Purpose Since anticancer medication nursing is an evaluation area for accreditation by medical institutions in Korea, all clinical nurses are required to attend an annual classroom lecture. However, it is necessary to reconsider the methods and effects of this requirement. This study was conducted to develop a web-based anticancer chemotherapy nursing course for clinical nurses and to examine its effectiveness in terms of job knowledge, self-efficacy, and nursing performance. Methods A randomized controlled design using random selection was utilized. The content was developed into 5 modules featuring basic and advanced learning, and the total learning time was 80 minutes. To test the effect of the multimedia contents, a randomized control group pretest-posttest study design was adopted. Clinical nurses with less than five years of experience were recruited from a university-affiliated hospital and randomly assigned to an experimental (n=28) or control (n=28) group. The experimental group autonomously learned web-based anticancer chemotherapy nursing for two weeks through a website. Results There was a statistically significant increase in the job knowledge of the experimental group receiving the classroom lecture (p=.001). However, there were no statistically significant differences between the two groups in self-efficacy (p=.055) and nursing performance (p=.359). Conclusion This study found that web-based self-learning could be a useful learning strategy for the anticancer chemotherapy and nursing education that clinical nurses must complete annually. However, it is necessary to verify the effect on self-efficacy and nursing performance through repeated studies.
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PURPOSE Health care professionals represent an immediately available resource to promote smoking cessation. However, the content in smoking cessation intervention courses in most institutions is insufficiently covered due to the limited number of class hours. The purpose of this study was to develop a comprehensive tobacco cessation-web-based, multimedia, educational program for a range of medical professionals. METHODS Based on Jung's Teaching and Learning Structure Plan Model, a development process was proposed comprising four stages: (1) analysis, (2) planning, (3) production, and (4) operation/evaluation. The effectiveness of the program was tested using quasi-experimental design, and the participants in experimental group were required to complete the program. Changes in the level of knowledge and attitude were measured. RESULTS The educational program developed includes nine topics and 26 sub-topics. A total of 180 storyboards, 15 videos, and 27 pictures were made. After the education, the level of knowledge was significantly increased in the experimental group. CONCLUSION This web-based program can be recommended as a potential medium for health care professionals to use in counseling smoking cessation. The study findings also indicated that the program may be either offered as a teaching aid or utilized concurrently with lectures for students studying health care-related topics.
PURPOSE The purpose of this study was to compare the difference of change in oxygen saturation, vital signs and suction time taken for the suctioning during endotracheal suctioning performed with closed suction system and with opened suction system. METHODS Data were collected from 31 adult patients with ventilator treatment who were admitted to a university hospital in Seoul and the collection period was from July 1 to November 15, 2005. Oxygen saturation, heart rate, respiration rate and mean arterial pressure were collected immediately prior to the suctioning intervention, during and 1 and 5 minutes after the suctioning from opened suction system and closed suction system. RESULTS 1) The difference in oxygen saturation was statistically significant in recovery time for oxygen saturation to return to baseline values after suctioning was significantly rapid on closed suction system (p < .05). 2) The difference in heart rate, respiration rate and mean arterial pressure was statistically insignificant. 3) The suction time was shorter in closed suction system. CONCLUSION Closed suction system is more efficient, as compared with the open suction system in the ventilator treatment.
PURPOSE This study was conducted to develop Web-based multimedia contents for supporting student nurses' clinical practice on critical care, and to evaluate learners' responses. METHODS Based on the steps of Assessment, Design, Development, Implementation, & Evaluation(ADDIE) model, a total of 13 self-directed learning modules including live lectures and real video clips were developed through faculty collaboration of nine nursing colleges in Gwangju and Chonnam province. The finally developed multimedia contents were published on the Web of the learning management system at a local e-learning center. RESULTS The Web contents were evaluated after self-learning by 81 junior college nursing students who were encouraged to study it at their own pace during their two-week clinical practice at a medical or surgical intensive care unit of a university hospital and two hospitals. The knowledge (t = -27.66, p < .001) and self-evaluated clinical performance level(t = 7.54, p < .001) were significantly increased after learning of the Web contents and clinical practice, and satisfaction level that measured post-test only was 4.0 out of 5 point. CONCLUSION The use of Web contents for critical care need to be extended as a complimentary material in a class room lecture or clinical practice of students to increase their self-learning ability and understandings of clinical knowledge and situation.
PURPOSE This study was conducted to develop a timeout protocol as the process of patients verification in the operating room, and to evaluate its effects. METHODS: The timeout protocol was developed based on the experience of practices and the universal protocol of JCAHO 2004. The subjects of this study were 192 surgical members working in the operating room at an university hospital in Daegu, Korea. RESULTS: The timeout protocol was developed in six steps; participants verification, encouragement of compliance, verification of right 3 PSP, agreement of surgical team members, verification of the parties to a patient, patient agreement. The data which have been resulted from the experimental group show significantly higher than those of control group as follows; cognition(t = -6.580, p = .000), contents of performance; progress of anesthesiologist as leader(chi-square = 29.029, p = .000), verification of right patient, right site and right procedure(chi-square = 40.663, p = .000), participation of surgical team(chi-square = 68.412, p = .000), and the number of cases of performance(chi-square = 242.900, p = .000). CONCLUSION: It suggests that medical accidents caused by failures in a preoperative verification process can be prevented if a timeout is conducted active involvement and effective communication among surgical team members for a final verification of the correct patient, procedure, and site.
PURPOSE This ethnography in communication aimed to explore the changes in consciousness on time and temporality as an elderly became older. This study focused on time as a primary message systems of Edward Hall. METHODS The assumption of the study was that the aging body as an expression of biological time is a meta of physical, personal, and social time. Data were collected from iterative fieldwork in a clan between Jan, 1990 and April, 2007. The key informants were 13 women and men aged 70 years old or more at the beginning of study. Changes in physical time and temporality as the women's body declined in its physical function was analyzed. As the cultural context, informants' every life and the history of the clan were also analyzed. RESULTS The meta-time of the informants were constituted as follows: In the low-contextual dimension, physical time perceived as longer and personal time perceived as shorter than they were young; In high-contextual dimension, informant and residents had a polychronic perspective and aged-centered time perspectives.; In the supernatural dimension of time, sacred time were reinforced by rituals. Informants extended temporality to their springs' world and ancestors' world. CONCLUSION As the informants recognized slugged body movements and time-limited present life, their views on their life world towards the future of spring and of the sacred world of ancestors. Thereby, their identity as a member of a clan was reinforced. This result informed us on what we should focus on when caring with older women.
PURPOSE This cross-sectional survey research was undertaken to identify the factors influencing time from onset to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. METHODS The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. RESULTS On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(chi-square=18.629, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. CONCLUSION According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients. Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.
The purpose of the study was to explore the effect of 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hour on the frequency of "red man syndrome", phlebitis and length of peripheral catheter placement of infected patients, in order to provide safe infusion method for reducing vancomycin-induced RMS and phlebitis. The subjects of the study consisted of 16 hospitalized patients; 3 oncology and gastro-intestinal patients, 1 neurological patient, 6 thoracic surgical patients and 6 orthopedic patients, who had received vancomycin from July to October in 1999 at S-hospital. The dependent variables were the incidence of RMS, phlebitis and the length of peripheral catheter placement. The incidence of RMS was checked by an inspector at the first night whenever the infusion method of vancomycin was changed. RMS was observed every 15 minutes during an hour for symptoms of RMS such as itching, erythema, chest pain and systolic blood pressure. Incidence of phlebitis was assessed by inspector twice a day from the insertion of peripheral catheter to the removal of the catheter. The data were analyzed by percentage, mean, X2-test, t-test, repeated ANOVA, and logistic regression analysis using the SPSSWIN program. The results are summarized as follows; 1. No significant difference was identified in frequency of RMS between the experimental group and control group. 2. There was no significant difference in the change of systolic blood pressure as the time goes on between the experimental group and control group. 3. The incidence of phlebitis was significantly lower in the experimental group than in the control group. 4. The length of peripheral catheter placement was significantly longer in the experimental group than in the control group. 5. Other drugs administrated with vancomycin didn't influence the occurrence of phlebitis. However, the infusion method of vancomycin influenced the occurrence of phlebitis. The results suggest that 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hours may decrease the incidence of phlebitis and increase the length of peripheral catheter placement compared to 1 hour infusion of vancomycin(1g) in 100ml of isotonic saline every 12 hours. However, it does not reduce the incidence of RMS.
The purpose of this study is to analyse and evaluate the characteristics of stroke patients and the causes of their spending time in arriving emergency room and the actual conditions of using alternative medicines before entering emergency room. The subject of this study four hundred seventy six patients who was hospitalized in Western Medical and Chinese Herb Medicine of D Hospital in Pusan within two weeks after attack. The collected data are analysed by the analysis method of narration statistics through SAS program and one-way analysis through ANOVA. The important results of this study are as followings: The spending time in arriving emergency room shows that under 3 hours is 19.5%, under 6 hours is 29.0%, under 24 hours is 55.1%. In the aspects of using alternative medicines before entering emergency room, the patients of 60.1% had used alternative medicines. Through the examination and analysis it can be seen that the geographical-environmental features and the clinical features for the acute stroke patients have more effect than the populational-sociological features on the spending time in arriving emergency room. For the aspects of using alternative medicines before entering emergency room, however, the charactericstics of clinical features have more effect than the populational-sociological features and the geographical-environmental features.