• Title/Summary/Keyword: Admission Care

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A nationwide study of children and adolescents with pneumonia who visited Emergency De­partment in South Korea in 2012

  • Lee, Chang Hyu;Won, Youn Kyoung;Roh, Eui-Jung;Suh, Dong In;Chung, Eun Hee
    • Clinical and Experimental Pediatrics
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    • v.59 no.3
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    • pp.132-138
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    • 2016
  • Purpose: Acute respiratory infection, particularly pneumonia, is the most common cause of hospitalization and death among children in developing nations. This study aimed to investigate the characteristics of children and adolescents with pneumonia who visited Emergency Department (ED) in South Korea in 2012. Methods: We analyzed National Emergency Department Information System (NEDIS) records from 146 EDs in South Korea for all pediatric patients aged ${\leq}18years$ who were diagnosed with pneumonia between January and December 2012. Results: Among 38,415 subjects, the male-to-female ratio was 1:0.8. Patients aged <12 months comprised 18.0% of the study population; those aged 1 to 3 years, 54.4%; those aged 4 to 6 years, 16.8%; those aged 7 to 12 years, 7.4%; and those aged 13 to 18 years, 3.4%. Presentation rates were highest in April, followed by January, March, and May. The hospital admission rate was 43.5%, of which 2.6% were in intensive care units. The mortality rate was 0.02%. Based on the International Classification of Diseases, 10th Revision, diagnostic codes, the types of pneumonia according to cause were viral pneumonia (29.0%), bacterial pneumonia (5.3%), Mycoplasmal pneumonia (4.5%), aspiration pneumonia (1.3%), and pneumonia of unknown origin (59.3%). Conclusion: Despite the limited data due to the ED data from the NEDIS lacking laboratory results and treatment information, this study reflects well the outbreak patterns among children and adolescents with pneumonia. Our results provide a basis for future studies regarding ED treatment for children and adolescents with pneumonia.

Multiparous Women's Experience of Labor Pain : Pheminological Method (경산모의 분만통증 경험에 관한 연구)

  • Yeo, Jung-Hee
    • Women's Health Nursing
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    • v.5 no.3
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    • pp.277-286
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    • 1999
  • Pain is a complex perceptual experience that is profoundly influenced by a number of variables, differing in quality as well as in intensity. Therefore we need to understand the actual experience of multiparous women in order to provide basic information for nursing care. The purpose of the study is to explore the experience of labor pain. The data are collected through in-depth interviews of 17 multiparous women in city of Pusan from October 1998 to March 1999. The interviews were conducted 1-2 days after delivery in the admission room. Each interview lasted about 45 minutes on average. Subjects were interviewed one at a time. The interviews were recorded with the consent of the subject. Data were analyzed by means of Giorgi's Phenomenological analysis methods and categorized according to the similarities of its contents. The investigator read the data repeatedly to identify themes and categories. Six categories that were identified were : 1) pain 2) regret 3) acceptance 4) maturity 5) accomplishment 6) newness. Under these categories there were seventeen themes. I. Pain: 1) too dependent on others 2) too painful 3) fear or anxiety from previous painful experience 4) avoidance of pain 5) couldn't control the pain II. Regret : 1) spouse's absence 2) unprofessional attitude of the staff 3) ignorance of other's towards their pain III. Acceptance : 1) took the pain for granted 2) accepted the pain as fate 3) endured the pain IV. Maturity : 1) appreciated the value of life 2) apprehension of parent V. Accomplishment : 1)is over sense of accomplishment 2) grateful the pain VI. Newness : 1) experienced a new feeling 2) quickly forgot the pain. The results of the study will provide basic data for labor pain management.

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Higher dextrose delivety via TPN related to the development of hyperglycemia in non-diabetic critically ill patients

  • Lee, Ho-Sun;Koh, Shin-Ok;Park, Moo-Suk
    • Nutrition Research and Practice
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    • v.5 no.5
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    • pp.450-454
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    • 2011
  • The beneficial effects of total parenteral nutrition (TPN) in improving the nutritional status of malnourished patients during hospital stays have been well established. However, recent randomized trials and meta-analyses have reported an increased rate of TPN-associated complications and mortality in critically ill patients. The increased risk of complications during TPN therapy has been linked to the development of hyperglycemia, especially during the first few days of TPN therapy. This retrospective study was conducted to determine whether the amount of dextrose from TPN in the 1st week in the intensive care unit (ICU) was related to the development of hyperglycemia and the clinical outcome. We included 88 non-diabetic critically ill patients who stayed in the medical ICU for more than two days. The subjects were 65 ${\pm}$ 16 years old, and the mean APACHE (Acute Physiology and Chronic Health Evaluation) II score upon admission was 20.9${\pm}$7.1. The subjects received 2.3${\pm}$1.4 g/kg/day of dextrose intravenously. We divided the subjects into two groups according to the mean blood glucose (BG) level during the 1st week of ICU stay: <140 mg/dl vs ${\geq}$ 140 mg/dl. Baseline BG and the amount of dextrose delivered via TPN were significantly higher in the hyperglycemia group than those in the normoglycemia group. Mortality was higher in the hyperglycemia group than in the normoglycemia group (42.4% vs 12.8%, P=0.008). The amount of dextrose from TPN was the only significant variable in the multiple linear regression analysis, which included age, APACHE II score, baseline blood glucose concentration and dextrose delivery via TPN as independent variables. We concluded that the amount of dextrose delivered via TPN might be associated with the development of hyperglycemia in critically ill patients without a history of diabetes mellitus. The amount of dextrose in TPN should be decided and adapted carefully to maintain blood glucose within the target range.

Intracranial Hemorrhage Developed from Patient Who Had Been Preeclampsia at Five Days Postpartum - A Case Report - (전자간이 있던 산모에서 분만 5일후 발생한 뇌실질내 출혈 - 증례보고 -)

  • Lee, Chang-Woo;Kim, Yong-Seog;Park, Moon-Sun;Ha, Ho-Guyn;Lee, Jong-Sun;Jung, Ho;Kim, Joo-Seung
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.371-375
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    • 2001
  • Intracranial hemorrhage due to preeclampsia in the postpartum woman is rarely documented. Generally, the incidence of stroke is increased during pregnancy and early postpartum. Preeclampsia is considered a main cause of both nonhemorrhagic and hemorrhagic stroke. We present a 32-year-old woman who had intracranial hemorrhage at 5 days postpartum. At admission, her consciousness was semicomatose with elevated blood pressure. Computerized tomography revealed intracranial hemorrhage on right frontal lobe. Additional angiography did not reveal abnormal vascular lesion. Emergency craniectomy with hematoma removal was done. However, the patient showed no recovery and died 2 weeks later. We conclude that postpartum care of preeclampsia is important to prevent intraparenchymal hemorrhage. Relative high risk of stroke during the postpartum period suggests a causal roles for the large decrease in blood volume or the rapid changes in hormonal status that follow a live birth or stillbirth, perhaps by means of hemodynamics, coagulative, or vessel wall changes.

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Evaluation of Clinical Usefulness of Critical Patient Severity Classification System(CPSCS) and Glasgow coma scale(GCS) for Neurological Patients in Intensive care units(ICU) (신경계 중환자에게 적용한 중환자 중증도 분류도구와 Glasgow coma scale의 임상적 유용성 평가)

  • Kim, Hee-Jeong;Kim, Jee-Hee
    • Proceedings of the KAIS Fall Conference
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    • 2012.05a
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    • pp.22-24
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    • 2012
  • The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$, .734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$, .612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

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Convergence effects of husband's help on self-efficacy and postpartum depression in mother (남편의 도움이 산모의 자기효능감과 산후우울에 미치는 융합적 영향)

  • Jung, In-Sook
    • Journal of Convergence for Information Technology
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    • v.8 no.1
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    • pp.69-77
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    • 2018
  • This study is to find the convergence effect of a husband's help on self-efficacy and postpartum depression in mother. Each husband did mother and baby care until postpartum 6th week after completing three sessions of education. The data was collected in the 1st and 6th week postpartum, and analyzed using SPSS 20.0. Husbands's practice rate was 80%. Factors affecting to mothers' self-efficacy were parity, antepartum admission and husband's job, and to their postpartum depression were mothers' education, monthly income and antepartum depression. Prevalence of postpartum depression in the 1st and 6th week were 33.3% and 1.7% each. There were significant differences in increasing self-efficacy and in decreasing postpartum depression(p<.001), and there was a negative correlation between two variables(r=-.62, p=.01). Husbands' help brought convergence effects on increasing mothers' self-efficacy and decreasing postpartum depression(p<.001). This results could be used in developing intervention programs in managing mothers' self-efficacy and postpartum depression after repeated studies with wider range of subjects.

A Comparative Analysis of Elderly Intoxication Patient between Urban and Rural Area for the Safety Management and Emergency Care (농촌과 도시지역 노인약물중독환자의 응급처치와 약물중독안전관리에 대한 연구)

  • Rhim, Jae-Dong;Cho, Byung-Jun;Seoung, Youl-Hun;Kim, Seon-Rye
    • Journal of the Korea Safety Management & Science
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    • v.12 no.1
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    • pp.19-25
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    • 2010
  • To investigate acute drug intoxication trends in the elderly visited Emergency Medical Centers, Data was collected from the records of poisoning patients visited Five different Hospitals from January 1. 2007 to December 31. 2007. The analysis was conducted by using 135 cases of 624 cases. When considering only the elderly and making comparisons between the urban areas and the rural areas the following data was produced. In regard to patients with acute drug intoxication, the main substance of choice was pesticides. Cases of acute drug intoxication are definitely higher for those categorized as the rural elderly (75.0%) when compared with those categorized as the urban elderly (44.1%). The male to female ratio, those living together as a family, past suicide attempts, mental state and sobriety condition when they came, monthly distribution etc. between the two groups did not demonstrate a difference between them. In regard to reasons given for acute drug intoxication, suicide was the highest at 60.7% of the cases. When comparing accidental reasons for poisoning, the urban elderly, at 34.2% of their cases, were higher than in the rural elderly, at 23.7%. After first aid was administered, the admission rate was higher for the rural elderly (47.4%) than for the urban elderly (33.9%). This shows that the rural elderly have a more severe acute drug intoxication poisoning problem than the urban elderly do.

A Case Study on a Patient with Non-alcoholic Fatty Liver Disease(NAFLD) Improved on Sonography by Oriental Obesity Therapy (한방비만치료 후 초음파 영상에서 비알코올성 지방간의 호전을 보인 환자 치험 1례)

  • Park, Kyoung-Sun;Hwang, Deok-Sang;Cho, Jung-Hoon;Lee, Chang-Hoon;Lee, Kyung-Sub
    • Journal of Korean Medicine for Obesity Research
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    • v.9 no.1
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    • pp.79-86
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    • 2009
  • Objectives The purpose of this study was to investigate the clinical effect of oriental obesity therapy on obese patient with non-alcoholic fatty liver disease(NAFLD). Methods The patient was treated from November 17, 2008 to May 15, 2009 for obesity treatment. And the patient had intensive care through admission treatment from November 17, 2008 to November 29, 2008. Electrolipolysis, auricular acupuncture, herbal medicine, low calorie diet and aerobic exercise were done during the treatment period. Results His body Weight decreased from 102.8kg to 82.7kg. The BMI decreased from 35.2kg/m$^2$ to 28.9kg/m$^2$. NAFLD effectively improved on sonography form grade II${\sim}$III to grade I${\sim}$II after oriental obesity therapy, AST decreased from 65 to 19. ALT decreased from 152 to 18. Oriental obesity therapy could be effective to treat obese patient with NAFLD. Conclusions The obese patient with NAFLD improved on sonography by oriental obesity therapy.

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A Case Study on A Non-alcoholic fatty liver disease(NAFLD) Patient Improved by The Oriental Obesity Therapy Program (한방 비만 치료 후 간기능 개선을 보인 비알코올성 지방간 환자 1례 보고)

  • Heo, Ja-Kyung;Hwang, Deok-Sang;Lee, Chang-Hoon;Lee, Kyung-Sub
    • Journal of Korean Medicine for Obesity Research
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    • v.7 no.2
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    • pp.85-94
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    • 2007
  • Objectives The purpose of this study was to investigate the clinical effect of oriental medical obesity therapy on obese patient with non-alcoholic fatty liver disease. We supposed to treat patient 21 years old that had non-alcoholic fatty liver with oriental medical obesity therapy. Methods The patient was treated from the 19th of July to the 22th of August for obesity treatment. And the patient had intensive care through admission treatment from the 19th of July to the 30th of July. Herbal medicine, low calorie and low cholesterol diet, electrolipolysis, auricular acupuncture, aerobic exercise was done during the treatment period. Results His body weight decreased from 107.10㎏ to 98.85㎏. The BMI decreased from 36.2㎏/$m^2$ to 34.5㎏/$m^2$. Abdominal visceral fat tissue decreased from 190.80$cm^2$ to 145.05$cm^2$. AST was decreased from 113 to 45. ALT was decreased from 145 to 40. r-GT was decreased from 123 to 51. Oriental obesity therapy could be effective to treat obese patient with non-alcoholic fatty liver disease. Conclusions The obese patient with non-alcoholic fatty liver disease had improved liver function after oriental obesity treatment.

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A Study of Anxiety of Families of Psychiatric Patients at Discharge (정신과 환자 퇴원시 가족들이 느끼는 불안에 관한 연구)

  • 김기숙
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.31-42
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    • 1977
  • This study investigated the anxiety of families of psychiatric patients at discharge. The purpose was to contribute to the improvement of psychiatric nursing care, rehabilitation and social adjustment of psychiatric patients and community mental health. The objectives of this study were to identify the acceptance of the psychiatric nurse by the families, their anxiety at the time of discharge, whether any help was wanted to reduce anxiety, the attitude toward the patient after discharge and feelings about the patients. The population studied consisted of 180 family members of patients from 10 mental hospitals (including local clinic) in Seoul and Kyung- Ki province, from March I to April 30, 1977. The date were collected by an interview schedule, and compared and analysed by Computer usings х$^2$- test. Results were as follows : 1. Many of the families(83.6%) expressed a acceptance of psychiatric nurse. 2. A little more than half of the families(51.1%) expressed happiness but a largo portion (38.9%) had "anxious" feelings at discharge. 3. Almost all families(92.6%) wanted a physician′s help to reduce discharge anxiety. Younger families tended to want the physician′s help more. 4. Many of the families(83.1%) wanted a nurse′s help. Families of parents patients admitted for the 1 st time wanted the nurse′s help more. 5. Comparing the feelings at a previous discharge with the present discharge, 49.1% of the family expressed greater happiness at tile latter than the former. 6. More than half the families responded positively toward the patient. Unmarried family members responded more positively than married Families of 1 st admission patients responded more positively than families of readmission patients. 7. Many families(78.8%)had positively feelings toward the patients. More negative responses came from women than from men, from lower education levels, lower incomes and readmission patients.

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