Journal of Korean Academic Society of Home Health Care Nursing (가정간호학회지)

Korean Academic Society of Home Health Care Nursing (한국가정간호학회)
권호 표지
DOI QR코드

DOI QR Code

Case-based Learning through Home Care Nursing Specialists' Critical Reflection: Application with Patients Using Home Mechanical Ventilator

가정전문간호사의 비판적 성찰을 통한 사례기반 학습: 가정용 인공호흡기 적용대상자

  • 박학영 (서울아산병원, 가정간호유닛) ;
  • 황문숙 (우석대학교 간호대학) ;
  • 김연희 (서울아산병원, 간호부)
  • Received : 2018.11.05
  • Accepted : 2018.12.05
  • Published : 2018.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study is know the home care nursing specialists' copying method for life-threatening emergency situation occurred while changing the tracheotomy tube in the patient's home through case-based learning. Methods: Two cases were analyzed using structured critical reflection while changing the tracheal tube. In the first case, the patient presented with dyspnea, cyanosis, and low oxygen saturation when connected to home mechanical ventilator after replacement of the tracheotomy tube. In the second case, replacement of the tracheal tube was difficult due to a narrowed airway from proliferated granulation tissue. Results: From the case-based learning. using a critical reflection instrument, home care nursing specialists indicated that it was important to explain the possibility of danger to the client and that nurses must check the operation of the ambu-bag to prepare for an emergency when replacing a tracheotomy tube. Moreover, they stated a need for two nurses during client visits when there is the possibility of an emergency. Conclusion: Case-based learning through critical reflection provides actual practice-focused knowledge that is helpful to home care nurse specialists who face emergency situations in a restricted environment. Therefore, we hope that home care nursing specialists will use this method to strengthen their professional knowledge.

Keywords

General Characteristics of each Case

GJHHBE_2018_v25n3_153_t0001.png 이미지

Critical reflection of Case 1

GJHHBE_2018_v25n3_153_t0002.png 이미지

Critical reflection of Case 2

GJHHBE_2018_v25n3_153_t0003.png 이미지

References

  1. Ministry of Health and Welfare. Handbook for hospital based home health care. 2nd ed., Seoul, 2010, 42-43.
  2. Hong JS, Lee GE. Scale development of job stress for home care nurses. Journal of Korean Academic Nursing. 2004;34(6):1097-1107. https://doi.org/10.4040/jkan.2004.34.6.1097
  3. King AC. Long term home mechanical ventilation in the United States. Respiratory Care. 2012;57:921-930. https://doi.org/10.4187/respcare.01741
  4. Epstein SK. Late complications of tracheostomy. Respiratory Care 2005;50:542-549.
  5. Al-Samri M, Mitchell I, Drummond DS, Bjornson C. Tracheostomy in children: a population-based experience over 17 years. Pediatric Pulmonology. 2010;45:487-93. https://doi.org/10.1002/ppul.21206.
  6. Mahadevan M, Barber C, Salkeld L, Douglas G, Mills N. Pediatric tracheotomy: 17 year review. International Journal of Pediatric Otorhinolaryngology. 2007;71:1829-1935. https://doi.org/10.1016/j.ijporl.2007.08.007
  7. Jeaon SY, Ryu KU. A qualitative study on resistance to learning in adult education contexts. Journal of Research in Education. 2011;41(1):99-119.
  8. Korean Society for Learning and Performance. Case based learning[Internet], Seoul: Korean Society for Learning and Performance[cited 2018 August 5]. Available from: https://terms.naver.com/entry.nhn?docId=2178315&cid=51072&categoryId=51072
  9. Park SO, Lee DH. The meaning of critical thinking and the principle of teaching critical thinking in adult education. Journal of Lifelong Education. 2016;22(3):1-26.
  10. Kwon IG, Park SM. Effects of critical reflective Inquiry on new graduate nurses' clinical decision-making. Nurses Clinical Nursing Research. 2007;13(2):39-50.
  11. Park MM, Han SJ. Relations of job satisfaction with emotional labor, job stress, and personal resources in home healthcare nurses. Journal of Korean Academic Community Health Nursing, 2013;24(1):51-61. http://dx.doi.org/10.12799/jkachn.2013.24.1.51.
  12. Choi SM, Lee MK. Relationship between critical thinking disposition and clinical decision-making abilities in home health advanced practice nurses. Journal of Korean Academic Society of Home Care Nursing. 2014;.21(2):147-155.
  13. Lee JY, Park SY. Relationship between the practice environment of nursing and critical thinking disposition of nurses in local general hospitals. Journal of Korean Academy of Nursing Administration. 2014;20(2):145-153. https://doi.org/10.11111/jkana.2014.20.2.145.
  14. Walker R, Cooke M, Henderson A, Creedy DK. Using a critical reflection process to create an effective learning community in the workplace. Nurse Education Today. 2013;33(5):504-511. https://doi:10.1016/j.nedt.2012.03.001.
  15. Zori S, Kohn N, Gallo K, Friedman MI. J Critical thinking of registered nurses in a fellowship program. Journal of Continuing Education in Nursing. 2013;44(8):374-380. https://doi.org/10.3928/00220124-20130603-03.
  16. Patricia Benner, From novice to expert. Lee JS, Kim SJ, Jang KS. Seoul:Hyunmoonsa; 1999. p. 29-48.
  17. Johns C. Achieving effective work as a professional activity. In: Schober JE, Hinchliff SM. editors. Towards advanced practice: key concepts for health care. Arnold:London;1995. p. 252-280.
  18. Heffernan C, Jenkinson C, Holmes T, Macleod H, Kinnear W, Oliver D, et al. Management of respiration in MND/ALS patients: An evidence based review. Amyotrophic Lateral Sclerosis. 2006;7(1):5-15. https://doi.org/10.1080/14660820510043235
  19. Shin HI. Survey of ventilator support in patients with rare and incurable disease. Service for scientific research report of KCDC, Seoul: Seoul National University Hospital. 2009 May. Report No.:2008-E00343-00.
  20. Suh SM, Lee JH, Chung MK Jeong HS, Son YI, Ahn KM, Lee SL, Causes and outcome of tracheostomy in children. Pediatric Allergy Respiratory Diseases. 2012;22:188-196. https://doi.org/10.7581/pard.2012.22.2.188.
  21. Song CR, Lee MK, Hwang MS, Yoon YM. The current state of hospital based home care services in Korea: Analysis of date on insurance clains for hom care from 2007 to 2012. Journal of Korean Academic Society of Home Care Nursing. 2014:21(2);127-138.
  22. Hwang MS, Lee MK, Song JR, Oh EK. Manual of respiratory care of amyotrophic lateral sclerosis. Seoul: Hyunmoonsa; 2013. p. 63-64.
  23. Kim BH, Joo MS, Kim YN, Shin TR, Park SM, Kim DG, Sim YS. Tracheoesophageal fistula with tracheal dilatation in a patient with a tracheostomy using a home mechanical ventilator. The Korean Journal of Medicine. 2014;87(1):87-91. https://doi.org/10.3904/kjm.2014.87.1.87.
  24. Koo SJ, Treatment through Solidarity between Disabled Persons: Focus on . Journal of Literary Therapy. 2015;34:159-188.
  25. Lee YJ. The influence of reflective learning on critically reflective work behavior with mediation effect of positive psychological capital. Journal of Agricultural Education and Human Resource Development. 2015;47(2):123-147. https://doi.org/10.23840/agehrd.2015.47.2.123
  26. Kim HS. Critical reflective inquiry for knowledge development in nursing practice. Journal of Advanced Nursing. 1999;29(5):1205-1212. https://doi.org/10.1046/j.1365-2648.1999.01005.x
  27. Yaremchuk K. Regular tracheostomy tube changes to prevent formation of granulation tissue. Laryngoscope. 2003;113:1-10. https://doi.org/10.1097/00005537-200301000-00001
  28. Suh US. Solidarity: Its History and Possibilities. Epoch and Philosophy. 2010;21(3):453-483.
  29. Kang HG. Death of Patient with change of tracheal cannula, judgment of criminal negligence?[Internet]. Seoul: Medical News[cited 2018 August 5]. Available from: http://www.newsmp.com/news/articleView.html?idxno=160587.
  30. Kwak SS. Operation of home medical project with a serious children[Internet]. Seoul: Young Physician[cited 2018 August 5]. Available from: http://www.docdocdoc.co.kr/news/articleView.html?idxno=1055213