• 한국산학기술학회논문지
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• 제17권6호
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• pp.113-120
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• 2016

본 연구의 목적은 유치도뇨관, 중심정맥관 및 인공호흡기 감염관리지침에 대한 중환자실 간호사의 지식과 수행도 정도를 파악하고자 하였다. 대상자는 2개의 상급종합병원과 3개의 종합병원의 중환자실에서 근무하는 간호사 175명이다. 자료수집은 2013년 7월 1일부터 7월 31일까지로, 수집된 자료는 SPSS 18.0 통계 프로그램을 사용하여 기술통계, t-test, ANOVA로 분석하였다. 각 지식수준은 유치도뇨 관리관(평균 0.87점), 중심정맥관(0.82점), 인공호흡기(0.82점)순으로 나타났으며, 수행도는 유치도뇨 관리관(평균 4.18점), 인공호흡기(4.04점)중심정맥관(4.07점)순이었다. 지식과 수행도에서는 유치도뇨관(r=.72, p<.00), 중심정맥관(r=.54, p<.001), 및 인공호흡기(r=.30, p<.001) 감염관리간 순 상관관계를 나타냈다. 유치도뇨관 감염관리지침에 대한 지식과 수행도는 성별, 최종학력, 근무경력, 담당환자 수, 병원규모, 세미나 참석 여부에 따라 통계적으로 유의한 차이가 있었다. 중심정맥관 감염관리지침에 대한 지식과 수행도는 최종학력, 근무경력, 담당환자 수, 병원규모, 세미나 참석 여부에 따라 통계적으로 유의한 차이가 있었다. 인공호흡기 감염관리지침에 대한 지식은 근무경력에 따라 통계적으로 유의한 차이가 있었다. 본 연구결과를 기초로 감염관리지침에 대한 지식과 수행을 향상 시킬 수 있는 교육 및 훈련 프로그램이 개발되어야 할 것이다.

• 가정∙방문간호학회지
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• 제12권1권
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• pp.92-116
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• 2005

Purpose: This study was a predicative survey to provide home care clients with indwelling urinary catheters for furnishing basic educational material to their families by analyzing the family members' knowledge, educational needs and educational experience about indwelling catheter management. Method : The subjects consisted of 108 family members who cared for home care clients with indwelling catheters. Data were collected by home care nurses in nine hospitals in Pusan, who directly interviewed with them through questionnaires from Sep. 6th to 30th in 2004. The questionnaires for data collection were developed through pre-survey and reference review. The collected data was analyzed by using frequency, percentile, mean, variation, t-test, ANOVA on SPSS 10.1 package. Results : There were characters of home care clients with indwelling catheters: women(67.6%) were more than men; the average age of them was $69.60{\pm}14.99$ years old; neurogenic and cerebrovascular diseases(80.0%) were the most common disease group; 81.5% of them were totally dependent on others in terms of level of activity. Home care clients' families had these characters: women(76.9%) were more than men; the average age was $54.5{\pm}13.70$ years old; 46.3% of them were parents or sons or daughters in terms of relation with patient; tl1e average care period was $39.8{pm}34.20$ months. Level of knowledge about indwelling catheter management of the family members were 69.8% and its mean were $20.24{\pm}4.53$. Educational needs were 90.9% and its mean were $14.55{\pm}3.56$. Educational experience were 53.3% and its mean were $8.53{\pm}4.30$. 'Complications in using an indwelling catheter', 'Symptoms to call for a home care nurse' and 'Method to attach an indwelling catheter' were high ranked in both educational needs and educational experience. 'Anatomy of urinary tract', 'Functions of urinary tract' and 'Catheter placement' were low ranked in both educational needs and educational experience Level of knowledge about indwelling catheter management of the families showed a significant difference according to their age(F=5.35, p=0.01). Educational needs showed a significant difference according to care period(F=3.06, p=0.04). Conclusion: the family members' level of knowledge and educational experience about indwelling catheter management and their educational were not sufficient while their educational needs were high. In other words although the family members were acknowledged education needs, but the care for the patients with indwelling catheter weren't performed well because of their lack of related knowledge. Therefore systematic educational programs about indwelling catheter management for home care clients and their families should be made on the base of this study.

• The Korean Journal of Pain
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• 제8권2호
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• pp.308-311
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• 1995

The incidence of contamination of epidural catheters used for pain control was investigated. To prevent epidural infection, all patients with epidural catheters had taken amoxacillin 1.5gm/day orally. Of the cultures of catheters catched from 303 patients undergoing continuous epidrual catheterization, 5 catheters (1.7%) were found to be contaminated; cervical 1/86 (1.2%), thoracic 1/27 (3.7%), and lumbar 3/190 (1.6%). Staphylococcus epidermidis was the most common etiologic agent (60%). To prevent epidural infection, sterilization of the skin around the epidural catheter and prophylactic use of broad-spectrum antibiotics are thought to be beneficial.

• The Korean Journal of Pain
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• 제4권1호
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• pp.26-30
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• 1991

Continuous epidural analgesia is widely used in pain management. We investigates the incidence of contamination of epidural catheters used in epidural catheters for pain control. The tips of epidural catheters were examined for bacterial growth after use. In culture from 250 patients undergoing continuous epidural catheterization, 33(13.2%) catheters were found to be contaminated: staphylococcus epidermis 66.9%; staphylococcus aureus 12.1%; alpha streptococcus 12.1%; and others 9.1%. One significant epidural infection occured. One of the most common causes of the epidural infection during long time epidural block is the transmission of the microorganism from the contaminated skin to the epidural space along the epidural catheter. To prevent epidural infection, sterilization of the skin around the epidural catheter is essential.

• 대한의생명과학회지
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• 제10권3호
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• pp.245-251
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• 2004

Microbial infection provokes one of the most serious complications to the patients with indwelling catheters. Ciprofloxacin (CFX) was added into the catheter materials (polyurethane or silicone) during the manufacturing process to avoid the microbial infection. Efficacy of the catheters containing CFX was investigated by using the in vitro zone of growth inhibition test method. The catheters made of polyurethane or silicone exhibited a strong antimicrobial activity against the major catheter-related microorganisms (S. aureus, S. epidermidis, P. aeruginosa and E. coli), when CFX was incorporated into the catheters. Fetal bovine serum (FBS) did not affected antimicrobial activities of the polyurethane catheters with CFX loading of 0.5 and 1.0％ (W/W) against S. aureus and S. epidermidis. However, the polyurethane catheters with 1.0％ (W/W) of CFX loading showed a significantly (P<0.05) reduced antimicrobial activity against E. coli when the catheters were exposed to FBS. Silicone catheters with 1.0 and 1.5％ (W/W) of CFX loading demonstrated effective antimicrobial activity against S. epidermidis for at least 2 weeks. These results suggest that the use of catheters containing ciprofloxacin could be effective in preventing catheter-related infections.

• 대한의생명과학회지
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• 제13권3호
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• pp.175-182
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• 2007

In vitro ciprofloxacin (CFX)-release study and bioassay using microorganisms were performed to estimate the retention of the antimicrobial activity of the CFX-incorporated central venous catheters (CFX-CVCs). The release experiments were carried out under the optional CFX-release conditions to mimic the in vivo environment. The release of CFX experienced an initial burst followed by a slow and steady matrix-diffusion controlled release. The 1.0CP (polyurethane catheter containing 1.0% (w/w) of CFX) under dynamic condition showed a near zero-order CFX release profile, which is beneficial for the long-tenn antimicrobial activity. The modified Kirby-Bauer method was performed employing S. aureus and E. coli to evaluate the retention of antimicrobial activity of the catheters retrieved from the release experiments. The 1.0CP showed the long-term antimicrobial activity (${\geq}\;21$ days) against both S. aureus and E. coli. These results indicate that 1.0CP is useful as a long-tenn indwelling CVC.

• The Korean Journal of Pain
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• 제23권4호
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• pp.247-253
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• 2010

Background: Epidural anesthesia is widely used to provide pain relief, whether for surgical anesthesia, postoperative analgesia, treatment of chronic pain, or to facilitate painless childbirth. In many cases, however, the epidural catheter is inserted blindly and the indwelling catheter position is almost always uncertain. Methods: In this study, the loss-of-resistance technique was used and an imaging agent was injected through the indwelling epidural anesthesia catheter to confirm the position of its tip and examine the migration rate. Study subjects were patients scheduled to undergo surgery using general anesthesia combined with epidural anesthesia. Placement of the epidural catheter was confirmed postoperatively by injection of an imaging agent and X-ray imaging. Results: The indwelling epidural catheter was placed between upper thoracic vertebrae (n = 83; incorrect placement, n = 5), lower thoracic vertebrae (n = 123; incorrect placement, n = 5), and lower thoracic vertebra-lumbar vertebra (n = 46; incorrect placement, n = 7). In this study, a relatively high frequency of incorrectly placed epidural catheters using the loss-of-resistance technique was observed, and it was found that incorrect catheter placement resulted in inadequate analgesia during surgery. Conclusions: Although the loss-of-resistance technique is easy and convenient as a method for epidural catheter placement, it frequently results in inadequate placement of epidural catheters. Care should be taken when performing this procedure.

• 폴리머
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• 제30권3호
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• pp.247-252
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• 2006

환자가 요도용 카테타를 장기간 착용할 경우 세균흡착에 의한 감염이 유발되어 심각한 부작용을 경험하게 된다. 본 연구에서는 다양한 양친성 폴리우레탄을 합성하여 요도용 카테타 도포용 소재로서의 응용가능성을 확인하고자 하였다. 양친성 폴리우레탄은 친수성 고분자인 poly(ethylene oxide)(PEO)와 소수성 고분자인 poly (tetramethylene oxide) (PTMO) 또는 poly (dimethyl siloxane) (PDMS)을 연질부로 도입하여 합성하였다. 상용 실리콘 카테타에 양친성 고분자를 도포한 결과 표면의 친수성이 현저히 개선되었다. 특히, PEO의 함량이 많은 폴리우레탄일수록 친수성이 높게 나타났으며, 세균 흡착량이 감소함을 확인할 수 있었다. 결론적으로, 본 연구에서 합성한 양친성 고분자는 요도용 카테타의 도포용 소재로 적합한 것을 알 수 있었다.

• Advances in pediatric surgery
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• 제12권2호
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• pp.167-174
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• 2006

Central venous catheter (CVC) for long-term venous access is indispensable for various reasons including hyperalimentation, frequent blood sampling, frequent IV drug use in pediatric patients. We report clinical experience of surgical neonates in whom CVC was inserted primarily via great saphenous vein into suprarenal inferior vena cava. From March 2004 to March 2006, we performed CVC insertion via saphenous vein - contralateral side to main wound - into suprarenal inferior vena cava in surgeries of neonates. 2.7Fr or 4.2Fr, single lumen, tunneled Broviac catheters (Bard Access system, Inc, Salt Lake City, Utah) were used. Skin exit site of tunneled catheter was located in ipsilateral flank area just below edge lower rib. At the end of the procedure, location of the catheter tip was confirmed by plain radiography of abdomen. We retrospectively reviewed the admission records of the patients including nursing staff charts. Nine (50.0 %) patients were male and nine (50.0%) were female. Median gestational age was 38 weeks (range, 29-42 weeks) and median birth weight was 3,105 gm (range, 1,040-3,720 gm). Median age at catheter insertion was 38.5 days (range, 1-236 days). The purpose of CVC insertion was short-and long-term hyperalimentation in nine (50.0 %) patients. CVC insertion was performed in operation room under general anesthesia in sixteen (88.9 %) patients (in these cases, CVC insertion was performed just prior to concurrent operation) and neonatal intensive care unit (NICU) under local anesthesia with adequate sedation in two (11.2%). During the admission period (total catheter-indwelling time: 553 days), CVC functioned well without any significant side effects. Transient swelling of the ipsilateral leg (n=1, 5.6 %) and transient migration of catheter tip (n=1, 5.6 %) were noted, which did not affect function of the indwelled CVC. Mean catheter-indwelling time was 30.7days (range, 3-72 days). All catheters were removed electively except two mortality case. Complications, such as thrombosis, infection, kinking or extravasation of drugs, were not observed in our study period. Tunneled trans-great saphenous vein inferior vena cava catheters are not only comparable to cervical CVCs in terms of function and complication rates, but also very beneficial in selected patients, especially those in whom cervical approach is technically impossible or contraindicated.

• Asian-Australasian Journal of Animal Sciences
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• 제25권6호
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• pp.785-788
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• 2012

The aim of the present study was to clarify the effect of kisspeptin-10 on LH secretion in prepubertal ewes. In experiment 1, prepubertal ewes fitted with indwelling jugular catheters were randomly assigned to receive 0, 0.5, 1 or 2 mg of kisspeptin-10 dissolved in saline, and serial blood samples were collected at 15-min intervals for 180 min to analyze the response curves of LH after injection. In experiment 2, prepubertal ewes fitted with indwelling jugular catheters were injected with 0 or 1 mg of kisspeptin-10 dissolved in saline and the injection was repeated 3 times at 1 h interval and serial blood samples were collected at 15-min intervals for 210 min to analyze the response curves of LH after injection. The results showed that single intravenous administration of 0.5, 1 and 2 mg of kisspeptin-10 all could significantly increased LH secretion in prepubertal ewes, and the effect of 1 and 2 mg of kisspeptin-10 on LH secretion was higher than that of 0.5 mg group. The results also showed that repeated intravenous administration of kisspeptin-10 could effectively increase LH secretion and repeated administration did not influence the effect of kisspeptin-10 on LH secretion in prepubertal ewe. In conclusion, the present study indicated that single or repeated intravenous administration of kisspeptin-10 could effectively increase LH secretion in prepubertal ewes.