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백성희 ( ) - 이화여자대학교 간호대학
이광자 ( ) - 이화여자대학교 간호대학
김경희 ( ) - 이화여자대학교 간호대학
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Abstract
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The purpose of this study is to establish and to practice the effective nursing care, to improve the nursing activites and the bedside of nursing.
During the past few years many studies have remarked that nurse spend less and less time at the bedside, largely because they have been busy with other timeconsuming activities such as charting notes.
If charting time could be reduces, the nurses would have more time for the patients.
Yet clear, concise, and accurate charting is essential.
We decided to review nursing recording methods.
Firstly, we identified that nursing record contents and pattens in recent years through 30 charts of nursing record of the psychiatric wards, in three of university hospitals. Most of that was descriptive and repeated which we confirmed. Also the data was devided by meaning and content. We developed our work with record of the behavior observation re-cord.
24 of psychiatric nurse specialists found the con-tent validity with high score.
From 1995, July 1 to July 3(three days), pretesting of behaviour observation record tool was done at one of sample psychiatric hospitals.
Then it was modified to 14 items by psychiatrists and psychiatric nurses.
The 14 items are delow ;
1, personal hygiene
2 psychiatrist´s rounding
3. activity therapy
4. walking
5. meals
6, wandering in the ward
7. bed rest
g, ward activity
9. visiting hour
10. interview
11. sleeping
12. laboratory exam
13. consultation to other department
14. special treatment
From Aug 1 to 20(20 days), we applied to 50 of inpatient with recorrected tools.
There were some limitations which are lack of explanations of need for a special form. For example, actingout patient, suicide attempt patient, special demanding patient and patients in seclusion room Because of this limitation, we decided to include the old nursing record for more effectivity.
With this research, some of nurses remarks were : "Very compart and much better than the old form.", "Save a lot of timeless waste of paper.", "New form is more efficient, concise and saves time. "
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KeyWords
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정신과병동의 간호업무, 간호기록도구
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원문 및 링크아웃 정보
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등재저널 정보
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