Nursing Activities Research Articles

Differences by Nurse Type in Professional Quality of Life Perceptions from Pre-COVID-19 to Intra-COVID-19

The healthcare environment has become increasingly difficult during the SARS-CoV-2 (COVID-19) pandemic that began in March 2020. In this article, we discuss a study that considered differences by nurse type in professional quality of life perceptions. The primary study aim was to quantify differences in pre-COVID-19 and intra-COVID-19 perceptions of compassion satisfaction (CS) and compassion fatigue (CF) by nurse type, using the ProQOL survey. A secondary aim was to evaluate nurse perceptions of the intra-COVID-19 work environment. The study methods utilized a survey design with random sampling by nurse type (clinical, nurse manager, nurse director, and other nurse). Results suggested that intra-COVID-19, nurse managers had significantly greater CF scores. Intra-COVID-19, nurse directors had greater CS. COVID-19 negatively impacted self-care activities for nurses. Our discussion considers these findings related to pre-pandemic research that considered CS and CF. Implications for research and practice included identification of best practices for improvement in work environment, especially for nurse managers, and general recommendations for hazard pay and paid time off. While nurse managers have the greatest CF, all nurses need pandemic-related support.

Increasing a patient'ssense of security in the hospital: A theory of trust and nursing action.

Having a decreased sense of security leads to unnecessary suffering and distress for patients. Establishing trust is critical for nurses to promote a patient's sense of security, consistent with trauma-informed care. Research regarding nursing action, trust, and sense of security is wide-ranging but fragmented. We used theory synthesis to organize the disparate existing knowledge into a testable middle-range theory encompassing these concepts in hospitals. The resulting model illustrates how individuals are admitted to the hospital with some predisposition to trust or mistrust the healthcare system and/or personnel. Patients encounter circumstances increasing their emotional and/or physical vulnerability to harm, leading to experiences of fear and anxiety. Without intervention, fear and anxiety lead to a decreased sense of security, increased distress, and suffering. Nurse action can ameliorate these effects by increasing a hospitalized person's sense of security or by promoting the development of interpersonal trust, also leading to an increased sense of security. Increased sense of security results in diminished anxiety and fear, and increased hopefulness, confidence, calm, sense of value, and sense of control. The consequences of a decreased sense of security are harmful to patients and nurses should know that they can intervene in ways that both increase interpersonal trust and sense of security.

Relationship between noise levels and intensive care patients' clinical complexity: An observational simulation study.

Noise pollution in intensive care units is a relevant problem, associated with psychological and physiological consequences for patients and healthcare staff. Sources of noise pollution include medical equipment, alarms, communication tools, staff activities, and conversations. To explore the cumulative effects of noise caused by an increasing number and type of medical devices in an intensive care setting on simulated patients with increasing clinical complexity. Secondly, to measure medical device alarms and nursing activities' sound levels, evaluating their role as potentially disruptive noises. Observational simulation study (reported according to the STROBE checklist). Using an electronic sound meter, the sound levels of an intensive care room in seven simulated clinical scenarios were measured on a single day (09 March 2022), each featuring increasing numbers of devices, hypothetically corresponding to augmented patients' clinical complexity. Secondly, noise levels of medical device alarms and specific nursing activities performed at a distance of three meters from the sound meter were analysed. The empty room's mean baseline noise level was 37.8 (±0.7) dBA; among the simulated scenarios, noise ranged between 45.3 (±1.0) and 53.5 (±1.5) dBA. Alarms ranged between 76.4 and 81.3 dBA, while nursing tasks (closing a drawer, opening a saline bag overwrap, or sterile packages) and speaking were all over 80 dBA. The noisiest activity was opening a sterile package (98 dBA). An increased number of medical devices, an expression of patients' higher clinical complexity, is not a significant cause of increased noise. Some specific nursing activities and conversations produce higher noise levels than medical devices and alarms. This study's findings suggest further research to assess the relationships between these factors and to encourageadequate noise reduction strategies. Excessive noise level in the intensive care unit is a clinical issue that negatively affects patients' and healthcare providers' well-being. The increase in baseline room noise from medical devices is generally limited. Typical nursing tasks and conversations produce higher noise levels than medical devices and alarms. These findings could be helpful to raise awareness among healthcare professionals to recognize noise sources. The noisiest components of the environment can be modified by staff behaviour, promoting noise reduction strategies and improving the critical care environment.

Impact of non-invasive ventilation and non-medical caregiver presence on nursing workload – an observational study

Objective: To find out if non-invasive ventilation (NIV) as a ventilation modality increases the burden on nursing personnel and give suggestions how the presence of non-medical caregivers in an ICU with an extreme staff shortage can reduce nursing workload during mechanical ventilation. Background: Although the European Union offers good quality healthcare, there are middle-income countries in the alliance that suffer from nursing staff shortage. For example, Bulgaria needs two times more nurses than it has now to meet the needs of its healthcare system. This calls for strategies that reduce nursing workload as much as possible. There is a common perception that NIV is more time-consuming for nurses compared to invasive mechanical ventilation (IMV) but only a few studies discuss the matter and none of them are settled in the unique environment where medical and non-medical caregivers provide direct patient care as a team. Study design and methods: This is an observational study conducted in a specialised respiratory ICU with trained nurses, physiotherapists, and non-medical caregivers in a university hospital in Bulgaria. Ninety adult patients (43 on NIV and 47 on IMV) with acute respiratory failure that were on mechanical ventilation for at least five days were included. Nursing workload was measured via the Nursing Activities Score (NAS). Average and daily NAS were compared between groups. Then individual components of the score were analysed to determine which activities have the greatest impact on nursing workload. Results: Average (39.72 ± 6.35 vs 46.08 ± 5,66, p< 0.001) and daily NAS for the first five days of mechanical ventilation and was significantly higher in the IMV group. There was a substantial drop of nurse workload with time in both groups, more significant for the patients who ventilated invasively. It occurred on the second day in both groups (NIV: p=0.005, 95%CI: 0.88-4.52; IMV: (p<0,001, 95%CI: 2.72-7.03). NIV patients required more time for monitoring but less for hygiene, fluid administration and nutrition. IMV patients also required specific care for their artificial airway and took more time for lung function improvement procedures. Conclusion: In a setting where direct patient care is provided by both formally trained nurses and nonmedical caregivers IMV was associated with a higher nursing workload than NIV. Implications for research, policy, and practice: In a situation with an extreme staff shortage some of the non-medical nursing activities involving patients on NIV can be potentially transferred to trained nonmedical caregivers. What is already known about the topic? According to the World Health Organization in 2018 there was a nurse shortage of around six million and by 2030 it will increase to 36 million. This negative trend is most prominent in low- and middle-income countries. There is a common perception that NIV is more time-consuming for nurses compared to IMV but only a few research groups address this matter. NIV may require additional time from nursing personnel mainly because of problems with mask fit, skin breakdown and maintenance of an optimal position in bed. NIV is more time-consuming in the first 48 h but then becomes much less demanding. What this paper adds This is the first study where the ICU nursing workload during NIV and IMV is compared in a setting where non-medical caregivers have a substantial role in direct patient care. In a setting where direct patient care is provided by both formally trained nurses and non-medical caregivers IMV was associated with a higher nursing workload than NIV. In a situation with an extreme staff shortage some of the non-medical nursing activities involving patients on NIV (like help with self-hygiene, food, and water intake) can be potentially transferred to trained non-medical caregivers under supervision.

Nursing actions in Primary Health Care to lesbian and bisexual women

Objective: to investigate the actions of nurses in regard to lesbian and bisexual women in the context of the National Policy for the Integral Health of Lesbians, Gays, Bisexuals, Cross-Dressers and Transgender Persons. Methods: qualitative study involving 25 nurses from the Family Health Strategy, contacted via electronic means. We applied a form containing sociodemographic data and an investigation of actions in primary health care, as well as a thematic content analysis. Results: we found there are professional capacitation activities, embracing of demands, and enhanced interprofessional work. Nonetheless, there were shortcomings in the knowledge regarding health care towards lesbian and bisexual women. Conclusion: there are still prejudices, difficulty to access, and little attendance of lesbian and bisexual women in health services, as well as a deficit in the support to health actions and lack of monitoring. Contributions to practice: the importance of the scientific, professional, and social experiences stand out, regarding the need to humanize the care to lesbian and bisexual women. It is a supporting material for researchers and nursing professionals, enabling them to direct their care to a holistic and integral care to be provided to these women, in addition to being an encouragement to further comparative studies.

Fanny Bré in the Spanish Civil War (1936-1939): The meaning of nursing care in the international brigades.

Fanny Bré was a volunteer nurse in the International Brigades, who fought in the Spanish Civil War (1936-1939) on the side of the democratically elected Republican government. The objective of this study is to understand the relationship between Bré's antifascist ideas, her conception of care and the activities she carried out in the Spanish hospitals of Casa Roja (Murcia), Villa Paz (Selices, Cuenca) and Vic (Barcelona). We use narrative biography to describe Bré's personal, political and professional trajectory. To do so, we conducted a content analysis of primary sources archived in Spain, Russia and France and secondary sources that emerged from a thorough literature review. We identified three thematic axes: (1) a concept of nursing in the service of the antifascist struggle, (2) nursing activity for high-quality care and (3) political action for improving hospital organisation and care. The interest of Bré's texts transcends the war in Spain because, in them, Bré questions the neutrality of care by revealing that care can itself be a political act.

Process Evaluation of a Wireless Wearable Continuous Vital Signs Monitoring Intervention in 2 General Hospital Wards: Mixed Methods Study.

Continuous monitoring of vital signs (CMVS) using wearable wireless sensors is increasingly available to patients in general wards and can improve outcomes and reduce nurse workload. To assess the potential impact of such systems, successful implementation is important. We developed a CMVS intervention and implementation strategy and evaluated its success in 2 general wards. We aimed to assess and compare intervention fidelity in 2 wards (internal medicine and general surgery) of a large teaching hospital. A mixed methods sequential explanatory design was used. After thorough training and preparation, CMVS was implemented-in parallel with the standard intermittent manual measurements-and executed for 6 months in each ward. Heart rate and respiratory rate were measured using a chest-worn wearable sensor, and vital sign trends were visualized on a digital platform. Trends were routinely assessed and reported each nursing shift without automated alarms. The primary outcome was intervention fidelity, defined as the proportion of written reports and related nurse activities in case of deviating trends comparing early (months 1-2), mid- (months 3-4), and late (months 5-6) implementation periods. Explanatory interviews with nurses were conducted. The implementation strategy was executed as planned. A total of 358 patients were included, resulting in 45,113 monitored hours during 6142 nurse shifts. In total, 10.3% (37/358) of the sensors were replaced prematurely because of technical failure. Mean intervention fidelity was 70.7% (SD 20.4%) and higher in the surgical ward (73.6%, SD 18.1% vs 64.1%, SD 23.7%; P<.001). Fidelity decreased over the implementation period in the internal medicine ward (76%, 57%, and 48% at early, mid-, and late implementation, respectively; P<.001) but not significantly in the surgical ward (76% at early implementation vs 74% at midimplementation [P=.56] vs 70.7% at late implementation [P=.07]). No nursing activities were needed based on vital sign trends for 68.7% (246/358) of the patients. In 174 reports of 31.3% (112/358) of the patients, observed deviating trends led to 101 additional bedside assessments of patients and 73 consultations by physicians. The main themes that emerged during interviews (n=21) included the relative priority of CMVS in nurse work, the importance of nursing assessment, the relatively limited perceived benefits for patient care, and experienced mediocre usability of the technology. We successfully implemented a system for CMVS at scale in 2 hospital wards, but our results show that intervention fidelity decreased over time, more in the internal medicine ward than in the surgical ward. This decrease appeared to depend on multiple ward-specific factors. Nurses' perceptions regarding the value and benefits of the intervention varied. Implications for optimal implementation of CMVS include engaging nurses early, seamless integration into electronic health records, and sophisticated decision support tools for vital sign trend interpretation.

Do ‘CARE’ labelled canine patients get a lower standard of nursing care?

Aggressive patients are labelled as ‘CARE’ within their clinical history and the quality of nursing care they receive may be compromised because of concerns for staff safety. The aim of this study was to investigate if a difference in the quality of nursing care exists between aggressive patients labelled as CARE and other patients not labelled as CARE, hoping to identify whether this suggested a breach of patient welfare. This study used a cross-sectional, observational survey distributed online via social media veterinary nursing community pages. Open invitations were also emailed to the first author's own practice, and the RVC's Queen Mother Hospital for Animals. UK-based registered veterinary nurses who had been in practice within the last 12 months participated. Likert response categories of 1-5 were used to question registered veterinary nurses about how likely they were to undertake certain nursing activities for both CARE and non-CARE canine patients. In total, 390 registered veterinary nurses completed the questionnaire. Pearson's chi-squared test was used to statistically analyse the data. An association was discovered between level of nursing care and CARE or non-CARE labelled patients. Statistically significant differences (P=0.05) in nursing care were found under every nursing category for CARE patients. The key categories identified were patient hygiene, feeding, pain scoring, exercise and restraint. The current study provides evidence that aggressive canine patients do get a lower standard of nursing care compared to other canine patients. Areas of concern are highlighted when these differences are discussed in the context of animal welfare. The authors hope these findings serve as a prompt for practices to examine their performance towards aggressive patients to ensure adequate standards of nursing care and patient welfare are sustained.

Understanding the impact of clinical and leadership development activities for pediatric cardiac nurses in India.

The major challenges for pediatric cardiac nursing in India include inadequacies in their levels of education and lack of recognition of their vital role in the health-care system. The aim of this study was to understand the impact of the leadership educational initiatives on pediatric cardiac nursing taken by Children's HeartLink and the Pediatric Cardiac Society of India. Semi-structured interviews were conducted with eight pediatric cardiac nurse leaders from different Indian hospitals. A review of interviews from a previous study and an extensive literature review provided further foundational data on two major themes. The first theme on nursing education focused on nursing curriculum update, continuing education, and leadership development. The second theme focused on improving the value of nursing in public perception, value in hospitals, and their career promotions. The study identified the potential targets for improvement and provided a nursing career development ladder applicable to India.

Use of SOAPIER format in rotating interns of the Nursing career

Introduction: the format SOAPIER is a systematic structure used for recording and interpreting the problems and care that the patient deserves. Objective: Identify the use of the SOAPIER format in rotating interns of the Nursing Career of the Technical University of Ambato. Methods: The research has a cross-sectional quantitative-descriptive approach. The sample consisted of 78 rotating inmates; a modified questionnaire was applied and validated by experts, with a Cronbach's Alpha of 0.811, thus guaranteeing the reliability of the instrument. Results: The 75.6% apply the recording of subjective data, as do 79.5% apply the recording of objective data. 61.5% apply the recording of nursing diagnoses. 61.5% plan the nursing activities in the nursing records. 56.4% make nursing notes by applying SOAPIER. 56.4% record the evaluation of nursing interventions based on the evolution of the patient's condition. 62.8% apply the recording of the re-evaluation of nursing interventions based on the evolution of the patient's condition. Conclusions: The use of the SOAPIER format is evident, which reflects that during the academic training the Nursing Care Process has been implemented and how to capture it through this record based on scientific evidence.

The Evolving Role of Haematology Nursing Practice: A Cross-Sectional Survey.

The scope of haematology nursing practice is dynamic and must respond to advances in treatment, patients' needs and service requirements. Little is known, however, about the different roles of haematology nurses across the European setting. The purpose of this study was to identify the professional practices of haematology nurses. A cross-sectional online survey design was used to investigate practice elements undertaken by haematology nurses. Frequencies and descriptive statistics were calculated for demographic variables and chi-square tests to examine relationships between practice elements, nursing role and country. Data is reported from 233 nurses across 19 countries, working as Staff Nurses (52.4%), senior nurses (12.9%) and Advanced Practice Nurses (APNs) (34.8%). Most frequently reported activities included medication administration - oral/ intravenous (90.0%), monoclonal antibodies (83.8%), chemotherapy (80.6%), and blood components (81.4%). APNs were more commonly involved in nurse-led clinics and prescribing activities (p < .001, p = .001, respectively); however, other nursing groups also reported performing extended practice activities. Patient and carer education was a significant part of all nurses' roles; however, senior nurses and APNs were more often involved with the multidisciplinary team (p < .001) and managerial responsibilities (p < .001). Nurses' involvement in research was limited (36.3%) and frequently reported as an out-of-work hours activity. This study describes haematology nursing care activities performed in various contexts and within different nursing roles. It provides further evidence of nursing activity and may contribute to a core skills framework for haematology nurses.

Elaboration of an educational flyer for patients on oral antineoplastic treatment in a highly complex oncology center

The incidence of cancer is growing in Brazil at a pace that accompanies the aging population due to increased life expectancy. Given the increase in supply and adherence to treatment using oral chemotherapy, we found the need for a nursing action extended to the home, proposing an orientation model for oncology patients about oral chemotherapy treatment, through a printed informative folder. Exploratory research, action research type, carried out from the identification of the needs of patients on oral antineoplastic treatment of a High Complexity Oncology Center of a teaching hospital, reference in oncology. Elaborated from a review of literature published in printed book format and through the MEDLINE, LILACS, SIELO databases, publications of the National Cancer Institute (INCA), in the period between 2015 and 2020. Our main contribution is to favor the understanding and adherence to oral home chemotherapy treatment, synthesize the main guidelines given in medical and/or nursing consultation in printed material - folder, so that he can consult it whenever he feels the need.

Live stream webcams on the neonatal unit: ‘An additional responsibility’ for nursing workload?

IntroductionLive stream webcams have been introduced to neonatal units to reduce the separation between parents and infants. However, this new technology has the potential to impact nursing workload. The aim of this study was to explore the impact of the new implementation of webcams on nursing workload. MethodA survey was developed to explore webcam related nursing activity. Workload evaluations were completed by each nurse per shift, over a three-month period. ResultsA total of 85 nurses took part in the study, completing 765 workload surveys. Findings revealed 95% of camera related tasks took less than 15 min. Parent phone calls related to webcams and changes in workflow for infant handling were identified. ConclusionThe introduction of webcams did not negatively impact nursing workload. Education for nurses and parents, and a technological support nurse or team would help lessen some of the challenges nurses experienced.

Assessing the Reliability and Validity of the Spanish Version of the Actual Scope of Nursing Practice Scale.

Nursing workforce shortage is one of the main challenges for healthcare organizations and it is important to determine if nurses are fulfilling their full scope of practice. There is a questionnaire that measures the activities carried out by nurses, but there is no version available for the Spanish context. The purpose of this study was to develop a cross-cultural adaptation of the "Actual Scope of Nursing Practice" questionnaire by D'Amour et al., and to assess the psychometric characteristics of the Spanish version. An exploratory sequential research design was used. The cross-cultural adaptation was performed using translation, back-translation, review, and pre-testing. Psychometric properties were assessed to determine its construct validity and internal consistency. Among the 501 eligible nurses from the three main hospitals in the region, the first 310 nurses to respond to an online questionnaire were included in our study. The response rate was 61.9%. They were invited via email and completed the survey using the SurveyMonkey platform. The Spanish version of the questionnaire was obtained. A final scale with twenty items and two factors was confirmed with an adequate fit, with the item scores demonstrating that all items were optimally related to their respective latent construct. The alpha coefficients for the Spanish ASCOP scale were robust and revealed good internal consistency. This study showed that the Spanish version of the scale, "Scope of Nursing Practice", has a good degree of validity and reliability. This questionnaire can support nurse managers in realising nursing activities within their organisations and in promoting desirable work outcomes among nurses.

On Bender's orientation to models: Towards a philosophical debate on covering laws, theory, emergence and mechanisms in nursing science.

Nursing scholars continuously refine nursing knowledge and the philosophical foundations of nursing practice. They advance nursing knowledge by creating new knowledge and weighing the relevance of developments in cognate sciences. Nurse philosophers go further by providing epistemological and ontological arguments for explanations of nursing phenomena. In this article, I engage with Bender's arguments about why mechanisms should have more primacy as carriers of nursing knowledge. Despite the careful scholarship involved, Bender's arguments need to be more convincing. Accordingly, this article encourages debate about Bender's arguments for reorientating nursing science to mechanisms. I begin by suggesting that the claim that the theory-practice divide can be overcome by reorientating to mechanisms is acceptable only if we accept Bender's depiction of the challenge. Then I question the ontology Bender relies on to justify reorientating nursing science. After that, I argue that mechanisms in models that parallel analytical sociology undermine the kind of nursing science Bender advocates. I illustrate my arguments with a social mechanism thought experiment. Then I explain why Bender's arguments cannot escape the received view of science or inform emancipatory nursing action without theory. Finally, I mention some caveats and implications for nursing science.

Exploring nurses' multitasking in clinical settings using a multimethod study

Nurses often multitask in the process of managing patient care and communicating with healthcare providers simultaneously within a limited time, which can negatively affect patient care and safety. In this multimethod research, we conducted a time and motion study to record nursing activities using eye trackers for 23 participants (9 nurses and 14 patients). The frequency and duration of single and multitasking activities were analyzed. Additionally, we conducted focus group interviews (FGIs) with 12 nurses (2–5 nurses per group) to further investigate their multitasking experience. The total duration of the eye tracker recordings was 3,399 min. Daily nursing activities comprised 23.7%, 21.1%, and 12.5% of scheduled medication, documentation, and monitoring and measurement, respectively. Among these activities, nurses mostly carry out scheduled medication, monitoring, and measurement together. Three themes emerged in the FGIs: "Being involved in every little task regarding patient care," "Getting swamped by the complexity of symptoms and problems of the patients at a given time," and "Getting interrupted at work too often." Nurses performed multiple activities while cooperating with other healthcare providers and providing care to patients. It is important to create an environment where nurses can focus on essential nursing activities to improve patient safety.

Hubungan Kepatuhan Sign-In Dengan Ketepatan Identifikasi Pasien Pre – Operatif Di RS Primaya Betang Pambelum

Before the patient is delivered to the operating room, the sign-in action is carried out in the reception room by the health worker before the patient is escorted to the operating table, the sign-in compliance includes identifying the patient, checking the informed consent (consent sheet), checking the surgical site marking, allergy history and supporting examination documents. Every health worker will take action on pre-operative patients in the application of health workers still do not properly identify patients during routine medical / nursing actions, patient identity is mentioned by health workers, health workers do not immediately record and report the results of sign in. This study aims to determine the relationship between sign-in compliance with the accuracy of pre-operative patient identification at Primaya Betang Pambelum Hospital, Method: This type of research is correlational using Cross sectional. The technique of determining respondents using purposive sampling using the Chi Square statistical test. The sample is patients who will undergo surgery at Primaya Betang Pambelum Hospital totaling 109 respondents. Results: The results of the Chi Square statistical test that obtained p value = 0.000 or the level of significance p &lt; 0.05 so that there is a relationship between sign-in compliance with the accuracy of pre-operative patient identification, Conclusion: There is a relationship between sign-in compliance with the accuracy of pre-operaif patient identification as evidenced by the results of p &lt; α with a significant level of 0.05 indicating a significant and meaningful relationship between sign-in compliance with the accuracy of patient identification at Primaya Betang Pambelum Hospital.

End-of-life Care in the Intesive Care Unit and Nursing Roles in Communicating with Families.

Professionals in Intensive Care Units face death, shifting their role from therapists to caregivers in end-of-life management. The nursing attitude and response to death has been shown to affect the quality of palliative care and end-of-life services that are interrelated services. The aim of this research was to evaluate the professional attitude of nurses towards the care of the families of critically ill patients in the ICU, leading to the emergence of specific attitudes, relating them to their demographic and professional characteristics, with the aim of drawing conclusions for the improvement of quality in end-of-life care. The sample of the study was 81 nurses from a large tertiary hospital. Participants completed the "Nurse Activities for Communicating with Families" (NACF) questionnaire. The questions are about ways in which nurses can help the patient's family during the patient's stay in the ICU. The results revealed that the nurses took actions related to the information and psychological support of the patient's family. On the contrary, they did not focus on the spiritual / religious needs of the patient and the needs of the family based on their cultural background. The professional treatment of staff is characterized by compassion and empathy, but it is necessary to train them on important issues related to diversity, including the religious, spiritual values and beliefs of patients and their relatives.

시뮬레이션 기반 인수인계 교육이 간호대학생의 지식, 비판적 사고 성향, 임상 판단력에 미치는 효과

Purpose Clinical nurses work in three shifts due to the specificity of the ward's work, and there is a handoff of nursing work for each shift. The nurse's handoff maintains the continuity of nursing care, ensuring the safety of patients and the quality of nursing care and medical care. Handoff is an important nursing activity that exchanges patient information, and it is the responsibility and duty of medical staff to accurately deliver this information. In addition, simulation-based education is an educational method that provides opportunities for clinical practice without having harmful results in nursing and medicine. This study was conducted to evaluate handoff knowledge, critical thinking disposition, and clinical judgment by developing and applying a simulation-based handoff education program for nursing college students. Method This study is a one-group pretest-posttest design to develop and operate a simulation-based handoff training program to verify its effectiveness. The subjects were 4th year students enrolled in the Department of Nursing at the College of Nursing in Gyeonggi-do, The data were collected from February 19 to March 2, 2018. For data analysis, SPSS Version 22.0 was used, and general characteristics were analyzed by numbers, percentages, averages, and standard deviations. Before and after participating in the educational program, the subject's handoff knowledge, critical thinking disposition, and clinical judgment were analyzed using a paired t-test. Results Thirty people participated in this study as subjects. All participants were female and the average age was 22 years. The main results of the study are as follows. There was a significant difference in handoff knowledge from 4.63±1.61 before education to 5.83±0.95 after education (t=-3.71, p=0.001). There was a significant difference from 3.39±0.46 before education to 3.75±0.42 after education (t=-4.69, p&lt;0.001). There was a significant difference in clinical judgment from 1.79±0.37 before education to 3.15±0.48 after education (t=-15.67 , p&lt;0.001). Conclusion As a result of this study, it was confirmed that the simulation-based handoff education program was effective in improving the handoff knowledge, critical thinking disposition, and clinical judgment of nursing students. Therefore, based on the results of this study, it is expected that it will be used as basic data for establishing an education system to improve the performance of handoff in the future. In addition, it is considered that it can be used for education for new nurses and idle nurses, contributing to the improvement of the quality of handoff in the future.

THE EFFECT OF TRADISIONAL MUSIC “CILOKAQ” THERAPY FOR THE ANXIETY LEVEL IN ELDERLY WOMEN AT THE RETIERMENT HOME

Background: Elderly is who’s over 60 years old with decline in biological, psychological, social, and economic changes. Method: The design of this research is Pre-Experimental with One-Group Pretest-Posttest design with 30 respondents. Results: of this study used the chi square test with p value 0.002 &lt;0.005, which means that there is an effect of cilokaq music therapy on the level of anxiety in the elderly. Conclution: Cilokaq music therapy can be used as an alternative to professional nursing actions for the elderly who experience anxiety and can be applied institutionally in the form of establishing permanent work procedures.