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의료기관인증의 효과에 대한 체계적 문헌고찰: Balanced Score Card 관점으로
박일태,정연이,박성희,황정해,석승한,Park, Il-Tae,Jung, Yoen-Yi,Park, Seong-Hi,Hwang, Jeong-Hae,Suk, Seung-Han 한국의료질향상학회 2017 한국의료질향상학회지 Vol.23 No.1
Purpose: The purpose of this study was to analyze the impact of healthcare accreditation and to provide empirical evidence to validate positive effectiveness. Methods:Six electronic databases (KERIS, KoreaMed, NDSL, Ovid-medline, Embase, Cochrane library) were accessed in May 2016. Keywords used were 'accreditation' and 'Joint Commission on Accreditation of Healthcare Organization (JCAHO)'. Of the initially identified 3,008 articles, 60 studies on healthcare accreditation were selected based on inclusion criteria that are hospital accreditation, accreditation by disease and clinical center accreditation. These were retrieved and analyzed. Result: The 60 study results were on the impact of healthcare accreditation. Results were classified into four perspectives of Balanced Score Card (Financial, Customer, Internal Process, Learning & Growth). In internal process perspective, results revealed that healthcare accreditation has made a positive impact on "care process and procedure". In learning & growth perspective, healthcare accreditation has made a positive influence on "leadership", "organizational cultures" and "change mechanisms". However, it revealed that healthcare accreditation does not directly affect financial performance. It is also difficult to reach a definitive conclusion that healthcare accreditation programs affect patient satisfaction of customer and clinical outcome of the internal process. Conclusion: Healthcare accreditation programs provide positive impact on change of care process and building communication-oriented hospital culture. However, more rigorous and diverse research is needed on financial effects and clinical outcomes of healthcare accreditation.
개심술 환자를 위한 조기 운동프로그램의 개발 및 적용에 관한 연구
하이경,정연이,Ha, Yi-Kyung,Jung, Yoen-Yi 한국중환자간호학회 2011 중환자간호학회지 Vol.4 No.1
Purpose: This study was to develop and evaluate stability and effects of an early exercise program for patients with open heart surgery. Methods: The subjects of this study were 30 patients who had either a coronary bypass surgery or a valvular heart surgery at a tertiary hospital in Seoul. The data was collected by observation and measurement from October 1, 2004 to November 15, 2004. Results: The early exercise program developed for this study consisted of range of motion exercise and walking. Intensity of walking was 1~3 METs and increased progressively to daily target distance. During exercise, the subjects were monitored heart rate, blood pressure and RPE (Rating of Perceived Exertion). The mean FIM (Functional Independent Measurements) score of subjects was significantly improved after the early exercise program. However, several complaints such as dizziness or pain were also reported. Most complaints were associated with chest tube and RPE. Conclusion: The early exercise program can help to recover patients' physical activities after surgery, and can be applied to most patients. Patients' RPE, dizziness and pain was possible limitations, therefore, active pain control and prevention of accidents for patients would be needed.
정연이 서울대학교 간호대학 간호과학연구소 1996 간호학 논문집 Vol.10 No.1
Oral cavity changes have been recognized as a problem in cancer treatment but the lack of clear, concise and clinically useful tool for assessing such changes has interfered with nursing care for the patient receiving stomatoxic treatments. The purpose of this study was to test the interrater reliability of an oral assessment guide. The OAG(Oral Assessment Guide) defines three levels of descriptor for each of eight categories(voice, swallowing lips, tongue, salivation, oral mucosa, gingiva & teeth). To establish the interrater reliability of OAG, eight registered nursed assessed the oral cavities of the subjects. The number of subjects was five, in which four patients who were undergoing stomatoxic therapy, and one without stomatotoxic therapy normal. The results obtained: 1. The nurse/nurse interrater reliability using Kendall's coefficient of concordance was W=0.894. 2. Swallowing was the most reliable(Kendall's W=1) and the tongue was the least reliable(W=0.3140). 3. The order of reliability of 8 categories were swallowing, lips, salivation, gingiva, voice, oral mucosa, teeth and tongue. High reliability of OAG among interrators indicated the usefulness of this tool in the clinic. By carefully and systematically inspecting a person's mouth, the nurse can detect alteration in oral status and provide early intervention. Additional testing of the OAG will help substantiate application of the tool.
박경희,이은희,김은옥,박주희,정연이,성영희 병원간호사회 2003 임상간호연구 Vol.9 No.1
Purpose: The purpose of this study was to examine the effect of crusting technique on the peristomal skin care. Method: The subjects of this study were 41 patients who had colostomy surgery at S-hospital; 20 were randomly selected for the control group and the remainly 21, for the experimental group. The instruments used for the data collection were Bates-Jensen(1995)'s assesment of skin status. Skin status scale were measured by researchers. Data were collected from June, 2002 to October, 2002 and the SPSS 9.0 statistical program was used for the analysis of data and Chi-square, t-test and intraclass correlation were used. Result: 1) There was no significant differences in general characteristics among experimental and control group. 2) The experimental group who used crusting technique showed a significant higher score at POD#60 measurement than the control group. The experimental group was a significant difference in size, type of exudate, amount of exudate, peristomal skin, edema, induration than the control group. Conclusion: In Conclusions, a group of used crusting technique showed a significantly higher level of skin status at POD#60 measurement than the not used group. The result of the study suggested that crusting technique may help relieve peristomal skin complication for colostomy patients.
욕창, 낙상예방 및 통증간호의 간호과정 적용 평가도구 개발
김금순,김진아,김문숙,김을순,박광옥,송말순,이영희,이인옥,정연이,최윤경 병원간호사회 2009 임상간호연구 Vol.15 No.1
Purpose: This study was conducted to construct evidence based clinical guidelines and to develop nursing process based performance measures for prevention and management of pressure ulcers, falls and pain. Method: Clinical guidelines were drafted through a comprehensive review of relevant literature, national guidelines and hospital protocols. The proposed guidelines were reviewed by a panel of experts and 90 hospital nurses, and refined on the basis of their suggestions. Nursing process based performance measures were developed based on the clinical guidelines and content validity was examined by surveys from 90 hospital nurses. Results: All items, except timetable for position change and pressure ulcer nursing record, in the guidelines for prevention and management of pressure ulcer were appropriate. Most items, except fall risk assessment tools, were appropriate for the guidelines of fall prevention. All other items, except the purpose of pain management, were appropriate for the guidelines of pain management. Performance measures developed in this study were acceptable as a tool to evaluate quality of nursing care. Conclusion: Nursing process based performance measures provide important indicators to monitor whether necessary nursing care is implemented and can be used as the primary resources to improve quality of nursing services.