• Journal of Korean Biological Nursing Science
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• v.21 no.1
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• pp.54-61
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• 2019

Purpose: This study aimed to identify the incidence and risks for pressure ulcer among older patients with hip fracture. Methods: The subject were 215 older patients suffering from hip fracture who were admitted for surgical operation from January 1, 2012 to April 30, 2016 in a university-affiliated hospital. The incidence of pressure ulcer was collected retrospectively through medical record review and the risk factors were analyzed using Cox's proportional hazard model. Results: Out of the total, 32 patients (14.9%) developed pressure ulcer with the average occurrence period being 4.72 (${\pm}3.81$) days. Stage II pressure ulcer was the most common at 72.0%. Risk factors included ambulation status before injury (p= .039), spinal anesthesia (p= .029), and stay at intensive care unit after operation (p= .009). Conclusion: Despite pressure ulcer prevention efforts, the incidence remained relatively high. Considering the identified risk factors, more efforts is needed for early detection and prevention of pressure ulcers in such patients.

• Journal of Korean Biological Nursing Science
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• v.22 no.4
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• pp.271-278
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• 2020

Purpose: This study was performed to identify the risk factors for oral mucosa pressure ulcer development in intubated patients in adult intensive care unit. Methods: Comparative descriptive study design using prospective observational design and medical record review was used. The inclusion criteria of case was that a) patients of 18 years in their age, b) patients with endotracheal tube. Data of 34 patients were analysed. Descriptive statistics, chi-square test, Fisher's exact test, Mann-whitney test, Spearman's rho correlation coefficients, and multiple logistic regression analysis were used. Resampling methods such as bootstrap was used in this study because of small number of patients. Results: Oral mucosa pressure ulcer developed in 44.1% of the intubated patients. The risk factors of oral mucosa pressure ulcer were steroid use, biteblock use and serum albumin level. Compared to the non-user of steroid, user of steroid had 32.59 times (95% CI: 1.47-722.44) higher risk of developing oral mucosa pressure ulcer. The user of biteblock had 18.78 times (95% CI: 1.00-354.40) and albumin level had 0.03 times (95% CI: 0.00-0.80) higher risk of oral mucosa pressure ulcer incidence. Conclusion: Based on the results of this study, tailored pressure relief strategies considering sex and therapeutic condition should be provided to decrease oral mucosa pressure ulcer.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.24-33
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• 2023

Purpose : This study aims to establish an optimal cut-off score on the Braden scale for the assessment of pressure injury to detect pressure injury risks among inpatients in a South Korean tertiary hospital. Methods : This retrospective study used electronic medical records, from January to December 2022. A total of 654 patients were included in the study. Of these, 218 inpatients with pressure injuries and 436 without pressure injuries were classified and analyzed using 1:2 Propensity Score Matching (PSM), and the generalized estimating equation was performed using SPSS Version 26 and the R Machlt package program. Results : The cut-off value on the Braden scale for distinguishing pressure injury was 17 points, and the AUC (area under the ROC curve) was 0.531 (0.484-0.579). The sensitivity was 56.6% (45.5-67.7%) and the specificity was 69.7% (66.0-73.4%). With 17 points, the Braden scale cut-off distinguished those who had pressure injuries from those who did not at the time of admission (p < .03). In the pressure injury group, the Braden score on the day of the pressure injury was 14, with significant results in all subcategories except the moisture category. Conclusion : Our findings revealed that a cut-off value of 17 was optimal for predicting the risk of pressure injuries among tertiary hospital inpatients. Future studies should evaluate the optimal cut-off values in different clinical environments. Additionally, it is necessary to conduct multicenter large sample studies to verify the effectiveness of a 17 value in PI risk assessments.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.466-470
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• 2007

Purpose: Active prevention is an essential component in reducing the development of pressure sores. For the high-risk patient group, following the certified pressure sore screening scale as well as educating the patient and the nurses who care for them can lead to optimal management of these patients. Applying a risk assessment scale along with a prevention strategy can reduce medical costs and length of stays at the hospital. The purpose of this study is to evaluate the efficacy of a new pressure sore risk assessment scale based on the universally recommended Braden scale and our prevention program. Methods: From June to August, 2003, our pressure ulcer risk assessment scale was applied to a total of 1882 patients admitted to the experimental group (intensive care unit, neurosurgery, general surgery, and oncology units). It was based on Braden scale. We analysed sensitivity, specificity, positive and negative predictive value and ROC curve to evaluate its efficacy. Pressure ulcer prevention program was composed of patient's education using protocol and specific nursing care. The incidence of pressure ulcers was also measured during the 3 months period, and those were compared to the control group of 1789 patients from March to May, 2002. Results: 118(6.27%) of the experimental group were high-risk with an incidence of pressure ulcers measuring 4 (0.21%). Sensitivity, specificity, positive and negative predictive value of our scale were 100%, 94%, 4%, 100%, respectively, and AUC(area under the curve) was 0.992. In the control group, the incidence of pressure ulcers was 11(0.61%). Statistical analyses using chisquared tests with a significance level of 5%, the results were such that ${\chi }^2=3.6482$(p=0.0561). The results proved to be statistically significant in borderline. Conclusion: The results from this study proved that pressure sore risk assessment scale based on Braden scale has an excellent efficacy, and shows that our pressure ulcer prevention program is partially effective in reducing pressure ulcer incidence.

• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.26-36
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• 2021

Purpose : This study aimed to present the incidence of pressure ulcers and identify different associated factors according to the time of occurrence of pressure ulcers in intensive care unit (ICU) patients. Methods : The participants were 313 patients who reported pressure ulcers among 2,908 patients in ICUs at a large tertiary hospital in Gyeonggi-do. Among them, 220 patients (70.3%) had a pressure ulcer before admission, and 93 patients (29.7%) reported newly developed pressure ulcers after admission to the ICU. Data were collected between August 2018 and April 2019. Along with the time of occurrence and characteristics of pressure ulcers, diverse associated factors were gathered through electronic medical records. Data were analyzed using descriptive statistics, independent t-tests, and 𝑥²-tests. Results : Different risk factors associated with pressure ulcers in ICU patients according to the time of occurrence were main diagnosis, score of acute physiology and chronic health evaluation, score of Richmond agitation sedation scale, level of consciousness, administered sedatives, use of a ventilator, insertion of a feeding tube, and the duration of fasting period. Conclusion : Based on the results of this study, healthcare providers, especially ICU nurses, should try to detect early signs and symptoms of pressure ulcers, taking into account the derived factors associated with pressure ulcers in ICU patients. Practical intervention programs and strategies considering the factors associated with pressure ulcers must be developed to prevent and alleviate such ulcers in ICU patients in the future.

• Journal of the Korean Data and Information Science Society
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• v.26 no.3
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• pp.715-727
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• 2015

This study was conducted to explore the impact of nursing staffing on inpatient nursing outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals. Patients per RN was a significant indicator of foley catheter ratio in high risk group and low risk group. Patients per RN&NA was a significant indicator of decline in ADL for patients with dementia, non dementia, urinary incontinence and new pressure ulcer development in the high risk group. The average nursing outcome of inpatient in high grade was higher than that low grade in long care hospital. This higher level of nursing staffing and the higher the grade shown a positive effect on the nursing outcomes of the inpatient. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving nursing outcomes.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.153-156
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• 1983

1950년(年) 이후(以後) 무연탄(無煙炭)으로 만든 연탄(煉炭)을 취사(炊事), 난방용(煖房用)으로 가정(家庭)에서 광범위(廣範圍)하게 사용(使用)하게 되면서 연탄(煉炭)가스내(內)의 일산화탄소(一酸化炭素)로 인(因)한 중독사고(中毒事故)가 빈발(頻發)하여 심각(深刻)한 국민보건(國民保健)의 문제(問題)가 되어왔다. 저자(著者)들의 실태조사(實態調査)(1975년도(年度))에 의(依)하면 서울특별시일원(特別市一圓)에 있어 일산화탄소중독(一酸化炭素中毒)의 년간발생(年間發生)은 인구(人口), 10만당(萬當) 경증(輕症) 260명(名), 혼수상태(昏睡狀態)의 중증중독(重症中毒) 45명(名), 사망(死亡) 1명(名)으로 위험인구(危險人口)를 3,000만명(萬名)으로 하였을 때 전국적(全國的)으로 일산화탄소중독(一酸化炭素中毒)의 추정발생수(推定發生數)는 년간(年間) 경증(輕症) 78만명(萬名), 중증(重症) 13만(萬) 5천명(千名), 사망(死亡) 3,000명(名)으로 그 피해(被害)의 규모(規模)가 100만을 육박(肉薄)하는 가공(可恐)할 수자(數字)를 보여주고 있다. 저자(著者)들은 이러한 심각(深刻)한 국민보건(國民保健)의 문제(問題)를 우선(于先) 실천가능(實踐可能)한 제이차예방(第二次豫防)에 역점(力點)을 두어 고압산소요법(高壓酸素療法)을 보급(普及)할 목적(目的)으로 일인용고압산소장치(一人用高壓酸素裝置)를 개발(開發)하고 1969년(年) 1월(月)에 서울대학교병원(大學校病院)에 고압산소치료실(高壓酸素治療室)을 개설(開設)하여 급성일산화탄소(急性一酸化炭素) 중독환자(中毒患者)에 대(對)한 응급치료(應急治療)를 실시(實施)하여 1978년(年)까지 10년간(年間)의 치료결과(治療結果)를 요약(要約)한바 다음과 같다. 1. 총치료환자수(總治療患者數)는 2,242명(名)이고 회복(回復)된 수(數)는 2,202명(名)으로 98.2%의 회복률(回復率)을 보였다. 2. 계절적(季節的)으로 10월(月)에서 4월(月)까지가 연중최성기(年中最盛期)이나 5월(月)에서 9월(月)까지도 적지않은 환자(患者)의 발생(發生)을 볼 수 있었다. 3. 연령별분포(年齡別分布)를 보면 15세(歲)${\sim}29$세군(歲群)이 전체환자(全體患者)의 반이상(半以上)인 52.7%를 차지하고 있고 $0{\sim}14$세군(歲群)은 인구비(人口比)에 대해 발생(發生)이 훨씬 적은 결과(結果)를 보이고 있다. 4. 도착시간별(到着時間別) 입원율(入院率)은 오전(午前) 10시이후(時以後) 도착군(到着群)서부터는 입원율(入院率)이 급증(急增)하는데 이는 병원도착(病院到着)이 늦일수록 당일회복(當日回復)이 되지못하고 입원가료(入院加療)하게 됨을 나타내주는 결과(結果)라 할 수 있다. 5. 병발증(倂發症)으로는 급성욕창, 폐렴(肺炎) 및 신경학적(神經學的) 이상등(異常等)의 소견(所見)을 많이 볼 수 있었다.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.27 no.4
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• pp.352-360
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• 2017

Objectives: This study aimed to determine the effects on musculoskeletal symptoms of both social demographic features and detailed characteristics of each task category of care workers who offer visiting home-help services. And to establish the measures that can reduce musculoskeletal symptoms among care workers. Methods: This study was conducted among 192 care workers from welfare centers C and K located in city P. After participants completed the task burden checklist regarding the scale of musculoskeletal symptoms and the details of their duties, the data collected were analyzed using the SPSS 21.0 program. Results: According to the degree of observable musculoskeletal symptoms in care workers, the highest figures were observed for back and shoulder pain. Based on the results of assessing the effect of detailed task category characteristics on musculoskeletal symptoms, "helping patients eat, helping patients move, helping patients bath, and changing body positions" were found to have an effect from the physical care category, "providing physical therapy assistance, treating bedsores" from the health care category, and "cleaning and doing laundry" from the facility management category. Conclusions: Due to the high proportion of patients requiring burdensome physical labor from care workers such as moving patients who have trouble doing so on their own, helping them change positions, and so on, it is highly likely that pain will occur in the low back, which carries most of the physical weight. So, education on human epidemiological positions that can reduce overload on areas prone to pain such as the low back and shoulders is essential. Proper equipment and personnel support must be provided for dangerous tasks. Further, multidimensional social support is required consistently.