ICU Nurses’ Experiences with Patient Care after Death / 간호행정학회지

Purpose@#This study aimed to identify ICU nurses‘experiences with patient care after death. @*Methods@#The data were collected through two focus group interviews with eight nurses who had experienced the death of patients in the ICU. Giorgi’s method of descriptive phenomenology was used to interpret the data. @*Results@#Five constituents and 14 subconstituents were extracted from the 68 units of meaning. The five constituents were as follows: respect the body as a person, consideration and support for the family, dichotomy between personal courtesy and performing tasks, overcoming the patient’s death and growing, and care after death: a unique role left to the nurse. @*Conclusion@#These findings illuminate the meaning of care after death as a continuation of person-centered care and can be used as primary data for the development of organizational, educational, and emotional support for nurses to accomplish their roles in the ICU.

New Nurses' Experience of Turnover: A Qualitative Meta-Synthesis / 간호행정학회지

Purpose@#The aim of this research was to identify, appraise and synthesize available evidence exploring new nurses' experiences of turnover. @*Methods@#The qualitative meta-synthesis method suggested by Thomas and Harden was used. Qualitative research articles considered for inclusion in the review were identified through an extensive search of relevant literature in scientific databases. Data were extracted from the aforementioned articles, and qualitative research findings were pooled according to Thomas and Harden's review process. This process involved the categorization of findings according to similarity of meaning and aggregation of these sub-themes to produce a comprehensive set of synthesized themes. @*Results@#A total of 4 research articles met the inclusion criteria and were included in the review. The review process resulted in 30 sub-themes that were aggregated into 10 themes: ineffective education; overwhelming work; personal maltreatment by doctors, career nurses, patients and caregivers; lack of professional vision; suffering; fear; loss of confidence; isolation; cynical reaction to turnover; new beginning and growth. @*Conclusion@#These findings illuminated the necessity of educational, organizational, emotional and social support for new nurses to help them accomplish their developmental tasks during their transition, as well as the need for this support to continue even after the turnover.

Relationship of Conflict Management Style, Professional Autonomy, Role Conflict and Organizational Commitment of Nurses in General Hospitals / 간호행정학회지

PURPOSE: The purpose of this research was to examine the relationship between types of conflict management style, role conflict, professional autonomy and organizational commitment of hospital nurses, and to identify factors influencing organizational commitment. METHODS: Participants were 165 conveniently selected nurses from one general hospital in Gangwon province. Data were collected from March 28 to April 6, 2018 using self-report questionnaires. RESULTS: There was a significant difference in the level of professional autonomy and organizational commitment depending on the nurses' styles of conflict management. A statistically significant positive correlation between professional autonomy and organizational commitment was found, and a negative correlation between environmental barriers in role conflict and organizational commitment. Participants' professional autonomy and environmental barriers in role conflict explained 17.9% of organizational commitment. CONCLUSION: These finding indicate that professional autonomy and environmental barriers are both very important factors influencing organizational commitment. Accordingly, it is necessary to improve nurses' organizational commitment, enhance autonomy and reduce environmental barriers for nurses performing nursing roles.

Development and Testing of a Mastery Learning Program of Nursing Skills for Undergraduate Nursing Students

PURPOSE: This study was undertaken to develop and test a mastery learning program of nursing skills for undergraduate nursing students. METHODS: In this methodological study, first, the preliminary draft of a mastery learning program to provide training for nursing skills was developed based on Bloom's framework for mastery learning. Second, to test the developed program, a single-blinded, nonequivalent control group nonsynchronized study was conducted on 50 senior nursing students in a University selected by convenient sampling. Thirteen students were assigned to a control group; 13, 12, and 13 of them were assigned to intravenous therapy, transfusion, and patient transfer groups, respectively. The achievement levels and performance scores of the selected nursing skills were measured before and after the completion of the program in all the groups. Lastly, the final program was confirmed based on the results of the program testing. RESULTS: Intravenous therapy, transfusion, and patient transfer were selected as essential nursing skills for the program based on the priorities rated by clinical instructors and staff nurses. The achievement levels of selected nursing skills were determined by Angoff scores. After participating in the program, the proportion of passers and performance scores of the nursing skills in the experimental groups were significantly higher than those in the control group. The final program was confirmed which included a diagnostic test, enrichment activities for the passers and three repetitions of corrective activities and formative assessments for non-passers. CONCLUSION: The results suggest that a mastery learning program for undergraduate students can lead to better improvement and performance of essential nursing skills.

Development and Evaluation of a Web-based Simulation Program on Patient Rights Education using Integrated Decision Making Model for Nurse Students / 간호행정학회지

PURPOSE: This study was designed to develop and evaluate the a web-based simulation program on patient rights education using integrated decision making model into values clarification for nurse students. METHODS: The program was designed based on the Aless & Trollip model and Ford, Trygstad-Durland & Nelms's decision model. Focus groups interviews, surveys on learning needs for patient rights, and specialist interviews were used to develop for simulation scenarios and decision making modules. The simulation program was evaluated between May, 2011 and April, 2012 by 30 student nurses using an application of the web-based program evaluation tools by Chung. RESULTS: Simulation content was composed of two scenarios on patient rights: the rights of patients with HIV and the rights of psychiatric patients. It was composed of two decision making modules which were established for value clarifications, behavioral objective formations, problems identifications, option generations, alternatives analysis, and decision evaluations. The simulation program was composed of screens for teacher and learner. The program was positively evaluated with a mean score of 3.14+/-0.33. CONCLUSION: These study results make an important contribution to the application of educational simulation programs for nurse students' behavior and their decision making ability in protecting the patient rights.

Effects of an Education Program on Prevention of Malpractice using Precedent Cases related to Patient Safety in Safety Perception, Safety Control, Autonomy and Accountability in Clinical Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to identify the effects of an education program on safety perception, safety control, autonomy and accountability in clinical nurses. Precedent cases related to patient safety were used in the education program. METHODS: A quasi-experimental design with pretest and posttest measures was used. Participants in the study, 72 nurses in the experimental group, 71 nurses in the control group, were enrolled for 3 months. The education program was composed of the 20 precedent cases related to patient safety from home and foreign countries. RESULTS: The major findings of this study were as follows: Safety perception (p=.000), Safety control (p=.000), attitude toward autonomy (p=.000), and attitude toward accountability (p=.000) improved after the education program. CONCLUSION: The findings from this study indicate that an education program using precedent cases is an efficient method to improve behavior and change attitudes towards protecting patients' safety and preventing malpractice claims against nurses.

Development of a Web-based Diagnostic Evaluation Program for Prevention of Nurse Malpractice Liability / 간호행정학회지

PURPOSE: This study was done to develop a web-based diagnostic evaluation program for nurses to prevent malpractice liability. METHODS: A comprehensive review of the literature and 9 specialist interviews were used to search for learning goals and content for protection for nurses from malpractice. Data on needs for learning goals were collected from 56 hospital nurses who agreed to complete a self-report questionnaire. The diagnostic program was evaluated between September 2008 and August 2009 by 35 new hospital nurses using an application of the web-based program evaluation tools by Chung (2000). RESULTS: A comprehensive review of the literature and interviews were used to search for learning goals and content. The evaluation program was composed of the 73 questions for diagnostic evaluation under 23 learning goals and 6 grand learning goals which included the principles of law, patient's rights, legal responsibility, patient's safety, regulation on nursing practice and patient's rights protection. Evaluation of the program showed that the mean for program evaluation was 3.43 (SD=.37). CONCLUSION: This diagnostic evaluation program could be an efficient method for teachers and learners to improve nurses' behavior in protecting the patient's rights and preventing malpractice claims.

Current Status and Considerations for Education in Nursing Management / 간호행정학회지

PURPOSE: The purpose of this study was to explore the current status of education for nursing management in Korea. METHODS: A descriptive study was done using a questionnaire developed by the investigators. The data were collected by survey from 96 out of 129 nursing schools, between December 2010 and February 2011. RESULTS: For 22.9% of nursing schools, there was no faculty for nursing management. The credits and subjects included in nursing management varied among the nursing schools. Lectures in subjects related to nursing management were given not only by nursing management faculty but also by faculty with other majors. There were more faculty and credits for nursing management courses in 4-year nursing schools than in 3-year schools. CONCLUSION: To improve the quality of education in nursing management, there is a need to standardized courses and provide nursing faculty who have majored in nursing management.

Comparison of the Hospice Systems in the United States, Japan and Taiwan

PURPOSE: The aim of hospice care is to provide the best possible quality of life both for people approaching the end of life and for their families and carers. The Korean government has been implementing a pilot project for hospital hospice services and trying to develop the national hospice system. To assist in the development of the Korean hospice system, the Korean government supported the present study comparing the hospice systems of three countries, United States, Japan, and Taiwan, which currently have a developed hospice system. METHODS: Data from three countries were collected in the following ways: reviewing hospice related literature, searching government documents on the Internet, collecting government hospice data, surveying six hospice institutions in each country, and conducting an international workshop. RESULTS: The hospice system was evaluated by comparing hospice management systems and hospice cost systems. The comparison of the hospice management system included five items of hospice infra structures and four items of hospice services. The hospice cost system included four items: funding source, hospital hospice cost, day care hospice cost, and home hospice cost. CONCLUSIONS: Based on the comparison of three countries, the most interesting thing was that home hospice care accounted for more than 90% of all hospice services in the United States and Taiwan. The results of this study will aid the countries that are in the process of developing a hospice system including Korea, which has been implementing a pilot project only for hospital hospice services.

Development of a Web-based Education Program for Nurses working in Nursing Homes on Human Rights of Older Adults

PURPOSE: This study was done to develop a web-based education program for nurses working in nursing homes. The focus was on the rights of older adults. METHODS: The program was designed based on the Network-Based Instructional System Design (NBISD) model and was operated and evaluated between July 2007 and June 2008. RESULTS: Out of nursing records of 40 residents from a nursing home, the final 7 cases were deducted through classification using the Resource Utilization Group (RUG)-III. The data on needs for education was collected from 28 nurses working in 15 nursing homes located in Seoul and Gyeonggi Province, who agreed to complete a self-report questionnaire. A comprehensive review of the literature and two focus groups interviews were used to search for risk factors and guidelines for protection of human rights. The education program was developed based on Kolb's experiential learning model and composed of 5 units, which included content on types of human rights and rights to death with dignity, elder abuse, physical liberty, and self-determination. The program was positively evaluated showing a score of 3.35 (SD=0.37) out of 4. CONCLUSION: The educational program developed in this study should promote nurses' sensitivity to the rights of elders and improve nurses' behaviors in protecting the rights of elders residing in nursing homes.

Content Analysis of the Experience of Preceptors in Clinical Education for Senior Student Nurses / 간호학회지

PURPOSE: The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city. METHOD: Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators. RESULT: The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads. CONCLUSION: This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.

Content Analysis of the Experience of Preceptors in Clinical Education for Senior Student Nurses / 간호학회지

PURPOSE: The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city. METHOD: Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators. RESULT: The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads. CONCLUSION: This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.

A case of placenta previa percreta with bladder invasion / 대한산부인과학회잡지

Placenta percreta with bladder invasion is an extremely rare complication causing life-threatening hemorrhage, up to 17 liters.1 Most reported cases have been diagnosed after 30 weeks of pregnancy and few have presented before 20 weeks.2 Only 20 cases of placenta percreta with invasion of the bladder have been reported during last decade. In this condition, chorionic villi attach directly to the myometrium without intervening decidua. The exact etiology of impaired decidualization is unknown; however, a previous endometrial insult, such as previous cesarian section or endometrial curettage may be a contributing factor. To avoid massive bleeding, uterine body incision, hypogastric artery ligation before hysterectomy and uterine cervical removal have been attempted.1 Chorionic villi may attach to the myometrium (accreta), invade the myometrium(increta), or in its severe form (percreta) the trophoblastic tissue penetrates the whole myometrium and invades adjacent structures. We experienced a case of placenta previa percreta with bladder invasion and review the literatures.