신규간호사의 역할 이행 예측모형

이월숙,이태화 한국간호과학회 2016 한국간호과학회 학술대회 Vol.2016 No.10

제한적 의료기술평가제도 -신의료기술평가를 위한 근거창출지원-

이월숙 한국보건행정학회 2017 한국보건행정학회 학술대회 논문집 Vol.2017 No.1

소아심장외과 중환자실에서의 실무의사소통 프로토콜이 수술 후 성과에 미치는 영향

이월숙,엄주연 한국간호과학회 간호행정학회 2015 간호행정학회지 Vol.21 No.3

본 연구는 소아심장외과 중환자실에서의 실무의사소통 프로토콜 적용 후 환자 위해사건 발생에 대한 성과를 확인하는데 그 목적이 있다. 소아심장수술 후 중환자실 입원환자를 대상으로 수술 후 인계 기록지와 당일 치료목표 기록지를 작성하는 실무의사소통 프로토콜 수립 전(216명)과 적용 후(156명) 소아심장외과 중환자실에서의 위해사건 발생률을 비교하였다. 일반병동에서 중환자실로의 재입실률이 프로토콜 적용 전 6.0%에서 적용 후 0.6%로 감소하였으며(χ2=7.23, p=.010), 중환자실 주요 합병증 발생률도 4.2%에서 0.6%로 감소하였다(χ2=6.66, p=.012). 중재 누락과, 처방 오류 등 경미한 위해사건 발생건수 또한 100재원일 당 23.3건에서 7.5건으로 감소하였다(χ2=20.31, p<.001). 따라서 인수인계 프로토콜 적용이 심장 수술 후 중환자실의 위해사건 발생률 감소에 긍정적으로 영향을 미치는 것을 확인할 수 있었다. 임상 실무에서의 효과적인 의사소통 전략 개발을 위한 노력과 의사소통 전략의 환자 위해사건 발생에 미치는 성과 연구를 제안한다 Purpose: The purpose of this study is was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between the staff members on a daily basis from the day of operation to the day of general ward transfer. The iIncidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with the incidence of AEs one year after the establishment of PCS. Results: Our The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. The iIncidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (χ2=7.23, p=.010). The iIncidence of other major complications decreased from 4.2% (9/216) to 0.6% (χ2=6.66, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding of the protocol were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (χ2=20.31, p< .001). Conclusions: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcomes research about communication strategies for patient safety should be further studied.

간호대학 4학년생이 지각한 간호사로의 역할 이행과 영향 요인

이월숙,엄주연,이태화 한국간호과학회 간호행정학회 2014 간호행정학회지 Vol.20 No.2

목적: 간호대학 4학년 학생이 지각한 간호사 역할 이행 정도를 파악하고 이에 영향을 주는 요인을 확인하기 위함이다. 방법: 간호대학 4학년생이 지각한 간호사 역할 이행 정도와 자아존중감, 대인관계능력, 임상실습수행 불안 및 학교생활 만족도와의 관계를 파악하기 위한 서술적 상관관계 연구로, 연구 참여에 동의한 서울시에 소재한 4년제 대학교 4곳의 간호학과에 재학 중인 4학년 학생을 편의 추출하였으며 자기기입식 설문조사를 시행하였다. 결과: 연구에 참여한 대상자는 총 226명으로 연구대상자가 지각한 간호사 역할 이행 점수는 5점 만점에 평균 3.34±0.44점이었다. 회귀분석 모형에서 간호사 역할 이행에 영향을 미치는 요인은 임상실습 만족도, 임상실습수행 불안, 자아존중감, 이론수업 만족도, 대인관계능력으로 확인되었다(Adjusted R2= .321). 결론: 간호대학생들의 간호사 역할 이행을 촉진하기 위해 자아존중감 및 대인관계능력을 향상시키고, 임상실습 불안감을 줄여 만족도를 높일 수 있는 이행 촉진 프로그램의 개발 및 운영이 필요하다. Purpose: The purpose of this study was to identify the perception of role transition from a student nurse to a registered nurse among senior year nursing students and to examine factors affecting their role transition. Methods: A descriptive survey with convenience sampling was conducted in four nursing colleges in Seoul, South Korea. Data were collected using a self-administrated questionnaire. Four instruments including role transition, self-esteem, interpersonal relationships and anxiety during clinical practicum were used and the students’demographics were also collected. A multiple logistic regression was used to identify predictors for the role transition. Results: A total of 233 nursing students were surveyed and final analysis was conducted utilizing 226 participants. Mean point of perceived role transition (5 point scale) was 3.34±0.44. In a multiple regression model, high self-esteem, good interpersonal relationships, low anxiety during clinical practicum, and high satisfaction in college life were significant predictors of a smooth transition (Adjusted R2=.32, F =22.28, p< .001). Conclusion: The findings suggest that role transition from a student nurse to a registered nurse is facilitated through the establishment of programs to improve self-esteem and interpersonal relationships and to reduce anxiety during clinical practicum.

수술 후 폐 합병증 예방을 위한 심호흡 운동의 효과에 대한 체계적 고찰

이월숙(Lee, Worlsook),양유리(Yang, You Lee),오의금(Oh, Eui Geum) 기본간호학회 2014 기본간호학회지 Vol.21 No.4

Purpose: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. Methods: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane’s risk of bias tool. Data were analyzed using RevMan 5.2 program. Results: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). Conclusion: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.

신의료기술 평가와 건강보험 급여화 절차

김별,이월숙,이현민,정회인 대한치과보험학회 2020 대한치과보험학회지 Vol.10 No.1

가상항법장치 유도 기관지경술의 안전성 및 유효성: 체계적 문헌고찰

박주연,박은지,이월숙,신채민 한국보건의료기술평가학회 2021 보건의료기술평가 Vol.9 No.1

Objectives: To evaluate the safety and effectiveness of virtual navigation guided bronchoscopy through systematic review. Methods: Three foreign databases (MEDLINE, Embase, and CENTRAL) and five domestic databases were used to search literature published until February 25, 2019. In clinical studies that compared virtual navigation guided bronchoscopy and conventional techniques, studies that contained at least one or more major results were selected. We performed each evaluation step independently and reported the evaluation results based on the quality and the level of evidence in the articles. Results: In this review, 11 studies (7 randomized controlled trials, 4 cohort studies) were selected. Of the three studies that reported the navigation guided success rate and/or the percentage of tissue collection for the target site, significant differences were observed between interventions and comparison techniques in one article (58% vs. 30%), but no significant difference on the other two articles. The diagnostic yield rate due to the intervention was reported in nine articles, the intervention showed 47−92% while the control showed 40−86%. The additional meta-analysis also showed that the diagnostic yield rate was higher in the intervention group. Conclusion: Virtual navigation guided bronchoscopy is a safe and effective technique for patients with thoracopathy, who require biopsy or localization.

거대세포 바이러스 특이항원 자극 인터페론-감마효소결합면역흡착점적법/ 효소결합면역흡착측정법의안전성과 유효성에 대한 체계적 문헌 고찰

최원정,한주희,이월숙,신채민 대한임상미생물학회 2021 Annals of clinical microbiology Vol.24 No.2

Background: This study evaluated the safety and effectiveness of the cytomegalovirus(CMV) Specific Antigen Induced Interferon-Gamma ELISPOT (enzyme-linked immunosorbentspot)/ELISA (enzyme-linked immunosorbent assay) procedure in predicting the risk of CMVinfection/disease in immunocompromised patients through a systematic literature review. Methods: The searched electronic databases included MEDLINE, EMBASE and the CochraneLibrary. A total of 884 non-duplicate citations were retrieved and a total of 25 studies (15cohort studies, 10 cross-sectional studies) were included in this review. Study subjects wereselected among patients with solid organ, hematopoietic stem cell transplantation, or thosewho were on hemodialysis. Data extraction and literature quality assessment were carried outindependently by two researchers. Results: Most of the studies were conducted on patients with solid organ transplants. As it isconducted outside the body, CMV Specific Antigen Induced Interferon-Gamma ELISPOT/ELISAassay was safe. Regarding its effectiveness, most studies on risk analysis based on prognosis related outcomes reported that the inactive group showed a significantly higher hazard ratioor odds ratio than the active group. Results of Kaplan-Meier survival analysis also showedthat the inactive group had a significantly higher incidence of CMV event (CMV infection,CMV disease, other events) than the active group. However, various thresholds for CMV cellimmune response were reported, as was a broad range of predictive diagnostic accuracies. Conclusion: CMV Specific Antigen Induced Interferon-Gamma ELISPOT/ELISA assay haspotential to stratify the risk of CMV infection/disease among solid organ transplant patients andto determine a policy for a prophylaxis/preemptive. However, additional literature evidence isneeded to establish thresholds for CMV cell immune response and standardized tests.