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중환자실 흡인간호 및 인공호흡기관리 표준화를 통한 인공호흡기 관련 폐렴발생 감소효과에 관한 연구
송경자,유정숙,권은옥,정은자,신현주,박옥향,옥순옥,유미,윤선희,이복남,최진아,황정해,오향순,Song, Kyung Ja,Yoo, Cheong Suk,Kwon, Eun Ok,Jung, Eun Ja,Shin, Hyeon Ju,Park, Ock Hyang,Ok, Sun Ok,Yu, Mi,Yun, Sun Hee,Lee, Bok Nam,Choi, Jin Ah,Hwan 한국의료질향상학회 2001 한국의료질향상학회지 Vol.8 No.1
Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.
송경자,박승현,조정숙,권미경,박정선,남승남,유미,김명애 병원간호사회 2006 임상간호연구 Vol.12 No.1
Purpose: To investigate the factors that affect nurse performance and to assess the characteristics of the high ranking group nurses based on performance appraisal in a university-affiliated hospital. Method: 49 head nurses evaluated their 830 nurses under direct control using performance appraisal tool and the nurses were grouped into 3 according to the performance score ; high ranking group(upper 10%), middle ranking group(middle 80%) and low ranking group(lower 10%). The characteristics of the nurses in high ranking group were compared with other groups on personal factors, job related factors, self concept, perceived head nurse leadership and performance self evaluations. Result: In high ranking group, the nurses were more aged. The proportion of the married nurse and nurses with over master degree were high. Total hospital career and current unit career of the nurses in the high ranking group were longer than nurses in other groups and more nurses had no career working for the other hospital in the past. In the high ranking group, more nurses had part time nurse career and preceptor experiences. The performance appraisal score has positive relationship with self-concept and perceived head nurse leadership and the self-concept and perceived head nurse leadership were higher in the high ranking group. The self evaluated performance appraisal was highest in the high ranking group but the score was lower than head nurse evaluated performance appraisal score. Conclusion: Strategic retention plan is needed because more aged and careered nurses exhibited higher performance. Educational program to improve self-concept and head nurse leadership would be helpful. Encouragement to level up nurses education status is essential.
일개 종합병원 임상 간호사의 경력별, 근무부서별 간호윤리관 비교
송경자,유정숙,유미,Song, Kyung-Ja,Yoo, Cheong-Suk,Yu, Mi 한국중환자간호학회 2010 중환자간호학회지 Vol.3 No.1
Purpose: This study was conducted to explore and compare the level and type of nursing ethical values according to career and nursing units of clinical nurses, Methods: The subjects were 944 nurses working in General Hospital in Seoul and the data were collected from March 8 to August, 2007 using the nursing ethical values questionnaire, The collected data were analyzed using SPSS WIN 10.0 program. Results: The results were as follows; The level of clinical nurses' ethical values were significantly different according to career and nursing units (p<.01) and it was found that most clinical nurses had deontological ethics in the areas of professional nursing domain ($2.77{\pm}.31$), cooperative relations domain ($2.90{\pm}.26$) and customer relation domain ($3.03{\pm}.32$). but that they had utilitarian ethics in human life domain ($2.53{\pm}.32$). Conclusion: Different approaches are needed to develop to establish clinical nurses' ethical values based on career, characteristics of nursing unit and various clinical situations.
송경자,최완희,최은하,조성현,유미,박미미,이중엽 병원간호사회 2018 임상간호연구 Vol.24 No.1
Purpose: The purpose of this study was to revise the KPCS-1 and to standardize the three patient classification systems for general ward, ICU and NICU. The actual utilization of the KPCS-1 score and each nursing activity was evaluated and the relationships between KPCS-1 score and nursing related variables were reviewed. Methods: The 47,711 KPCS-1 scores of 6,931 patients who discharged from 1st to 30th April 2017 were analyzed and the statistical significance between KPCS-1 score and nursing related variables was reviewed by Generalized Estimating Equation. The revision of the KPCS-1 was carried out by Partial Least Square model. The 3 patient classification systems (KPCS-1,KPCSC and KPCSN) were standardized by professional reviews. Results: KPCS-1 was a valid instrument to express nursing condition adequately and was revised as a new version which has 34 nursing activity items. The names and terminologies of pre-existing 3 patient classification systems developed by KHNA were standardized as KPCS-GW, KPCS-ICU, KPCS-NICU. Conclusion: KPCS-1 was a valid instrument to represent diverse nursing conditions precisely and was revised as a 34-item KPCS-GW. The terminologies of the other patient classification systems by KHNA were standardized as KPCS-ICU and KPCS-NICU.
간호요구 정도에 기초한 한국형 환자분류도구(KPCS)의 개발
송경자,김은혜,유정숙,박혜옥,박광옥 병원간호사회 2009 임상간호연구 Vol.15 No.1
Purpose: This study was to develop a factor-type patient classification system for general nursing unit based on nursing needs (KPCS; Korean patient classification system for nurses). Method: We reviewed workload management system for nurses(WMSN) of Walter Reed Medical Center, Korean patient classification system for ICU, and nursing activities in nursing records and developed the first version of KPCS. The final version KPCS was evaluated via validity and reliability verifications based on panel discussions and data from 800 patient classifications. Content validity was performed by Delphi method and concurrent validity was verified by the correlation of two tools (r=.71). Construct validity was also tested by medical department (p<.001), patient type (p<.001), and nurse intuition (p<.001). These verifications were performed from April to October, 2008. Results: The KPCS has 75 items in classifying 50 nursing activities, and categorized into 12 different nursing area (measuring vital sign, monitoring, respiratory treatment, hygiene, diet, excretion, movement, examination, medication, treatment, special treatment, and education/emotional support). Conclusion: The findings of the study showed sound reliability and validity of KPCS based on nursing needs. Further study is mandated to refine the system and to develop index score to estimate the necessary number of nurses for adequate care.