Hospital-Acquired Pressure Injury: Clinical Characteristics and Outcomes in Critical Care

현수경,Susan Moffatt-Bruce,Cheryl Newton,Brenda Hixon 국제문화기술진흥원 2019 International Journal of Advanced Culture Technolo Vol.7 No.2

Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.

Comorbidity Analysis on ICU Big Data

현수경,Cheryl Newton 국제문화기술진흥원 2019 International Journal of Advanced Culture Technolo Vol.7 No.2

Comorbidity is the simultaneous presence of two chronic diseases or conditions in a patient. As part of a larger research study, the aims of this study were to explore comorbid conditions in intensive care unit (ICU) patients and to compare the comorbidity across different demographic groups, and to determine what comorbid health problems coexisted in the patients with hospital-acquired pressure injury (HAPI). The average number of comorbid conditions was 6.4 with range from 0-20 in the ICU patients. African American patients had significantly more comorbid health problems than other race/ethnicity groups. Asian and Hispanic female patients showed higher comorbidity than male patients across age. The patients with HAPIs had significantly more comorbid health problems than the patients without HAPIs -- the average numbers were almost two-fold. We found comorbid health problems that existed with HAPI in ICU patients. ‘Other diseases of lung’ and ‘Disorders of fluid, electrolyte, and acid-base balance’ were most frequently coexisting health problems in the ICU patients with HAPI. Exploratory plots are helpful to discover patterns or hypotheses relevant to clinical management in critical care. Inclusion of patients’ comorbid health problems to ICU HAPI risk assessment may be helpful. Identification of patients at a high risk for the development of HAPI and the early preventative interventions can help reduce length of stay as well as costly complications.

통합간호용어체계구축을 위한 ICNP와 NANDA, HHCC, Omaha, NIC의 교차분석

현수경,박현애 대한간호협회 2001 대한간호 Vol.40 No.4

Impact of COVID-19 on Clinical Training in Undergraduate Nursing Students: A Scoping Review

현수경 부산대학교 간호과학연구소 2023 글로벌 건강과 간호 Vol.13 No.2

Purpose: This scoping review aims to explore the challenges encountered by undergraduate nursing students during the COVID-19 pandemic and the strategies employed to address these challenges in the context of clinical teaching. Methods: A systematic search was conducted across electronic databases, including PubMed, Embase, CINAHL, and the Cochrane Library. A total of twenty-nine studies were included. Data extraction and synthesis were performed to identify key issues faced by nursing students and the strategies implemented by educators and institutions. Results: The analysis of this study revealed several significant issues encountered by undergraduate nursing students during the pandemic, including limited interaction and communication, changes in healthcare practices, emotional and psychological impact, and limited supervision and support. To address these challenges, various strategies were employed, such as telehealth, simulation, case studies, virtual tours, online forums, and video lectures. These strategies aimed to provide alternative avenues for clinical learning and foster critical thinking and decision-making skills. Conclusion: This scoping review highlights the critical issues faced by undergraduate nursing students during the COVID-19 pandemic and the diverse strategies implemented to mitigate these challenges. The findings underscore the importance of adapting clinical teaching methodologies to ensure educational continuity during times of disruption. The identified strategies provide valuable insights for nursing educators and institutions seeking innovative approaches to enhance clinical teaching. Future research should focus on evaluating the long-term outcomes and effectiveness of these strategies while exploring additional innovative approaches to optimize nursing education during times of crisis.

Tree-based Approach to Predict Hospital Acquired Pressure Injury

현수경,Susan Moffatt-Bruce,Cheryl Newton,Brenda Hixon,Pacharmon Kaewprag 국제문화기술진흥원 2019 International Journal of Advanced Culture Technolo Vol.7 No.1

Despite technical advances in healthcare, the rates of hospital-acquired pressure injury (HAPI) are still highalthough many are potentially preventable. The purpose of this study was to determine whether tree-basedprediction modeling is suitable for assessing the risk of HAPI in ICU patients. Retrospective cohort study hasbeen carried out. A decision tree model was constructed with Age, Weight, eTube, diabetes, Braden score,Isolation, and Number of comorbid conditions as decision nodes. We used RStudio for model training and testing. Correct prediction rate of the final prediction model was 92.4 and the Area Under the ROC curve (AUC) was0.699, which means there is about 70% chance that the model is able to distinguish between HAPI and non-HAPI. The results of this study has limited generalizability as the data were from a single academic institution. Our research finding shows that the data-driven tree-based prediction modeling may potentially support ICUsensitive risk assessment for HAPI prevention.

대학생들의 인간관계 향상에 도움이 되는 수업모형 개발을 위한 예비연구 : 덕성여자대학교 인간관계심리학 교양과목을 중심으로 Focusing on the Liberal Arts Course of "Psychology of Human Relationship" at Duksung Women's University

주은선,현수경 덕성여자대학 학생생활지도연구소 2005 學生生活硏究 Vol.21 No.-

인생에 있어서 대학생의 시기는 가장 많은 인간관계의 갈등을 경험하는 매우 중요한 시기이다. 이 연구는 교양수업인 "인간관계 심리학"의 집단프로그램이 대학생들의 성공적인 대인관계에 미치는 영향을 알아보기 위한 것이다. 이 연구의 목적은 다양한 인간관계에서 발생할 수 있는 심리적 문제들을 다루어 나가는데 도움이 될 수 있는 수업모형을 개발하는 데 있다. 연구의 대상은 "인간관계심리학" 수업을 듣는 71명의 대학생이었으며 수업내에서 실시한 16주간의 집단프로그램 전과 후에 대인관계를 측정하는 척도를 반복 시행했다. 본 연구에 사용한 도구는 대인관계 질문지, 자기 및 타인 표상 척도, 가족기능척도(family functioning Scales), 심리적 분리척도(Psychological Separation Inventory)였다. 사전 및 사후 비교분석 결과는 다음과 같다 대인관계 질문지에서는 유의미한 증가를 나타냈고, 자기 및 타인표상 점수에서도 자기표상의 유능성 점수를 제외한 모든 점수가 사후검사에서 유의미한 증가를 보였다. 가족기능 척도에서는 가족간의 친밀감과 가족관계의 민주성에서 유의미하게 점수가 증가되었으며, 심리적 분리 척도에서는 정서적 독립과 갈등적 독립에서 유의미한 증가를 보였다. 본 예비연구는 "인간관계심리학"에서 실시하였던 인간관계 향상 집단 프로그램의 효과를 입증하였고, 이론과 실제를 겸비할 수 있는 수업모형의 가능성을 보여주었다고 할 수 있다. Many college students are reported to experience issues related to conflicts in human relationship. This study intends to examine the effect of group counseling program administered as a part of lecture program in one of Duksung Women’s University liberal arts course, “Psychology of Human Relationship”. The purpose of this study is to develop a lecture model for students to cope psychological difficulties in human relationship. The research subjects are 71 college students who took the course and various human relationship scales are administered before the group counseling program and after the program was finished during the course. The scales are “Questionnaire for Human Relationship”, “Self and Other Projection Scale”, “Family Functioning Scales”, and “Psychological Separation Inventory”. The results show that (except a few sub-scales) the scores of scales significantly increased after the group counseling was administered. This preliminary study suggests the effects of the human relationship group counseling program administered in “Psychology of Human Relationship” course and proposes the possibility of developing a lecture model of balancing the theory and practice of subject of human relationship.

국내 간호인력 수급 분석 및 추계연구

박현애,현수경,한경자,박정호,박성애 대한간호협회 2002 대한간호 Vol.41 No.1

상급종합병원의 간호·간병통합서비스 병동에 근무하는 간호사의 직무스트레스, 직무만족 및 이직의도

곽숙희,현수경 국제문화기술진흥원 2019 The Journal of the Convergence on Culture Technolo Vol.5 No.2

The purpose of this study was to examine job stress, job satisfaction, and turnover intention of the nurses who work at the comprehensive nursing service units in two academic medical institutions that provide healthcare service at the tertiary care level in Korea. A descriptive study was conducted with the nurses by using self-reported questionnaires. We used descriptive statistics to summarize the data and Mann-Whitney U test for group comparison. The mean scores of job stress, job satisfaction, and turnover intention were 89.17±12.56, 107.25±6.85, 37.19±4.86, respectively. Nurses with religion showed more job stress than those without. Nurses with their age below 30 years old had significantly less job satisfaction than those older than 30 years old. Monthly income was significantly associated with turnover intention in our data. The top three sub-category of the job stress were conflict with physicians, patients and their caregivers, and conflicts with others; and those of the job satisfaction were pay and promotion and task requirement. Job stress, job satisfaction, and turnover intention were significantly correlated. In order to reduce turnover intention of nursing professionals in the comprehensive nursing service, job stress related to issues on relationships with patients, their family, health care providers need to be taken into consideration. Policy and administrative support are needed to improve their work environment. 본 연구는 상급종합병원의 간호·간병통합서비스 병동에서 근무하는 간호사의 직무스트레스, 직무만족도, 이직의도를 파악하기 위한 서술적조사연구로서 상급종합병원 두 곳을 편의추출하여 이 두 의료기관의 간호·간병통합서비스병동에 근무하고 있는 간호사를 대상으로 설문조사를 실시하였다. 자료 분석은 대상자의 일반적 특성, 직무스트레스, 직무만족, 이직의도는 서술통계로, 대상자의 일반적 특성에 따른 직무스트레스, 직무만족, 이직의도의 비교는Mann-Whitney U test를 이용하였다. 본 조사연구가 실시된 상급종합병원 두 곳의 간호·간병통합서비스 병동에서근무하는 간호사는 모두 여성으로 30세 미만이며 미혼이 대부분이었다. 학력은 학사가 대부분이었다. 간호사 월수입은 93.8%가 150이상 300만원 미만으로 응답하였다. 직무스트레스가 높게 나타난 하위영역은 ‘의사와갈등’, ‘보호자와환자’, ‘대인관계갈등’이었고, 직무만족이 가장 낮은 영역은 ‘보수및승진’ ‘필수적직무’였다. 높은 이직의도를 보인 경우는 ‘본인이 원하지 않는 부서이동이 되었을때 이직하고 싶다’, ‘부서이동을 인해 업무수행에 어려움이 심할 때 이직하고 싶다’, ‘업무에 비해 월급이 적다고 느낄 때 이직하고 싶다’ 등이었다. 간호·간병통합서비스 본래의 취지에 부합하도록 이 서비스를 정착하고 확대하기 위해서는 이 서비스를 제공하는 주요 의료인력인 간호사의 근무환경에 대한 체계적인 평가가 필요하다. 간호·간병통합서비스를 제공하는 간호사의 직무스트레스를 낮추고, 직무만족을 높이기 위해서는 적절한 보상, 명확한 업무에 대한 규정, 일반병동과 간호·간병통합서비스 병동 중에 선호하는 곳에서 근무할 수있는 여건 등이 고려되어야 하며 이를 위해 정책적인 지원이 필요하다.

중학생의 성인지감수성, 양성평등의식, 성적자기결정권, 온라인성폭력인식

한윤지,현수경 한국간호과학회 2022 한국간호과학회 학술대회 Vol.2022 No.10

이차 혈류감염의 특성과 예후 관련요인 분석

송주연,정인숙,현수경 대한의료관련감염관리학회 2017 의료관련감염관리 Vol.22 No.2

Background: Bloodstream infections are the most common type of healthcare-associated infections in which the proportion of secondary bloodstream infections (SBSIs) is noticeably high. SBSIs can result in negative patient outcomes and additional care costs. The purpose of this study was to describe the characteristics of SBSIs among hospitalized patients, identify potential predictors of SBSIs, and explore the prognoses of community-acquired and healthcare-associated SBSIs. Methods: This study was conducted with 237 adult patients with SBSIs in a general hospital in 2015. Results: The most common primary infection among SBSIs was urinary tract infection (UTI). The most common pathogens were Escherichia coli for UTI and Staphylococcus aureus for pneumonia. Mortality due to SBSIs was 4.24 times higher among patients in intensive care units than among those in general units; mortality also increased by 1.24 times as the APACHE II scores increased by 1 point. Conclusion: Patients with UTI and pneumonia are at high risk for developing SBSIs. Further research is needed to identify risk factors for SBSIs by comparing SBSI and non-SBSI cases in a case-control study.