• Journal of Korean Academy of Nursing
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• v.11 no.1
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• pp.19-27
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• 1981

This Study was conducted at Intensive Care Unit of H & S Hospitals from Jan 4 to April 7, 1981 on 14mail & 26female adult patients. Each patient was screened and found to have nonbacteriuria in clean catch specimen before catheterization. Clean catch apecimen through Foley catheter were obtained after 24hours, 48hours and 72hours from catheterization. The result of this study is reviewed in a statistical analysis of percentage ＆ Chi Square test to obtain the following findings. 1) The occurenc of bacteriuria in patients according to duration of indwelling catheter. a. 9.1％ of the patient showed evidence of bacteriuria 24hours post catheterization specimen and 60％ showed 48hours post cathetreization, while 68.4％ of the patient showed evidence of bacteriuria 72hours post catheterization specimen. The occurence of bacteriuria in patients were significant differences at 1％ level between duration of indwelling catheter. b. Mail patients had no infection 24hours post catheterization, 50％ displayed bacteriuria 48hours post catheterization ＆ 62.5％ displayed bacteriuria 71hours post catheterization. 11.1％ of femail patients displayed infection 24hours post catheterization 66.7％ displayed infection 48hours post catheterization and 72.7％ displayed infection 72hours post catheterization. There were significant differences at 1％ level between bacteriuria occurence of mail ＆ femail patients and the duration of insertion. 2) 56％ of those patient who have altered mental state developed bacteriuria, while 40％ of those patient who have alear mental state developed bacteriuria. But there was without statistically any significant difference between patient's mental status. 3) The occurence of bacteriuria with the administration of antibiotics in 36 patient was in 50％. The occurence of bacteriuria without the administration of antibiotics in 4 patients was in 50％. But there was without statistically any significant difference between the administration of antibiotics. 4) The occurence of bacteriuria in patients according to frequency of bladder irrigation. 50％ of those patient who irrigated twice a day developed bacteriuria, 63.6％ of those patient who irrigated once a day developed bacteriuria. The occurence of bacteriuria in patients were significant differences at 1％ level between frequency of bladder irrigation. 5) The occurence of bacteriuria in patients who did perineal care once a day was 58.1％, 22.6％ of those patient who did perineal care twice a day developed bacteriuria. But there was without statistically any signiticant differences between frequency of perineal care. 6) Most frequent bacteria of all bacterial strains isolated by culture of the urine was E. coli(45％). Enterococci & Staphylococcus were 15％ respectively.

• Advances in pediatric surgery
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• v.14 no.1
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• pp.67-74
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• 2008

The usefulness of totally implantable central venous port for long-term intravenous infusion is widely accepted in children. Usually the catheters are placed through the internal or external jugular vein. In case of jugular vein cut-down, two separate incisions are needed for catheter and port respectively. Patients also feel uncomfortable as the catheter run through the neck. However these disadvantages can be overcome by using the cephalic vein (CV). We reviewed our experiences on CV cut-down for totally implantable central venous port in children. From January 2002 to December 2006, 201 patients (M:F=127:74) underwent 218 central venous port insertions. Mean age at operation was 5.9 years (2 months - 19 years). Indications included chemotherapy (N=167), long-term intravenous antibiotics infusion (N=36), and total parenteral nutrition (N=15). CV was selected preferentially. The incision includes the deltopectoral triangle laterally, and both the CV cut-down and port insertion were achieved with a single incision. The number of insertion through external, internal jugular vein, and CV was 77, 66 and 75, respectively. The median age, height and body weight were higher in CV cut-down group. The youngest age for CV cut-down was 8 months, the shortest height was 69 cm and the smallest body weight was 5.9 kg. Of 118 trials of CV cut-down, cut-down was successful in 75 cases (63.6 %). CV was absent in 10 cases(8.4 %) and CV was sacrificed after catheter tip malposition in 10 cases (8.4 %). There was only one complication, in which the catheter was inserted into the minute branch of subclavian artery. The CV cut-down method for totally implantable central venous port was safe and feasible in selected groups of patients in children. In addition, preservation of jugular vein and a more favorable cosmetic effect are other benefits of CV cut-down.

• Journal of Chest Surgery
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• v.46 no.3
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• pp.223-225
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• 2013

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.

• Journal of Korean Academy of Nursing
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• v.8 no.2
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• pp.79-88
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• 1978

Utilizing Foley catheter in therapy of inpatient cause bacteriuria and urinary tract infection that leads to first ranked factor's in hospital infection (nosocomial infection). To protect the patient from such infections, emphasis should be placed on catheterization technique and management of the closed drainage system, this reducing the chances of introducing organisms. This study has been done at Intensive Care Unit of A and B hospitals from May-Oct. 1978 on 20 male and 18 female adult patients. Each patient was screened and found to have nonbacteriuria in clean catch specimen before catheterization. Clean catch specimen via foley catheter were obtained after 48 hours and 96 hours from catheterization. The findings are as follows: A. The occurrence of bacteriuria in patients according to duration of indwelling catheter. 1 213.9% of the patient showed evidence of bacteriuria 48h post catheterization specimen, while 57.9% of the patient showed evidence of bacteriuria 96h post catheterization specimen. 2 25% of male patients had infection 48h post catheterization and 45% displayed bacteriuria post catheterization. 33％ of female patients displayed infection 48h post catheterization and 72.2% having infection 96h post catheterization. Statistically there were significant differences between female patients and the duration of insertion. (P < 0.025) B. The occurrence of bacteriuria with the administration of bacteriuria with the ad-ministration of antibiotic in 24 patients was in 41,7%. The occurrence of bacteriuria without the administration of antibiotic in 14 patients was in 92.3%. Statistically there were very significant difference between the administration of the antibiotis and bacteriuria. (P < 0.005) C. Studies were done according to the consciousness level of the patients, 71.4% of those patient who displayed mental disorder developed bacteriuria, while 30.0% of those patient who displayed non mental disorder developed bacteriuria.

• Advances in pediatric surgery
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• v.4 no.1
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• pp.1-15
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• 1998

To evaluate the effectiveness of central venous catheters(CVCs) in children, 320 CVCs placed in 255 neonate and children over a 10-year period were analyzed retrospectively. CVC was placed by one pediatric surgeon for a total of 6, 116 patients days. Catheters were placed preoperatively for TPN or chemo in 223 cases. CVC was solely for TPN in 57 cases and for chemotherapy in 40. Local anesthesia was utilized in 71 cases, and the general anesthesia was administered in the remainder of the patients. The subclavian vein was catheterized(SCV) in 202 cases(82 infants and neonates), tunneled external jugular venotomy(EJV) was utilized in 38, tunneled internal jugular venotomy(UV) in 2, the facial venotomy(FV) was used in 3, and the umbilical vein was catheterized UVC) with vein transposition in 74 infants. In neonates, 72 UVCs were placed during laparotomy. SCV was increased with ages, from 3 kg of minimal body weight. The average catheter-periods over-all were 19.1 days, SCV 17 days, EJV 40, IJV 60 and UVC 14. Technical complications were; arterial puncture(6), puncture failure(5) and abnormal location(12) in SCV; insertion failure(3) in EJV; abnormal location in the portal vein(4) and the liver parenchyma(2) cystic fluid accumulations in UVC. Twelve migrations(3.8 %) out of position occurred; SCV(2), EJV(1) and UVC(9). There were 4 cases(1.2 %) of catheter obstruction and 11(3.4 %) of catheter infection(3 SCV, 2 EJV and 6 UVC). Rescue procedures were utilized with some success. There was one mortality(0.3 %) due to deep sedation in a 1.06 kg baby during placement of an EJV. The surgeon's experience, proper catheter selection and following safety rules are the most important factors for successful CVCs.

• Journal of Korean Clinical Nursing Research
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• v.21 no.1
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• pp.31-42
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• 2015

Purpose: This study was done to develop evidence-based nursing practice guidelines to prevent complications related to indwelling urinary catheterization (IUC) in patients in Korea. Methods: A guideline adaptation process was conducted according to the guideline adaptation manual which consists of three main phases, and 9 modules with a total of 24 steps. Results: The newly developed IUC guideline consisted of an introduction, urinary catheterization, summary of recommendations, recommendations, references, and appendices. There were 110 recommendations in 8 sections including assessment, equipment, catheter insertion, catheter maintenance, catheter change, catheter removal, management of complications, and education/consultation. For the grade of recommendations, there were 6.4% for A, 22.7% for B, 67.3% for C. Conclusion: The IUC guideline was developed based on evidence and therefore it is recommended that this guideline be disseminated and utilized by nurses nationwide to improve the quality of care for patients with IUC and decrease complications related to IUC and that it be revised regularly.

• Journal of Korean Clinical Nursing Research
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• v.29 no.3
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• pp.211-222
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• 2023

Purpose: This study was conducted to update the existing evidence-based nursing clinical practice guideline for indwelling urinary catheterization (IUC). Methods: The guideline have been revised in 22 steps based on international standards. The quality of the practice guidelines to be used for revision was evaluated using the Appraisal of Guidelines for Research and Evaluation II. The evaluation of the content appropriateness and applicability of the draft recommendations of the revised practice guidelines was performed using the RAND/UCLA Appropriateness Method, a decision-making method developed by the RAND Corporation. Four guidelines were used for the revision. Results: The updated nursing practice guideline for IUC consisted of 9 domains and 134 recommendations. The numbers of recommendations in each domain were: 4 Assessment, 20 Equipment, 11 Catheter insertion, 52 Catheter maintenance, 4 Catheter and drainage bag change, 9 Catheter removal, 22 Complications management, 5 Education and consult, and 7 Hospital support. The recommended grade was 8.2% for A, 38.1% for B, and 53.7% for C. Among these, the major revision was done in 11 recommendations (8.2%). A total of 29 recommendations (21.6%) were newly added. 30 (22.4%) recommendations had minor revisions such as changes or addition for some words or sentences, and 13 (9.7%) recommendations were deleted. Conclusion: Revised nursing practice guideline is expected to serve as an evidence-based practice guideline for IUC in Korea. This guideline will provide health care providers, patients, and caregivers with information to help manage IUC, leading to improved patient outcomes.

• Childhood Kidney Diseases
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• v.11 no.1
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• pp.51-58
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• 2007

Purpose : To assess the early complication of laparoscopic peritoneal dialysis catheter implantation in children. Methods : Medical record review was carried out on 21 laparoscopic and 16 conventional peritoneal dialysis catheter implantations which were performed in 31 children under 18 years of age between 2002 and 2006. All medical records were retrospectively analyzed. The patients were followed until 2 months after catheter placement. Patient characteristics and catheterrelated complications, such as significant bleeding, leakage, obstruction, migration, insertion site infection and peritonitis during the first 60 days after implantation were recorded. Results : After conventional operation, dialysate leakage occurred in 2 of 16 cases and all cases improved after conservative management. In 1 case, significant bleeding occurred and re-operation was performed. Three cases of obstruction due to migration were reported, 2 cases underwent reoperation and 1 case improved without intervention. After laparoscopic surgery, outflow obstruction occurred in 1 out of 21 cases, which was caused by adhesion after several reinsertions of the catheter and recurrent peritonitis. No migration was noted after laparoscopic surgery. There was no significant difference in the complication rate between the two groups. Conclusion : Laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups, with at least equivalent functional results compared to conventional surgery. The additional advantage of laparoscopic catheter insertion is the option to identify and eliminate anatomical risk factors, such as intra-abdominal adhesions, and to perform partial omentectomy without additional incisions.

• Tuberculosis and Respiratory Diseases
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• v.67 no.1
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• pp.27-31
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• 2009

Background: The large caliber catheter used in the treatment of pneumothorax causes great damage to the chest wall and organs. The purpose of this study was to prove that the use of a smaller caliber catheter is effective in treating pneumothorax with decreasing admission period and that the recurrence rate of spontaneous pneumothorax is low. Methods: Patients who had been admitted for treatment of first time occurrence of pneumothorax between May, 2004 and December, 2008 were included in the study. The caliber of catheter used this study is 18 Guage (1.2mm). The efficacy of treatment, admission period and recurrence rate of treating pneumothorax with small caliber catheter were compared to the control group using a tube thoracostomy for treatment. Results: The admission period for primary spontaneous pneumothorax was 10.8$\pm$3.6 days for the group (n=68) using tube thoracostomy compared to 4.5$\pm$1.3 days for the group (n=31) using the small caliber catheter (p<0.05). There was no statistically significant difference in recurrence rate between the two groups. Conclusion: The use of a smaller caliber catheter for the treatment of pneumothorax reduces the admission period without a significant increase in recurrence rates.

• Journal of Korean Biological Nursing Science
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• v.16 no.3
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• pp.182-191
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• 2014

Purpose: The aim of this study was to identify necessary emergency treatment and nursing activities for severe trauma patients according to elapsed time and vital signs. Methods: A survey was conducted with 121 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. Collected data were analyzed with descriptive statistics, applying McNemar's test using SPSS 12.0. Results: Almost all of the subjects were men and the mean age was 46.9. Run-time for primary diagnosis, treatment decision, and leaving for the hospital room was 0.19, 4.36, and 4.21 hours, respectively, and stayover time was 9 hours. Regardless of vital signs, emergency treatments involving ambu-bagging, intubation, ventilator, and central vein catheterization insertion were offered within an hour. Central venous pressure, Foley catheter/Levin tube preparation and maintenance were performed in cases of unstable vital sign patients within an hour. Unrelated to vital signs, nursing activities for consciousness assessment, skin assesment and wound care, bed sore/fall down assesment and care, intravenous injection insertion and maintenance were conducted for all severe trauma patients within an hour. Foley catheter/Levin tube drainage care was performed for patients who had unstable vital signs within an hour. Conclusion: Emergency treatment and nursing activities for severe trauma patients were specific according to elapsed time and vital signs.