PURPOSE: Effective communication is an essential aspect of nursing care. This qualitative study was performed to analyze nurse-patient conversations about medication. METHOD: The nurse-patient dialogue was collected by video tape recording during the nurse's duty time in an internal medicine ward. One hundred seventy-eight episodes were extracted from the conversation. Using conversational analysis, the functional phases and patterns of dialogue sequence pertaining to medication were analyzed. RESULTS: Conversations about medication were very brief dialogues, so 68.8% of the dialogue had a duration of less than 20 seconds. However, it was a systematic and comprehensive dialogue which had structures and sequential dialogue patterns. Four functional phases were explored: greeting, identifying the patient, medicating, finishing. The medicating phase was essential, in which the nurse gave the drug to the patient and provided information initiated by the nurse simultaneously. The patterns of the dialogue sequence represented were the nurse provided information first, and then, patients responded to the nurse as accepting, rejecting, raising an objection, or asking again later. CONCLUSION: As the results of this study show, a nurse's role is important as an educator. For effective conversation about medication, the development of an educational program should be considered, which includes knowledge about medication and communication skills.
*Communication ; Drug Therapy/*psychology ; Humans ; Internal Medicine ; Nurse's Role/*psychology ; *Nurse-Patient Relations ; Nursing Care ; Nursing Education Research ; Nursing Staff, Hospital/*psychology ; Tape Recording

PURPOSE: This study was to analyze the sustainable effects of cardiopulmonary resuscitation (CPR) reeducation on nurses' knowledge and skills. METHODS: A repeated experimental design was used for a single sample group of 47 nurses working for a general hospital. The nurses were tested on their skill of CPR 3 times at an interval of 4 months. In order to test nurses' knowledge and skills, the researcher used a CPR assessment program linked to an adult practice doll (Anne). RESULTS: 1) The amount of decrease of nurses' knowledge about CPR between points of time was wide between the first and second points of time but small between the second and third time owing to the effects of reeducation between the two points of time. 2) Nurses' skills between the first and second time dropped but they improved between the second and third time owing to the effects of reeducation. CONCLUSION: As confirmed by the above findings, reeducation of CPR clearly affects nurses' knowledge and skills. Given the fact that the same period of time (4 months) elapsed between the 3 tests, it could be argued that the reeducation at the second test served to maintain nurses' knowledge and enhance their skills.
Adult ; Cardiopulmonary Resuscitation/*education/nursing ; *Clinical Competence ; Cognition ; Education, Professional, Retraining ; Emergency Medical Services ; *Health Knowledge, Attitudes, Practice ; Humans ; Nursing Staff, Hospital/*education/psychology ; Retention (Psychology)

PURPOSE: The purpose of this survey was to investigate clinical nurses' understanding of delirium and their educational need of delirious patient care. METHOD: A survey questionnaire regarding nurses' general perception and understanding of delirium, experience with delirious patients and educational need was developed and conducted with 179 clinical nurses in a university hospital in Seoul. Data was analyzed using descriptive statistics. RESULTS: Nurses thought that delirium was one of the most important nursing problems and they considered it to be more treatable than to be preventable. However, the majority of nurses were not confident in caring for delirious patients. Nurses reported that delirium happened most often after surgery, and that possible contributing factors could be changes in physical environment and anxiety/stress, as well as medication and long-term isolation. Thirteen nursing interventions were identified but half of the nurses utilized only one or two of the thirteen. The most frequently used intervention was reorienting the patient followed by medication and emotional support, presenting family, and close observation. 99.5% of nurses addressed the importance of professional education on delirium care, especially in the area of intervention and management. CONCLUSION: The results support the strong need for development of a multi-component educational program on delirium care.
Adult ; Delirium/*nursing/psychology ; Female ; Hospitals, University ; Humans ; Male ; Models, Nursing ; Nursing Staff, Hospital/education/*psychology ; Program Evaluation ; Qualitative Research ; Questionnaires

PURPOSE: To examine geographical imbalances by analyzing new graduate nurses' migration patterns among regions where they grew up, attended nursing school, and had their first employment and to identify factors related to working in non-metropolitan areas. METHODS: The sample consisted of 507 new graduates working in hospitals as full-time registered nurses in South Korea. Migration patterns were categorized into 5 patterns based on sequential transitions of "geographic origin-nursing school-hospital." Multiple logistic regression analysis was conducted to identify factors associated with working in non-metropolitan hospitals. RESULTS: Nurses who grew up, graduated, and worked in the same region accounted for the greatest proportion (54%). Sixty-five percent had their first employment in the region where they graduated. Nurses tended to move from poor to rich regions and from non-metropolitan to metropolitan areas. Working in non-metropolitan hospitals was related to older age, the father having completed less than 4 years of college education, non-metropolitan origin, non-capital city school graduation, and a diploma (vs. baccalaureate) degree. CONCLUSION: Admitting students with rural backgrounds, increasing rural nursing school admission capacities, and providing service-requiring scholarships, particularly for students from low-income families, are recommended to address geographical imbalances.
Adult ; Attitude of Health Personnel ; Education, Nursing, Baccalaureate ; Employment ; Female ; Hospitals, Rural ; Hospitals, Urban ; Humans ; Logistic Models ; Male ; Nursing Staff, Hospital/*psychology ; Poverty ; Professional Practice Location

PURPOSE: This study was done to compare edema and pain after completing a nurse's daily shift and to examine the effects of self leg massage which was usually used for reducing nurses' lower extremity edema and pain after their shift. METHODS: The research design was a nonequivalent control group pretest-posttest design. Study subjects wer 81 nurses who took a self leg massage program created by the researcher. Self leg massage was done 15 times during 3 weeks. Data were collected from September 21 to October 31, 2007. The level of lower extremity edema was measured by ankle and calf circumference by a tapeline in cm and the pain score was measured by using a subjective numbering rating scale. Data were analyzed with the SPSS 12.0 program using statistics of repeated measures ANOVA. RESULTS: There was a statistically significant difference in pain according to the department. There was a statistically significant difference in lower extremity edema and pain in nurses after their shift and self leg massage. CONCLUSION: Self leg massage was effective for relieving nurses' lower extremity edema and pain. Therefore, it is proposed that standardized self leg massage should be applied as a method for nurses' lower extremity edema and pain.
Adult ; Edema/*therapy ; Education, Nursing, Continuing ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; *Leg/physiology ; *Massage ; Nursing Staff, Hospital/*psychology ; Pain/*therapy ; Pain Measurement ; Self Care ; Young Adult

PURPOSE: The purpose of this study was to investigate the effects of assertiveness training on nurses' assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate. METHOD: A non-equivalent control group pretest-posttest design was used in this study. Nurses were assigned into the experimental or control groups, each consisting of 39 nurses. Data was collected between January to March 2004. An 'Assertiveness Training Program' for Nurses developed by Park was used for the study. To emphasize assertiveness practice, 5 practice sessions utilizing ABCDE principles were added to Park's program. To examine the effects of the program, differences between the two groups in assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate were analyzed using ANCOVA. RESULTS: The assertiveness training was effective in improving the nurses' assertiveness behaviors, but was not effective in improving interpersonal relations, reducing the subjects' communication conflicts, changing the conflict management style or reducing their personnel turnover rate. CONCLUSION: There have been many studies about factors affecting nurses' personnel turnover rates, but few have been done about methods of intervention to reduce the personnel turnover rate. Thus, this study provides a significant contribution in attempting such an intervention from nursing management perspectives.
*Assertiveness ; *Attitude of Health Personnel ; Communication ; Conflict (Psychology) ; Female ; Humans ; Inservice Training/methods ; Interpersonal Relations ; Nursing Staff, Hospital/education/*psychology ; *Personnel Turnover ; Program Evaluation

PURPOSE: To determine and compare the perception among nurses and doctors of the roles and tasks of critical care advanced practice nurses (APNs) in order to establish standardized and formally agreed role criteria for such critical care APNs. METHOD: This study measured and analyzed the necessity of each of the roles and tasks of critical care APNs, as perceived by nurses and doctors, through a survey of 121 participants: 71 nurses in 7 intensive care units (ICUs) at a general hospital in Seoul, and 50 doctors who used ICUs. Data collection utilized a questionnaire of 128 questions in the following fields: direct practice (79), leadership and change agent (17), consultation and collaboration (15), education and counseling (11), and research (6). RESULTS: Both the nurses' and the doctors' groups confirmed the necessity of critical care APNs, with doctors who frequently used ICUs indicating a particularly strong need. As for the priority of each role of critical care APNs, the nurses considered direct practice to be the most critical, followed by education and counseling, research, consultation and collaboration, and leadership and change agent. The doctors also considered direct practice to be the most critical, followed by education and counseling, consultation and collaboration, research, and leadership and change agent. There was a statistically significant difference between how the two groups regarded all the roles, except for the consultation and collaboration roles. As for the necessity of each role of critical care APNs, the nurses considered research to be the most necessary, followed by education and counseling, consultation and collaboration, leadership and change agent, and direct practice. The doctors, on the other hand, considered education and counseling to be the most necessary, followed by research, consultation and collaboration, leadership and change agent, and direct practice. The responses of the two groups to all the roles, except for education and counseling roles, were significantly different. CONCLUSION: Nurses and doctors have different perceptions of the roles and tasks of critical care APNs. Thus, it is necessary for the combined nursing and medical fields to reach an official agreement on a set of criteria to standardize for the roles and tasks of critical care APNs.
Adult ; Attitude of Health Personnel ; Cooperative Behavior ; Counseling ; *Critical Care/organization & administration ; Cross-Sectional Studies ; Education, Nursing, Graduate ; Female ; Humans ; Korea ; Leadership ; Male ; Medical Staff, Hospital/*psychology ; Middle Aged ; Nurse Clinicians/education/*organization & administration ; Nurse Practitioners/education/*organization & administration ; *Nurse's Role ; Nursing Methodology Research ; Nursing Staff, Hospital/*psychology ; Practice Guidelines as Topic ; Professional Autonomy ; Questionnaires

PURPOSE: To develop a web-based program on blood-borne infection control and to examine the effect of the newly developed program on perceived threat of diseases, knowledge, preventive health behaviors for blood-borne infections, and incidence rates of accidental needle sticks and other sharp object injuries in nurses. METHODS: The program was developed through the processes of analysis, design, development, implementation, and evaluation. The research design involved a nonequivalent control group for pretest and posttest experiments. The setting was a 745-bed general hospital located in Korea. RESULTS: The program was designed and developed after consulting previous studies. After development of the program was completed, it was evaluated and revised by a panel of experts. The total score for perceived threat of diseases, knowledge, preventive health behaviors in the experimental group was significantly higher compared to the control group (p<.05). The incidence rates for needle sticks and other sharp object injuries in the experimental group were significantly lower compared to the control group (p<.05). CONCLUSION: Application of a Web-based, blood-borne infection control program is effective, and can be expanded to other healthcare workers who also have a high risk of blood-borne infections.
Adult ; *Blood-Borne Pathogens ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Infection Control/*methods ; *Internet ; Needlestick Injuries ; Nursing Staff, Hospital/education/*psychology ; Occupational Exposure/*prevention & control ; Questionnaires

PURPOSE: The purposes of this study were to develop a PBL program for continuing nurse education and to evaluate the program after its implementation. METHODS: The PBL program was developed in the core cardio-pulmonary nursing concepts through a collaborative approach with a nursing school and a hospital. The PBL packages with simulation on ACLS were implemented to 40 clinical nurses. The entire PBL program consisted of six 3-hour weekly classes and was evaluated by the participants' subjective responses. RESULTS: Two PBL packages in cardio-pulmonary system including clinical cases and tutorial guidelines were developed. The 57.5% of the participants responded positively about the use of PBL as continuing nurse education in terms of self-motivated and cooperative learning, whereas 20.0% of the participants answered that the PBL method was not suitable for clinical nurses. Some modifications were suggested in grouping participants and program contents for PBL. CONCLUSION: The PBL method could be utilized to promote nurses' clinical competencies as well as self-learning abilities. Further research is needed in the implementation strategies of PBL-based continuing education in order to improve its effectiveness.
Adult ; Attitude of Health Personnel ; Cardiology/education ; *Clinical Competence ; Computer Simulation ; Curriculum ; Education, Nursing, Continuing/*organization & administration ; Health Services Needs and Demand ; Heart Diseases/nursing ; Hospitals, University ; Humans ; Lung Diseases/nursing ; Manikins ; Middle Aged ; Nursing Education Research ; Nursing Methodology Research ; Nursing Staff, Hospital/*education/psychology ; Organizational Objectives ; Pilot Projects ; Problem-Based Learning/*organization & administration ; Program Development ; Program Evaluation ; Pulmonary Medicine/education

PURPOSE: The purpose of this study is to identify the role adaptation process experienced by head nurses. METHODS: Data were collected from 10 head nurses with in-depth interviews about their actual experiences. All the interviews were recorded and transcribed. The collected data were analyzed by the grounded theory methodology of Strauss and Corbin. RESULTS: The core category was identified as "weighing and balancing," and the role adaptation process was divided into six stages by time sequence: inquiring, approaching to others, bringing people into their fold, working with conviction, avoiding conflicts, and settling. CONCLUSION: The results of this study yield useful information for top mangers of nursing to identify, by stages, the demands of the head nurses in their role adaptation process. The findings of this study contributes to developing programs that facilitates the head nurses' role adaptation.
*Adaptation, Psychological ; Adult ; *Attitude of Health Personnel/ethnology ; Avoidance Learning ; Conflict (Psychology) ; Female ; *Hospitals, General/organization & administration ; Humans ; Interprofessional Relations ; Korea ; Leadership ; Models, Nursing ; Models, Psychological ; Needs Assessment ; Nurse Administrators/education/organization & administration/*psychology ; *Nurse's Role ; Nursing Methodology Research ; Nursing Staff, Hospital/organization & administration/psychology ; Nursing, Supervisory/organization & administration ; Philosophy, Nursing ; Power (Psychology) ; Professional Competence/standards ; Qualitative Research ; Questionnaires ; Self Efficacy