Journal of Korean Academy of Nursing

Research Paper

Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients: Kim, Soomi , Kim, Chul-Gyu; J Korean Acad Nurs 2023;53(3):275-294. Published online June 30, 2023; DOI: https://doi.org/10.4040/jkan.22109

Abstract PDF: Purpose
This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol.
Methods
The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol’s effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses’ outcome variables were evaluated using a questionnaire.
Results
First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001).
Conclusion
This protocol may help prevent infections and pressure injuries in patients, and improve nurses’ satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.

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Review Article

Nurse Staffing and Health Outcomes of Psychiatric Inpatients: A Secondary Analysis of National Health Insurance Claims Data: Park, Suin , Park, Sohee , Lee, Young Joo , Park, Choon-Seon , Jung, Young-Chul , Kim, Sunah; J Korean Acad Nurs 2020;50(3):333-348. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.19203

Purpose
The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Koreaby assessing National Health Insurance claims data.
Methods
The dataset included 70,136 patients aged 19 years who were inpatientsin psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia,schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registerednurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomesincluded length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint,and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and systemcharacteristics using multilevel modeling.
Results
Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatientsper registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission.More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnoticsuse but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injectedpsycholeptics for chemical restraint.
Conclusion
Lower nurse staffing levels are associated with negative health outcomes of psychiatricinpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatricinpatients in Korea.

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The Association Between Nurse Staffing and Conflict and Containment in Acute Mental Health Care: A Systematic Review
Samuel Woodnutt, Simon Hall, Paula Libberton, Jane Ball, Chiara Dall'Ora, Peter Griffiths
International Journal of Mental Health Nursing.2025;[Epub] CrossRef
Comprehensive Symptom Prediction in Inpatients With Acute Psychiatric Disorders Using Wearable-Based Deep Learning Models: Development and Validation Study
Minseok Hong, Ri-Ra Kang, Jeong Hun Yang, Sang Jin Rhee, Hyunju Lee, Yong-gyom Kim, KangYoon Lee, HongGi Kim, Yu Sang Lee, Tak Youn, Se Hyun Kim, Yong Min Ahn
Journal of Medical Internet Research.2024; 26: e65994. CrossRef
Changing the focus of adverse incident reporting in mental health nursing
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Mental Health Practice.2024; 27(2): 20. CrossRef
Factors associated with readmissions in psychiatric inpatient care: a prospective cohort study based on hospital registers
Marianna Virtanen, Laura Peutere, Mikko Härmä, Annina Ropponen
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Workload and psychosocial risks among nurses in mental health and psychiatry in Chile
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NEAT: Nurse Effort Assessment Tool—Human Factors Considerations in Designing for Appropriate Staffing
Scott Good, Michael W. Boyce, Leigh V. Evans, Mark Sevilla
Proceedings of the Human Factors and Ergonomics Society Annual Meeting.2024; 68(1): 1680. CrossRef
Developing nurse‐sensitive outcomes in acute inpatient mental health settings—A systematic review
Irene Ngune, Helen Myers, Amanda Cole, Peter Palamara, Robina Redknap, Michael Roche, Diane Twigg
Journal of Clinical Nursing.2023; 32(17-18): 6254. CrossRef
An Exploratory Study on Current Nursing Issues in the COVID-19 era through Newspaper Articles: The Application of Text Network Analysis
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Journal of Korean Academy of Nursing Administration.2022; 28(3): 307. CrossRef
Time to readmission in psychiatric inpatients with a therapeutic leave
Tiziana Ziltener, Julian Möller, Lukas Imfeld, Roselind Lieb, Undine E. Lang, Christian G. Huber
Journal of Psychiatric Research.2021; 144: 102. CrossRef
Physical Comorbidity According to Diagnoses and Sex among Psychiatric Inpatients in South Korea
Suin Park, Go-Un Kim, Hyunlye Kim
International Journal of Environmental Research and Public Health.2021; 18(8): 4187. CrossRef

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Original Articles

A Review of the Effects of Respite Care for Patients with Dementia and Caregivers: Jin Sun Kim, Eun Hyun Lee; Journal of Korean Academy of Nursing 2001;31(6):1077-1087. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.6.1077

Abstract PDF

PURPOSE: The purpose of this study was to analyze the effects of respite care. The analysis was conducted by reviewing published intervention studies on the effects of formal respite care for caregivers of dementia patients, patients with dementia, and the prevented or delayed rate of institutionalization of the patients.
METHOD
Two computerized databases (MEDLINE, CINAHL) were searched to find respite care-related articles published from the year of 1981 to 2000. A total of 49 published articles were identified. Of them, nine studies, which met for the inclusion criteria of this study, were included.
RESULTS
Results revealed that there was little evidence of the effect of respite care on, not only caregivers' burden, stress, depression and well-being, but also the rate of institutionalization of the patients. It was noteworthy that dementia patients reported fewer problems in behavior, although cognitive functioning and activity of daily living abilities continued to decline. However, these findings should be carefully interpreted because of methodological problems, such as non-random sampling, non random group assignment, a small sample size, uncontrolled confounding variables, limited period of services, and no specific types of services.
CONCLUSION
It is recommended to conduct intervention studies of respite care being conducted in Korea with the corrections of methodological problems suggested from this study.

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Factors Relevant to Life Satisfaction of Female Caregivers for the Elderly: Focused on Long-Term Care Insurance Settlement
Sang-Nam Jeon, Hak-Gene Shin
The Korean Journal of Health Service Management.2014; 8(4): 187. CrossRef
An Analysis of the Meaning of Respite for Family Caregivers of Elderly with Dementia
Mi Ryeong Song, Yong-Mi Lee, Suk-Hee Cheon
Journal of Korean Academy of Nursing.2010; 40(4): 482. CrossRef

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Recovery outcomes of Korean adolescents with substance Abuse problems: Myung Sun Hyun; Journal of Korean Academy of Nursing 2000;30(7):1658-1666. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.7.1658

Abstract PDF: Recovery in substance abuse has been simplistically measured; a more comprehensive understanding of recovery outcomes is needed. This study therefore explored recovery outcomes of Korean adolescents with substance abuse by qualitative research. The recovery was found to occur in several domains; they included reconciliation with the self, hope for the future, reconciliation with family, self-liberation, socialization, conventional norm pursuit, and a struggle for realistic independence. An understanding of the recovery process and recovery outcomes may provide guidance for clinical interventions with substance abuse adolescents.

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Effects of Rehabilitation Program on Functional Recovery in Stroke Patients: Yeon Ok Suh; Journal of Korean Academy of Nursing 1999;29(3):665-678. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1999.29.3.665

Abstract PDF

Stroke is a major cause of death and long-term disability. Because muscle weakness is one of the most prominent consequences of stroke, it was considered important to determine whether exercise if order to improve muscle strength and range of motion could have an effect in limiting the learned disuse of the affected side. The purpose of the study was to identify the effects of an 8 week rehabilitation program on physical and cognitive ability in stroke patients. A total of 18 patients who were admitted to the oriental medicine unit of a K medical center in Seoul were recruited : Ten for the experimental group and eight for the control group. The rehabilitation program consisted of three level's of active and passive exercises for prevention of muscle contracture and at range of motion. Muscle strength, flexibility of the upper and lower extremity, perceived balance, functional independence, depression, and quality of life for the two groups were compared at the pretest and 4 and 8 weeks after the rehabilitation program. The results are as follows: 1) When measuring muscle strengths of shoulder abduction and elbow flexion, hip flexion and knee extensor, ankle dorsi-flexor and muscle strength of knee flexor. Muscle strength of knee flexor for the experimental group was significantly higher than the comparison group at the 4 weeks. 2) Muscle strength and flexibility of the ankle dorsi-flexor for the experimental group was significantly better than for the control group at 8 weeks. 3) Functional independence, perceived balance, and Tinetti balance for the experimental group as measured at 4 and 8 weeks were better than for the control group. Also, there were changes over time in physical balance and functional ability, but there was no significant differences between the groups. 4) The experimental group showed a higher quality of life and lower depression than the control group at 8 weeks. 5) Muscle strength and flexibility of ankle dorsi-flexor were significantly changer over time and an interaction between group and time. The findings suggested that the rehabilitation program would improve the physical and psychological status of the stroke patients. Thus, the gains in actual or perceived ability to perform physical activities was marked.

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Effects of Group Rehabilitation Gymnastics for Stroke Patients
Sun-Houng Kim, Nam-Eun Moon, Mi-Yang Jeon, Hyeon-Cheol Jeong
Physical Therapy Rehabilitation Science.2022; 11(2): 207. CrossRef
Development and Evaluation of a Hybrid Walking Rehabilitation Robot, DDgo Pro
Jung-Yup Kim, Ji-Yong Kim, Hyeong-Sic Kim, Kiwon Park
International Journal of Precision Engineering and Manufacturing.2020; 21(11): 2105. CrossRef
Effects of Bilateral Passive Range of Motion Exercise on the Function of Upper Extremities and Activities of Daily Living in Patients with Acute Stroke
Hyun Ju Kim, Yaelim Lee, Kyeong-Yae Sohng
Journal of Physical Therapy Science.2014; 26(1): 149. CrossRef

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Perception of Nurse Experts on the Contribution of Nursing Interventions to NOC Nursing Outcomes in General Hospitals in Korea: Byoungsook Lee; Journal of Korean Academy of Nursing 2005;35(4):649-655. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.4.649

Abstract: The purpose of this study was to identify the perception of nurse experts on the contribution of nursing interventions to Nursing Outcomes Classification NOC nursing outcomes. A nursing outcome is a nursing-sensitive patient outcome primarily affected by nursing interventions. As one of the standardized language systems of nursing outcomes, the NOC must be examined for applicability before it is used in Korea. Data were collected in February and March 2003 using a 5-point Likert scale. For data collection, 230 quality improvement (QI) or quality assurance (QA) nurses from general hospitals in Korea were asked to rate the extent that nursing interventions contribute to each of the NOC nursing outcomes (2000) in their hospitals. Ninety-six nurses from 63 hospitals responded and the response rate was 41.7%. Mean scores for perception of contribution of nursing interventions to each of the NOC nursing outcomes ranged from 2.18 to 4.54. Vital Signs Status had the highest score (M=4.54), and Abuse Recovery: Financial, the lowest score (M=2.18). Of the seven NOC domains, the mean score was highest for Physiologic Health (M=3.91) and lowest for Community Health (M=2.92). Of the 29 NOC classes, the mean score for perceived contribution was highest for Metabolic Regulation (M=4.32) and lowest for Community Well-Being (M=2.92). Participants perceived that nursing interventions in general hospitals in Korea contributed, at least to a certain extent, to most of the NOC nursing outcomes. Based on these results, NOC should have relatively good applicability in Korea.

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Effects of a Closed Endotracheal Suction System on Oxygen Saturation, Ventilator-Associated Pneumonia, and Nursing Efficacy: Eun Sook Lee, Sung Hyo Kim, Jung Sook Kim; Journal of Korean Academy of Nursing 2004;34(7):1315-1325. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.7.1315

Abstract PDF

Purpose

The purpose of this study was to examine the effects of a closed endotracheal suction system(CES) on oxygen saturation, ventilator associated pneumonia(VAP), and nursing efficacy in mechanically ventilated patients.

Method

This study was conducted in the intensive care unit of a University Hospital in Gwangju City. Data was collected from July to October, 2003. Seventy mechanically ventilated patients were randomly divided into two groups; 32 for CES and 38 for open endotracheal suction system(OES) protocol. Twenty one nurses were also involved to examine the nurses' attitude of usefulness about CES.

Result

SaO₂ was significantly different between CES and OES. The incidence of VAP in CES was lower than that of OES. Nursing efficacy was related to time, cost, and usefulness of the suction system. Time of suctioning in CES was shorter than that of OES. CES also contributed significantly to lower the cost of treatment than OES. The usefulness score of CES increased after 6 months of use.

Conclusion

CES prevented VAP, was cost effective, and a safe suctioning system. CES ncan be used with patients with sensitivity to hypoxygenation and with a high risk of VAP.

Citations

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EFFECTIVENESS OF A PLANNED TEACHING PROGRAMME ON KNOWLEDGE REGARDING VENTILATOR ASSOCIATED PNEUMONIA AMONG STAFF NURSES WORKING IN A TERTIARY CARE HOSPITAL IN SRINAGAR
Nusrat Jan, Rajinderjit Kaur Bajwa
INTERNATIONAL JOURNAL OF RESEARCH IN MEDICAL SCIENCES & TECHNOLOGY.2021; 12: 207. CrossRef
A Closed-Suction Catheter with a Pressure Valve Can Reduce Tracheal Mucosal Injury in Intubated Patients
Jin-Heon Jeong, Sung-Jin Nam, Young-Jae Cho, Yeon Joo Lee, Se Joong Kim, In-Ae Song, Sang-Heon Park, Young-Tae Jeon
Korean Journal of Critical Care Medicine.2014; 29(1): 7. CrossRef
Effects of Open or Closed Suctioning on Lung Dynamics and Hypoxemia in Mechanically Ventilated Patients
Eun Young Lee, Su Hyun Kim
Journal of Korean Academy of Nursing.2014; 44(2): 149. CrossRef
Comparison of the Pattern in Semi-Quantitative Sputum Cultures Based on Different Endotracheal Suction Techniques
Jiwoong Oh, Kum Whang, Hyenho Jung, Jongtaek Park
Korean Journal of Critical Care Medicine.2012; 27(2): 70. CrossRef
Endotracheal Colonization and Ventilator-associated Pneumonia in Mechanically Ventilated Patients according to Type of Endotracheal Suction System
Kyeong-Sook Cha, Ho-Ran Park
Journal of Korean Academy of Nursing.2011; 41(2): 175. CrossRef

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The Development of a Client Health Status Outcome Evaluation Instrument in Home Care: Hyun Tae Park; Journal of Korean Academy of Nursing 2004;34(3):552-564. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.3.552

Abstract PDF

Purpose

This study was to develop a client health status outcome evaluation instrument, and examine content validity, reliability, construct validity, and the acceptability of this instrument.

Method

A preliminary list was made of such key information as standards, criteria, indicators and measures, by means of a broad review of literature within the field. After determining the preliminary instruments, the study sought to obtain examination, consensus, and modification of two groups of experts in the home-care field. Finally, the instrument examined content validity, reliability, construct validity, and the acceptability of this instrument.

Result

The tool was considered of 13 criteria, 48 indicators, and 167 detail measures. The content validity index of the tool was above 0.8 according to the expert group. Regarding the reliability of the evaluators of standards 1 and 2, the degree of agreement between evaluators was high(96.4% through 98.2%). Construct validity in this study, the difference in the mean score between the baseline point and the follow up point of each of standards 1 and 2 was significant, and the mean score of the follow up point was more than that of the baseline point. After examining the acceptability of this instrument with practice managers and home care nurses in home care institutions, a positive opinion was given of this instrument, and it was indicated that to be useful and applicable in home care practice.

Conclusion

The results of evaluating client outcome will contribute to overall outcome-based quality improvement and service marketing in home care by providing a constant gauge of home care effectiveness.

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Identifying core nursing sensitive outcomes associated with the most frequently used North American Nursing Diagnosis Association—International nursing diagnoses for patients with cerebrovascular disease in Korea
Eunjoo Lee, Hyejin Park, James Whyte, Youngae Kim, Sang Youn Park
International Journal of Nursing Practice.2014; 20(6): 636. CrossRef

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The Study for Development of Day Hospital Program of Eating Disorders: Seong Sook Kong; Journal of Korean Academy of Nursing 2004;34(1):25-34. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.1.25

Abstract PDF

Purpose

The purpose of this study was to develop the day hospital program for Korean eating disorders patients and to examine the effect of the day hospital program on improving frequency of binging and purging, eating disorders symptoms, self-esteem, and depression.

Method

The subjects were 24 binge eaters visited at eating disorders clinic “M”. They participated in a modified day hospital program based on the Toronto Day Hospital Program. All subjects completed the Eating Disorders Inventory(EDI)-2, Rosenberg Self-Eesteem Scale, Beck Depression Inventory(BDI) at pre and post intervention, and recorded daily food records.

Result

In paired t-test analysis, frequency of binging and purging, self-esteem, depression, and 11 sub-scales of EDI-2(drive for thinness, bulimia, body dissatisfaction, ineffectiveness, interoceptive awareness, perfectionism, interpersonal distrust, maturity fear, asceticism, impulse regulation, social insecurity) were significantly improved after treatment.

Conclusion

The results of this study suggest that the day hospital program for Korean eating disorders patients may be an effective initial approach to overcoming various eating disorders symptoms. Further studies should investigate longer term outcome data using a larger sample.

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The effects of non-pharmacological interventions for adults with eating disorders : A systematic review and meta-analysis
So Hyeon Yun, Gaeun Kim
Korean Journal of Health Education and Promotion.2018; 35(5): 35. CrossRef

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Validation of Nursing Care Sensitive Outcomes related to Knowledge: Eun Joo Lee; Journal of Korean Academy of Nursing 2003;33(5):625-632. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.5.625

Abstract PDF

Purpose

The purpose of this study was to assess the importance and sensitivity to nursing interventions of four nursing sensitive nursing outcomes selected from the Nursing Outcomes Classification (NOC). Outcomes for this study were “Knowledge: Diet”, “Knowledge: Disease Process”, “Knowledge: Energy Conservation”, and “Knowledge: Health Behaviors”.

Method

Data were collected from 183 nurses working in 2 university hospitals. Fehring method was used to estimate outcome and indicators' content and sensitivity validity. Multiple and stepwise regression were used to evaluate relationships between each outcome and its indicators.

Result

Results confirmed the importance and nursing sensitivity of outcomes and their indicators. Key indicators of each outcomes were found by multiple regression. “Knowledge: Diet” was suggested for adding new indicators because the variance explained by indicators was relatively low. Not all of the indicators selected for stepwise regression model were rated for highly in Fehring method. The R² statistics of the stepwise regression models were between 18 and 63% in importance by selected indicators and between 34 and 68% in contribution by selected indicators.

Conclusion

This study refined what outcomes and indicators will be useful in clinical practice. Further research will be required for the revision of outcome and indicators of NOC. However, this study refined what outcomes and indicators will be useful in clinical practice.

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Developing an Electronic Nursing Record System for Clinical Care and Nursing Effectiveness Research in a Korean Home Healthcare Setting
EUN JOO LEE, MIKYOUNG LEE, SUE MOORHEAD
CIN: Computers, Informatics, Nursing.2009; 27(4): 234. CrossRef

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Analysis of Direct Nursing Activity and Patient Outcomes Related to Graded Fee of Nursing Management for Inpatient: Seong Hi Park; Journal of Korean Academy of Nursing 2003;33(1):122-129. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.1.122

Abstract

Purpose

The purpose of this study is to examine the difference of direct nursing activity and patient outcomes as mortality rate, complication rate, readmission rate and length of stay related to graded fee of nursing management for inpatient.

Method

The subjects of this study were 44 general hospitals with more than 500 beds. Data totaled to 86,044 claims provided to inpatients in Jan. 2001 requested by an electronic data interchange from a Health Insurance Review Agency. The data was analyzed by SPSS win(ver.10.0) and statistical methods used were frequency, one-way ANOVA, χ²-Test and regression.

Result

Synthetic judgment through performance index and 95% confidence interval, direct nursing activity showed to provided adequate quality of nursing care on 2nd, 3rd, 4th and 6th nursing degree. Also, patient outcomes showed difference by graded fee of nursing management for inpatient. Mortality rate of 2nd was the lowest with P.I. 67.9, 3rd, 5th, 6th, 4th in order. In case of complication rate, 2nd, 3rd and 4th were lower than other nursing degree. Readmission rate of 4th and 5th was the lowest. Length of stay of 2nd was the shortest with P.I. 88.3, 3rd, 4th, 5th, 4th, 6th in order.

Conclusion

The findings from this study showed that, the higher nurse-to-patient ratio, the greater amount of direct nursing care activity for the patient. Also, the more direct nursing activities influenced a lower mortality rate, complication rate and readmission rate, shorter length of stay.

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Jeong Eun Mun, Bohyun Park
Journal of Korean Academy of Nursing Administration.2024; 30(5): 439. CrossRef
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EunYoung Jeong
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Mee-Suk Wang, In Deok Lee, M.S. Kang, Eun-Kwang Cha, Dae-Ho Choi, Hyeon-Cheol Jeong
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Ho-Soon Yoon, Jinhyun Kim
Journal of Korean Academy of Nursing Administration.2013; 19(4): 449. CrossRef
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Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients
Yunmi Kim, Sung-Hyun Cho, Kyung Ja June, Soon Ae Shin, Jiyun Kim
Journal of Korean Academy of Nursing.2012; 42(5): 719. CrossRef
Maternal and Hospital Factors Impacting the Utilization of Rooming-in Care in South Korea: Secondary Analysis of National Health Data
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Journal of Korean Academy of Nursing.2011; 41(5): 593. CrossRef
Inpatient Outcomes by Nurse Staffing Grade in Korea
Su-Jin Cho, Han-Ju Lee, Ju-Yeon Oh, Jin-Hyun Kim
Korean Journal of Health Policy and Administration.2011; 21(2): 195. CrossRef
The Effects of Medical Staffing Level on Length of Stay
Hanju Lee, Yu Kyung Ko, Mi-Won Kim
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The Effect of Dialysate Flow Rate on Dialysis Adequacy and Fatigue in Hemodialysis Patients: Sun Mi Cha, Hye Sook Min; J Korean Acad Nurs 2016;46(5):642-652. Published online October 31, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.5.642

Abstract PDF

Purpose

In this single repeated measures study, an examination was done on the effects of dialysate flow rate on dialysis adequacy and fatigue in patients receiving hemodialysis.

Methods

This study was a prospective single center study in which repeated measures analysis of variance were used to compare Kt/V urea (Kt/V) and urea reduction ratio (URR) as dialysis adequacy measures and level of fatigue at different dialysate flow rates: twice as fast as the participant’s own blood flow, 500 mL/min, and 700 mL/min. Thirty-seven hemodialysis patients received all three dialysate flow rates using counterbalancing.

Results

The Kt/V (M±SD) was 1.40±0.25 at twice the blood flow rate, 1.41±0.23 at 500 mL/min, and 1.46±0.24 at 700 mL/min. The URR (M±SD) was 68.20±5.90 at twice the blood flow rate, 68.67±5.22 at 500 mL/min, and 70.11±5.13 at 700 mL/min. When dialysate flow rate was increased from twice the blood flow rate to 700 mL/min and from 500 mL/min to 700 mL/min, Kt/V and URR showed relative gains. There was no difference in fatigue according to dialysate flow rate.

Conclusion

Increasing the dialysate flow rate to 700 mL/min is associated with a significant nicrease in dialysis adequacy. Hemodialysis with a dialysate flow rate of 700 mL/min should be considered in selected patients not achieving adequacy despite extended treatment times and optimized blood flow rate.

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Computer Methods and Programs in Biomedicine.2022; 221: 106867. CrossRef
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Journal of Korean Academy of Fundamentals of Nursing.2022; 29(3): 295. CrossRef
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Clinical Therapeutics.2020; 42(8): 1564. CrossRef
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Journal of Mechanics in Medicine and Biology.2019; 19(05): 1850063. CrossRef
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Hyun Mi Jeon, Hye Sook You
Journal of Korean Academy of Fundamentals of Nursing.2019; 26(1): 23. CrossRef

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Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals: Yunmi Kim, Ji Yun Lee, Hyuncheol Kang; J Korean Acad Nurs 2014;44(1):21-30. Published online February 28, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.1.21

Abstract PDF

Purpose

This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals.

Methods

A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators.

Results

Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable.

Conclusion

To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

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Meta-Analysis of Spiritual Intervention Studies on Biological, Psychological, and Spiritual Outcomes: Pok-Ja Oh, Young-Hyun Kim; J Korean Acad Nurs 2012;42(6):833-842. Published online December 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.6.833

Abstract PDF

Purpose

The purpose of this study was to evaluate the effectiveness of spiritual intervention studies by examining biological, psychological, and spiritual outcomes.

Methods

From electronic databases 2522 studies were retrieved, of which 21 studies met the inclusion criteria. These studies had 1411 participants. Two authors independently extracted data from the selected studies and assessed the methodological quality. The data were analyzed using the RevMan 5.1 program of the Cochrane library.

Results

Overall effect size of spiritual intervention on spiritual and psychological (depression and anxiety) outcomes were moderate (d=-0.65 to d=-0.76, p<.001). The effects on biological outcomes (pain and functional status) ranged from -0.51 to -0.39, respectively. No publication bias was detected as evaluated by a funnel plot. Spiritual intervention had a moderate effect on psychological and spiritual outcomes and a smaller effect on biological outcomes.

Conclusion

The results of this study suggest that spiritual intervention can relieve depression and anxiety. Further randomized controlled trials studies are needed to evaluate the effects of spiritual intervention on biological outcomes.

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Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients: Yunmi Kim, Sung-Hyun Cho, Kyung Ja June, Soon Ae Shin, Jiyun Kim; J Korean Acad Nurs 2012;42(5):719-729. Published online October 12, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.5.719

Abstract PDF

Purpose

This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance.

Methods

Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes.

Results

An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)= 2.99, 95% CI (confidence interval)= 1.94-4.60], those with Grades 4-5 (OR= 1.78, 95% CI= 1.24-2.57) and those with Grades 2-3 (OR= 1.57, 95% CI= 1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis.

Conclusion

Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.

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Impact of Prepregnancy Body Mass Index on Pregnancy Outcome in Women with a Singleton Conceived by Assisted Reproductive Technology and Spontaneously Conceived Pregnancy: A Case-Control Study: Ju Hee Kim, Hye Sook Shin, Bo Kyung Park, Kwang Moon Yang, Young Ho Lee, Hyun Mee Ryu; J Korean Acad Nurs 2012;42(4):517-524. Published online August 12, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.4.517

Abstract PDF: Abstract Purpose
To compare and confirm the impact of prepregnancy body mass index on pregnancy outcome in women with a singleton conceived by assisted reproductive technology and spontaneously conceived pregnancy.
Methods
A sample of 165 and 247 pregnant women with and without assisted reproductive technology were retrospectively recruited from electronic medical charts of C hospital.
Results
There were significant differences between the two groups for maternal age, paternal age, length of marriage, prepregnancy body mass index, parity, spontaneous abortion experience, and preterm delivery. A prepregnancy body mass index of ≥25 was associated with higher risk for maternal and neonatal complication in the assisted reproductive technology group.
Conclusion
The results indicate that a higher prepregnancy body mass index is associated with increased risks for adverse pregnancy outcomes for women using assisted reproductive technology. So these women need appropriate care to compensate for the risk.

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Development and Validation of the Hospice Palliative Care Performance Scale: So-Hi Kwon; J Korean Acad Nurs 2011;41(3):374-381. Published online June 13, 2011; DOI: https://doi.org/10.4040/jkan.2011.41.3.374

Abstract PDF

Purpose

The purpose of this study was to develop and validate a hospice·palliative care performance measure which would cover more than just physical symptoms or quality of life.

Methods

Through an intensive literature review, the author chose questions that measured aspects of physical, emotional, spiritual, social, or practical domains pertinent to hospice·palliative care for inclusion in the scale. Content validation of the questions was established by 15 hospice·palliative care professionals. A preliminary Hospice Palliative Care Performance Scale (HPCPS) of 20 questions was administered to 134 pairs of terminal cancer patients from 5 hospice palliative care units and their main family caregiver. A validation study was conducted to evaluate construct validity and internal consistency.

Results

Factor analysis showed 14 significant questions in five subscales; Physical, Emotional, Spiritual, Social, and Patient' rights. There were no significant differences between the ratings by patients and family members except for three out of the 14 questions. The measure demonstrated construct validity, and Cronbach's α of the subscales ranged from .73 to .79.

Conclusion

The HPCOS demonstrated acceptable validity and reliability. It can be used to assess effectiveness of hospice·palliative care for terminal cancer patients in practice and research.

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Effects of Case Management using Resident Assessment Instrument-Home Care (RAI-HC) in Home Health Services for Older People: Kyung Ja June, Ji Yun Lee, Jong Lull Yoon; J Korean Acad Nurs 2009;39(3):366-375. Published online June 29, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.3.366

Abstract PDF

Purpose

To evaluate the effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health service for older people.

Methods

All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), Pain and the number of Clinical Assessment Protocols (CAP).

Results

Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression (odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL (OR: 4.423, CI: 1.151-16.999) and the number of CAP (OR: 11.443, CI: 3.805-34.410).

Conclusion

Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

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Effects of Community-based Case Management Program for Clients with Hypertension: Ae-Young So, Yun-Mi Kim, Eun-Young Kim, Chang-Yup Kim, Cheol-Hwan Kim, Hee-Gerl Kim, Eun-Young Shin, Weon-Seob Yoo, Ggod-Me Yi, Kyung-Ja June; J Korean Acad Nurs 2008;38(6):822-830. Published online December 31, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.6.822

Abstract PDF

Purpose

The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community.

Methods

The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence.

Results

Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months.

Conclusion

The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.

Citations

Citations to this article as recorded by

An Education-Counseling Program for Young Prehypertensive Adults
Eunhee Jo, Soon-jung Hwang, Eun- jin Jeong, Minsun Kim
Clinical Nursing Research.2023; 32(2): 349. CrossRef
Nursing case management for people with hypertension in primary health care: A randomized controlled trial
Ângela Taís Mattei da Silva, Maria de Fátima Mantovani, Ricardo Castanho Moreira, Juliana Perez Arthur, Roberto Molina de Souza
Research in Nursing & Health.2020; 43(1): 68. CrossRef
Case management effectiveness for managing chronic illnesses in Korea: a systematic review
J.Y. Joo, M.F. Liu
International Nursing Review.2019; 66(1): 30. CrossRef
Obesity and Hypertension in Association with Diastolic Dysfunction Could Reduce Exercise Capacity
JinShil Kim, Myeong Gun Kim, SeWon Kang, Bong Roung Kim, Min Young Baek, Yae Min Park, Mi-Seung Shin
Korean Circulation Journal.2016; 46(3): 394. CrossRef
The Impact of a Nurse‐Led Home Visitation Program on Hypertension Self‐Management among Older Community‐Dwelling Koreans
Eunok Park, JinShil Kim
Public Health Nursing.2016; 33(1): 42. CrossRef
Changes in Adherence to Non-Pharmacological Guidelines for Hypertension
Kyong Park, Sukyung Cho, Julie K. Bower, Yan Li
PLOS ONE.2016; 11(8): e0161712. CrossRef
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G. Cicolini, V. Simonetti, D. Comparcini, I. Celiberti, M. Di Nicola, L.M. Capasso, M.E. Flacco, M. Bucci, A. Mezzetti, L. Manzoli
International Journal of Nursing Studies.2014; 51(6): 833. CrossRef
The Effect of Case Management Program for Hypertensive Patient
Jung-Soon Chung, Sun-Ock Lee
The Journal of Korean Academic Society of Nursing Education.2014; 20(2): 321. CrossRef
Effectiveness of Community-based Case Management for Patients with Hypertension
Soon-Nyoung Yun, In-Sook Lee, Jin Hyun Kim, Young Ko
Journal of Korean Academy of Community Health Nursing.2014; 25(3): 159. CrossRef
The Effect of Face-to-Face Education and Educational Booklet on Heart Health Indexes of the Hospitalized Patients with Myocardial Infarction
Safar Ali Esmaeili Vardanjani, Laleh Fanisaberi, Firozeh Alirezaee Shahraki, Ahmad Khalilzadeh, Abdolazim Tavakoli Vardanjani, Fatemeh Ghani Dehkordi
Nursing Research and Practice.2013; 2013: 1. CrossRef
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Young-Joo Park, Nah-Mee Shin, Ji-Won Yoon, Jiwon Choi, Sook-Ja Lee
Journal of Korean Academy of Nursing.2010; 40(6): 831. CrossRef
The Effects of Tele-care Case Management Services for Medical Aid Beneficiaries
Yang Heui Ahn, Eui Sook Kim, Il Sun Ko
Journal of Korean Academy of Community Health Nursing.2010; 21(3): 351. CrossRef
Factors Influencing Medication Adherence in Hypertensive Patients
Yeong-Mi Seo
Journal of Korean Academy of Community Health Nursing.2010; 21(1): 82. CrossRef

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Development and Application of a Computerized Nursing Process Program for Orthopedic Surgery Inpatients: NANDA, NOC, and NIC Linkages: Hye Suk Kim; Journal of Korean Academy of Nursing 2005;35(6):979-990. Published online October 31, 2005; DOI: https://doi.org/10.4040/jkan.2005.35.6.979

Abstract PDF

Purpose

The purpose of this study was to develop and to apply the NANDA, NOC, and NIC (NNN) linkages into a computerized nursing process program using the classification systems of nursing diagnoses, nursing outcomes and nursing interventions.

Method

The program was developed with planning, analysis, design and performance stages. The program was applied to 117 patients who were admitted to orthopedic surgery nursing units from January to February, 2004.

Results

Thirty-five of fifty-three nursing diagnoses were identified. Five nursing diagnoses in order of frequency were: Acute pain (28.4%), Impaired physical mobility (15.6%), Impaired walking (8.7%), Chronic pain (5.5%) and Risk for disuse syndrome (5.0%). The nursing outcomes of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (95.2%), Comfort level (35.5%) and Pain level (17.7%). The nursing interventions of the ‘Acute pain’ nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (71.0%), Splinting (24.2%) and Analgesic administration (17.7%). In comparison of outcome indicator scores between before and after the intervention according to the 61 nursing outcomes, the mean scores of 52 outcome indicators after the intervention were significantly higher than before the intervention.

Conclusion

It is expected that this program will help nurses perform their nursing processes more efficiently.

Citations

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Elif GÜNAY İSMAİLOĞLU, Seda ŞAHAN, Kemal YILMAZ, Serkan TİMUÇİN, Oğuzhan TAŞKIN
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Sena Chae, Hyunkyoung Oh, Sue Moorhead
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Se Young Kim, Insook Lee, Shinmi Kim, Kisook Kim, Bohyun Park, Yoon Goo Noh
The Journal of Korean Academic Society of Nursing Education.2016; 22(3): 396. CrossRef
Relationships Among NANDA‐I Diagnoses, Nursing Outcomes Classification, and Nursing Interventions Classification by Nursing Students for Patients in Medical‐Surgical Units in Korea
Hyun Kyung Noh, Eunjoo Lee
International Journal of Nursing Knowledge.2015; 26(1): 43. CrossRef
Identifying core nursing sensitive outcomes associated with the most frequently used North American Nursing Diagnosis Association—International nursing diagnoses for patients with cerebrovascular disease in Korea
Eunjoo Lee, Hyejin Park, James Whyte, Youngae Kim, Sang Youn Park
International Journal of Nursing Practice.2014; 20(6): 636. CrossRef
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Gisoo Shin, Mi-Kyoung Cho
Journal of Korean Biological Nursing Science.2014; 16(4): 276. CrossRef
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Eun Ko, Hyang-Sook So
Korean Journal of Adult Nursing.2013; 25(4): 365. CrossRef
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Hune Cho, Sung-Jung Hong, Hwa-Sun Kim
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Jeong-Eun Park, Kwi-Ae Chung, Hune Cho, Hwa Sun Kim
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