Analysis of Medical Records and Development of Chest Pain Care Record in the Emergency Department / 성인간호학회지
Journal of Korean Academy of Adult Nursing
;
: 533-542, 2006.
Artigo
em Coreano
| WPRIM
| ID: wpr-210786
ABSTRACT
PURPOSE:
The purposes of this study were to investigate medical records and to develop care records for management of patients with chest pain in the emergency department.METHOD:
Retrospective review of the 42 medical chart of patients presented to the emergency department with chest pain were used. The collected data were analyzed with a frequency of items in the medical records.RESULTS:
In a frequency analysis of recorded items for doctors' chest pain assessment during history taking, the history/risk factors was the highest rank. The following ranks were 'commenced with when/ timing, extra symptoms, place, nature, stay/ radiate, alleviate/aggravate, intensity' in sequence. In a frequency of recorded items in nurse's progress notes according to nursing actions, the 'checking/monitoring' was the highest rank. The following ranks were 'performing, administering/injecting, referring/ arranging, testing, preparing/catheterizing, teaching/informing' in sequence. Chest pain care records for the emergency department was designed, based upon data analysis and literature review.CONCLUSION:
The designed records can be a rapid and effective approach tool for assessment and recording of patients with chest pain. Further research is necessary for evaluating the designed chest pain care records.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Tórax
/
Dor no Peito
/
Registros de Enfermagem
/
Prontuários Médicos
/
Estudos Retrospectivos
/
Estatística como Assunto
/
Enfermagem
/
Emergências
/
Serviço Hospitalar de Emergência
Tipo de estudo:
Estudo observacional
/
Fatores de risco
Limite:
Humanos
Idioma:
Coreano
Revista:
Journal of Korean Academy of Adult Nursing
Ano de publicação:
2006
Tipo de documento:
Artigo
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