전자간호기록 적용 전ㆍ후 환자의 간호기록 비교: 복식자궁절제술 환자를 중심으로

최완희,박영숙,조인숙 대한의료정보학회 2009 Healthcare Informatics Research Vol.15 No.4

Objective: This study compared the abilities of electronic nursing records, which are based on standard nursing terminology, and paper-based nursing records to support the nursing process. Methods: The nursing records of 38 pairs of inpatients admitted to a gynecology nursing unit were selected. The data from the paper records were obtained manually by a chart review as single statement units. The electronic records were extracted from a computerized system. The statements were categorized using the NANDA diagnosis and the modified Clinical Care Classification. Based on a semantic analysis of the components of the nursing process, the completeness of the nursing records was classified into complete and incomplete patterns according to the presence and relevancy of the assessment, the diagnosis, the intervention and the outcome. Results: The numbers of nursing diagnoses used and the unique nursing diagnoses were both higher in the electronic records than those in the paper records. The number of statements of nursing assessments/outcomes, and nursing interventions was 1.4-fold higher in the electronic records than that in the paper records respectively. The proportion of complete patterns of the nursing process was 3.4% in the paper records and 25.7% in the electronic records. Conclusion: These results suggest that electronic records are better than paper records to support the nursing process in terms of the quantitative and qualitative aspects of nursing documentation.

차세대 전자간호기록 시스템 유스케이스 개발 : 업무흐름 분석과 전문가 델파이 기법 적용

조인숙,최완희,현미숙,박연옥,이유나,이수연,황옥희 병원간호사회 2015 임상간호연구 Vol.21 No.3

연구목적: 본 연구는 간호사가 간호기록을 효율적으로, 오류 없이, 만족스럽게 수행할 수 있도록 사용성이 향상된 전자간호기록(ENR) 시스템 개발과 관련한 사용자 요구사항 규명을 위해 수행되었다. 연구방법: 본 연구는 혼합연구 설계로 간호업무 내용과 업무흐름 패턴 분석, 시스템 사용성과 ENR에 대한 문헌고찰이 이루어졌으며, 이를 기초로 추상적 단계의 유스케이스 도출과 타당도 조사가 이루어졌다. 업무내용과 업무흐름 패턴 분석은 6개 종합병원에서 타임모션 방법으로 내외과, 중환자실에서 무작위 층화표출 한 간호활동 로그 샘플 중 무작위 추출된 21회 근무조 데이터였다. 문헌고찰은 간호계, 의료정보학 분야 학회와 협회, 국립표준원에서 개발한 원칙, 지침, 권고사항, 가이드라인 중심으로 이루어졌다. 유스케이스 타당도는 8명의 실무 전문가 패널과 2명의 학계 전문가 패널이 참여한 델파이 조사를 통해 각 유스케이스별, 상세 항목별 중요도(5점 Liker scale)와 수렴도로 측정되었다. 연구결과: 업무분석과 문헌고찰로부터 최종 9개 유스케이스와 상세 내용이 도출되었으며, 4회 데파이 조사 과정을 유스케이스와 항목 내용이 정련되었다. 최종 확정된 유스케이스와 항목에 대해 중요도는 4점 이상이었으며, 수렴도는50 ~ 70%이상을 보였다. 결론: 전자간호기록 시스템 요구사항으로 도출된 9개 유스케이스는 사용성 향상을 위해 기존 시스템 개선과 차세대 시스템 개발에 필수적으로 고려되어야 할 내용이다 Purpose: To identify user requirements for electronic nursing record (ENR) systems so as to ensure system usability. Methods: A mixed methods approach were applied in three steps : (i) task and workflow analysis with literature review of nursing documentation, (ii) literature reviews of system usability, and (iii) Use Case idenfication and consensus-based validation. We analyzed the nursing activity logs collected from a time-motion investigation of six hospitals. The Use Cases were validated by eight clinical experts from different hospitals and two experts from academia in a sequential Delphi survey. Consensus was achieved for the significance score and agreement among the panel. Results: Eight task groups and patterns of task flow were observed, which were translated into nine Use Cases. The specification of Use Cases was derived from principles, guidelines, and recommendations on nursing documentation and electronic health record systems, which was organized into three requirements of each Use Case: functionality, information, and design characteristics. Each Use Case achieved an agreement of 50~70%, and significance scores of 4 or 5 on a 5-point Likert scale. Conclusion: The nine Use Case identified were considered to be important and adequate in terms of both clinical and informatics contexts.

한국형 환자분류체계의 개정연구

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.

간호과정 적용 평가도구 개발 : 수분섭취/배설간호와 튜브간호를 중심으로

김금순,최윤경,최완희,안정원,김진아,박승미,최경옥,김을순 병원간호사회 2012 임상간호연구 Vol.18 No.1

Purpose: This study was conducted to develop standards ensuring nursing process-based fluid intake/output and tube care, and to develop a performance measurement tool evaluating the level of care according to the standards, and finally to determine validity of the standards and the tool. Methods: The standards and the tool were reviewed by a panel of experts and refined based on the panel’s suggestions. Validity of the standards and the tool were examined using a survey of 293 hospital nurses. Results: The mean validity scores of the performance measurement standards and the tool were 3.86 and 4.02, respectively, out of 5.00. So the performance measurement standards and the tool in this study were found to be acceptable in evaluating quality of nursing care for fluid intake/output and tubes. Conclusion: This result indicates that the performance measurement standards and the tool developed in this study are valid instruments to monitor and improve quality of nursing care for fluid intake/output and tube interventions, such as intravenous catheters, nasogastric tube and urinary catheters.

국내 전자간호기록 개발 및 실무적용 현황 조사

조인숙,최원자,최완희,김민경 병원간호사회 2013 임상간호연구 Vol.19 No.3

Purpose: To provide clear estimates of the adoption and use of electronic nursing records (ENRs) with standard terminology in Korea and identification of the scope and use as well as perceived or potential benefits of ENRs. Methods: A survey was done of 733 hospitals at three levels: tertiary advanced hospitals, general hospitals, and community hospitals. After performing a literature review a modified version of an existing survey tool was used for 2 months in 2012. The collected information related to EHR functionality and coverage of nursing documentation and nursing process, application of standard terminology, and perceived satisfaction and benefits of ENRs. Results: The response rate was 39.4% (289/733), and 202 hospitals (70.1%, 95% CI64.8~75.5%) of the respondents had ENR systems (82.5% of tertiary hospitals, 66.7% of general hospitals, and 70.1% of community hospitals). Out of these hospitals less than 10% had ENRs fully covering nursing documentation. The adoption rate of standard terminology was 55%, and hospital satisfaction with ENRs was 70%. But personalized care was identified as needing improvement in ENRs. Conclusion: The ENR adoption rate was high but there are many potential opportunities for improving ENR systems in terms of the data standardization and personalized care.

교대근무 경력 간호사의 식행동과 영향요인 분석: 2차자료 분석

김소연,기지선,최지윤,최완희,최스미 한국여성건강간호학회 2023 여성건강간호학회지 Vol.29 No.1

Purpose: This study investigated the dietary behavior of experienced shiftwork nurses and aimed to identify factors related to dietary behavior. Methods: This study was a secondary analysis based on the Shift Work Nurses’ Health and Turnover study among Korean nurses. In total, 247 experienced shiftwork nurses were included in this study. The participants’ dietary behavior, depression, level of occupational stress, fatigue, physical activity, and general characteristics were measured. Using SPSS ver. 28.0, data were analyzed to obtain descriptive statistics and Pearson correlation coefficients. The independent t-test, one-way analysis of variance, the Kruskal-Wallis test, and multiple regression analysis were also conducted. Results: The dietary behavior score of the participants using the Mini-Dietary Assessment Index was 29.35±5.67. Thirty percent of the participants were depressed, the participants experienced moderate occupational stress, and 74.1% of the participants engaged in an inadequate amount of physical activity. The factors influencing shiftwork nurses’ dietary behavior were having child(ren) (β=.16, p=.027), depression (β=–.13, p=.032), level of occupational stress related to occupational climate (β=–.13, p=.035), and an inadequate amount of physical activity (β=–.17, p=.006). These factors explained 10.4% of the variance in experienced shiftwork nurses’ dietary behavior scores. Conclusion: Experienced nurses with child(ren) tended to have healthier diets. However, a higher level of occupational stress related to occupational climate, depression, and engaging in an inadequate amount of physical activity were associated with a higher risk of having an unhealthy diet. Therefore, strategies are needed to encourage physical activity and alleviate adverse occupational climate and depression among experienced nurses.

전자간호기록에 사용된 간호과정 완성도 분석 : 위절제술 환자를 중심으로

박인숙,유정숙,이순형,우경선,주영희,최완희,강현숙,정미라,김희진,박미옥,이수희,안선영 병원간호사회 2009 임상간호연구 Vol.15 No.3

Purpose: This study was conducted to evaluate the record completeness of the nursing process in the Electronic Nursing Record(ENR) in a university hospital. Methods: We compared nursing statements documented in 2004 with those from the year 2007, given the fact that the ENR system had been utilized since 2004. The ENRs of 35 gastrectomy patients in each year were selected for evaluation. The selected data were 11,822 nursing statements in 2004 and 27,870 in 2007. Results: The number of nursing records which documented the whole nursing process completely was 4,010 (48.3%) in 2007, whereas 513 (5.9%) in 2004 (p<.001). The number of incomplete records in 2004 was 8,142 (94.1%), while 4,300 (51.7%) in 2007 (p<.001). The number of nursing diagnoses was 846 in 2004 and 4,313 in 2007, which increased in number more than 5 times. The most frequently used diagnoses were ‘pain’, ‘risk for infection’ and ‘risk for ileus’ in both years. Conclusion: There was a significant increase in the record completeness on nursing process in 2007 compared to the records in 2004. The reasons for this increase are attributed to nurse training for encouraging to complete recording and nursing record auditing.

전자간호기록 시스템의 사용성 수준 및 관련 요인 분석

조인숙(Cho, Insook),최원자(Choi, Won-Ja),최완희(Choi, WoanHeui),현미숙(Hyun, Misuk),박연옥(Park, Yeonok),이유나(Lee, Yoona),조의영(Cho, Euiyoung),황옥희(Hwang, Okhee) 한국간호과학회 2015 Journal of Korean Academy of Nursing Vol.45 No.4

Purpose: The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated. Methods: This mixed-method research was performed as a time?motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed. Results: The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p <.001, F=53.08 and p <.001, and F=29.13 and p <.001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics?educational background, practice period, and experience of using paper records?significantly affected the system usability and satisfaction scores. Conclusion: The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.

저압주조 Dual-gate system에 의한 마그네슘 합금 로드 휠의 제조기술 개발

김정호(Jeong-Ho Kim),이종주(Jong-Ju Lee),박수민(Su-Min Park),최완희(Wan-Hee Choi),윤형석(Hyung-Seok Yoon) 한국자동차공학회 2013 한국자동차공학회 부문종합 학술대회 Vol.2013 No.5

자동차용 알루미늄 휠의 코너링 피로시험 해석 자동화

김성훈(Sung Hoon Kim),박시종(Si Jong Park),전인기(In Ki Jun),박상범(Sang Bum Park),최완희(Wan Hee Choi),윤형석(Hyung Seok Yun) 대한기계학회 2014 대한기계학회 춘추학술대회 Vol.2014 No.4-2