군 병원 병동에서의 전자간호기록시스템 구축을 위한 표준간호진술문 개발

박임희 ( Im Hee Park ),최지안 ( Ji Ahn Choi ),한자경 ( Ja Kyoung Han ),금경림 ( Kyeong Lim Keum ),심현옥 ( Hyeon Ok Sim ),이영선 ( Young Seon Lee ),정재은 ( Jae Eun Jung ),최효선 ( Hyo Seon Choi ),김유진 ( You Jin Kim ),정은영 ( E 국군간호사관학교 군진간호연구소 2012 군진간호연구 Vol.30 No.1

Purpose : The purposes of this study were to analyze narrative nursing statements retrieved in a military hospital based on the ICNP(International Classification of Nursing Practice) system to develop the standard nursing statements, and to serve as a foundation for establishing an electronic nursing record system. Method : Narrative nursing statements were retrieved in medical/surgical wards of a military hospital, and nursing phenomena, nursing action and other nursing statements were extracted and refined. Mapping statements with ICNP concepts and integration of statements were conducted. Content validity of Statements was examined by experts. Based on how well the ICNP system can explain a statement, statements were categorized into full, partial and non description classes, and frequency of each was investigated. Frequency & Percentage of the ICNP axes and concepts were examined. Results : From 56,193 statements, 2,236 standard nursing statements were extracted. Nursing phenomena statements took a larger portion than nursing action statements. Most of the statements were explained by the ICNP. Nursing statements used only 19.1% of ICNP concepts, indicating nursing officers document similar expressions. Military-specific concepts such as sick-leave were discovered. Conclusion : The standard nursing statements are the foundation for a new electronic nursing record system promising quality care.

환자 분류에 기초하여 입원병동의 적정 간호인력을 산정하는 모델

김경옥,박미정,이인광,박경순,손호선,김경아,서창진,차은종,Kim, Kyoung-Ok,Park, Mi-Jung,Lee, In-Kwang,Park, Kyung-Soon,Shon, Ho-Sun,Kim, Kyung-Ah,Seo, Chang-Jin,Cha, Eun-Jong 대한의용생체공학회 2016 의공학회지 Vol.37 No.2

Nursing staffing is of major interest in hospital management, however, no practical method has been developed. The present study proposed a mathematical model based on the patient classification system for nursing staffing optimization. A few characteristic parameters possibly determined experimentally and/or empirically were introduced followed by systematic calculation of the required number of nurses. An essential concept of the model is the unit work load defined as the amount of nursing work performed on single patient per unit time, where the work load is defined as the number of nursing staffs multiplied by the working hours. The unit work load was considered to vary with the patient classification level as well as the working time during a day, both of which were represented by corresponding parameter values. The number of patients for each class and the number of working hours were multiplied to the unit work load, and added up to obtain the total required work load. As the next step, the averaged number of hours that a nurse could provide per day was formulated considering the degree of nursing practice experience into 3 levels. Finally, the appropriate number of nursing staffs was calculated as the total work load divided by the average working hours per nurse. The present technique has a great advantage that the number of nursing staffs to fulfill the required work load is systematically calculated once the characteristic parameters are appropriately determined, leading to instant and fast evaluation. A practical PC program was also developed to apply the present model to nursing practice.

환자 중증도 분류를 통한 간호업무량 측정과 적정 간호인력 산정

신동순,문원희,정애란,민신홍,이윤경,황윤신,송재금,심희숙,김태숙 충남대학교 간호과학연구소 2004 충남대 간호학술지 Vol.7 No.1

Purpose : The purpose of this study is to determine the appropriate nursing personnel required for nursing units by estimating both the total hours needed for nursing care and the amount of nursing activities based on the patient classification system. Method : The subjects of this study consisted of 1122 patients and 78 nursing staff in a tertiary hospital. The data was collected through personal observations from march 3, 2003 to June 30, 2003. The data was analyzed by the SPSS(ver. 10.0) computer program. Results : The amount of nursing activities and the total hours needed for nursing care were increased, depending on the severity of the patients. The number of nursing personnel required for each nursing unit, based on a 10 bed system, was seen as 5.6 nursing personnel in the medical nursing unit, 7.4 nursing personnel in the surgical nursing unit, 20.6 nursing personnel in the ICU nursing unit. Conclusion : According to the results, it is necessary to consider both the patient classification system and the nursing workload needed for nursing care when we estimate the proper nursing manpower.

요양병원 수가제도에 대한 소고-환자군 조정 판결을 중심으로-

권혜옥 대한의료법학회 2017 의료법학 Vol.18 No.2

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system. 요양병원에 대한 진료비의 증가폭이 비정상적으로 늘어나고 있어 건강보험재정에 막대한 부담을 주고 있다. 이는 요양병원 특수성이 급속한 노령화라는 사회적인 현상과 맞물리면서 나타나게 된 현상인데, 이 중 요양병원에 대하여 입원일당 정액수가제에 의하여 비용이 지급되는 점은 일부 요양병원이 환자를 돈벌이 수단으로 이용하는 유인이 되었다. 이러한 요양병원들은 일당정액수가를 지급받고도 그에 합당한 진료비용의 지출을 줄이기 위해 의도적으로 입원 환자를 타병원에서 정기적으로 진찰을 받게 하거나 주요 약제를 처방받게 하는 등 건강보험재정이 이중으로 지출되게 하였다. 이러한 재정누수를 방지하기 위하여 심사평가원은 위와 같은 환자들에 대하여 기존의 환자군을 부정하고 ‘신체기능저하군’으로 환자군을 조정한 다음 요양급여비용을 삭감하였다. 그렇지만 위 결정은 규정상근거가 없음을 이유로 법원으로부터 취소판결을 받았다. 그러나 위 사건을 계기로 요양병원 수가제도의 문제점을 도출하고 제도를 정비하는 기회가 될 수 있다고 생각한다. 현재의 정액수가제를 수정하여 약제비 및 진료자체에 대한 행위별 청구를 일부 도입하면 요양병원의 의료적 기능을 강화할 수 있다고 생각한다. 또, 현재의 환자군 중 비슷한 군들은 통합하고 신체기능저하군은 입원이 부적절하므로 환자군에서 제외하는 것이 타당하다고 보인다. 다만, 사회적 필요에 의해 신체기능저하군을 입원대상으로 인정하게 된다 하더라도 장기요양대상과의 형평성, 건강보험재정의 건전성 등을 고려하여 건강보험대상에서는 제외되어야 한다고 생각한다.

간호진단, 간호중재 및 환자결과에 대한 분류체계의 비교분석

박현애,김정은 서울대학교 간호대학 간호과학 연구소 1998 간호학 논문집 Vol.12 No.1

The purpose of this review study is to describe and to compare the classification systems currently utilized of being developed to classify the nursing care elements. The review is limited to three elements only, namely client status, nursing intervention, and client outcome. In client status, the NANDA Taxonoomy I, Saba's Home Health Care classification System, the Omaha Classification System were reviewed. In nursing intervention, the Nursing Intervention Classification, Saba's Home Health Care Classification intervention scheme, the Omaha intervention scheme were reviewed. In client outcome, Nursing Outcome Classification, Marek and Lang's Classification of Patient Outcomes, the Omaha System : Problem Rating Scale and the Client Focused outcome Measurement System Tool was reviewed. In order to describe and compare the classification for each element, background information for development was examined, characteristics of each classification was reviewed and classification systems were compared. After reviewing the classification systems for the elements of client status, nursing interventions and client outcomes, it is concluded that there is no single classification system adequate for all of the elements. The classification system for all the elements, particularly client outcomes, are in their beginning stage and require considerable development. Further research is necessary to determine whether or not one system can be expanded to collect client focused data in all of the settings in which nurses practice, or whether it is possible to merge these existing classification systems to create an integrated system that is sufficiently comprehensive to meet the requirements of a client focused, cross-sectoral database.

ICNP (International Classification for Nursing Practice ) 의 한글 명명화에 대한 타당성 연구

이향련,최영희,김정은,박현애,김혜숙,박현경,조인숙 성인간호학회 1999 성인간호학회지 Vol.11 No.4

The purpose of this study was to develop and test the validity of standardized Korean nomenclature of the International Classification for Nursing Practice (ICNP), developed by the International Council of Nursing (ICN). The four phases of the study were : (1) Two professors and 15 graduate students translated who were taking a nursing intervention course, translated nursing phenomena and nursing action of the ICNP into Korean ; (2) 12 nurses with various clinical backgrounds reviewed the nomenclature taking into consideration of the definition, and contents for each Korean nursing terminology, and the Delphi method was used to determine the best appropriate nomenclature for each terminology ; (3) 20 academic and clinical experts in nursing were given a questionnaire to rate the validity of each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate ; (4) five members of the Korean Nursing Association Research Committee reviewed the survey results and determined the most appropriate Korean nomenclature for each nursing phenomena and activity of the ICNP. Most nomenclature of the ICNP had a score of more than 4.0, but four nursing phenomena had a score between 3.5 and 4.0 : Unilateral neglect(3.86), Care Given strain(3.86), Health denial(3.86), Health Adjustment(3.86) and draining(2.63). In nursing activity 726 items, except for twelve items, had a score of over 4.0 : Drainage(2.63) Weaning(3.13), Caring(3.75), Cold Wrapping(3.63), distraction Technique(3.57), drawing(3.88), Establishing Report with(3.5), Heating Wrapping(3.5), Manipulating(3.75), Performing(3.88), Reading material(3.75) and Restricting(3.75)

의학진단과 표준간호분류체계를 기반으로 한 간호진단 및 중재관리 시스템의 유용성 검증

이혜자,박성애,박성의 대한의료정보학회 2002 Healthcare Informatics Research Vol.8 No.2

제목 : 의학진단과 표준간호분류체계 기반 간호진단중재시스템의 유용성검증이혜자, 박성애*, 박성희*용인송담대학 의료정보시스템과, *서울대학교 간호대학

Nursing Outcomes Classification(간호결과 분류체계)의 한글 명명화에 대한 타당성 연구

박현애,조인숙,황지인,근효근 성인간호학회 2000 성인간호학회지 Vol.12 No.2

The purpose of this study was to develop and test the validity of the standardized Korean nomenclature of Nursing Outcomes Classification (NOC), developed by Johnson & Maas at the University of Iowa. The four phases of the study were : (1) translation of the NOC into Korean by the research team, (2) four nursing professors and eight nurses with various clinical backgrounds reviewed each nomenclature taking into consideration definitions and nursing activities. The modified Delphi method was used to determine the most appropriate nomenclature for each term; (3) Twenty four academic and clinical experts in nursing were given a questionnaire to rate each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate ; (4) the team determined the most appropriate Korean nomenclature for each class of the NOC. The mean validity score of 190 items was 4.54, but several nursing outcome had a score lower than 4.0. They included' adherence behavior(3.3)', 'ambulation : walking(3.57)', 'transfer performance(3.57)', 'caregiving endurance potential(3.57)'.

Home Health Care Classification(가정간호 분류체계)의 한글 명명화에 대한 타당성 연구

조인숙,황지인,박현경,최영희,이향련,박현애 성인간호학회 1999 성인간호학회지 Vol.11 No.2

The purpose of this study was to develop and test the validity of standardized Korean nomenclature of the Home Health Care Classification(HHCC), developed by Saba at the University of Georgetown. The four phases of the study were : (1) Two professors and 15 graduate students, who were taking a nursing intervention course, translated the HHCC into Korean. (2) 12 nurses with various clinical backgrounds reviewed each nomenclature taking into consideration of the definition and activities, and the Delphi method was used to determine the best appropriate nomenclature for each term; (3) 20 academic and clinical experts in nursing were given a questionnaire to rate the validity of each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate : (4) Five members of the Korean Nurses Association Research Committee reviewed the survey results and determined the most appropriate Korean nomenclature for each term of the HHCC. Most of the nomenclatures had a score of more than 4.0, but several terms had a score lower than 4.0. They are Ambulation therapy(3.11), Anticipatory grieving(3.11), Sexual pattern alteration(3.17), Nursing care coordination(3.22), Physical therapist service(3.22), Regular diet(3.33), and Instrumental activities of daily living(3.44). These research results will be included in the nursing vocabulary dictionary to be published by the Korean Nurses Association.

ICNP 활용 전자간호기록 시스템을 위한 수작업 간호기록내용 분석: 모성간호기록을 중심으로

조인숙,박현애 대한의료정보학회 2002 Healthcare Informatics Research Vol.8 No.3

간호기록 내용 분석(Contents Analysis of Paper-based Nursing Documents))조인숙, 박현애서울대학교 간호대학