• 보건행정학회지
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• 제15권4호
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• pp.26-45
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• 2005

The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

• 기본간호학회지
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• 제9권2호
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• pp.237-245
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• 2002

Purpose: This study was to examine the changes in cold discomfort according to the type of blanket used after surgery. Methods : Women scheduled for Cesarean Section were divided into two groups. After the surgery, 30 patients were covered with a warming blanket which was set at $40^{\circ}C$ by the warmer and the other 30 patients were covered with an ordinary blanket. Both group's cold discomfort was measured at 5 time points using a mercury thermometer, shivering scale. and subjective thermal sensation scale. Data were analyzed by using mean scores with t-test, paired t-test using the SPSS/WIN program. Result: At 30 min after being covered with the blanket, the axillary temperature had returned to the pre-operation temperature in both groups. At 45 min after being covered with the blanket, the women in the warming blanket group had no further shivering but for those in the ordinary blanket group shivering continued. At 45 min after being covered with the blanket, the women in the warming blanket group had returned to the condition before surgery, but those in the ordinary blanket group continued to complain of cold sensation. Conclusion: This study suggests that use of a warming blanket helps to relieve cold discomfort following surgery. This study is also expected to enhance understanding of the Importance of subjective data by exploring the difference between subjective complaints and objective data about cold discomfort.

• 혜화의학회지
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• 제5권2호
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• pp.513-522
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• 1997

Clinical studies were done on 94 patients with the General Pain after Childbirth(GPC). which were treated in Dept. of Oriental Gynecology. Oriental Medical Hospital. Dae Jeon University from July 1st 1995 to June 30th 1996. 1. The total incidence of GPC was about 13.2% of the 1162patients. 2. In age distribution of GPC. after twenty years old was the most in 40.4%. the next ration was thirty years old. forty years old. early twenty years old. 3. In inducing factor. overlook was the most in 29.8%. the next ration was delivery itself. difficult delivery. cesarean section in 26.6%. 4. In therapeutic response. excellence was the most in 38.3%. the next ration was improvement. good. non improvement. 5. In onset. within ten days of postpartum was the most in 35%. the next ration was from 11 to 30 days. from 91 to 180 days. during the period of pregnancy. from 61 to 90 days. from 180 to 360 days. 6. Remedical value of abortion was relatively emedical value of difficult delivery. Cesarean section was bad. 7. In delivery times. abortion times and pregnant times did not concern therapeutic response. 8. In therapeutic period. from 11 to 30 days was the most in 46.8%. 9. In delivery seasons. Feburary was the most in 15.9%. and there were many occurrence of GPC in the winter season. 10. Past history did not concern GPC. 11. In prescriptions. Bohuh Tang Kamibang(B) was the most in 33%.

• Journal of Yeungnam Medical Science
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• 제35권2호
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• pp.187-191
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• 2018

Background: Respiratory distress syndrome (RDS) is a one of the most common cause of respiratory morbidity and mortality in neonates. This study was conducted to investigate the risk factors for RDS in full-term neonates. Methods: We conducted this retrospective study using medical records. The study group included 80 full-term neonates diagnosed with RDS and hospitalized in the neonatal intensive care unit between January 2012 and December 2016, at Yeungnam University Hospital. We analyzed sex, gestational age, birth weight, delivery method, maternal age, number of pregnancy, history of abortion, and complication of pregnancy. The control group included 116 full-time neonates who were hospitalized with jaundice during the same period. Results: The incidence of full-term RDS was more common in males (odds ratio [OR], 3.288; 95% confidence interval [CI], 1.446-7.479), cesarean section (OR, 15.03; 95% CI, 6.381-35.423), multiparity (OR, 4.216; 95% CI, 1.568-11.335). The other factors rendered no significant results. Conclusion: The risk factors for RDS in full-tern neonates were identified as male sex, cesarean section, and multiparity. Further studies involving more institutions are needed to clarify the risk factors for RDS in full-term infants.

• Journal of Medicine and Life Science
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• 제19권2호
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• pp.39-45
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• 2022

This study was undertaken to assess the potential of body mass index (BMI) as a risk factor for massive hemorrhage (MH) after cesarean section (CS) in patients with placenta previa. We retrospectively reviewed the medical records of patients who underwent CS for placenta previa between January 2010 and December 2018. MH was defined as an estimated blood loss ≥2,000 mL during surgery. Clinical characteristics, including BMI, were compared between the groups with and without MH. Subsequently, multivariable logistic regression analysis was conducted to identify the independent risk factors for MH. A total of 189 patients were included in this study. MH was observed in 28 patients (14.8%). According to the multivariable logistic regression analysis results, the risk factors independently associated with MH were BMI at delivery (adjusted odds ratio [aOR], 1.19; 95% confidence interval [CI], 1.04-1.35; P=0.012), placenta accrete (aOR, 24.55; 95% CI, 2.75-219.02; P=0.004), and total previa degree (aOR, 9.86; 95% CI, 2.71-35.96; P=0.001). The study findings showed that maternal obesity, namely a higher BMI at delivery, was an independent risk factor for MH after CS in patients with placenta previa. Close attention should be paid to the potential risk of hemorrhage associated with maternal obesity as well as the well-known risk factors of placenta accreta and total previa degree.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.203-210
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• 1985

1985년 3월 1일부터 영남대학교 의과대학 부속병원 산부인과에서 제왕절개술로 분만한 예중 적응이 되는 예에서 Velosef의 자궁강내 세척을 실시한 30예, 정맥주입을 한 35예와 대조군 35예로 총 100예를 연구대상으로 하여 수술후 자궁내막염 및 감염의 발생반도를 비교 분석하였고, 연구대상자에 대한 fever index를 산출 비교하여 다음과 같은 연구 결과를 얻었다. 1. 역학적 변수에서 Velosof 자궁강내 세척군과 Velosef 정맥주입군, 대조군 각각은 통계적으로 유의한 차이를 보이지 않음으로써 세 연구군은 서로 유사하였다. 2. 감염에 대한 위험인자에서도 각 실험군과 대조군은 통계적으로 유의한 차이를 보이지 않음으로써 연구집단은 서로 감염에 대한 위험인자 분포가 유사하였다. 3. 제왕절개술의 적응증에 있어서도 각 실험군과 대조군에서 유사한 분포를 보였으며, 기왕제왕절개술, 아두골반불균형, 둔위 등의 순서로 많았다. 4. 수술후 자궁내막염의 발생반도는 대조군보다 정맥주입군과 자궁강내 세척군이 낮았으며 특히 정맥주입군은 대조군과 통계적으로 유의성을 보였다 ($x^2$=6.248, d.f.=1, P<0.05). 5. 자궁내막염을 포함한 수술후 감염에서도 정맥주입군, 자궁강내 세척군에서 대조군보다 낮은 발생빈도를 보였으며, 특히 정맥주입군에서 대조군과 통계적으로 유의한 차이를 보였다 ($x^2$=5.352, d.f.=1, P<0.05). 6. Fever index는 자궁강내 세척군, 정맥주입군 모두가 대조군에 비해 통계적으로 유의한 차이를 보였다 (t=-3.251, d.f.=68, P<0.05). 7. 수술적응증에 따른 수술후 자궁내막염 발생 빈도에서, 특히 기왕제왕절개술과 아두골반불균형에서 실험군이 대조군에 비해 낮은 경향을 보였다. 8. 감염에 대한 위험인자 별 자궁내막염 발생 빈도에서는 진통이 있는 경우, 6 시간 이상의 양수파막, 5번 이상의 내진, 응급제왕절개술의 경우에 대조군보다 각 실험군에서 자궁내막염 발생 빈도가 현저히 낮았다. 9. 연구대상의 fever index산포도에서 임상적으로 자궁내막염으로 진단된 경우 높은 fever index 수치를 보였다.

• The Korean Journal of Pain
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• 제10권1호
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• pp.34-41
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• 1997

Background : Patient-controlled analgesia(PCA) is a safe and effective technique for providing postoperative pain relief. Studies that compare epidural vs intravenous routes of opiate administration show conflicting results. We designed a prospective, randomized, controlled study to evaluate the safety and efficacy of epidural(EPI-PCA) morphine-bupivacaine versus intravenous (IV-PCA) nalbuphine when administered with a PCA system. Methods : Forty healthy women were randomly assigned to receive an epidural bolus of morphine 3 mg and 0.5% bupivacaine 10 ml, followed by a EPI-PCA with 0.01% morphine and 0.143% bupivacane (basal infusion 1 ml/hr, bolus 1 ml, lock-out interval 30 min) or intravenous bolus of nalbuphine 0.1 mg/kg followed by a IV-PCA with nalbuphine(basal infusion 1 mg/hr, bolus 1 ml, lock-out interval 20 min) for pain relief after cesarean delivery. This study was conducted for 2 days after cesarean section to compare the analgesic efficacy, side effects, patient satisfaction either as EPI-PCA or as IV-PCA. Results : EPI-PCA group had significant lower visual analog pain scale(VAS) at immediate postoperative period, whereas no significant difference was observed when pain was assessed at other time sequence. Urinary retention and pruritus were more frequent with EPI-PCA group, although the incidence of other side effects were the same. Conclusions : Although EPI-PCA with morphine-bupivacaine was of significantly lower VAS at immediate postoperative period, IV-PCA with nalbuphine is a safe and effective alternative to EPI-PCA with morphine-bupivacaine for providing pain relief after cesarean delivery. Further studies about IV-PCA with nalbuphine are needed to control the immediate postoperative pain and to further improve effective pain management.

• 간호행정학회지
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• 제5권3호
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• pp.547-561
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• 1999

The purpose of this study was to determine which nursing activities are performed for patients in each of the nine KDRGs and to examine common nursing activities between patients with the nine KDRGs and special nursing activities which were not common to patients with the nine KDRGs. The study will provide basic data for estimation of nursing fees. The nine KDRGs in model project are Lens procedures, tonsillectomy, &/or adenoidectomy, appendectomy &/or not complicate principal diagnosis, vaginal delivery, cesarean section, anal & stomal procedures, inguinal & femoral hernia, uterine & adneza procedure for nonmalignancy, and simple pneumonia & pleurisy. To determine the nursing activities for each of the nine KDRG, checklists of nursing activities in each nine KDRG were developed from the literature and a total of 115 records of patients 'who were diagnosed and discharged between January and April, 1999 from a tertiary medical center. Nursing activities for each of the nine KDRG were verified through two consecutive content analyses. The results of study are followed as: 1. The checklists of nursing activities developed included direct and indirect nursing activities, for a total of 241 nursing activities. Direct nursing consisted of physical, educational, emotional-socioecomomic-spiritual nursing in 17 areas. Indirect nursing had four areas. 2. Through the two consecutive content analyses, 197 nursing activities were selected, having item CVIs of .83 or more. Those included 81 nursing activities for Lens procedures, 95 for Tonsillectomy &/or Adenoidectomy. 93 in Appendectomy &/or not complicated principal diagnosis, 155 for vaginal delivery, 172 for cesarean section, 89 for anal & stomal procedures, 93 for inguinal & femoral hernia, 108 for uterine & adneza procedures for non-malignancy, and 68 for simple pneumonia & pleurisy. 3. Nursing activities for each of the nine KDRG were compared. Activities with 80% or higher commonality within the nine KDRGs consisted of 86 of 197 nursing activities for the total designated common nursing activities, 30 common nursing activities for patients in the operation group, 45 common activities for patients in the delivery Group. Special nursing activities not common within the nine KDRGs were : 3 for Lens procedures, 1 for Tonsillectomy &/or Adenoidectomy. 2 for Appendectomy &/or not complicated principal diagnosis, 27 for vaginal delivery, 21 for Cesarean section, 6 for anal & stomal procedures, 3 for inguinal & femoral hernia, 16 for uterine & adneza procedure for non-malignancy, 8 for simple pneumonia & pleurisy. In this study, nursing activities for each of the nine KDRGs verified through two consecutive content analyses are those that are performed in the hospital. And, nursing activities for each of the nine KDRGs included all nursing activities from hospital admission to discharge. So. the checklists consisted of nursing activities that allow for an estimation of nursing fees under PPS. The classification of nursing activities in the study will provide a reference for the development of a nursing activity classification.

• 농업과학연구
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• 제38권4호
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• pp.681-687
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• 2011

Bioorgan transgenic cloned mini pig has a problem of growth retardation in uterus during end of pregnancy so that survival rate is very low in newborn piglet. In order to support their life after birth, cesarean section of fetus with sufficient growth in uterus was tested in this study. First of all, fetus growth measured using a ultrasound scanner during pregnancy in transgenic mini pig, comparing normal pig. After 113 days for delivering, fetus was removed out of uterus. Fetus growth for normal pig was 1.8 cm at 4weeks and 14.4 cm at end of pregnancy (15 weeks). At 113 days, fetus growth was $15.9{\pm}4$ cm in ultrasound scanner and real growth measurement from fetus removal out of uterus was $16.0{\pm}2$ cm. It is very a similar result between measurement of ultrasound scanner and real measurement. Therefore, using ultrasound scanner for measuring fetus growth will be useful to predict fetus growth in uterus.

• 대한영상의학회지
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• 제79권6호
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• pp.315-322
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• 2018

목적: 속발성 분만 후 출혈 환자에서 임상 양상 및 혈관 조영술의 특징과 경도관 동맥 색전술의 결과를 알아보고자 하였다. 대상과 방법: 속발성 분만 후 출혈로 인해 단일 3차 의료기관에서 동맥 색전술을 시행한 38명의 환자를 대상으로 분만 방식, 출혈 원인, 임상 증상, 혈관 조영술 소견, 색전 물질과 방법, 결과 등에 대하여 후향적으로 분석하였다. 결과: 20명(53%)의 환자가 제왕절개를 시행하였으며, 출혈 원인은 의인성 혈관 손상(n = 11), 잔류 태반(n = 10), 자궁근 무력증(n = 8), 후천성 자궁 동정맥 기형(n = 5) 등이었다. 간헐적(50%) 및 지속적(50%) 대량 질 출혈이 임상적으로 관찰되었다. 7명(18%)의 환자에서 내원 시 저혈량 쇼크를 보였다. 혈관 조영술 상 18명이 양성 소견을 보였으며, 제왕절개 후 가성동맥류 빈도가 통계학적으로 의미 있게 높았다(p < 0.001). 젤폼 이외에 N-butyl cyanoacrylate (7예), 미세 코일(7예)을 사용하였다. 출혈 부위 초선택이 가능하였던 10명의 환자(26.3%)에서는 단측 혈관 선택 색전술만으로 지혈이 성공적이었다. 기술적 성공률은 100%였으며, 임상적 성공률은 97.4%이었다. 추적 관찰이 가능했던 16명에서 정상 월경 주기를 보였으며, 1예의 정상 임신이 관찰되었다. 결론: 속발성 분만 후 출혈은 저혈량 쇼크를 보일 수 있으며, 양성 출혈 소견을 보이는 빈도가 높았다. 따라서 조기 혈관 조영술과 동맥 색전술이 필요하리라 생각된다.