2007, Vol.25, No.1

The Development of the Standardized Nursing Diagnosis-Intervention Protocol for the Critically Ill Patients in the Military Hospital

Lee， Soon-Young , 유경숙 , 서미영 and 4 other persons | 2007, 25(1) | pp.5~39 | number of Cited : 1

The purpose of the study was to develop the standardized nursing diagnosis-intervention protocol which can be applied to critically ill patients who are under critical care in military hospitals. The specific aims are to select the medical diagnoses dealt in the protocol through the analysis of cases hospitalized in the ICU, to identify the nursing diagnoses based on the NANDA classification, to identify the nursing interventions from NIC related to the identified nursing diagnoses, and to develop and validate the nursing protocol that is applicable. The study was conducted from March. 2 to September 30 in 2006. The Cases admitted in the ICU of the Military Capital Hospital during last 3 years were analyzed, and 52 medical diagnoses were selected. Based on the list of selected medical diagnoses, nursing diagnoses and interventions were identified while chart review and reference review from NANDA classification and NIC. The results of the study were as follow. 1. Fifty two medical diagnoses in 8 systems were decided to deal in the protocol in consideration of the severity, frequency, and validity. 2. Forty seven nursing diagnoses, which are considered applicable during acute phase, were identified. Twenty two diagnoses in respiratory, 20 in cardiovascular, 33 in neurologic, 16 in renal, 20 in digestive, 11 hematologic, 14 in endocrine system, and 33 in others were suggested after modification. Forty four collaborative problems were suggested because nursing officers should monitor to detect and prevent the physiological complication 3. 117 nursing interventions and 1,905 nursing activities were selected to solve the nursing diagnoses identified. This study has a limitation in generalizing to all the critical care settings in the military because the cases in the OO military hospital were reviewed. According to the results, a follow-up study is recommended to study the clinical applicability of the protocol.

A Comparison of the Efficacy between Traditional Surgical-Hand Scrubbing and Brushless-Hand Rub with Alcohol-based agent

Yoomi Jung , GuJeungah , Hyun Jin Sook and 1 other persons | 2007, 25(1) | pp.40~62 | number of Cited : 0

A Fundamental Study to Measure the Nursing Workload in Military Hospitals (Grouping a list of Direct/Indirect Nursing Activities and Producing an Average Nursing Minutes by Processing a Nursing Activities Time)

문숙남 , 김윤주 , 박준향 and 1 other persons | 2007, 25(1) | pp.62~98 | number of Cited : 2

Needs of the Study Military hospitals are calculating the direct nursing workload through both a patient classification system and the indirect nursing workload. The indirect nursing workload, especially, was yielded by inputting the unit number of items conducted by each nursing unit. However, some of calculating items of the nursing workload are restricted to high frequency items, which makeit impossible to measure the total nursing workload. Gye-hwa Park and Seon-joo Kang(2000) calculated the time of direct nursing activities targeting on 16 military hospitals. The results from the 2000 study was not reflected in the DEMIS(Defense Medical Information System). The DEMIS, however, has been installed in 14 hospitals with the plan of modernizing hospitals, which shaped the working environments and climates of the hospitals. In this context, we found more itemsof the direct/indirect nursing activities than those of previous study. We, also, categorized a list of direct/indirect nursing activities including newly-found items. On top of this, most importantly, we succeed in explaining each item of activities, and thenwe established a category including a grouped list. The study can be a standard when measuring nursing workload in militaryhospitals by utilizing the study results in connection with DEMIS. Objectives of the Study 1) Analyzing patient classification System and a list of direct/indirect nursing activity in DEMIS. 2) Categorizing the direct/indirect nursing activities that are suitable for general Nursing Unit Environment of Military Hospitals. 3) Producing the time of direct/indirect nursing activities in the general nursing unit of military hospitals. Procedure and Tools for the Study The Study was conducted with the 4 steps. In the first step, the direct/indirect nursing activities are categorized by referring to the patient classification system in DEMIS and reviewing previous results of studies and other related resources. We, basing on the found, explained each item of activities, and then we established a category including a grouped list. In the second step, the validity of contents was examined by an expert group composed of both 10 nursing professors and 5 head nursing officers with over 7 years experiences. In the third step, the time of direct/indirect nursing activities in the general nursing Unit of Military Hospitals was measured. In case of direct nursing activities, the measuring methods were conducted by observing nursing officers and by utilizing previous studied results. In case of indirect nursing activities, it was conducted by a self-reporting method. In the fourth step, the study averaged the nursing activity time by general nursing units of the third step. As a study tool, the survey form for measuring the time of direct/indirect nursing activities was made by analyzing data gathered in the first and second steps. The part of direct nursing activity is composed of 8 categories: checking & observation, respiratory nursing, nutrition & excretion, activity & individual hygiene, medication, treatment & procedure, patient education & support, and crisis management. On the other hand, the part of indirect nursing activities is composed of 4 categories: the operating nursing unit, reporting, supporting and other administration jobs. Subject of the Study and Investigation Method The gathering data for the direct nursing activities in 2 hospitals was conducted from Aug. 30th to Sep. 8th of 2006 by applying observation methods. Survey forms, also, for measuring the time of indirect nursing activities were distributed to 14 military hospitals from Sep. 7thto 15th of 2006, and the 90 percent of survey forms was returned. Result of the Study 1) Average Practicing Time for Direct Nursing Activities Survey forms for direct nursing activities were used in 2 military hospitals to measure the time spent for 163 nursing activity items. The period spent from preparation to closing of activities per a time was recorded as average practicing minutes. 2) Average Practicing Time for Indirect Nursing Activities Survey Forms from 14 military hospitals were used to check the minutes spent for 37 nursing activities. The average practicing minutes for indirect nursing was produced by applying self-reporting methods excluding minimum and maximum values.

The Development of Simulation-Oriented Educational Program for Disaster Nursing

Myoungran Yoo , Lee， Soon-Young , Yoomi Jung and 1 other persons | 2007, 25(1) | pp.99~128 | number of Cited : 21

Purpose : A descriptive study was conducted in order to develop the simulation-oriented educational program for disaster nursing. Method : The program was designed on the systematic instructional design model which was created by Dick and Carey in 1996. The developmental process included reviewing literature, setting an instructional assignment, getting advice from various experts on designing instruction, revising the program, and making a summative evaluation. Result : The contents of the program were developed through the need analysis. The six problems, such as the abscence of the command-control system on the scene of disaster, the abscence of the triage system, the lack of an immediate response system to the disaster, the disorganized evacuation system, the lack of established nurse's roles on the spot, and the lack of situational training. Based on the problems, four instructional assignments were developed which including 4 topics: the relative law for disaster safety management, the disaster managed on the spot, the emergency medical-facility on the spot, and the nursing practice during the disaster. In order to complement the above-mentioned problems, the educational goals of this program were established and teaching strategies were set. The effectiveness of the simulation-oriented education program applying PBL(Problem-Based Learning) method were evaluated. The average score of satisfaction on education was 4.9, and the satisfaction score on educational method was 4.7 at the 5 Likert scale. This program can be applied to all the nurses. However, it is recommended that a class consist of at the maximum number of 30 students. The total teaching hour is 30 hours. The lectures, discussion, and practice were conducted in order, and the comprehensive practice is carried out in order to combine and to develop the participant's skills and knowledge. Conclusion : This study developed the systemic and practical contents of disaster nursing education for nurses. The newly designed program will put a basic foundation on establishing nurse's roles on the spot of disaster, and furthermore, it will contribute to the national policies such as 'Safe Korea'.

The Development of Evaluation Tool for ROKAF Medical Unit

조선희 , Na， Jung Soon , 우정희 and 1 other persons | 2007, 25(1) | pp.129~157 | number of Cited : 0

The purpose of this study is to develop evaluation tool for ROKAF medical unit. and is composed of the following contents. The study is a methodological research to develop evaluation tool for ROKAF ASMC(Aerospace Medical Center) and 14 medical units at the level of Fighter Wing. About 300 servicemen including nursing officers and flight surgeons in ASMC and 14 medical units at the level of Fighter Wing are selected for survey. We distributed, through military e-mail, the questionnaire with explanations on the purpose of the survey to 300 medical servicemen including nursing officers in 14 medical units at the level of Fighter Wing and analysed 273 responses which was delivered before deadline. SPSS 10.0 PC+ was used for the statistical analysis. For the verification of the developed evaluation tool for ROKAF medical unit. and is composed of the following contents, the reliability obtained by calculating Cronbach's α was 0.9286. Among 100 evaluation items which relatively new activities like as‘pilot obesity management(1.85±.87)’,‘quarterly maintenance flight activity/report (1.91±.86)’,‘statistics & report of civilian medical service(1.65±.80)’, ‘achievement report of anti-smoking campaign(1.67±.81)’,‘keeping and report of treatment records(2.07±.71)’,‘QI activity(1.57±.85)’ and‘medical advisor system(1.59±.87)’ appeared to be lowly necessary for evaluation, while conventional activities such as‘observance of decision procedure on transient grounding/waiver/permanent grounding(2.67±.52)’,‘observation of disqualification decision criteria in physical examination(2.59±.60)’,‘establishment & execution of food poisoning counterplan(2.31±.65)’,‘education of emergency treatment(2.29±.68)’,‘ambulance maintenance(2.65±.74)’,‘treatment document management(2.41±.66)’,‘personnel management(2.33±.68)’ and‘equipment management(2.27±.65)’ appeared to be highly necessary. Administrative support domain is the highest score among whole groups. Items related to departments of training and research in ASMC appeared to be lowly necessary for evaluation.

The Survey Study for the Nurturing Facility Establishment for the Military Personnel's Children (Targeting on the Area around Ja-woon Military Camp)

Choi， Yun-Jung , Jongpil Yoon , GuJeungah and 1 other persons | 2007, 25(1) | pp.158~190 | number of Cited : 0

The purpose of this study is a basic pilot study in order to present a proposal for the introduction of a day nursery facility in Jawoon Unit. The study was initiated with the necessity that the founding in this paper might contribute to improving nurturing policies, in that it can create safe working conditions for military personnel and help their children grow up healthily. For this survey was a questionnaire developed by researcher. The sample were 309 military-related personnel that bringing up children between 0 and 6 years old. The results from the survey are as follow. First of all, as for children between at the age of 0 and 6, 211 children were brought up a day nursery, and other 211 children were took care of by parents, which indicate the number answered in different category were identical in number. The reasons why children were took care of in a day nursery were mainly for the children's development of sociality and for the condition that nobody can take care of children while in workplace. Second, the approval rate for the introduction of a day nursery facility was 84.5%. Also, 83.8% people surveyed answered that they would use a day nursery facility when the facility were in Jawoon Unit. In the category asking the necessity of introduction the facility, most people responded that they needed it in order to improve the level of working satisfaction by securing safety. Third, as for managing types of a day nursery most favored by military personnel, there was little difference between civilian founded facility and facility attached to Jawoon Unit. Also, most people surveyed favored whole-day-care curriculumand considered the qualification and quality of teachers. Most people responded that the children's stable development of emotion and sentiment should be emphasized while their children are in a day nursery. In conclusion, based on the result of this, I proposed a proposal for the introduction of a day nursery with 6 categories: the foundation and managing types of a day nursery facility, the subject of the facility and criteria for class formation, the organization of facility and environment, the operating time, the objectives of a day nursery, teachers, and human personnel. With the deep understanding on the necessity and advantage of the introduction of a day nursery facility in Jawoon Unit, it is time for the related organization and personnel to roll up their sleeves so as to launch the introduction of a day nursery facility.

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2007, Vol.25, No.1