A Literature Review of Research on Medical Service Design in Korea / 간호행정학회지

PURPOSE: Purpose of this study was to analyze research on the service design process applied to domestic medical service areas. METHODS: A review was made through domestic databases including RISS, KISS, DBpia, and NDSL and for the analysis framework: a medical service classification code which integrated the medical service area and the design fields. RESULTS: In the healthcare service field there were 9 studies (69.2%) in the medical area, 1 study (7.7%) each in nursing and oriental medicine, and 2 studies (15.4%) in healthcare. According to analysis results based on the medical service classification code, there were 5 studies in prevention and management, 6 studies in curative care, 1 each in rehabilitation and ancillary care. Double diamond process was used in 8 studies. CONCLUSION: Service design was applied mainly to the curative care in the domestic medical settings but little research on service design in the long-term nursing care area was identified. As a strategy to improve the quality of nursing service, it is necessary to adopt the service design process for various nursing service areas in Korea.

Perception of Healthcare Accreditation System on Patient Safety Management Activities and Nursing Performance of Regional Public Hospital Nurses / 간호행정학회지

PURPOSE: This study was done to identify the ways regional public hospital nurses perceive the healthcare accreditation system as related to their patient safety management activities and nursing performance. METHODS: The participants were 190 nurses chosen with convenient sampling from nurses who worked at regional public hospitals that had obtained healthcare accreditation as of May, 2016 and who had experienced the healthcare accreditation process at least once and whose clinical experience was one year or longer. Collected data were analyzed using t-test, ANOVA, Scheffé test, Pearson correlation coefficients and multiple regression analysis. RESULTS: There were significant positive correlations between perception of the Healthcare Accreditation System, patient safety management activities and nursing performance. Factors affecting patient safety management activities were activities to improve medical service quality, patient dissatisfaction and difficulties, changes and values. These factors explained 55.4% of variance in patient safety management activities (F=22.25, p<.001). The factors affecting nursing performance were being charge nurses and activities to improve medical service quality. These factors explained 48.1% of the variance in nursing performance (F=16.57, p<.001). CONCLUSION: Finding indicate that positive perception of the healthcare accreditation system by nurses at local government institutions is a factor in heightening patient safety management activities and nursing performance.

A Study on the Critical Thinking Disposition, Self-directed Learning Readiness and Professional Nursing Competency / 간호행정학회지

PURPOSE: A descriptive survey was used in this study to identify the relationship between nurses' critical thinking disposition, self-directed learning readiness and professional nursing competency and to examine factors that influence professional nursing competency. METHODS: The data were collected from 188 nurses and analyzed using t-test, ANOVA, Scheffe' test, Pearson correlation, and stepwise multiple regression analysis with the SPSS/WIN 20.0 PC program. RESULTS: Professional nursing competency was found to have significant pure correlations with critical thinking disposition (r=.59, p<.001), and self-directed learning readiness (r=.54, p<.001). The most influential factor influencing nurses' professional nursing competency was critical thinking disposition, followed by self-directed learning readiness (beta=.25, p=.003), work department (beta=.19, p=.001), total clinical career (beta=.19, p=.003), and position (beta=.12, p=.040), and these factors explained 43.8% of the variance in professional nursing competency. CONCLUSION: The findings indicate the necessity of developing and applying strategies and educational programs to enhance individual nurse's critical thinking disposition and self-directed learning readiness. Furthermore, exploration is needed on ways to enhance professional nursing competency.

An Example of Systematic Searching for Guidelines to Prevent Catheter-associated Urinary Tract Infections - Part I: Using the PubMed Database / 간호행정학회지

PURPOSE: Effective literature searching is essential to support evidence-based nursing. The aim of this study was to present our recent systematic search experience to identify guidelines in PubMed for prevention of catheter-associated urinary tract infections. METHODS: Five approaches to the literature search via PubMed were employed. The searches were restricted to items published from 1980 to 2010, for patients admitted to hospital, and in the English language. The search results were compared using the number of records and relevant items, and the sensitivity and precision of each search strategy. RESULTS: The individual approaches retrieved 19-141 of records and 3-6 of relevant items. Sensitivity ranged from 37.5% to 75.0% with the highest values for simple searches and a search combining MeSH terms and free textwords with a methodological search filter. Precision varied from 4.3% to 21.7% and the highest precision was found for MeSH terms with limits feature. CONCLUSION: The simple search in PubMed is an appropriate way for nurses in a busy clinical practice to search the literature for evidence. However, several approaches using MeSH terms, free textwords, limits feature or methodological search filters are also required to have more efficient and better informed search results.

The Effects of Aerobic Exercise Therapy on Physical Functions in the Elderly

PURPOSE: Designed to examine the effects of aerobic exercise therapy on elders' physical functions. METHODS: Selected from an elderly welfare center in an agricultural district located in N City. Thirty seven elders were selected in the experimental group and 38 in the control group, and all the subjects aged over 65. Collected data were statistically analyzed by SPSS/PC 12.0 Win. Detailed data analysis methods were Chi-square, Fisher's exact test, Kolmogorov-Smirnov test, t-test, Mann-Whitney u-test, paired t-test, and Wilcoxon's rank sum test. RESULTS: The first hypothesis "The experimental group who had the aerobic exercise therapy will have greater development in lower leg muscular strength compared to the control group" was supported (t=8.95, p<.001). The second hypothesis "Aerobic exercise therapy participants will show greater development in lower leg endurance" was supported (t=6.12, p<.001). The third hypothesis "Aerobic exercise therapy participants will show greater development in flexibility" was supported (U=49.00, p<.001). The forth hypothesis "Aerobic exercise therapy participants will show greater development in balance" was supported (U=322.00, p<.001). CONCLUSION: The aerobic exercise therapy showed positive effects on physical functions of the elderly in a rural area.

Nursing Activities and Outcomes Related to Indwelling Urinary Catheterization from a Review of Medical Records and Interviews / 기본간호학회지

PURPOSE: The purpose of this study was to identify nursing activities and to analyze patient outcomes related to indwelling urinary catheterization. METHOD: A review was done of 628 medical records from five units for patients admitted between January 1 and June 30, 2006. Twelve nurses who worked in the same units were interviewed. RESULTS: In the interviews, nurses reported considering several non-invasive interventions prior to catheterization but there were no medical records of this activity. Results from the in-depth interviews showed that infection control activities such as urinary bag management were conducted but again there were no medical records. Seventy-five percent of the catheters were removed without prescription. In the medical records there were no notes for approximately 15%, on the time of first voiding and 80%, on volume of first voiding after removal of catheter. There was a significant difference in hospitalization days between the group catheterized for 5 days or less and the group catheterized for 6 days or more. CONCLUSION: Results indicate a need to close the gap between recorded and described activities and between current and best evidence based practice. Further study is needed to develop a standard recording system and guidelines related indwelling catheterization to decrease the gaps identified in this research.

Development of a Critical Pathway for Patients with Uterine Artery Embolization / 여성건강간호학회지

PURPOSE: The purpose of this study was to develop a Critical Pathway for Uterine Artery Embolization patients. METHOD: There were 6 steps that were taken. Step 1 was selecting a diagnosis, and Step 2 was organizing a development team consisting of 7 experts. Step 3 analyzed the medical records, and Step 4 drew up a preliminary Critical Pathway. Step 5 tested the clinical validity of the preliminary Critical Pathway, and Step 6 developed the final Critical Pathway. RESULT: The contents of the medical practices observed in the medical records were investigated in seven areas: monitoring/assessment, treatment, medication, diet, activity, consults, and education/discharge plan; and a total of 73 items was identified. The validity of the 73 items was examined by a group of specialists. 68 items were adopted, 4 items revised, 1 item removed, and 1 item was added. Using the results, a preliminary Critical Pathway was drawn up. According to the results from examining the clinical validity of the preliminary Critical Pathway with five patients for five weeks, 3 items which showed discrepancy were revised and another 3 items were added. Then, the final Critical Pathway was completed. CONCLUSION: This Critical Pathway needs to be clinically applied and continuously to measure its effects in terms of the length of stay, cost?effectiveness, and the patients' and staffs' satisfaction.