Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation

권은옥,최경숙 한국간호과학회 2017 Asian Nursing Research Vol.11 No.1

Purpose: This study aimed to identify risk factors of unplanned extubation in intensive care unit (ICU) patients with mechanical ventilation using a patient safety model. Methods: This study was designed to be a case-control study. Data collection sheets, including 29 risk factors of unplanned extubation in mechanically ventilation patients were retrospectively collected based on a patient safety model over 3 years. From 41,207 mechanically ventilated patients, 230 patients were identified to have unplanned extubation during their ICU stay. Based on the characteristics of the cohort of 230 patients who had unplanned extubation, 460 case control comparison groups with planned extubation were selected by matching age, gender and diagnosis. Results: Risk factors of unplanned extubation were categorized as people, technologies, tasks, environmental factors and organizational factors, by five components of the patient safety model. The results showed the risk factors of unplanned extubation as admission route [odds ratio (OR) = 1.8], GlasgowComa Scaleemotor (OR = 1.3), Acute Physiology and Chronic Health Evaluation score (OR = 1.06), agitation (OR = 9.0), delirium(OR = 11.6), mode of mechanical ventilation (OR = 3.0-4.1) and night shifts (OR = 6.0). The significant differences were found between the unplanned and the planned extubation groups on the number of reintubation (4.3% vs. 79.6%, p < .001), ICU outcome at the time of discharge (X2 = 50.7, p < .001), and length of stay in the ICU (27.0 ± 33.0 vs. 43.8 ± 43.5) after unplanned extubation. Conclusion: ICU nurses should be able to recognize the risk factors of unplanned extubation related with the components of the safety model so as to improve patient safety by minimizing the risk for unplanned extubation.

신규간호사를 위한 맞춤형 멘토 프로그램(새싹프로그램)의 개발 및 적용 : 일개 대학병원 중환자실을 중심으로

권은옥,조정숙,송경자,최스미,장선주,김주희,박승현,신효연,유미,김정아 대한간호학회 간호행정학회 2009 간호행정학회지 Vol.15 No.4

Purpose: The purpose of this study was to develop specialized mentor program to improve adaptation for new nurses of intensive care unit and to identify the effect of the program on early resignation rate. Methods: The study adopted nonequivalent control group, non synchronized design. Based on the identification of problems and the needs of new nurses, a 6 month specialized mentor program was developed. The program was consisted of three parts; developing knowledge, improving interpersonal relationship and increasing coping competency for emergency situation. Data were collected between July 2006 and 2008 from 37 nurses and the early resignation rate was compared before and after the implementation of the mentoring program. Results: Early resignation rate of the nurses who received the mentor program was significantly lower than that of the nurses who didn't. The resignation rate within 1 year dropped from 44.5% to 8.3%(p=.034). Conclusions: The specialized six month mentoring program was effective in reducing early resignation rate.

간호사의 입원환자 욕창 사정에 대한 정확성

권은옥,엄인향,장선주,심미영,이수희 병원간호사회 2012 임상간호연구 Vol.18 No.1

Purpose: The purpose of this study was to examine the accuracy of general nurses' assessments of pressure ulcers in hospitalized patients. Methods: A total of 129 nursing records of assessments on pressure ulcers were analyzed. Assessment records of pressure ulcers by general nurses were compared to those by Wound, Ostomy, Continence Nurses (WOCN) on the same pressure ulcers. A WOCN of a nursing unit was a nurse certified by the hospital after completion of a formal WOCN course and passing a cyber education course, both offered by the hospital. The formal WOCN course was taught by an internationally certified WOCN. The inter-rater reliability among WOCNs was 98.2%. General nurses in this study did not receive a structured pressure ulcer education. Results: The accuracy for nursing assessment of pressure ulcers by general nurses compared to WOCNs' were evaluated in various ways and resulted in as follows; the existence of pressure ulcer 91.4%, site of pressure ulcer 85.3%, stage of pressure ulcer 85.3%, Braden scale 36.3%, size of pressure ulcer 51.9~64.3%, details of pressure ulcer 0~100%. Conclusion: The structured education about pressure ulcer assessment is important to enhance the accuracy of pressure ulcer assessment of hospitalized patients by general nurses.

Orotic acid의 Amino acid誘導體 合成

權恩玉,吳末福,金柱淑,李英,金敏姬,鄭泰姬,金惠慶,黃畢淑 曉星女子大學 藥學會 1972 曉星藥學會誌 Vol.- No.-

완전학습 모델을 기반으로 한 시뮬레이션 훈련이 전문심장소생술 습득에 미치는 효과

권은옥,심미영,최은하,임상희,한경민,이은준,장선주,이미미 병원간호사회 2012 임상간호연구 Vol.18 No.1

Purpose: This study was aimed to develop a simulation training program of an advanced cardiac life support (ACLS) based on the mastery learning model (Simulation-MLM), and evaluate the effects of the program on critical care nurses. Methods: As an experimental pre-post test with a non-equivalent control group, the study employed convenience sampling of 38 critical care nurses. The experimental group received the Simulation- MLM including a theoretical lecture, formative evaluation, and simulation training, whereas only a theoretical lecture for the control group. The knowledge, self-efficacy, and performance degrees of respondents were measured to verify the effects of the Simulation-MLM. The statistical processing of the collected data utilized the SPSS WIN 17.0 program. Results: After receiving Simulation-MLM, the participants in the experimental group reported higher marks in the knowledge, self-efficacy and performance of ACLS compared with those in the control group. However, both experimental and control groups demonstrated no significant differences in knowledge, self-efficacy and performance. Conclusion: Despite of the limitation of a small sample size, this study was considered meaningful in a sense that it showed a venue for improving ACLS training efficiency. Future research with more distinct treatment differentiation and better adequate outcome variables was warranted in order to prove the effects of a theory-based simulation education.

회복실에서 정상체운 회복을 위한 피부 가온요법의 효과에 관한 연구

권은옥,김수경,구정애,전상은,김정연,최미정,김난아,양수임 병원간호사회 1998 임상간호연구 Vol.4 No.1

Management of shivering and hypothermia in the immediate postoperative period is a major concern of postanesthesia nurse. This study compared time required to rewarm, incidence of shivering, in hypothermic post operative patients treated with a forced air warmer and warming pad. The purpose of this study is to develop effective nursing intervention methods to rewarm post operative general surgery patients. External Warming methods principally act by preventing convective heat loss from the skin to the environment. Most of the newer methods of external warming claim to produce active heat gain from the environment to the skin. The degree to which a warming method results in heat gain from the environment will depend not only on the amount of heat the instrument produces, but also in its success at maintaining that heat near the skin. This study was to compare time required to rewarm postoperative general anesthesia patients and incidence of shivering in patients treated with forced warm air versus patients treated with a warm pad. In addition, information on vital sign changes, patient's discomforts, general characteristics were gathered. We use non equivalent quasi-experimental study design. The Experimental groups were treated with forced warm air & The Comparative groups were treated with warm pad. We measured vital signs, shivering scale, patients discomforts until the patient's temperature recovered normal body temperature. Axillary temperature was measured using ⅣAC temp plus Ⅱ. The ⅣAC temp plus Ⅱ thermometer was calibrated internally prior to study. Necessary calibration adjustments occur automatically through a microprocessor program when the probe is returned to its holder. The Warm Touch system was used to supply warm air. Warm pad was supplied using the K thermia. Patients were randomly assigned to treatment. Data were collected on 20 experimental group & 20 comparative group. Data were measured for 50 minutes & analyzed with SPSS PC statistic package. There were no significant differences between the experimental group & the comparative group. The warm air subjects showed neither significant higher skin temperature nor lower incidence of shivering in warm pad group. The relationships between two group time to rewarm & shivering is obscured. Patients in the warm air & the warm pad groups rewarm at nearly equal rates. We conclude rewarming equipment doesn't affect patient's temperature recovering time and incidence of shivering in immediate post operative period. Therefore it's necessary to study the effect of rewarming machine for patient's thermo-resuscitation in PACU repeatedly. We suggest that the research on rewarming in PACU patients should be repeated by various nursing intervention methods.

한국 간호사의 UAE 전문병원 근무경험

권은옥,김영미 대한질적연구학회 2023 대한질적연구학회지 Vol.8 No.2

Purpose: This study describes and seeks to understand the experiences of Korean nurses at a specialty hospital in the United Arab Emirates. Methods: Data were collected from September 12 to October 12, 2023, through in-depth interviews with 10 Korean nurses who had worked at a specialty hospital in the Middle East for more than five years. Recorded interviews were transcribed verbatim. The data were analyzed using the qualitative thematic analysis method suggested by Braun and Clarke. Results: The analysis identified four themes and 10 sub-themes. The themes are as follows: “Job insecurity and a rapid change of employment conditions”, “Stress of a dual organizational culture”, “Confusion due to cultural differences”, and “Advantages and rewards of working abroad”. Conclusion: Korean hospitals expanding into the Middle East through international medical projects can utilize the information gleaned from Korean nurses' experiences at the United Arab Emirates Specialty Hospital.

회복실에서 정상체온 회복을 위한 피부 가온요법의 효과에 관한 연구

권은옥,김수경,구정애,전상은,김정연,최미정,김난아,양수임 병원간호사회 1998 임상간호연구 Vol.4 No.1

가족구성원의 입원으로 인한 가족의 스트레스와 대처방안에 관한 연구

권은옥,Kwon Eun-Ok 한국보건간호학회 1991 韓國保健看護學會誌 Vol.5 No.1

The purpose of this study was to assess the degree of stress and patterns of coping for that Stressful events on family members because of the hospitalization of the patients. Stress and coping were measured with a tool on the basis of Volicer and Bell's questionnaire. In data collection, the modified 38 items of Volicer's stress scale and Bell's 18 item coping scale were administered. The subjects consisted of 259 family members of general ward-patients in Seoul National University Hospital during April in 1990. They were randomly selected on the basis of relationship of patients; patient's spouse, patient's daughters or sons. The stressors of the family members were ranked as follows; The first rank Stressful events was related to the patient's diseases and pain, the second ones was related ·to caring of their patients and family's psychosocial life. Families used long term coping method significantly more than short term ones. The results indicated that there was no difference in use of coping method between pre and post hospitalization. Finding out more about situation and optimism were the most common coping methods, and the least frequent coping method was the use of drugs. In conclusion, the identification of perceived stress and coping patterns of family members provides useful information for family nursing and aimes at better nursing care for the hospitalized in patients.

家族構成員의 入院으로 因한 家族의 스트레스와 對處方法에 關한 硏究

權殷玉(Kwon, Eun-Ok) 한국보건간호학회 1991 韓國保健看護學會誌 Vol.5 No.1