간호사가 인식하는 환자안전문화의 영향요인: 진정성 리더십과 팀효과성을 중심으로

이태화(Lee, Tae Wha),김필자(Kim, Phill Ja),이혜영(Lee, Hye Young),신혜경(Shin, Hae Kyung),이현심(Lee, Hyun Sim),최윤아(Choi, Yoona) 한국간호행정학회 2021 간호행정학회지 Vol.27 No.1

Purpose: This study was conducted to test a structural model for patient safety culture of clinical nurses focusing on organizational policy and interpersonal factors. Methods: A descriptive structural equation model design was used. Participates in this study were 385 clinical nurses. The variables of safety management system, authentic leadership, team effectiveness, and patient safety culture were measured to test the hypothetical model. SPSS 25.0 and AMOS 21.0 were used to analyze descriptive statistics and path analysis. Results: The final model fit satisfied goodness-of-fit and all path were significant. Authentic leadership (β=.54, p=<.001) was reported as the most influencing factor, followed by team effectiveness (β=.24, p<.001) and safety management system (β=.21, p<.001). Safety management system (β=.38, p=.002) and authentic leadership (β=.12, p=.002) had indirect effects on patient safety culture as well. Conclusion: The findings of this study show the importance of authentic leadership, team effectiveness, and safety management system to develop patient safety culture. The health care organization should develop the programs to increase these influencing factors.

원예치료 프로그램을 접목한 텃밭활동과 유아들의 정서지능, 과학적 탐구능력 및 사회성 발달

임은애(Eun Ae Im),엄미라(Mi-Ra Eum),김필자(Pil-Ja Kim),홍선희(Sun Hee Hong),손기철(Ki-Cheol Son) 한국원예학회 2013 한국원예학회 학술발표요지 Vol.2013 No.5

병원 간호사의 외상사건 경험과 극복력이 전문직 삶의 질에 미치는 영향

유단비(Yoo, Dan-Bi),박혜자(Park, Hye-Ja),김필자(Kim, Phill-Ja) 한국재활간호학회 2019 재활간호학회지 Vol.22 No.1

관상동맥 조영술 후 체위변경이 불편감과 출혈에 미치는 효과

김필자,정정인,노정숙,나향,김가연,김경선,이근화,이은숙,홍순복,황정화,김선경,한송이,김희순 병원간호사회 2009 임상간호연구 Vol.15 No.1

Purpose: The purpose of this study was to examine the effect of position change on discomfort and bleeding in patients undergone coronary angiography with a vascular device and required bed-rest. Method: This study utilized nonequivalent control group non-synchronized design. Data were collected from 118 inpatients after coronary angiography and stayed in general ward at Y hospital in Seoul, from June 5 to August 12, 2008. After coronary angiography, position change was performed to the experimental group who consisted of 59 patients. They stayed in supine position just after angiography and then head-up position with 15 degrees was applied 1 hour later. After that, they could change the position alternatively into lateral position with leg down and supine position. The control group was positioned keeping the affected leg immobile with supine position for 4 hours. Results: The experimental group reported significantly more comfortable than control group after position change. There were no significant differences in the grades of bleeding or hematoma at puncture site between the two groups. Conclusion: The position change in patients undergone angiography could be applied without any harm such as bleeding or hematoma, but effective in reducing back pain and subjective patients' discomforts.

피혁제조 산업장의 작업환경실태에 관한 조사 연구

조윤숙,문덕환,김필자,안진홍,김영기,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective: This study was aimed to prepare the fundamental data on the exposure level of physical agents and hazardous materials originated from in the leather manufacturing industry to identify potential factors capable of causing worker's health problems. Method and Materials: Subjects related to this study consist of 50 leather manufacturing factories located in Busan area from Feb. 1. 2000 to Dec. 31. 2001 Results: Potentially hazardous chemical substances and physical agents originated from the leather manufacturing industry were noise, dust, chromium, eight organic chemical substances, and three specific chemical substances, buffing and setting process were exceeded Threshold Limit Values-Time Weighted Average(85 dBA) recommended in American Conference of Governmental Industrial Hygienists. The exposure level for chromium in dyeing process was higher than that of other processes. Organic solvents capable of causing health problems were originated from the painting and coating process. Exposure level for chromium and organic solvents were not exceeded in each permissible exposure level established in Korea. Conclusion: As a result, a wide variety of hazardous materials related to occupation were originated from the leather manufacturing industry. The author suggests that more positive work environment management program should be required to identify factors relative to occupational health problems.

반복작업에 의해 발생한 척골관 증후군 1례

김정원,박인선,이영준,김유창,김필자,강동묵,이채언 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : To report cubital tunnel syndrome due to repetitive motions. Methods : A worker complaining muscle weakness and atrophy of the right hand intrinsic muscles admitted to a hospital. We evaluated him with blood tests, neurophysio-logic studies (NCV & EMG), plain X-ray and US at the both elbows. We investigated his occupational history, and videotaped his work motions based on the work cycle at his previous work site. Finally, an ergonomics expert analyzed the motions using rapid upper limb assessment (RULA). Results : NCV & EMG studies reveals slow conduction velocity on both ulnar nerve across the elbow, more severely in the right side. US shows us compatible finding with diffuse neuritis of both ulnar nerves at both elbows. RULA score is 7. Conclusion : We confirmed that the worker's symptoms were related to his previous jobs demanding repetitive motions using the elbow joints. It is necessary that we should prepare appropriate measures to evaluate, prevent, rehabilitate, and help injured workers to return to work.

제조업 산업장의 유기용제 노출에 관한 연구

문덕환,김정하,김필자,박명희,황용식,이채관,이창희 한국산업위생학회 2001 한국산업보건학회지 Vol.11 No.3

Objective : For the purpose of preparing the fundamental data and health promotion and control program on organic solvents in air of manufacturing industry. Methods : The author surveyed number of organic solvent components which was used in working site and also determined the organic solvents concentration in air of 927 manufacturing industries and 1,267 working process with gas chromatography(NIOSH manual) for five years from 1995 to 1999. Results : Mean numbers of solvents components by type of industry, working process was number of 12. There were exceeded to TLV of 1,2-dichloroethane in textile manufacturing industry N,N-dimethyl furan in tanning and dressing of leather ; luggage, handbags, saddlery, harness and footwear manufacturing industry and chemical and chemical product manufacturing industry by type of industry. There were exceeded to TLV of 1,2-dichloroethane in handwriting and drawing process, cellosolove in adhesive spreading process, N,N-dimethly furan in production of solvent process and adhesion process by working process. Total exceeded rate to threshold limit values of organic solvents mixture were 12.9% for EI(Exposure index) and 10.0% for Em(Estimation of mixture) by type of industry, 11.3% for EI and 8.2% for Em by type of working process. The highest exceed rate was 36.7% for EI in tanning and dressing of leather ; luggage handbags, saddlery, harness and footwear manufacturing industry and 29.0% for Em in textile manufacturing industry. the highest exceeded rate was 23.1% for EI and 12.5% for Em in adhesive spreading process by working process. Mean values of total subjects by type of industry and type of working process were 0.7±1.8 for EI and 0.7±1.7 for Em respectively. Conclusions : As above results, the author suggest that it makes the environmental control program on 1.2-dichloro-ethane, N,N-dimethyl furan, cellosolve by kind of organic solvent and on textile manufacturing industry, tanning and dressing of leather ; luggage, handbags, saddlery harness and footwear manufacturing industry by type of industry, and on handwriting, drawing process and adhesive spreading process and adhesion process by type of working process.

암환자에게 제공된 다빈도 간호중재 분석 : 5개 종합병원을 중심으로

문경희,안미정,김필자,박정연,김명애,박인숙,배수현,이소정,권인각,김소선 병원간호사회 2009 임상간호연구 Vol.15 No.1

Purpose: The purpose of this study was to identify nursing interventions frequently used with cancer patients. Nursing records from 5 general hospitals for patients with stomach, liver, lung or colon cancer were analyzed. Method: A descriptive study methodology was used and nursing records for 15 patients in each disease category at each hospital, who were admitted and discharged during June 2007 were analyzed. Results: Five domains of NIC were found and the physiological(basic) domain was most frequent (31.52%). Twenty two classes of NIC were identified with risk management for safety being most frequent (22.49%). For the 119 nursing interventions identified, the most frequent was pain management with 7,827 (12.31%), followed by prevention of falls (11.76%), surveillance (6.79%) and wound care (5.12%). Nursing activities of pain management and prevention of falls were comparable to activities listed in literature on guidelines for evidence based and best practices in nursing care. Eight of the 17 nursing activities for pain management, and 9 of 14 for fall prevention were consistent with these guidelines. Conclusion: In this study, nursing interventions were found to be focused on physical care, monitoring patients' condition and education. We have to develop diverse nursing interventions and a convenient recording process.

중환자 통증사정 도구 개발

최은희,김진희,최경옥,유정숙,김미순,김필자,장인순 병원간호사회 2012 임상간호연구 Vol.18 No.1

Purpose: The purpose of this study was to develop a reliable and valid pain assessment tool suitable for critically ill patients with communication problem in Korean intensive care unit. Methods: This pain assessment tool, Critical Care Non-verbal Pain Scale (CNPS), was developed based on review of national and international researches. Data were collected from ten intensive care units at five major general hospitals in Seoul. Reliability and validity were tested during performance of position change and endotracheal suctioning. Pain was measured before, during, and 20 minutes after the two procedures. Results: Interrater reliability of the CNPS was analyzed by ICC (Intraclass correlation coefficients). ICC values were significant from .833 to .883. Significant correlation between the FPS (Face Pain Scale) scores and the CNPS scores verified concurrent validity of the CNPS. For position change, CNPS scores increased significantly between before and during (t=-23.399, p<.001) and decreased significantly between during and 20 minutes after (t=22.760, p<.001). For endotracheal suctioning, CNPS scores increased significantly between before and during (t=-29.064, p< .001) and significantly decreased between during and 20 minutes after (t=28.194, p<.001), verifying construct validity of the CNPS. Conclusion: Results indicate that the CNPS can be used to assess pain of critically ill patients who have communication problem.