Effects of Direct Practice of Newborn Health Assessment on Students' Nursing Clinical Competence and Self-Efficacy

PURPOSE: This study was done to examine the effect of direct practice of newborn health assessment on nursing student's clinical competence and self-efficacy and to propose effective strategies for clinical education on newborn care. METHODS: Design was a nonequivalent control group quasi-experimental study. The direct practice program was composed of a lecture, demonstration, drill and feedback using a manikin, and repeated direct practice regarding newborn health assessment. Participants were 65 student nurses taking the pediatric nursing practicum in the nursery room at M hospital. The experimental group (n=33) participated in the direct practice program for newborn health assessment and the control group (n=32) received the traditional practice method. Nursing clinical competence was assessed by two nurse investigators and structured questionnaires were used to measure self-efficacy. RESULTS: The experimental group's clinical competence was significantly higher than that of the control group (t=-4.82, p=.000). However no significant difference was found between the two groups for self-efficacy (t=1.264, p=.211). CONCLUSION: These findings indicate that the direct practice program is effective in improving nursing student's clinical competence, but it was not effective in increasing self-efficacy. Direct practice in various clinical education settings is recommended and longitudinal effects be evaluated.

An Example of Systematic Searching for Guidelines to Prevent Catheter-associated Urinary Tract Infections - Part I: Using the PubMed Database / 간호행정학회지

PURPOSE: Effective literature searching is essential to support evidence-based nursing. The aim of this study was to present our recent systematic search experience to identify guidelines in PubMed for prevention of catheter-associated urinary tract infections. METHODS: Five approaches to the literature search via PubMed were employed. The searches were restricted to items published from 1980 to 2010, for patients admitted to hospital, and in the English language. The search results were compared using the number of records and relevant items, and the sensitivity and precision of each search strategy. RESULTS: The individual approaches retrieved 19-141 of records and 3-6 of relevant items. Sensitivity ranged from 37.5% to 75.0% with the highest values for simple searches and a search combining MeSH terms and free textwords with a methodological search filter. Precision varied from 4.3% to 21.7% and the highest precision was found for MeSH terms with limits feature. CONCLUSION: The simple search in PubMed is an appropriate way for nurses in a busy clinical practice to search the literature for evidence. However, several approaches using MeSH terms, free textwords, limits feature or methodological search filters are also required to have more efficient and better informed search results.

Current Status in Management of Children with Atopic Dermatitis and Knowledge and Practice of Preschool Teachers

PURPOSE: The purpose of this study was to describe current status in management of children with atopic dermatitis and to examine knowledge and care practices of preschool teachers. METHODS: A survey using a self-administered questionnaire was conducted. Knowledge and practice were measured with the questionnaire by Park (2011). Data were analysed using SPSS.WIN 20.0. RESULTS: Of the teachers, 81.3% managed children with atopic dermatitis depending on parents' needs and 58.9% reported difficulties due to limited knowledge and expressed a need for continuing education and provision of educational guidelines. Preschool teachers had a mean score for knowledge about atopic dermatitis of .75 out of 1 point. Among three domains of knowledge, signs & symptoms had the highest score and management, the lowest. The mean score for care practices for children with atopic dermatitis was 3.4 out of 4 points. Among the four domains of care practices, food had the highest score and dress & bedclothes, the lowest. Knowledge and practice of the teachers were different according to responsibility in management and educational need. The correlation between knowledge and practice was not significant. CONCLUSION: These results suggest that educational programs and strategies should be developed to increase preschool teachers' knowledge and improve care practice for children with atopic dermatitis.

Perception of Recovery, Self-esteem, Role Performance, and Job Satisfaction in Psychiatric Mental Heath Nurse / 간호행정학회지

PURPOSE: The purpose of this study was to identify perception of recovery, self-esteem, role performance, job satisfaction and factors influencing job satisfaction of psychiatric mental heath nurses. METHODS: Data were collected from 161 psychiatric nurses from G city & J province who understood the purpose of the study and agreed to participate. Data were analyzed using descriptive statistics, t-test, Pearson correlation coefficient, and multiple regression with SPSS 18.0. RESULTS: There were significant differences in job satisfaction between upper 25% and lower 25% group for perception of recovery, self-esteem, and role performance. Results from the multiple regression analysis revealed difference in the related factors and in the magnitude of the relationship evaluated by standardized beta coefficients. Significant factors, listed by the magnitude of beta coefficients, were role performance, self esteem, roles and responsibilities in recovery, expectations regarding recovery in perception of recovery. These variables accounted for 16% of job satisfaction. CONCLUSION: Results indicate that to improve psychiatric nurses' job satisfaction, there is a need to develop programs including personal qualities and perception of recovery. Further research is necessary in order to establish consensus on roles of the related factors of job satisfaction.

Degree of Dry Mouth and Factors Influencing Oral Health-related Quality of Life for Community-Dwelling Elders

PURPOSE: This study was conducted to investigate the degree of dry mouth and oral health-related quality of life and to identify factors contributing to oral health-related quality of life for community-dwelling elders. METHODS: A descriptive correlational study design was used. Participants were 156 older adults from two senior welfare centers. Data were collected on February 21, 22 and 29, 30, 2009 using structured questionnaires. Enter type multiple regression analysis was used to identify factors influencing oral health-related quality of life according to general and oral health characteristics. RESULTS: There were significant differences in oral health-related quality of life according to living arrangement, insurance, smoking, number of natural teeth, and denture type. The oral health-related quality of life had significant correlations with the number of chronic disease, number of medications, and dry mouth. Factors influencing oral health-related quality of life for community-dwelling older adults were dry mouth, number of chronic disease, and medical aid, which explained about 47.9% of total variance. CONCLUSION: These results indicate that in order to promote oral health-related quality of life for older adults, prevention or management of chronic diseases as well as oral health and dry mouth are needed for this population, and especially economically poor elders.

Factors Influencing Sleep Disorders in Patients on Hemodialysis / 기본간호학회지

PURPOSE: This study was conducted to identify the factors contributing to sleep disorders in patients on hemodialysis. Methods: A descriptive correlational study design was used. The participants were 135 patients on hemodialysis in hemodialysis clinics. Data were collected from March to May 2007 using structured questionnaires and hematologic sample. Stepwise multiple regression was used to identify factors influencing sleep disorders among the demographic-clinical factors, depression and fatigue. RESULTS: About 69% of the patients had a sleep disorders. There were significant differences in sleep disorders according to marital status, caregiver, religion, economic level, insurance, erythropoietin, somnifacient, and antihypertensive agents. But there were no differences according to age, gender, dialysis period, or antidepressants. Their sleep disorders had significant correlations with depression, and fatigue, and a significant negative correlation with Protein, Albumin, Phosphate and BUN. But there were no correlations with hematocrit, hemoglobin, creatinine, sodium, potassium, or calcium. Depression and fatigue were factors influencing sleep disorders. They accounted for 43.8% of the variance in sleep disorders in these patients. CONCLUSION: Findings provide an understanding of sleep disorders and the factors that are an influence in patients on hemodialysis. To promote sleep in these patients, nursing interventions to manage depression and fatigue are needed.

Nursing Activities and Outcomes Related to Indwelling Urinary Catheterization from a Review of Medical Records and Interviews / 기본간호학회지

PURPOSE: The purpose of this study was to identify nursing activities and to analyze patient outcomes related to indwelling urinary catheterization. METHOD: A review was done of 628 medical records from five units for patients admitted between January 1 and June 30, 2006. Twelve nurses who worked in the same units were interviewed. RESULTS: In the interviews, nurses reported considering several non-invasive interventions prior to catheterization but there were no medical records of this activity. Results from the in-depth interviews showed that infection control activities such as urinary bag management were conducted but again there were no medical records. Seventy-five percent of the catheters were removed without prescription. In the medical records there were no notes for approximately 15%, on the time of first voiding and 80%, on volume of first voiding after removal of catheter. There was a significant difference in hospitalization days between the group catheterized for 5 days or less and the group catheterized for 6 days or more. CONCLUSION: Results indicate a need to close the gap between recorded and described activities and between current and best evidence based practice. Further study is needed to develop a standard recording system and guidelines related indwelling catheterization to decrease the gaps identified in this research.

Development of Clinical Performance Indicators for Establishing a Connecting System between Hospital Performance Management and Quality Improvement / 간호학회지

PURPOSE: This study aimed at developing integrated clinical performance indicators(CPIs) through the analysis of quality improvement(QI) activities of a hospital and literature review about performance measures. METHOD: The CPIs were developed through the following three stages; 1)Identifying preliminary CPIs 2)A staff validity test in preliminary CPIs 3)Developing final CPIs. RESULT: One hundred twenty-three preliminary CPIs were developed through QI activities of the target hospital for 8 years and literature review. The results of the validity test for the preliminary CPIs supported ninety-one items. Sixty-two CPIs were selected through integration, reclassification and renaming. Then, eighteen items were deleted on account of an imprecise calculation method. Finally, forty-four CPIs were confirmed. They consisted of twenty-six items at the hospital level and eighteen items at the department level. CONCLUSION: CPIs can be used as criteria to evaluate the performance of healthcare organizations, and to decide the quality of healthcare for customers. This study may contribute to establishing an integrated system between QI activities and performance measurement of healthcare organizations.

Comparison of Nursing Activities Reflected in Nursing Notes and In-depth Interviews of Nurses in an Acute Hospital / 간호학회지

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.

Impact of Urinary Incontinence on Daily Life after Stroke / 성인간호학회지

PURPOSE: This study was performed to identify the prevalence and type of urinary incontinence (UI) after a stroke, to find the differences in urinary symptoms according to continence or incontinence, and to find the degree of impact of UI on daily life. METHOD: For data collection, we had a structured interview with a questionnaire. The subjects were 239 post stroke patients. RESULTS: Among the subjects(mean age: 65 +/- 10), 66.1 percent had an infarction, and 25.5 percent had a hemorrhage. And 26.4 percent of subjects were within 2 weeks and 28.9 percent from 1 year to 5 years since their episodes of a stroke. Forty five point six percent of subjects had various types of UI: urge 25.7 percent, stress 14.7 percent, functional 20.2 percent, and mixed 39.4 percent. There were significant differences in frequency, nocturia, decreased stream, and incomplete emptying between the incontinent and continent groups. Subjects reported UI influenced various aspect of daily life, 54.1 percent as cause of distress, 53.2 percent on overall quality of life, and 40.4 percent on sleep. The Mixed UI, including urge UI, had higher impact on daily life than others. CONCLUSION: There was a high prevalence of UI, mixed, urge, and functional type as most prevalent, and it had a strong impact on daily life of post stroke patients.

Development of the Web-Based Instruction Program for Nurses: Focused on Nursing Care after Open-Heart Surgery / 대한의료정보학회지

This study was conducted to develop a web-based instruction program for nurses caring patients with open heart surgery. Actually, the web-based instruction program was developed for the purpose of improving knowledge and problem solving skills among nurses for intensive care units. Also, I hope this program will be used as a tool of continuing education program for nurses and contributed to the building of life-time learning system focused on advanced nursing practice. Based on the Instructional Systems Development(ISD) model and the model of Web-Based Instruction(WBI) developmental process by Chang(1998), this study was conducted from May, 1998 to May, 1999 with the five steps: analysis, design, data collection and reconstruction, programming and publishing, and evaluation steps.