• 제목/요약/키워드: 서울대학교병원

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신생아중환자실에서의 가족중심돌봄 기반 가족중재연구에 대한 통합적 문헌고찰 (An Integrative Review of Family Interventions based on a Philosophy of Family-Centered Care in Neonatal Intensive Care Units)

  • 정나리;김예슬;박은영;여리사;황지원
    • Perspectives in Nursing Science
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    • 제16권1호
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    • pp.35-44
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    • 2019
  • Purpose: The aim of this study is to analyze the characteristics of family interventions based on a philosophy of family-centered care conducted in neonatal intensive care units through an integrative literature review. Methods: We searched the PubMed, CINAHL, RISS, KISS, and DBpia databases; a total of 20 studies, published between January 2013 and May 2018, was selected according to our criteria. Results: Mothers accounted for a greater proportion of participants in family interventions than did fathers. Family interventions described in the studies were categorized into four educational and sixteen non-educational interventions. Among non-educational interventions, skin-to-skin-contact interventions, such as kangaroo care, accounted for the highest proportion. Only one paper employed a theoretical framework. Conclusion: More family interventions based on theoretical frameworks should be conducted as these frameworks serve as guidelines for nursing research. As the stress patterns experienced by parents in neonatal intensive care units showed gender differences, more programs tailored for fathers are needed. Moreover, further research should be conducted to evaluate feasibility as an outcome variable, and studies of family interventions based on a philosophy of family-centered care should be performed more actively in the neonatal intensive care units in Korea.

국내 급성기 의료기관 고위험 의약품 목록 도출 (Developing national level high alert medication lists for acute care setting in Korea)

  • 한지민;허규남;이아영;민상일;김현지;백진희;노주현;김수인;김지연;이해원;조은주;아영미;이주연
    • 한국임상약학회지
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    • 제32권2호
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    • pp.116-124
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    • 2022
  • Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.

간호사가 생각하는 손의 의미 (The Meanings of Hands among Clinical Nurses in a Tertiary Hospital)

  • 유혜진;서은영;신연희;최정선;박광희;김정윤;김현선;강지영
    • 중환자간호학회지
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    • 제12권3호
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    • pp.50-60
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    • 2019
  • Purpose : The purpose of this study was to explore and describe the meanings of hands among clinical nurses. Methods : A descriptive qualitative study design was used. Participants were 1,048 nurses working in a tertiary hospital in G city. From April to May 2018, an open-ended survey on how nurses felt about their hands and what their hands meant to them was conducted. The collected data were analyzed using MAXQDA 2018 version as well as content analysis. Results : A total of 1,048 pieces of data were analyzed, and 2,094 units of analysis were categorized based on their attributes, resulting in physical, emotional, and social domains. The data in the social domain were reported in a narrative format; thus, they were analyzed using content analysis. Three themes and eight sub-themes were elicited. The three themes included "meaning as an instrument," "meaning of infection control," and "meaning of caring." Conclusion : Nurses imbue essential meanings of caring on their hands even though they face negative skin symptoms. Furthermore, nurses understand the importance of hand hygiene on infection control. The findings of this study provide an in-depth look into nurses' perceptions of their hands.

사람유두종바이러스 백신접종 후 발생한 소섬유신경병과 기립빈맥증후군 (Small Fiber Neuropathy and Postural Orthostatic Tachycardia Syndrome after Human Papillomavirus Vaccination)

  • 이채원;임영민;고명아;김현진;김광국
    • 대한신경과학회지
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    • 제36권4호
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    • pp.318-321
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    • 2018
  • We describe a 44-year-old woman with paresthesia, fatigue, and palpitation, 10 days after human papillomavirus (HPV) vaccination. The quantitative sensory test showed abnormal detection threshold in her foot. Tilt test result indicated postural orthostatic tachycardia syndrome. Symptoms were improved after immunomodulating therapy, pain control drug, and oral beta blocker medication. This is first case report for small fiber neuropathy and autonomic dysfunction after HPV vaccination in Korea.

경동맥스텐트삽입술 직후 악화된 혈관신생녹내장 사례 (Acute Exacerbation of Neovascular Glaucoma after Carotid Artery Stenting)

  • 고명아;이채원;조성양;강동화;전상범
    • 대한신경과학회지
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    • 제36권4호
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    • pp.325-328
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    • 2018
  • Neovascular glaucoma is a subtype of secondary glaucoma that is characterized by proliferation of fibrovascular tissue in the anterior chamber angle. This condition may be acutely aggravated by carotid revascularization therapies. There have been few previous reports of acute aggravation of neovascular glaucoma following carotid artery stenting. We report the case history of a patient who had acute exacerbation of neovascular glaucoma following carotid artery stenting and required surgical management.

개인선량계 분실 사례 및 분실 방지 방안 조사 (Investigation of Personal Dosimeter Loss Case and Measures to Prevent Loss)

  • 박성우;박현식;박영재;이경재;오기백;이성하;김민석;박주언;원문희
    • 핵의학기술
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    • 제27권1호
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    • pp.66-70
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    • 2023
  • Purpose It is intended to improve the management efficiency of personal dosimeters by analyzing and sharing personal dosimeter loss cases and loss prevention measures. Materials and Methods From 2017 to 2021, data on the number of lost personal dosimeters were collected at large hospitals, and the number of personal dosimeters issued and lost were investigated. Results In order to prevent loss by institution, methods such as the use of auxiliary rings, contact stickers and dosimeter necklaces were implemented. Conclusion Hospitals are a business that frequently changes clothes, such as surgical gowns and work clothes, so there is a lot of loss. In addition, it was confirmed that the loss rate increases as the number of personal dosimeters issued increases.

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파킨슨병의 자기공명영상 소견: 흑질선조체 변성의 영상학적 평가 (MRI Findings in Parkinson's Disease: Radiologic Assessment of Nigrostriatal Degeneration)

  • 배윤정;김종민;최병세;송요성;남윤호;조세진;김재형;김상은
    • 대한영상의학회지
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    • 제83권3호
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    • pp.508-526
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    • 2022
  • 파킨슨병은 중뇌 흑질에 위치한 도파민성 신경세포의 퇴행성 소실로 인해 발생하는 이상운동질환이다. 최근 다양한 자기공명영상기법의 발전으로 파킨슨병에서 일어나는 병리생태학적인 변화를 반영하는 여러 영상 소견들이 보고되었다. 여러 연구에서 이러한 영상 소견들은 파킨슨병의 진단 및 비정형 파킨슨증과의 감별 등에 유의미한 도움을 줄 수 있는 것이 밝혀졌다. 본 종설에서는, 파킨슨병에서 일어나는 흑질선조체 변성의 병태생리를 나타낼 수 있는 나이그로좀 영상 및 뉴로멜라닌 영상 등을 포함한 자기공명영상기법들과 각 영상에서 나타나는 소견에 대하여 자세히 다루었다.

노인환자의 복약순응도 현황 및 영향인자 분석 (Predictive Factors for Medication Adherence in a Geriatric Assessment Program in Korea)

  • 김민소;최나예;서예원;박진영;이정화;이은숙;김은경;김선욱;김광일;김철호
    • 병원약사회지
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    • 제35권4호
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    • pp.418-429
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    • 2018
  • Background : To improve medication adherence in elderly patients, the role of pharmacists in teambased services has been highlighted in the literature. However, not much is known about the role and the service elements involved in comprehensive geriatric programs in South Korea. This study was designed to describe the current status of medication adherence in geriatric patients based on the comprehensive geriatric assessment program and analyze the predictive factors for medication adherence in a tertiary teaching hospital. Methods : A retrospective cohort study was performed using electronic medical records of 247 patients from March 1st, 2015 to August 31st, 2015. Medication adherence and the types of non-adherence were also collected. Predictive factors for adherence were evaluated by including factors related to demographics, medications, illness, and patterns of medical usage. Results : The mean age of the study population was 81.2 years (range 65~98 years) and they were taking 9.7 drugs on an average (SD 5.0 drugs). The overall rate of non-adherence was 34%. About 48% of the patients had any forms of assistance in the medication administration. The most common type of non-adherence was "self-adjustment". The multivariate analyses revealed that age (adjusted odds ratio, 0.87 [95% CI, 0.80-0.96]; p 0.05) and the number of inappropriate medications (adjusted odds ratio, 0.59 [95% CI, 0.40-0.89]; p 0.05) were strong predictors for non-adherence. Conclusions : These results indicate that strategic considerations of the predictors of non-adherence should be improved in medication counseling services targeting elderly patients.

원내 폐렴 진료 지침 수립 후 경험 항생제 선택의 적절성 평가 (Evaluation of the Appropriateness of Empirical Antibiotic Prescription after Implementation of Antibiotic Treatment Guidelines for Pneumonia in a Hospital)

  • 강지영;김형숙;정영미;남궁형욱;이은숙;김은경;황주희;송경호;김의석;김홍빈
    • 병원약사회지
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    • 제35권4호
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    • pp.391-399
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    • 2018
  • Background : The Antimicrobial Stewardship Program promotes interdisciplinary interventions and targeted recommendations for the proper utilization of antibiotics. In particular, the aim of the program is to avoid indiscriminate use of broad-spectrum antibiotics based on the documented literature on the significant impact of unsystematic usage of antibiotics on the distribution of antibiotic-resistant microorganisms. To improve the care process for pneumonia treatment using antimicrobial agents, institution-level guidelines were established and disseminated at the Seoul National University Bundang Hospital in April 2016. In this study, we evaluated changes in the physicians'antibiotic prescribing patterns both before-and after-the implementation of the guidelines. Methods : The electronic medical records of inpatients who were prescribed with one or more antibiotics in May 2014 (Group A) and May 2016 (Group B) were reviewed. Data on demographic characteristics, clinical outcomes, and antibiotic prescriptions were collected and the prescription records were compared both before- and after- the implementation of the guidelines. Results : A total of 180 patients were included in the study: 77 patients in group A and 103 patients in group B. The baseline characteristics of the patients were not significantly different between the two groups. Community-acquired pneumonia was the most common diagnosis in both the groups and the difference was not significant (68.8% vs. 67.9%; p=0.67). The type of antibiotic prescriptions used for empirical treatment was not different between the two groups. The most commonly prescribed empirical antibiotics were cephalosporins, with no significant difference (p=0.31). One of the most inappropriately used antibiotics was piperacillin/tazobactam and the rate of prescription was similar in both the groups (p=0.68). The rates of appropriate empirical selection of antibiotics remained unaltered between the two groups (67.5% vs. 71.8%; p=0.53). Conclusions : Implementation of the guidelines only exhibited no significant effect on the antibiotic prescribing patterns of physicians for the treatment of pneumonia. To improve the adequate use of empiric antibiotics, more active interventions and closer monitoring of the feedbacks should be additionally considered and evaluated in future studies.