Comparing Satisfaction and Importance of Nursing Care Nursing Work Environment, Nurse's Intention to Work between Comprehensive Nursing Care Unit and General Nursing Care Unit / 임상간호연구

PURPOSE: This study was aimed to identify the difference in satisfaction and importance of nursing care between patients in comprehensive nursing care unit (CNCU) and general nursing care unit (GNCU). It also confirms the difference between practice environment of nursing work and nurse's intention to work. METHODS: Nursing care satisfaction and importance levels were measured from 202 patients. Practice environment of nursing work and nurse's intention to work were measured from 54 nurses. RESULTS: The satisfaction level was higher in the CNCU in comparison to the GNCU (p < .001). There was no significant difference between the importance and satisfaction level of nursing care for patients at the CNCU (p=.973), whereas in the GNCU, patients' satisfaction level was lower than the importance level (p < .001). The score for practice environment for nursing work was higher in the CNCU than in the GNCU (t=3.34, p=.002). The nurse's intention to work in the CNCU was higher than that of the GNCU, but there was no statistically significant difference. CONCLUSION: Through the survey, the paper suggests that comprehensive nursing care is a service type that satisfies the nursing demand (importance) that patients consider important. Results from nurses showed no significant differences.

Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care / 간호행정학회지

PURPOSE: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. METHODS: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. RESULTS: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. CONCLUSION: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.

Knowledge and Awareness of Nurses and Doctors Regarding Cancer Pain Management in a Tertiary Hospital

PURPOSE: The purpose of this study was to compare and check the levels of cancer pain management knowledge and awareness between doctors and nurses in a tertiary hospital and to develop an intervention program. METHODS: Participants were 725 nurses and 95 doctors working in a hospital from May 2 to 29, 2009. Data were analyzed using t-tests, chi2-tests, and ANOVA with SPSS WIN 18.0. RESULTS: In a comparison of the pain management score, nurses showed significant results for age (p<.001), carrier (p<.001), education (p<.001), workplace (p<.001), and doctors showed significant results only for age (p=.032). Doctors' marks were significantly higher than nurses' in pain management scores (p<.001). Knowledge about analgesic medication (t=-5.38, p<.001) and analgesic drug effect (t=-8.59, p<.001) were significantly different in the pain management subcategory score between nurses and doctors. There were four items with different awareness levels related to analgesics between nurses and doctors. CONCLUSION: The findings of this study demonstrate that it is possible to develop pain education content for nurses and doctors. The findings of this study are useful when seeking to change the awareness level of a medical team regarding opioid analgesics.

Predictive Effects of Previous Fall History on Accuracy of Fall Risk Assessment Tool in Acute Care Settings / 기본간호학회지

PURPOSE: To explore the usefulness of previous fall history as a triage variable for inpatients. METHODS: Medical records of 21,382 patients, admitted to medical units of one tertiary hospital, were analyzed retrospectively. Inpatient falls were identified from the hospital's self-report system. Non-falls in 1,125 patients were selected by a stratified matching sampling with 125 patients with falls (0.59%). A comparative and predictive accuracy analysis was conducted to describe differences between the two groups with and without a history of falls. Logistic regression was used to measure the effect size of the fall history. RESULTS: The fall history group showed higher prevalence by 9 fold than the non-fall history group. The relationships between falls and relevant variables which were significant in the non-fall history group, were not significant for the fall history group. Falls in the fall history group were 25 times more likely than in the non-fall group. Predictive accuracy of the risk assessment tool showed almost zero specificity in the fall history group. CONCLUSION: The presence of fall history, the fall prevalence, variables relevant to falls, and the accuracy of the risk tool were different, which support the usefulness of the fall history as a triage variable.

Evaluation of a Fall Risk Assessment Tool to Establish Continuous Quality Improvement Process for Inpatients' Falls / 간호행정학회지

PURPOSE: The aims of study were; (1) to evaluate the validity and sensitivity of a fall-risk assessment tool, and (2) to establish continuous quality improvement (CQI) methods to monitor the effective use of the risk assessment tool. METHODS: A retrospective case-control cohort design was used. Analysis was conducted for 90 admissions as cases and 3,716 as controls during the 2006 and 2007 calendar years was conducted. Fallers were identified from the hospital's Accident Reporting System, and non-fallers were selected by randomized selection. Accuracy estimates, sensitivity analysis and logistic regression were used. RESULTS: At the lower cutoff score of one, sensitivity, specificity, and positive and negative predictive values were 82.2%, 19.3%, 0.03%, and 96.9%, respectively. The area under the ROC was 0.60 implying poor prediction. Logistic regression analysis showed that five out of nine constitutional items; age, history of falls, gait problems, and confusion were significantly associated with falls. Based on these results, we suggested a tailored falls CQI process with specific indexes. CONCLUSION: The fall-risk assessment tool was found to need considerable reviews for its validity and usage problems in practice. It is also necessary to develop protocols for use and identify strategies that reflect changes in patient conditions during hospital stay.

The Effects of Nursing Information System on the Nursing Job: Focused on Direct and Indirect Nursing Time, the Number of Cases and of Patient's Treatment Fees / 대한의료정보학회지

The purposes of this study were to identify the effects of the Nursing Information System on time of the direct and indirect nursing activities, the frequencies of verbal and telephone order, the number of cases and patient's treatments fees before and after NIS. 10 nursing units in the S.N.U.H. were se lected. The data were colle cted for 6 month prior and pa st to NIS. The frequencies of verbal and telephone order were reported from staff nurses for 3 days. The numbers of cases and fees of patient's treatments were taken for 3 month before and after NIS. The results of this study were as follows: 1. 66.9% of participants said direct nursing activities were increased. Any changed nursing performances were patients education, nursing rounds, care of patient's hygiene, care for patient's movements, oral and tracheal suctioning, changing position, and feeding. 2. The difference of amount of time of dir ect and indirect nursing activities 1)There was 14 minutes increase indirect,4 minutes decrease in indirect. 2)NA's activities we re increased by 30minute in direct, decreased by 16 minute in indirect. 3. The frequency of telephone order decreased 16 and verbal order decreased 46 per day. 4. The difference of the number of patient treatment case before and after NIS was increased 9,907 per 3 months and of fees for patient treatment was increased 797,811,067 won per 3 months.