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기관내관 소독방법 개선에 따른 간호업무 시간단축 및 비용 절감 효과
이행선,김해리나,김은숙,김보람,성선숙 한국의료QA학회 2008 한국의료질향상학회지 Vol.14 No.1
Background: The purposeof innercannula is to protect the upperair wayand permitair to pass freely, in addition, to provideendotrachealsuction, artificial respiration and to maintain adequate oxygensaturation. The tubeneeds to be sterilizedformaintenanceand cleannessof air wayand forprevention of bronchospasm. However, it has been reportedthat there is no guideline forsterilization and manyhospitalsconducttheirown sterilization methods, forexample, oncea day(13's generalhospital), three timesa day(TheCatholic University of Korea STMary's hospital) or evenno cleansing. Consequently, the QI team of our hospitalsuggested the SOP(standard operatingprocedure) of sterilization and evaluate cost and timeeffect in nursing. Method: 1) Benchmarking of 13's neurosurgery departmentof generalhospital in Seoul 2) Investigation of test recordsof sputumculture from patientswith intubation for tracheotomy 3) Checkof resultsof 02 Sat. monitoring to confirm of maintainingopenedair way Result : 1) Improvement of process: decrease of excess sterilization of inner cannula (from 3 timesa day to oncea day) 2) Costeffects: saving over10 million wonper oneyear 3) Providing better nursing: time effects (30 mina day) permit to conductmorenursing activities Conclusion: Itcan get Costand timeeffectsin nursing withimproved sterilization methodof innercannula It needs to do researchon improvement of the monthly exchangeprotocol of outercannula and providesupportingdata forthe properexchangeschedule. The resultof additionalmicroorganism detection frompatients withnewprocessneeds to be evaluated furthermore.
일 상급종합병원 병동간호사의 업무량 측정 및 간호사 배치수준의 적절성 연구: 혼합연구 설계 적용
김현주,이선희,이재정,성선숙,양희,이향열 한국간호과학회 2024 Journal of Korean Academy of Nursing Vol.54 No.2
Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.
신경계 간호사의 신경학적 검진 수행정도와 교육요구도에 대한 조사연구
김정희,최은미,고영미,박희라,김윤경,구종모,박주연,성선숙,권미희,윤연숙,박윤례 병원간호사회 2016 임상간호연구 Vol.22 No.1
Purpose: The purpose of this study was to describe performance and education needs related to neurologic assessment by neurologic ward nurses. Methods: The study was conducted with a cross-sectional descriptive design. Participants, 297 neurologic ward nurses working in tenmajor hospitals in Seoul and Gyeonggi were surveyed from September 7 to October 1, 2015. Results: The mean score for performance of neurologic assessments was 3.04 points. Performances performed with high quality were orientation exam, mental status documentation, and muscle strength of extremities in that order. Performances performed with low quality were assessment of accessory nerves, hypoglossal nerves, and cerebellum function in that order. There were significant differences according to whether there was ward education programs on neurologic assessment and teaching experiences within a year. These variables significantly affected the quality of neurologic assessment performance. The need for neurologic assessment training was 3.14 points. Conclusion: Amount of performance and demand for education on neurologic assessment, which are required in the clinical setting, were significantly high. To perform neurologic assessments with high quality, development of education program for neurologic assessment and continuous education courses are required at either the department or neurological nursing organization level.
이민지(Lee, Min-Ji),윤선희(Yun, Sun-Hee),최경옥(Choi, Kyoung-Ok),성선숙(Seong, Sun-Suk),이선미(Lee, Sun-Mi),강재진(Kang, Jae-Jin) 기본간호학회 2018 기본간호학회지 Vol.25 No.2
Purpose: The purpose of this study was to investigate the effects of a delirium prevention intervention for patients in neurology and neurosurgery intensive care units (ICUs). Methods: This study was a quasi-experimental study. Participants were 87 patients. The experimental group was provided with nonpharmacologic and multicomponent delirium prevention interventions, consisting of regular delirium assessment, improvement in orientation, early therapeutic intervention, and environmental interventions. The control group was provided with routine intensive care. Data were analyzed using χ² test, Fisher’s exact test, and t-test. Results: Both groups were homogeneous. The incidence of delirium and length of hospitalization were significantly lower in the experimental group compared to the control group. ICU stay, mortality and unplanned extubation were lower in the experimental group compared to the control group, but there was no significant difference. Conclusion: Findings indicate that the delirium prevention intervention is effective in reducing incidence of delirium and length of hospitalization. Therefore, this intervention should be helpful in preventing delirium in neurology and neurosurgery ICUs and can be used as a guide in the prevention of delirium in neurological diseases’s patients.