general hospitals and to suggest basic data guiding research on developing Standards of clinical nursing practice in Korea. METHOD Fourteen nurses working at general hospitals with over 300 beds in Seoul were interviewed in-depth until saturation using tape-recorders and transcription. RESULT The central theme of clinical nursing practice experienced by subjects was "being with clients" that means accepting client's personal character, solving client's needs and providing client-centered nursing. A also "being with clients" was felt to be the responsibility of nurses which was learned from their nursing schools. The nursing strategies performed in order to be with patients were proving skillful nursing techniques, accepting, educating, emotional support, advocating, and self-reflecting, the subjects experienced somewhat problematic affects such as difficulties in interpersonal relationship, work overload, negative image of nursing, deficit of self-confidence for nursing actions, poor working conditions, and unfair treatment. Nurses at the hospital practiced with pride when they felt that they were accepted by clients. CONCLUSION Further research is needed to analysis problems in clinical practice and the comparison of nurses' experiences of clinical practice, with nurses' experiences in various settings.
PURPOSE The purpose of this research was to describe how nurses in intensive care units (ICU) work. METHOD A total of 18 ICU nurses participated in the research. The data was collected through individual in-depth interviews and analyzed by grounded theory method using NUDIST 4.0 software program. RESULTS Three different patterns regarding nursing performance among ICU nurses were identified. These are 1) nursing performance of nurses who perform excellently, 2) nursing performance of nurses who do not perform well because of their lack of experience, and 3) nursing performance of nurses who do not perform well in spite of their good years of experience. These three different nursing performances were described in terms of seven different categories; 1) assessing and monitoring nursing problems, 2) clinical decision making, 3) interpersonal relationships, 4) holistic care, 5) technical skills, 6) problem solving, 7) working independently and creatively. This study also identified two intervening factors that influenced the advancement of their expertise. CONCLUSION The results of this study might help nurse managers in developing continuing educational programs for inexperienced nurses or those nurses not performing well to become experts by a deeper understanding of the nature of nursing performance and the factors that influence nursing performance in ICU settings.
The purpose of this study is to explore perception types and to understand the nature of experience of nursing students' clinical education by using the Q methodology. A Q sample was developed through a review of the literature and descriptions about nursing students' experience in clinical practice. Thirty-six statements made up the finalized Q sample. The P sample consisted of 33 third grade nursing students in K university. Q statements were written on separate cards and were given to the 33 subjects to sort according to degree of agreement or disagreement. The Q-sorts by each subject were coded and analysed with the Quanl PC program. A a result, three major perception types, namely, 'alienation of ideal and reality', 'active participation', and 'perception of limitation of ability' were identified. By identifying the nature of the three types, this study suggests efficient strategies for developing clinical educational programs according to the perception types of nursing students. Clinical education would thereby be more valuable.
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