• Title/Summary/Keyword: 간호사고

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Lumbar Puncture in Patients Who Experienced First Seizure with Fever (열이 동반된 첫 경련시의 뇌척수액검사)

  • Kim, Jung;Lee, Jun Su;Lee, Sang Eun;Choi, Wan Suk;Han, Sung Ryoung;Cho, Kyunglae
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1008-1012
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    • 2003
  • Purpose : We aimed to ascertain whether lumbar punctures should be done to prove febrile seizure, and to study what conditions can delay or abolish lumbar puncture. Methods : This retrospective study was done for four years, from January, 1996 to December, 1999. The subjects were the patients who visited Masan Samsung Hospital for the first convulsion with fever, and whose age ranged from 1-month to 5-years old. The total number of patients was 197. We investigated the rate of meningitis, which was classified by age, season, convulsion type, associated symptoms, and results of blood test. All data were tested chi-square. Results : The diagnosis rate of meningitis among all 197 patients was 7.6%, and of these only one patient was proved to have bacterial meningitis. The rate was high in the young(below 6 month), in males and in summer and autumn. Although the general appearance was good after resolution of the fever, the rate of meningitis was 6.5%. Patients with nausea and vomiting totalled 11%; 9.1% of them were diagnosed with meningitis. The diagnosis rate of meningitis in cases in which additional seizures took place were 33.3%. Conclusion : The ultimate goal of lumbar punctures in seizure patients with accompanying fever is to rule out bacterial meningitis, which, has been demonstrated to be rare. So we think that lumbar puncture can be postponed by close observation of pediatrics specialists and skilled nurses.

Hospice Education among Hospice Professionals and Its Regional Variations in Korea -Outcomes from a 2008 Hospice Palliative Care Institutions Support Project- (한국 호스피스.완화의료 전문인력 교육의 지역적 변이 -2008년 말기 암환자 전문기관 활성화 지원사업 신청기관 인력을 중심으로-)

  • Kang, Jin-A;Shin, Dong-Wook;Hwang, Eun-Joo;Kim, Hyo-Young;Ahn, Seong-Hoo;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.12 no.3
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    • pp.132-138
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    • 2009
  • Proper education of hospice professionals is essential for ensuring quality of end-of-life care. In 2005, 'End-of-life Care Task Force Team' by Ministry of Health and Welfare established '60 hours of hospice education' as basic requirement for hospice professionals. This study is aimed to determine how many of the hospice professionals meet with the criteria and whether there are significant regional variations. Methods: We analyzed the data from 46 hospice organizations, which submitted the application to the 2008 designation program of Ministry of Health, Welfare, and Family Affairs. Data included details of the educational records of each hospice professionals. Results: Total 673 hospice professionals were included in the analysis. Overall, only 41.5% (279/673) met the requirement. Nurses (46.8%; 177/378) were more likely to meet the requirement than doctors (35.8%; 38/106), social workers (32.0%; 24/75) and clergies (35.1%; 40/114). Hospice professionals of the organizations in metropolitan area received more education than those in small cities or rural area (52.4% vs. 25.0% for doctors, 50.6% vs. 43.9% for nurses, 42.9% vs. 25.5% for social workers). By geographic areas, hospice professionals in southeast regions received less education than other part of Korea (28.1% vs. 43.0${\sim}$48.8%, respectively). Conclusion: Less than half of the Korean hospice professionals has received proper amount of hospice education, and significant regional variations existed. National programs to promote the education of hospice professionals and eliminate its disparities are greatly warranted. Implementation of the 60-hour currirulum for hospice professionals, based on the train-the-trainer model, would be regarded as one potential solution.

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A Study on the Hull-dimension of 89 ton class Stow-net Vessel with Stern-fishing (89톤급 선미식 안강망어선의 선형치수에 관한 연구)

  • Park, Je-Ung;Lee, Hyeon-Sang
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.33 no.3
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    • pp.159-165
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    • 1997
  • This paper presents the optimum dimension of 89 ton class stow-net vessel with stern-fishing. The model of basic design is developed by using the optimization techniques referring to objective function and numerous constraints as follows; speed, fishing quantity, fishing days, catch per unit effort(CPUE), and weight/ratio of main dimensions, etc. Thus, the basic design of stow-net fishing vessel is built up by using the optimization of the design variables called the economic optimization criteria, and the objective function represents the criterion which is cost benefit ratio(CBR). The main conclusions are as follows. 1. S/W for decision of optimum hull size is developed in 89 ton class stow-net fishing vessel which is constructed with optimization of the design variables called the economic optimization criteria. 2. For optimum ship dimensions in 89 ton class stow-net fishing vessel, the hull dimensions can be obtained in the range of L= 27.3m, B = 6.6m, D = 2.80m, Cb = 0.695, T/D = 0.80, $\Delta$(displacement)=281.7ton with 10 knots.

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Quantitative Assessment of the Radiation Exposure during Pathologic Process in the Sentinel Iymph Node Biopsy using Radioactive Colloid (방사성 콜로이드를 이용한 감시림프절 생검 병리처리과정에서 방사선 피폭의 정량적 평가)

  • Song, Yoo-Sung;Lee, Jeong-Won;Lee, Ho-Young;Kim, Seok-Ki;Kang, Keon-Wook;Kook, Myeong-Cherl;Park, Weon-Seo;Lee, Geon-Kook;Hong, Eun-Kyung;Lee, Eun-Sook
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.4
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    • pp.309-316
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    • 2007
  • Purpose: Sentinel lymph node biopsy became the standard procedure in early breast cancer surgery. Faculty members might be exposed to a trace amount of radiation. The aim of this study is to quantify the radiation exposure and verify the safety of the procedure and the facilities, especially during pathologic process. Materials and Methods: Sentinel lymph node biopsies with Tc-99m human serum albumin were performed as routine clinical work. Exposed radiation doses were measured in pathologic technologist, nuclear medicine technologist, and nuclear medicine physician using a thermoluminescence dosimeter (TLD) during one month. We also measured the residual radioactivities or absorbed dose rates, the exposure distance and time during procedure, the radiation dose of the waste and the ambient equivalent dose of the pathology laboratory. Results: Actual exposed doses were 0.21 and 0.85 (uSv/study) for the whole body and hand of pathology technologist after 47 sentinel node pathologic preparations were performed. Whole body exposed doses of nuclear medicine physician and technologist were 0.2 and 2.3 (uSv/study). According to this data and the exposure threshold of the general population (1 mSv), at least 1100 studies were allowed in pathology technologist. The calculated exposed dose rates (${\mu}$ Sv/study) from residual radioactivities data were 2.47/ 22.4 ${\mu}$ Sv (whole body/hand) for the surgeon; 0.22/ 0 ${\mu}$ Sv for operation nurse. The ambient equivalent dose of the pathology laboratory was 0.02-0.03 mR/hr. The radiation dose of the waste was less than 100 Bq/g and nearly was not detected. Conclusion: Pathologic procedure relating sentinel lymph node biopsy using radioactive colloid is safe in terms of the radiation safety.(Nucl Med Mol Imaging 2007;41(4);309-316)

A Survey of Cancer Patients Who Visited Emergency Room (일 대학병원 응급실에 내원한 암 환자 실태)

  • Yang, Sun-Ae;Cho, Ok-Hee;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.12 no.4
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    • pp.228-233
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    • 2009
  • Purpose: The purpose of this study was to retrospectively examine the factors and characteristics of cancer patients who visited the emergency room, as well as to offer some educational materials for to manage acute symptoms. Methods: Data for this study were selected from the period of January to December, 2006. A total of 564 patients were examined using the tool which we developed by ourselves for the study. The collected data were analyzed using the SAS program for frequencies and percentage. Results: As for disease-related characteristics of the subjects, 28.9% of them had gastric and colorectal cancer; 66.9% were in stage 4; 51.6% had been in chemotherapy prior to visiting the emergency room; and 82.5% had their anticancer drug administrated average 1~5 times. As for the characteristics in regard to visit the emergency room, 62.9% were admitted to hospital within 2 weeks of being treated. As for chief complaints for visiting the emergency room, the worst symptom was pain, followed by symptoms such as gastro-intestinal symptoms, respiratory symptoms, high fever, and weakness. As for the disease-related symptoms, the worst symptom that gastric, colorectal, pancreatic, liver and gallbladder cancer patients complained of was pain, high fever for lymphoma patients was respiratory symptoms for lung cancer patients, and gastrointestinal symptoms for head and neck cancer and other patients. Conclusion: Therefore, according to their need and background, an individualized consultation and teaching program should be provided to cancer patients.

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Survey on Quality of Hospice.Palliative Care Programs in Korea (한국 호스피스.완화의료기관 실태 조사)

  • Yun, Young-Ho;Choi, Eun-Sook;Lee, In-Jeong;Rhee, Young-Sun;Lee, Jung-Suk;You, Chang-Hoon;Kim, Hyun-Sook;Paek, Yu-Jin
    • Journal of Hospice and Palliative Care
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    • v.5 no.1
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    • pp.31-42
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    • 2002
  • Purpose : The purpose of this study was to evaluate the present status of hospice palliative care programs in Korea as a basic database for standardization of hospice palliative care. Method : The data was collected from July to October, 2001. The instrument used for this study was the questionnaires which was consisted of the general characteristics of organization, recipient of service, manpower, contents of service, financial conditions and facilities. Sixty-four hospice palliative care programs answered the questionnaires, confirmed by telephone. Results : They were 40 hospital-based hospice palliative care programs and 24 nonmedical hospice palliative care programs. 11 Hospital-based hospice palliative programs have isolated unit or hospital affiliated free standing hospice. 6 Non-hospital hospice palliative programs have a free standing hospice. Major subjects of hospice palliative program were terminal cancer patients but patients with non-terminal illness were also included. Only 24 of 64 hospice palliative programs had all of the essential professionals : physicians, nurses, social workers, and clergies. Home hospice palliative care programs have a referral system in hospital based (89.7%) and nonmedical programs (73.7%). 24hr hospice are were provided in 26 hospital-based (65.0%) and 9nonmedical programs (37.5%). There were rooms for family in half of hospital-based programs. 73.9% of hospice palliative care programs have financial problems. 62.0% of Hospice palliative care programs need financial support from government. Conclusion : 64 Hospice palliative care programs provided hospice palliative services but had many problems in manpower, quality of care and facility. For improving the quality of terminal patients' life and promoting the cost effectiveness of health care resources, it is necessary to consider the standardization and institutionalization of hospice palliative care.

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Care Needs of Hospice Patients in Comparison with Those from the Family Caregivers' Perspective: Q methodology (호스피스 환자의 돌봄 요구와 가족이 인지하는 환자의 돌봄 요구 비교: Q 방법론)

  • Yong, Jin-Sun;Hong, Hyun-Ja
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.153-168
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    • 2004
  • Purpose: The purpose of tile study was to identify types of care needs of hospice patients and those from the family caregivers' perspective and to compare these two groups in reporting patients' care needs through Q-methodology. Methods: Twenty three Q-statements concerning care needs were selected through in-depth interviews of hospice patients. Data were collected from 20 hospice patients as well as 20 family caregivers respectively by sorting 23 Q-statements into 9 points standard. Data analysis was performed by using PC QUANL program. Results: Principal component analysis identified four types of care needs of the hospice patients. Overall, the accuracy of family caregiver reports was 48% in all types of care needs. Type 1 was named 'physical care needs type' for those whose greatest need was physical care to be free of pain and comfortable. The accuracy in Type 1 was 62.5%. Type 2 was named 'emotional care needs type' for those who would like to share love and intimacy with their family members. The accuracy in Type 2 was 20%. Type 3 was named 'spiritual care needs type' for those who would like to receive forgiveness from their God and prayers and visitation of clergy. The accuracy in Type 3 was 60%. Type 4 was named 'social care needs type' for those who would like to complete their ongoing work and to give service to others. The accuracy in Type 4 was 50%. Conclusion: There was a great difference between hospice patients and the family caregivers in reporting patients' care needs. Thus, hospice nurses need to educate family caregivers to more accurately assess patients' care needs.

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The Need for Child Hospice Care in Families of Children with Cancer (암 환아 가족의 아동 호스피스 요구도)

  • Kang, Kyung-Ah;Kim, Shin-Jeong;Kim, Young-Soon
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.221-231
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    • 2004
  • Purpose: The purpose of this study was to analyze the need for child hospice care programs in families of children with cancer. Methods: The survey of 104 families who were taking care of children with cancer was conducted. This survey was conducted from February 2004 to July 2004 at two general hospitals in Seoul. The data were collected through a self-reporting questionnaire of 22 items. The items were classified into five areas by factor analysis to identify the construct validity. The reliability of the tool was established by Cronbach's alpha as .94 and the data collected were analyzed by descriptive statistics, t-test and ANOVA. Results: 1) The degree of need for hospice care of the subjects showed a high average of 3.40 (${\pm}3.8$). The need for 'emotional care of children' showed the highest mean (M=3.55), 'management of terminal physical symptoms'(M=3.49), 'control of secondary physical problems' (M=3.41), 'acceptance of the family's difficulty' (M=3.20), 'spiritual care for preparing for death'(M=3.17), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the child's mother's age (F==4.980, P=.009), whether or not there were cancer patients among their siblings or relatives (t=2.423, P=.017). Conclusion: The family of children with cancer have a heavy burden of ambivalence, especially in relieving the anxiety and fear of their children, communicating about death, and managing physical symptoms. Child hospice care must be provided considering the needs of families of children with cancer. Thus popular needs as well as hospice nurses' higher concern and support for hospice care of children require further education and program development to meet the current demands.

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Premenstrual Syndrome and its Relationship with Previous Abuse History and Dissociative Symptoms (월경전기 증후군과 해리증상 및 과거 학대 경험과의 연관성)

  • Kim, Jong-In;Choi, Tae-Kyou;Yoon, Jae-Hang;Suh, Shin-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.2
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    • pp.112-119
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    • 2008
  • Objectives : Premenstrual syndrome(PMS) is known to occur in more than 80% of reproductive women. Since PMS is closely related to changes in sex hormones, biological factors are suspected to be associated with the syndrome, but there have been no consistent reports regarding biological causes. In that sense, it is postulated that the occurrence of PMS is much dependent on the biological aspects, but that the severity or characteristics of the syndrome is more dependent on the psychological factors. Studies focusing on psychological factors are based on the theory that symptoms of PMS and previous psychologically traumatic events are closely related. If the theory is valid, it can be further postulated that symptom severity of PMS is associated with dissociative symptoms, since traumatic events are known to be related to dissociative symptoms. In this study, we tried to find out the association of PMS symptom severity with previous abuse history and dissociative symptoms. Methods : Subjects for the study were 377 nurses working in Seoul, Kyung-gi, and Kyung-book. 183 subjects who submitted valid data entered the study. The presence and the symptom severity of PMS were rated using Daily Records of Severity of Problems(DRSP) and Shortened Premenstrual Assessment Form(SPAF). Dissociative symptoms were evaluated with Dissociation Experience Scale Korean version(DES-K). Previous physical/verbal abuse, sexual abuse, and parental spouse abuse experience were rated with correspondent abuse scales. Results : Subjects were divided into 3 groups as No PMS group, mild to moderate PMS group, and severe PMS group according to SPAF total score. There was a statistically significant difference in DES-K total score among 3 groups($x^2=14.966$, df=2, p=0.001). Physical/verbal abuse scale($x^2=14.397$, df=2, p=0.001), sexual abuse scale($x^2=8.376$, df=2, p=0.015), and parental spouse abuse scale($x^2=9.322$, df=2, p=0.009) also revealed a significant difference among 3 groups. Symptom severity of PMS using SPAF total score showed a positive correlation both with degree of dissociative experience and previous abuse experience. There was a statistically significant difference in both dissociative experience and previous abuse experience among 3 groups. Conclusion : These results show that there can be a possible association among PMS symptoms, dissociative symptoms, and previous psychologically traumatic experience.

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A study on simple nursing activities for the registered nurses and nurse aides in the hospital (단순간호활동에 관한 간호사 및 간호조무사의 태도조사연구)

  • Lee Jung-Hee
    • Journal of Korean Public Health Nursing
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    • v.4 no.1
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    • pp.37-55
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    • 1990
  • Every country in the world has been trying to expand the basic health right for the peoples as W.H.O has established the goal 'health for AU' by the year of 2000. Related to this goal, our government authority has establish the policy 'the insurance of health for all' into effect from July 198\). Recently hospitalshave been making a ceaseless effort for the plan for the rationalization of its management the academic World is making it a subject of discussion by doing the secure of manpower at a resonable level and the increase of productivity by the manpower. As a result of the efforts the study was established to secure the numbers of nursing manpower at a resonable level and use the unskilled persons at the utilizing field and seek the possible area of their activity for more efficient service through the investigation of ablity of simple nursing activities of regiestered nurses and nurse aides for rational function according to the educational levels and talents. The method of study was established by the registered nurses and nurse and nurse aides(R.N 229, N.A 226) who are working in 15 hospitals with over 200 beds. This surrey was conducted from Mar 29, 1989 to April 8, 1989. The method to test the degree of importance, difficulties, and the abillity of performance of a simple nursing activities was classified into 35 activities on the basis of references on this field. The degree of importance was composed from point l(Not so important) to 5(Very important). the degree of difficulties. was composed as follows; very easy - Point 1 very difficult and complicated - Point 5. and the ability of performance was composed from point 1 to 5. The materials gathered through the survey were analyzed with frequency, mean standard deviation, percentage. t-test, Anova, pearson's coefficient of correlation, stepwise multiple regression. factor analysis, discriminant analysis. The obtained results are summarized as follows: 1. The recognition values of the simple nursing activities of each group of registered nurse and nurse aides show; The degree of importance; 4.04 and 4.26 The degree of difficulties; 2.72 and 2.94 The ability of performance; 2.07 and 2.38 The brief summary shows there are little differences between who two groups the simple nursing activities turned out to be easy and simple work. 2. Regardless of the degree of importance, and difficulties, the ability of performance the important in fluencing of the degree of the simple nursing activities between the registered nurses and nurse aides was the order of educational level, hospital career, working career in wards and ages of the registered nurses and ages and hospital creer of nurse aides. The result was that the simple nursing activities could easily be familiar through the training of their working environment and period of experience. 3. Among the 35 simple nursing activities the items capable of resonable entrusting to the nurse aides are 5 that is helping bed-bathing, 8itz Bath, using bed pan, care while delivering patient, accompaying patient when visitor's check. There wasn't and differences between RN and nurse aides in performing the above 5 items. In anywhere. so we can say obviosuly that this nursing activities should be performed under the nursing system of which chief of nurse are supposed to supervise nurse aides as a possible function to be entrusted. In view of the above mentioned results, therefore, this partial functional job of the simple nursing activities can able be entrusted to the nurse aides through the regular training course. In case of these functional activities could be entrusted under, the responsibility of registered nurse, we can able suggest to for that there are the following advantages: 1.. In the nursing activities-affairs, the qualified guarantee of the nursing services can be kept and increased or promotoed with accommodation of the required nursing service and roles being expanded presently. 2. In the productivity of the hospital manpower, therefore, we have comt to view and consider in favourly that when an automational administration times would be come in the near future time to hospital affairs as a reality, to utilize the existing nures aides is better rather than investing so as to develop the other source manpowers or seek its for the efficient business management in the operational strategy or its policy.

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