• Title/Summary/Keyword: Admission Care

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A Study on the perception Level of Nursing Students in the First Clinical practice (첫 임상 실습에 대한 간호학생의 인지 정도에 관한 연구)

  • Park Chung-Ja;Lee Kyung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.1 no.2
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    • pp.149-164
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    • 1994
  • This stidy was carried out for purpose of investigating the degree of perception in the First clinical practice. The data of this study were collected by self-reported questionnaire composed of 5point rating scale measure the ideal level, satisfaction level and Stress level. For the analysis of the data, percentage, MANOVA, ANOVA and Scheffe test were 216 nursing students in 1 Junior College and 2 university in Taegu. Data was administrated from October 4 through 13, 1994 The results were as follow : 1. The average mean Score for the ideal level was 3.91 with a maximum possible score 5points. The highest mean score was infection controll 4.40 and the lowest mean score was comfort measure 3.44. The average mean score for the satisfaction level was 3.33 with a maximum possible score 5points. The highest mean score was Medication 3.54 and the lowest mean score was communication 3.01. The average mean score for stress level was 3.10 with a maximum possible score 5points. The highest mean score was spiritual and psychological care 3.45, the lowest mean score was Temperature controll 2.51. 2. In the analysis of the relationship between the ideal level, Satisfaction level and Stress level, no significant differance was found in college and university, religion, admission, satisfaction, health, economy, parent 3. In the analysis of the relationship between the ideal level, satisfaction level, stress level and general characteristics, significant difference was found in economicststus in the ideal level. Significant difference was found in economic status(upper class, middle class)in Scheffe test of the ideal level.

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Analysis of the Characteristics and the Nursing Interventions for Children in Regional Emergency Departments -Using the Nursing Intervention Classification- (지역 응급의료기관의 아동 간호중재 분석 -4차 개정 Nursing Intervention Classification을 적용하여-)

  • Kim, Young-Hae;Lee, Nae-Young;Ha, Jae-Hyun
    • Child Health Nursing Research
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    • v.16 no.4
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    • pp.277-286
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    • 2010
  • Purpose: The purpose of this study was to provide descriptive data about the characteristics of pediatric patients and nursing interventions in Regional Emergency Medical Centers (REMC). Methods: A retrospective design was used to examine the medical records of 4,310 children. The clinical data and nursing terminologies of REMC were analyzed using the Nursing Intervention Classification (NIC). Results: Male toddlers dominated the sample. The mean age of the children was 3.51 yr. In more than half of the visits, patients arrived between from 7 a.m. to 3 p.m., on a weekday. There were only 189 ambulance transports to REMC, (4.4% of visits). The most frequent injuries were due to falls (28.0%) and contusions (27.3%), but the most common reasons for visits were non-injury (73.4%): fever, cough/shortness of breath, seizures, and abdominal pain. Of the 4,310 visits, 27.8% spent 6-24 hours in the REMC, while 33% resulted in hospital admission and 2.1% in transfer to another hospital. Of the 17,929 nursing interventions, 17,909 elements (99.9%) were classified under NIC. All the listed NIC interventions, however, were not reflected in the level of practice demonstrated by REMC nurses. Conclusion: These results can enhance the understanding of pediatric emergency nursing interventions and can make NIC more applicable.

A Case of the Localized Tension Pneumothorax Mimicking Giant Bullae (거대 폐기포 (giant bulla)로 오진된 국소형 긴장성 자발 기흉)

  • Ko, Hyuk;Park, Sung-Ho;Kim, Su-Hee;Park, Wan;Park, Chong-Bin;Kim, Jong-Wook;Ryu, Dae-Sik;Jung, Bock-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.740-746
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    • 2001
  • Background : A 35-year-old woman was admitted to the emergency room with sudden dyspnea that developed one day prior. The initial Chest X-ray showed multiple bullous changes at the right middle and lower lung field and long standing fibrotic tuberculous changes at the right upper lung field. The left lung field was totally collapsed by an fibrotic old tuberculous lesion. In spite of supportive medical care with oxygen therapy after admission, the radiographic lesions were no significant change but the respiratory distress had worsened. The patient suffered respiratory failure and received mechanical ventilatory support. The HRCT showed a localized tension pneumothorax mimicking multiple giant bullae at the right lower lung field. Immediately after a closed thoracostomy with a 32 French chest tube and air drainage, her vital signs and dyspnea were gradually improved. The patient was successfully weaned from mechanical ventilation after 5 days of mechanical ventilatory support. The patient had received talc pleurodesis through a chest tube to prevent the recurrence of the life-threatening localized pneumothorax. The patient was discharged without recurrence of the pneumothorax.

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Korean Medicine approach to traffic accident victims (교통사고 후유증관리에 관한 한의학적 임상 고찰)

  • Shin, Young-seung;Park, Jong-bae;Kim, Chong-hoon;Choi, Jung-lim;Kim, Dok-ho
    • Journal of Acupuncture Research
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    • v.19 no.6
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    • pp.1-11
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    • 2002
  • Objective : Korean medicine treatment method is noted as alternative in treating traffic accidents(TA) victims recently. The main purpose of this research is to make a survey of the effective way of the Korean medicine treatment about TA victims. Methods : In following research, 389 cases of traffic victims who hospitalized in the Youngsaeng Korean Medicine Hospital & Youngsaeng Clinic from March 1, 2001 to November 30, 2001 were surveyed. The research is focused on finding out the distribution, such as sex and age, damaged part of the body of 389 TA victims, nature of damage of 389 TA victims, chief complaint of 389 TA victims, nature of damage by Korean medicine code classification, treatment given to 389 TA victims, Extract(Ex) medicine given to 389 TA victims, days in hospital of 389 TA victims. Results : The patients reached korean medicine hospital in fewer numbers from most of TA victims. As neck pain and L-spin sprain, most of symptoms was light and the treatment of medicine as well was limited for TA. The treatment method which was used for treating TA was acupuncture, cupping therapy, physical therapy, Ex medicine. Few ways could use the Ex medicine as well. Conclusions : The achieving rate of treatment was marked highly by using Haenggi(行氣) Hwalhyeol(活血) Guyea(祛瘀) and we confirmed a possibility for the treatment of TA in korean medicine treatment method. It needs to increase all kinds of treatment-ways which can treat successfully and needs to come into application of insurance. Korean medicine method will have possibility to take part in TA injury admission, by presenting basis to prove effectiveness of treatment-ways.

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Evaluation of Clinical Usefulness of Instant Nutritional Assessment Scale for the Nutritional Status and Prognosis of Hemodialysis Patients (만성질환자의 영양상태와 예후판정에 대한 간이영양평가 도구의 유용성 평가 -혈액투석환자를 중심으로-)

  • Sohng Kyeong-Yae;Kim Myung-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.337-349
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    • 1997
  • The prognosis of maintenance hemodialysis (HD) patients is closely related to their nutritional status. It is important to develop and use of a reliable, useful and easy method of nutritional assessment scale for evaluation of nutritional status and progression of the patients. This study was initiated to evaluate the clinical usefulness of Instant Nutritional Assessment Scale(INAS) by cross-sectional and longitudinal studies. One hundred HD patients entered a continuing nutritional study and followed for 1 year. The results were as follow ; 1. 24% of patients was normal to mild, 43% was moderate and 33% was severe deficit of nutritional status. 2. The mean INAS score of the patients was 8.00(S. D.=2.83), and there didn't reveal any differences in INAS score by general characteristics. The mean transferrin score was 1.98, whih was the highest of 5 nutirtional parameters of INAS. Only 7 patients had within nomal range of transferrin concentration. 3. Within one year since this study was initiated, 10 patients died. Six of them were with severe deficit and one of them was normal to mild deficit groups. The death rate in severe deficit group was higher than that of normal to mild deficit group (P=.0640). 4. Occurrence of acute complication during HD in severe deficit guoup was higher than that of normal to mild deficit group(P=.001). 5. The number of consultation to the doctor and hospital admission in severe deficit group was higher than that of normal to mild deficit group(P=.0001). 6. INAS score was significantly correlated with occurrence of acute complications during HD and the number of consultation to the doctor. In conclusion, INAS based on the levels of body mass index, midarm circumference, triceps skinfold thickness, transferrin concentration and total lymphocyte count seems to be a reliable predictive nutritional index for prognosis. So nurses are encouraged to adopt INAS in care of the chronically illed patients. Recommendations for further research was suggested.

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The Influence of the Risk Factors and Nutritional Status on the Development of Pressure Sores for the Risk Patients in ICU (욕창발생위험요인과 영양상태가 중환자실 입원환자의 욕창발생에 미치는 영향 - 욕창발생위험집단을 중심으로 -)

  • Yang Young-Hee;Kim Won-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.5 no.2
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    • pp.280-292
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    • 1998
  • Pressure sores are a serious concerns in that respect to increasing risk of medical complications and medical costs. Prevention and care of pressure sores is an essential area of nursing practice. The nurse at ICU should be more careful of maintaining the skin integrity of patients especially than at any other place. This study was conducted to determine if the risk facotrs of pressure sores and nutritional status of the patients at risk for pressure sores is related the occurance of pressure sore. The risk group refers the patients having the below 14 scores of the braden scale. The 100 subjects were recruited from the ICU ward at an university hospital in Choongnam. The parameters for nutritional status are the blood chemistry including plasma protein, albumin, hemoglobin and the anthropometric measurements consisting of weight, BMI, LBM, the proportion of body fat, body fluid and triceps skin fold using bioimpedence analizer and caliper. The results are as follows : 1. The subjects were 55 years and stayed 8 days on average. Of the 100 subjects, males were 61%, neurologic/neurosurgical diseases were 68% and the incidence of pressure sores was 17% mainly occuring within 3days after the admission. 2. The present paralysis(or paraplegia) and edema(arm, leg, trunk) were showed more significantly the subjects with pressure sores than those without pressure sores. 3. Regarding with the nutritional status, the subjects with pressure sores had significantly lower the weight, BMI, LBM, body fluid, albumin than the ones without pressure sores. This results were supported the reports of previous studies that the decreased weight and albumin could be the important predictors of pressure sores. Thereafter we should encourage these factors to be utilized in predicting pressure sores for a comprehensive assessment. Nurse should identify patients at risk of the development of pressure sores, assess their nutritional status and dietary intake at regular intervals.

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The Effectiveness of Korean Medical Rehabilitation Treatment after Musculoskeletal Surgery: A Retrospective Observational Study (근골격계 수술 후 한방재활치료의 효과: 후향적 관찰연구)

  • Woo, Hyeon-Jun;Geum, Ji-Hye;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.3
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    • pp.151-162
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    • 2020
  • Objectives This study aimed to evaluate the effectiveness of postoperative Korean rehabilitation treatment for patients with musculoskeletal disorders. Methods The medical records of patients undergoing Korean medical rehabilitation after a musculoskeletal surgery, from January 1, 2016, to December 31, 2019, were analyzed retrospectively. The effect of treatment was evaluated by using a numeric rating scale (NRS) and questionnaire for each surgical site. When the same patient was re-admitted after discharge, it was treated as the same case if it was within 7 days from the discharge date; otherwise, it was treated separately. If the period of hospitalization was within 7 days or the chief complaint was not related to musculoskeletal surgeries, the case was excluded. Results In total, 480 cases were included in this study. Acupuncture (99.8%), moxibustion (95.6%), cupping (97.5%), Chuna manual therapy (81.5%), Korean medical physiotherapy (61.0%), Daoyin exercise therapy (26.3%), and herbal medicine (87.7%) were used as the Korean medical rehabilitation treatments. A significant improvement was noted when comparing the NRS and questionnaire results for each surgical site at the time of admission and discharge. Conclusions Korean medical rehabilitation can be effectively used for patients who have undergone musculoskeletal surgeries, to relieve pain and enable returning to daily activities. However, further research with a high level of evidence is necessary to support this finding.

Multimorbidity and Its Impact on Workers: A Review of Longitudinal Studies

  • Cabral, Giorgione G.;de Souza, Ana C. Dantas;Barbosa, Isabelle R.;Jerez-Roig, Javier;Souza, Dyego L.B.
    • Safety and Health at Work
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    • v.10 no.4
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    • pp.393-399
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    • 2019
  • Objective: This study investigates the impact of multimorbidity on work through a literature review of longitudinal studies. Methods: A systematic review was carried out in the databases Lilacs, SciELO, PAHO, PubMed/Medline, Scopus, Web of Science, and Cochrane. There were no restrictions regarding the year of publication or language to maximize the identification of relevant literature. The quality of studies was assessed by the protocol STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). Results: An initial database search identified 7522 registries, and at the end of the analysis, 7 manuscripts were included in the review. Several studies have demonstrated direct and indirect impacts of multimorbidity on the health of workers. For this, the number of missed days due to health-related issues was evaluated, as well as the reduction in work productivity of the unhealthy worker, vulnerability of the worker with multimorbidity regarding higher indices of dismissal and recruitment difficulties, and incidence of early retirement and/or receipt of benefits due to disabilities. Conclusions: Multimorbidity has a negative impact on work, with damages to quality of life and work productivity, worsening the absenteeism/presenteeism indices, enhancing the chances of temporary or permanent leaves, and lowering employability and admission of individuals with multimorbidity.

Trends Analysis of Suicidal Poisoning in Korea- Comparison before and after the IMF Crisis and the Economic Recession (IMF와 경기침체 전후 음독자살 환자에 대한 분석 -1997년부터 2004년까지 일개 대학병원 응급센터 연구조사를 중심으로-)

  • Lee Won Jae;Park Kyu Nam;Choi Seung Pil;Lee Mi Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.33-39
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    • 2005
  • Purpose: Nowadays the Korean society is in the center of time of the social change. Because of dissociation of traditional family, IMF (International Monetary Fund) crisis and economic recession, the mortality rate of suicidal attempts are increasing annually. The majority of suicidal attempts were by poisoning considering the characteristics of korean society. Therefore we studied to find out the characteristics of suicidal poisoning before and after social economic stress, and to suggest the direction for the proper management. Methods: We reviewed medical records of 547 patients of suicide by poisoning who visited the emergency medical centers of St. Mary's hospitals from 1997 to 2004. For the annual trends analysis, we analyzed the demographic and toxicologic data of these patients compared with before and after IMF crisis (1998) and the economic recession ($2003\~2004$). Results: At the time of IMF and the economic recession, the number of suicidal poisoning increased, especially in fifth decade. The refusal rate of toxicological emergency treatment increased. Also the mortality rate and the admission rate to ICU (Intensive Care Unit) increased during the same period. In the result of the comparison analysis, clinical severity and mortality of social problem group were higher. However they couldn't be treated appropriately because of financial problem and the family indifference. Conclusion: At the economic recession period, the severity of suicidal poisoned patients was high. But the refusal rate of toxicologic treatment also increased, so the patients had lost the chance for proper toxicologic treatment. Therefore they would be supported by medical institution and public health.

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Mortality Reduction in Major Trauma Patients after Establishment of a Level I Trauma Center in Korea: A Single-Center Experience

  • Roh, Young Il;Kim, Hyung Il;Cha, Yong Sung;Cha, Kyoung-Chul;Kim, Hyun;Lee, Kang Hyun;Hwang, Sung Oh;Kim, Oh Hyun
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.131-139
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    • 2017
  • Purpose: Trauma systems have been shown to decrease injury-related mortality. The present study aimed to compare the mortality rates of patients with major trauma (injury severity score >15) treated before and after the establishment of a level I trauma center. Methods: During this 20-month study, participants were divided into pre-trauma center and trauma center groups, and trauma and injury severity score (TRISS) method was used to compare mortality rates during 10-month periods before and after the establishment of the trauma center (October 2013 to July 2014 vs. October 2014 to July 2015). Results: Of the 541 total participants, 278 (51.5%) visited after the establishment of the trauma center. The Z and W statistics indicated better outcomes in the trauma center group than in the pre-trauma center group (Z statistic, 2.635 vs. -0.700; W statistic, 4.640). The trauma center group also exhibited meaningful reductions in the time interval from the emergency department (ED) visit to emergency surgery (118.0 minutes vs. 142.5 minutes, p=0.020) and the interval from the ED visit to intensive care unit admission (202.0 minutes vs. 259.0 minutes, p=0.035) relative to the pre-trauma center group. Conclusions: The TRISS and multivariate analysis revealed significant improvements in survival rates in the trauma center group, compared to the pre-trauma center group.