The purposes of this study were to identify the effects of the Nursing Information System on time of the direct and indirect nursing activities, the frequencies of verbal and telephone order, the number of cases and patient's treatments fees before and after NIS. 10 nursing units in the S.N.U.H. were se lected. The data were colle cted for 6 month prior and pa st to NIS. The frequencies of verbal and telephone order were reported from staff nurses for 3 days. The numbers of cases and fees of patient's treatments were taken for 3 month before and after NIS. The results of this study were as follows: 1. 66.9% of participants said direct nursing activities were increased. Any changed nursing performances were patients education, nursing rounds, care of patient's hygiene, care for patient's movements, oral and tracheal suctioning, changing position, and feeding. 2. The difference of amount of time of dir ect and indirect nursing activities 1)There was 14 minutes increase indirect,4 minutes decrease in indirect. 2)NA's activities we re increased by 30minute in direct, decreased by 16 minute in indirect. 3. The frequency of telephone order decreased 16 and verbal order decreased 46 per day. 4. The difference of the number of patient treatment case before and after NIS was increased 9,907 per 3 months and of fees for patient treatment was increased 797,811,067 won per 3 months.
Education, Nursing ; Fees and Charges* ; Humans ; Hygiene ; Information Systems* ; Nursing* ; Suction ; Telephone

PURPOSE: This study was conducted to plan and apply simulation-based practice for raising the achievement of program outcomes (POs) in nursing students. METHODS: Using convenience sampling, 95 nursing students participated in this descriptive study. A self-reported questionnaire was used to measure the achievement of POs (self-directed learning, problem-solving ability, critical thinking) and usefulness of curriculum in addition to observing tracheal suction skills using a checklist. RESULTS: A scenario with a pneumonia patient was developed to observe tracheal suction skills during simulation-based practices. Self-directed learning, problem-solving ability, and critical thinking were then scored. The mean scores of performance skill, self-directed learning, problem-solving ability, critical thinking were 37.82+/-6.03. 3.61+/-0.38, 3.61+/-0.33, and 3.73+/-0.32, respectively. All students passed the simulation-based practice in terms of performance ability and met the required achievement level for the POs at this university. Students with good suction skills showed significant differences in problem identification (p=.044) and alternative development (p=.019), which are components of problem-solving ability, compared to students with only fair skills. CONCLUSION: These findings indicate that simulation-based practice related to an adult nursing respiratory course was useful for evaluating the achievement of POs in nursing students. Further study is needed to develop a universal method of outcome measurement.
Adult ; Checklist ; Curriculum ; Humans ; Learning ; Nursing* ; Patient Simulation ; Pneumonia ; Students, Nursing* ; Suction ; Thinking

PURPOSE: This study was conducted to explore the relationship between simulation-based clinical judgment and performance ability for tracheal suction in nursing students. METHODS: With a convenience sampling, 207 nursing students participated in this descriptive study. Lasater clinical judgment rubric was used for self-reported clinical judgment in addition to observe the skill of tracheal suction using a checklist. Data were analyzed by descriptive statistics, t-test and Pearson's correlation coefficients using the SPSS/WIN 22. RESULTS: A scenario with pneumonia patient was developed to observe the skill of tracheal suction during simulation-based practices. Then self-reported clinical judgment was scored. The mean score of total sum of clinical judgment, total mean of clinical judgment, and performance skill were 36.44±4.82, 13.44±1.71, and 42.32±5.05, respectively. Statistically, students having good skills in suction showed significant differences in clinical judgment of interpreting (p=.031) compared to students having fair skills. CONCLUSION: The results of this study show that a structured debriefing method utilizing Lasater clinical judgment rubric is helpful. Also, simulation-based practice related to adult nursing in the respiratory system was useful for increasing the core basic skills among nursing students.
Adult ; Checklist ; Clinical Competence ; Humans ; Judgment* ; Methods ; Nursing* ; Patient Simulation ; Pneumonia ; Respiratory System ; Students, Nursing* ; Suction*

PURPOSE: This study was done to present guidelines for deciding appropriate times for measuring blood pressure (BP) in patients with neurological disorders who had surgery due to brain damage. METHOD: It was a repeated measures-experimental research on time variants in BP after nursing care. SBP (Systolic BP) and DBP (Diastolic) were measured every 2 minutes up to 5 times using an EKG patient monitor. Measured data were analyzed using repeated measures ANOVA and paired t-test. RESULTS: For suctioning, there were significantly higher differences for SBP averages after 2 min. (138mmHg, p<0.01) and 4 min. (133mmHg, p<0.01) compared to before suctioning (120mmHg). For position change, there were significant differences in SBP averages after 2 min. (136mmHg, p<0.01) and 4 min. (130mmHg, p=0.01) compared to before changing position (121mmHg). For position change followed by suctioning there were significant differences in SBP averages after 2 min. (136mmHg, p<0.01), 4 min. (136mmHg, p<0.01) and 6 min. (125mmHg, p=0.003) compared to before the interventions (121mmHg). CONCLUSIONS: Results indicate that there are significant differences in SBP and DBP over time during nursing interventions, suggesting clinical measurement of BP after 6 min. or 8 min. be done for patients with neurological disorders in neurosurgery clinics.
Blood Pressure* ; Brain ; Electrocardiography ; Head* ; Humans ; Nervous System Diseases ; Neurosurgery ; Nursing ; Nursing Care ; Suction*

PURPOSE: This research was a descriptive study of nursing activities observed in nursing simulation during a senior nursing student practicum. Content and frequencies of nursing activities during the simulation practice were identified. METHODS: Thirty-six episodes of pediatric nursing simulation were videotaped. Both verbalizations and descriptions of nonverbal behaviors were recorded from the videotapes. The data were coded and analyzed. The coded nursing activities were evaluated for frequency and purpose of interaction. RESULTS: Average time per simulation episodes was 27 minutes and ranged from 3.30 to 32.54 minutes. Nursing activities in these simulation episodes included nursing assessments such as vital sign measurement, associated symptom assessment, and check of patient condition, nursing interventions such as medication, tepid water massage, fluid therapy, provision of oxygen, suctioning, hyperglycemia and hypoglycemia management, communication such as parent education, procedure guidance, and communication among providers. Activities in assessment were most frequent, and among them, vital sign measurement and check of patient condition were more frequent than others. CONCLUSION: Students showed enhanced nursing activities such as more frequent nursing assessment, communication and interventions in their simulation experience. Therefore simulation experience can be considered as one strategies to provide nursing students with better and more intense practicum experience.
Education, Nursing ; Fluid Therapy ; Humans ; Hyperglycemia ; Hypoglycemia ; Massage ; Nursing Assessment ; Oxygen ; Parents ; Patient Simulation ; Pediatric Nursing ; Students, Nursing ; Suction ; Symptom Assessment ; Videotape Recording ; Vital Signs

The purpose of this was to provide fundamental data for determining contents of Fundamental Nursing Practice and developing desirable bedside nursing techniques for clinical nursing areas. Subjects for this study were 86 nurse who were employees of two university hospitals located in Seoul and a district area. Data were collected by questionnaires. Items of Fundamental Nursing Practice from were content into 72 items according to the result from content analysis of 9 textbooks of Fundamental Nursing. The results are as follows: 1) Items which above 80% of respondents practiced during the school inside practice or clinical nursing practice course were axillae temperature measurement, radial pulse measurement, respiratory rate measurement, application of oral hygiene, hand-washing technique, application of hot and cold bags, intermuscular injection technique, open bed-making, soap enema method, application of nelaton cathetrization and oral and nasal suction methods. 2) Above 90% of respondents replied that all items except temperature measurement and bed-making were requisite contents for Fundamental Nursing Practice. Above 10% of respondents replied oral and rectal temperature measurement and bed-making were unnecessary content. 3) Above 90% of respondents replied that operating method of all items except isolation technique, admission and discharge procedures, and retention enema in the Fundamental Nursing Practice course and clinical situation were consistent. The main reasons that respondents did not apply methods which they learned in the Fundamental Nursing Practice course to the clinical situation were 'insufficient time', 'colleagues were using different methods', 'insufficient supply of instruments' or 'inappropriate appliances'.
Axilla ; Surveys and Questionnaires ; Enema ; Hospitals, University ; Humans ; Nursing* ; Oral Hygiene ; Respiratory Rate ; Seoul ; Soaps ; Suction

PURPOSE: The purpose of this study was to evaluate the selected nursing interventions and to describe the most common nursing interventions used by neurosurgery unit nurses. METHOD: The data was collected from 65 nurses of 5 general hospitals from Jan. 8, 2001 to Feb. 28, 2001. The instrument for this study was the Korean translation of 486 nursing intervention classifications, developed by MacClosky and Bluecheck in 2000. In the 486 nursing interventions 310 nursing interventions were selected, 8 from among the 10 professional nurses group in the neurosurgery care unit. The 310 nursing interventions were used in a secondary questionnaire. In the secondary questionnaire, all 310 intervention lables and definitions were listed. The data was analysed with SPSS program. RESULT: The results of this study are as follows. 1.The most frequently used nursing intervention domains were "physiological: complex", "physiological: basic", "Health system", "Behavior", "Safety", "Family". 2.Neurosurgery care unit core nursing interventions were performed several times a day by 50% or more of the Neurosurgery care unit. Neurosurgery core nursing intervention, 5 domain ("physiological: complex", "physiological: basic", "Health system", "Safety", "Behavior"), 16 class, 48 core nursing intervention. The most frequently used Neurosurgery core nursing interventions were Intravenous Therapy, Pressure ulcer prevention, Documentation, Airway suctioning, Medication: intravenous, Pain management, Medication: intramuscular, Shift report, Intravenous insertion, Positioning, Aspiration precaution, Pressure management, Physician support, Pressure ulcer care. 3.Compared with carrier and age of nurses, the more effective nursing interventions were "Family", Compared with the nursing place and the use of nursing interventions of nurses the most effective nursing interventions were "Health system" performed by nurse in university hospital. CONCLUSION: The purpose of this study was to analysis the nursing intervention performed by neurosurgery unit nurses. This study analyses nursing intervention and core nursing interventions performed by neurosurgery unit nurses. Basis on this study result, neurosurgery nursing interventions will be systematized, and progression of qualitative nursing, data of computerized nusing information system will be utilized.
Classification ; Hospitals, General ; Information Systems ; Neurosurgery* ; Nursing* ; Pain Management ; Pressure Ulcer ; Suction

The purpose of study is to prevent Nosocomial Respiratory Infection after understand the Correlation about Recognition and Performance of Critical Nurses. Data were collected from Critical Nurses 300 persons who has worked in 14 Subsidary Hospitals of University in Seoul and the collection periode is from Nov. 1st, 1997 to Jul. 14th, 1998. There are 40 questions and constructed by 6 Domains which Hand Washing, Suction Management, Airway Management, Respiratory Instrument, Ventilation and Respiratory Intervention. Also, the Data were analized with SPSS program. The obtained results are as follows ; (1) The Mean of Recognition for Prevention of Nosocomial Respiratory Infection is 4.649 and by Domains, Respiratory Intervention(4.758), Suction Management (4.669), Airway Management(4.660), Hand Washing(4.651), Ventilation(4.605) and Respiratory Instrument(4.561) according to the Mean. (2) The Mean of Performance for Prevention of Nosocomial Respiratory Infection is 3.991 and by Domains, Respiratory Intervention(4.498), Airway Management (4.107), Hand Washing(4.084), Suction Management(3.898), Respiratory Instrument (3.860) and Ventilation(3.690) according to the Mean. (3) In the Correlation of Recognition and Performance for the Prevention of Nosocomial Respiratory Infection, Hand Washing(r=0.755, p=0.000), Airway Management(r=0.724, p=0.000), Respiratory Intervention(r=0.693, p=0.000) are mentioned significant correlation level. The Performance is good whenever the Recognition is high for Respiratory Instrument(r=0.143, p=0.054) but it's not significant level and Suction Management and Ventilation has no Correlation. (4) In Normal Properties, The Recognition is good(p<0.05) when Nurses has plenty Clinical Career, Attendance of the Education and Exclusive Nurse for the Respiratory Infection is in Hospital. The Age is not significant correlation level statistically but represent a little correlation. The Performance is good(p<0.05) when Elder Age, Attendance of the Education and the plenty Clinical Career is not significant correlation level statistically but represent a little correlation. Another properties has no menas. According to the results, Suggestion is as follows ; (1) Required Education to advance Recognition and Performance about Prevention of Nosocomial Respiratory Infection for a little clinical career of Nursing and younger Nurses. (2) It needs to analyze Performance about Prevention of Nosocomial Respiratory Infection by observation of research worker.
Airway Management ; Critical Care* ; Education ; Hand ; Hand Disinfection ; Humans ; Nursing ; Seoul ; Suction ; Ventilation

PURPOSE: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. METHODS: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. RESULTS: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. CONCLUSION: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed.
Child ; Dyspnea ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Learning ; Nursing Care ; Nursing Process ; Oxygen ; Patient Simulation ; Problem Solving ; Students, Nursing ; Suction ; Thinking

This study was conducted to investigate the effects of a no saline, a 2 ml and a 5 ml saline instillation prior to endotracheal suctioning on oxygen saturation in patients with pneumonia. The subjects in this study were 16 pneumonic patients with a tracheotomy tube, who had been admitted to the neuro-surgical intensive care unit at a university hospital in Seoul Korea. All three (0, 2 and 5 ml) saline instillation methods were applied to the 16 patients. The methods were randomly assigned to each patient. Each of the instillation methods was applied in a four-step sequence: 1) recording the level of oxygen saturation (baseline levels), 2) instilling normal saline, 3) supplying oxygen and suctioning, and 4) recording the level of oxygen saturation. The oxygen saturation was evaluated using pulse oximetry. The recovery times for oxygen saturation to return to baseline levels following suctioning were, just after suctioning, 45seconds after suctioning and in excess of 5 minutes with 0, 2 and 5 ml saline instillations, respectively. Instillation of normal saline before suctioning could have an adverse effect on oxygen saturation, and should be used carefully as a routine intervention in patients who have pneumonia.
Adult ; Aged ; Aged, 80 and over ; Female ; Human ; Instillation, Drug ; Intubation, Intratracheal/*nursing ; Male ; Middle Age ; Oxygen/metabolism ; Pneumonia/*nursing ; Sodium Chloride/*administration & dosage ; Suction/*nursing ; Tracheotomy