A multi-cavity injection mold system of protein chip for point-of-care with cavity temperature and pressure sensors was proposed in this work. In advance of manufacturing for the multi-cavity injection mold system, a single cavity injection mold system to mold protein chip was considered. Injection molding analysis for the presented system was performed to optimize the process of the molding and suggest guides to design. On the basis of the results for the single cavity system, a multi-cavity injection mold system for protein chip was analyzed, designed and manufactured with cavity temperature and pressure sensors. Results of balanced filling for protein chip models were obtained from the presented mold system.
Purpose: This paper reviews current diagnostic evaluation, treatment, nursing considerations, and the nurse practitioner’s (NP) role in acute ischemic stroke care. Methods: National guidelines and extensive literature on acute stroke care were reviewed and a relevant clinical case was introduced. Results: Computerized tomography (CT) of the head without contrast is the initial brain imaging procedure for patients with an acute stroke. Magnetic resonance imaging (MRI) can be an alternative test. Restoration of cerebral perfusion to the affected area is a key therapeutic strategy for ischemic stroke. A number of treatment strategies such as thrombolysis, anticoagulation, antiplatelet, and surgical treatment can be selected to improve blood flow to the ischemic region. The NP on the stroke team is involved with immediate stroke management including neurological assessment, ensuring adequate oxygenation, blood pressure management, activity, and diet. Discharge planning with the patient, family teaching and coordination of follow up care should also be implemented early in the hospitalization. Conclusion: The nurse practitioner is one of the cardinal members on the stroke team, and must be updated with current treatment and management guidelines.
Background: Emphasis in healthcare during the 1990s has been to provide both optimal wellness and function with quality in a Cost-effective manner. Critical pathway was developed to meet the need to guide clients along the continunm of care and to achieve continuity of care. The purpose of this study is to review and analyze articles related to the critical pathway that had developed and applied in Korea and abroad from 1995 to 1999. Methods: Total 39 studies were analyzed in terms of group of application, need of development, horizontal axis: time frame, vertical axis : items of care, task force team, identification of preliminary critical pathway, validation of preliminary critical pathway, types of final critical pathway, a person who coordinates and effects on critical pathway. Results: In the aspect of group of application, there were various diseases in the overseas than in Korea. In domestic and overseas, the horizontal axis included mainly the time from the start of hospitalization to discharge and vertical axis of the critical pathway included commonly the following nine items : tests, diet, medications, consultations, activity, assessments, treatments, education, discharge planning. Preliminary critical pathway was mainly drawn up through chart review in both. Types of final critical pathway were mostly for medical team use in Korea and were for medical team and patient use in abroad. A person who coordinates critical pathway was mostly nurse in abroad. There was positive effects on critical pathway in both. Conclusion: Staff education and information about critical pathway are needed to use it effectively.
Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.
본 연구는 3차병원에서 퇴원하는 환자의 상처관리에 대한 지식과 염려사항을 파악하기 위해 112명의 피부상처를 지니고 퇴원을 앞둔 112명 환자에게 구조화된 설문지로 면담을 통해 조사하였다. 상처의 유형은 외과적 절개(52.7%), 삽관상처(26.8%), 욕창(9.8%), 당뇨발과 동맥궤양(5.4%) 등이었다. 상처관리에 관한 지식은 52.0%의 정답률을 보였고, 상처관리에 대한 염려(범위1-7)는 2.79였고, 상처관리에 대한 지식과 염려는 상관관계가 유의하지 않았다. 퇴원후 상처관리에 관한 염려에 영향을 미치는 요인으로 유의한 변수는 상처관리에 대한 두려움, 상처통증, 입원기간, 및 주관적 건강인식으로 나타났다. 상처를 지니고 퇴원하는 환자들의 상처관리에 대한 지식은 부정확한 것이 많으며 다양한 염려사항들을 가지고 있으므로 퇴원계획시 이에 대한 구체적인 교육이 필요할 것이다.
This paper aims to share the course, performance and implications of Project-Based Learning (PBL) education in healthcare data science (HDS). The HDS team of the business group of Soonchunhyang University, which was selected for the health care field of 'University Innovation Project', considered that the health care IT-based education of the current university differs greatly from the rapidly changing health care 3.0 environment of the fourth industry, and emphasized the PBL practice-oriented specialization program as a learning model. The PBL focused on self-directed learning experiences, real analysis problems, and team-oriented classes. In other words, it was implemented with three specialized strategies: 'Field Inside Education', 'Fusion-type Track Education', and 'Training to strengthen resilience and change response'. This collaborative, practical learning experience, etc. resulted in significant results. The results were recognized as being rated A by the Korea Research Foundation and the comprehensive evaluation, and the results were significantly elevated through the analysis of the student survey and the results index.
The coverage of the National Health Insurance for the elderly is expanding to denture and implants. Although the National Long-Term Care Insurance was just being settled, Oral health service was not provided to the Elderly in Long-Term Care Facilities. The long-term care facilities had part-time facility doctors. However, there is no dentist in the long-term care facility because of lack of long-term care insurance-related legislations. The amendments of long-term care insurance-related legislations for the introduction of part-time facility dentists are needed because the elderly in long-term care facility are vulnerable to oral health. For the substantial management of the National Long-Term Care Insurance, the development of oral health service model for the elderly and education materials for the dental team will be needed. Also, adequate dental service fee of the National longterm care insurance will be needed.
Background : Because unplanned readmissions to intensive care unit(ICU)might be related with undesirable patient outcomes, we investigated the pattern of and reason for unplanned ICU readmission to provide baseline data for reducing unplanned returns to ICU. Methods : The subjects included all patients who readmitted to ICU during the same hospitalization at a tertiary referral hospital between January 1st and June 30th 2002. Quality improvement(QI) nurse collected the data through medical records and a medical director reviewed the data collected. Results : 1) The average unplanned ICU readmission rate was 5.6%(gastroenterology 14.6%, pediatrics 12.7%, pulmonology 11.9%, neurosurgery 6.3%, general surgery 5.3%, chest surgery 3.9%, and cardiology 3.3%). 2) Among the unplanned readmissions, more than 50% of cases were from patients older than 60 years, and the main categories of diagnose at hospital admission were neurologic disease(29.9%) and cardiovascular disease(27.6%). 3) Of unplanned ICU readmissions, 41.8% had recurrence of the initial problems, 44.8% had occurrence of new problems. And 9.7% required post-operative care after unplanned operations. 4) The most common cause responsible for unplanned ICU readmission were respiratory problem(38.3%) and cardiovascular problem(14.3%). 5) About 40% of unplanned ICU readmission occurred within 3 days after ICU discharge. 6) Average length of stay of the readmitted patients to ICUs were much longer than that of non-readmitted patients. 7) Hospital mortality rate was much higher for unplanned ICU readmitted patients(23.6%) than for non-readmitted patients(1.5%) (P<0.001). Conclusions : This study showed that the unplanned ICU readmitted patients had poor outcomes(high morality and increased length of stay). In addition study results suggest that more attention should be paid to patients in ICU with poor respiratory function or elderly patients, and careful clinical decisions are required at discharged from ICU to general ward.
The general objective of this study is to grasp the treatment expenses of common diseases by character of medical care institutions. The specific objective is to find out the treatment expenses for selected common diseases by type of medical care institutions and also by level of symptom. A record review method was employed to obtain required information for the analysis of expenses. A total of 40,000 cases treated by 85 medical care institutions were selected by the study team during the period 22 June to 14 July 1988. The 85 medical care institutions were sampled by stratified proportionate random sampling method. The major findings obtained from the information collected by the study team are as follows ; 1) Treatment expenses were composed of physical examination, medication, injection anesthesia, rehabilitation surgical intervention, lab test, X-ray and diagnosis. The highest expenses was for medication, accounted for 36.7% of the total: 13.9%, injection; Lab, tests respectively: 10.5%, physical examination : 8.6% surgical intervention; 7.9% admission : 6.3%, X-ray and diagnosis: 1.5%, rehabilitation. 2) Treatment expenses per case of common diseases were quite different from not only type of medical care institutions, such as university hospital, general hospital, hospital and clinic, but also from level of symptom. 3) Treatment expenses per case for the aged were higher than that of the young. The treatment cases for over 60 years of age accounted for 19.4% of the total, however the proportion of treatment expenses accounted for 23.8% of the total. 4) Duration of treatment and visits for same diseases varied from type of medical cara institutions. Based on these study findings, the following further research should be conducted: (1) Establishment of health care delivery system. (2) Feasibility of the development of health care programme for the aged. (3) Strengthening for primary health care approach.
This study was designed to investigate the family burden, family home care needs and to identify the relationship between family burden and home care needs for families of psychiatric in-patients. The subjects for this study were 104 family members of psychiatric in-patients at two private hospitals and one municipal hospital. The data were collected during the period from February 1. 1993 to March 30. 1993. The questionnaire developed by Montgomery to measure the family burden was used as modified by the research team for this study. The questionnaire was developed by Garrad to measure the home care need was also used as modifed by the research team. The data was analyzed using descriptive statistics, t-test, ANOV A and Pearson Correlation Coeffcient. with the SPSS program. The Result of this study can be summarized as follows ; 1. For perceived family burden, the meanscore as measured by the guestionnaire was 70.6 of a possible to total of 110. 2. For home care need. the meanscore as measured by the questionnaire was 44.8 fo a possible total of 66. 3. The results showed a higher score for cases from the municipal hospital for family burden and a higher score for cases at the private hospitals for home care need. 4. Ther was a statistically significantly higher score on family burden for female family member (T =-2.77. P<.05) and for bereaved family members. (F=2.862. p<.05) 5. There was a statistically significantly higher score (F= 10.3535, P<.001) for family burden when the hospitalization period was between 7~ 12 months and a statistically significantly higher score (F =7.679.P<.001) for home care need when the hospitalization period was over 37 months. 6. Ther was a significant correlation between family burden and home care need. (r=.4002, P<.05) The conclusion that can be drawn from this study is that addressing home care needs would contribute to reduce family burden.
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