• Title/Summary/Keyword: Clinical Practices

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Improvement of Transfusion Practice in Cardiothoracic Surgery Through Implementing a Patient Blood Management Program

  • Hee Jung Kim;Hyeon Ju Shin;Suk Woo Lee;Seonyeong Heo;Seung Hyong Lee;Ji Eon Kim;Ho Sung Son;Jae Seung Jung
    • Journal of Chest Surgery
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    • v.57 no.4
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    • pp.390-398
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    • 2024
  • Background: In this study, we examined the impact of a patient blood management (PBM) program on red blood cell (RBC) transfusion practices in cardiothoracic surgery. Methods: The PBM program had 3 components: monitoring transfusions through an order communication system checklist, educating the medical team about PBM, and providing feedback to ordering physicians on the appropriateness of transfusion. The retrospective analysis examined changes in the hemoglobin levels triggering transfusion and the proportions of appropriate RBC transfusions before, during, and after PBM implementation. Further analysis was focused on patients undergoing cardiac surgery, with outcomes including 30-day mortality, durations of intensive care unit and hospital stays, and rates of pneumonia, sepsis, and wound complications. Results: The study included 2,802 patients admitted for cardiothoracic surgery. After the implementation of PBM, a significant decrease was observed in the hemoglobin threshold for RBC transfusion. This threshold dropped from 8.7 g/dL before PBM to 8.3 g/dL during the PBM education phase and 8.0 g/dL during the PBM feedback period. Additionally, the proportion of appropriate RBC transfusions increased markedly, from 23.9% before PBM to 34.9% and 58.2% during the education and feedback phases, respectively. Among the 381 patients who underwent cardiac surgery, a significant reduction was noted in the length of hospitalization over time (p<0.001). However, other clinical outcomes displayed no significant differences. Conclusion: PBM implementation effectively reduced the hemoglobin threshold for RBC transfusion and increased the rate of appropriate transfusion in cardiothoracic surgery. Although transfusion practices improved, clinical outcomes were comparable to those observed before PBM implementation.

Fertility preservation during cancer treatment: The Korean Society for Fertility Preservation clinical guidelines

  • Kim, Jayeon;Kim, Seul Ki;Hwang, Kyung Joo;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.4
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    • pp.171-174
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    • 2017
  • While many fertility preservation (FP) options now exist for reproductive-aged cancer patients, access to these services continues to be limited. A comprehensive FP program should be organized to serve oncofertility patients effectively. Also, much effort is needed from various individuals-patients, specialists from various fields, and consultants-to facilitate FP in a timely manner. Various challenges still exist in improving access to FP programs. To improve access to FP treatment, it is important to educate oncologists and patients via electronic tools and to actively navigate patients through the system. Reproductive endocrinology practices that receive oncofertility referrals must be equipped to provide a full range of options on short notice. A multidisciplinary team approach is required, involving physicians, nurses, mental health professionals, office staff, and laboratory personnel. The bottom line of FP patient care is to understand the true nature of each patient's specific situation and to develop a patient flow system that will help build a successful FP program. Expanding the patient flow system to all comprehensive cancer centers will ensure that all patients are provided with adequate information regarding their fertility, regardless of geography.

The Current State of Clinical Studies for Herbal Medicine of Attention Deficit Hyperactivity Disorder (ADHD) -Focusing on Chinese Journals- (ADHD의 한약물 치료에 대한 최신 임상연구 동향 -2007년부터 2012년까지 중국 논문을 중심으로-)

  • Ryu, Chun-Gil;Cho, A-Ram;Seo, Joo-Hee;Jeong, Seong-Sik;Lee, Ji-Su;Sung, Woo-Yong
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.1
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    • pp.1-12
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    • 2013
  • Objectives : The purpose of this study was to take around herbal medicine for Attention Deficit Hyperactivity Disorder in China. Methods : A journal search was performed using China National Knowledge Infrastructure (CNKI) from 2007 to 2012. Key words searched were 'ADHD'. Results : 25 studies were selected. Case control studies showed that herbal medicine treatment reported better results than the western medicine treatment group. 12 case reports reported a significant improvement in herbal medicine treatment for patients with ADHD. Frequently used herbal materials were Rhizome of Polygalae Radix and Rhizome of Acori Gramineri Rhizoma (16 times), Root of Glycyrrhiza uralensis Fisch (14 times), Root of Rehmanniae Radix et Rhizoma Preparata and Sclerotium of Poria cocos Wolf (12 times). Conclusions : There have been many studies regarding herbal medicine for Attention Deficit Hyperactivity Disorder in China, and these studies can be applied to the clinical practices in Korea.

A Research of Body Size Analysis and Graphing in 30yrs Korean Women (30대 한국 여성의 체위 분석과 도식화 연구)

  • Park, Hyun-Jung;Choi, Min-Sun;Lee, Jeong-Won;Jeon, Gyu-Il;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.2
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    • pp.232-251
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    • 2008
  • Purpose: Obesity is already a major clinical problem in Korea, so obesity prevention and treatment practices are gradually interested in Korean Medicine doctors. Moreover subjective body shape image entered as a important medical topic recently. To make a graph system for clinical tool which based on the Korean national standard physical scale in 30yrs Korean women. Methods: Physical data of the girth of upper arm, abdomen, hip, buttock, flank, calf, and body weight were statistically analyzed, which collected through the fifth national standard physical scale research. And then reviewed those statistical validation. Results: Relationship of the each body scale data and those graphs were fit and right statistically. Conclusion: These new achieved graph system of Korean standard body scales could be adopt as a useful clinical tool for body image related patients such as obesity, PCOD and postpartum patient in 30yrs Korean women.

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Trends of Market and Approval Management System for in vitro Diagnostic Veterinary Medical Reagents in Korea

  • Kang, Kyoung-Mook;Kang, Min-Hee;Suh, Tae-Young;Kang, Hwan-Goo;Moon, Jin-San
    • Journal of Veterinary Clinics
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    • v.35 no.4
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    • pp.119-125
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    • 2018
  • In vitro diagnostic veterinary medical reagents (IVDVMRs) were diverted the medical devices from medicine by the revision of the pharmaceutical affairs act enforcement regulations in 2015 in Korea. It classified into class I-IV according to risks of individual and public health. However, good manufacturing practices requirements on IVDVMRs were exempted from the current system. The registration of IVDVMRs by the Animal and Plant Quarantine Agency has gradually increased since 2012, and total of 584 products from 68 companies were registered from 1978 to 2017. Most of these items are clinical immunochemistry (infection disease), clinical immunochemistry (non-infection disease), molecular genetics, endocrinology, blood gas analysis, clinical microbiology, toxin, heavy metal and drug of abuse, other etc. The market size of IVDVMRs reported from the Korea Animal Health Products Association was estimated to be approximately 51.9 billion won in 2017. The domestic consumption and the export sales were approximately 31.2 and 20.7 billion won, respectively. They are increasing 23.9% (CAGR) in domestic consumption and 40.4% (CAGR) in export from 2011 to 2017.

Clinical Work Experience of Korean Immigrant Nurses in U.S. Hospitals (한인간호사의 미국병원 내 임상실무경험)

  • Seo, Kumsook;Kim, Miyoung
    • Journal of Korean Academy of Nursing
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    • v.46 no.2
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    • pp.238-248
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    • 2016
  • Purpose: The purpose of this qualitative study was to explore the meaning of the experience of Korean immigrant nurses working in US hospitals. Methods: Purposive sampling yielded 15 Korean immigrant nurses who had more than one year of clinical experience in US hospitals. Data were collected from March to August 2012 through in-depth interviews and thematic analysis was conducted using van Manen's hermeneutic phenomenological approach. Results: The findings were classified into eight themes: 'struggling from staff at workplace being territorial to outsiders', 'feeling oppressed due to language barrier', 'accepting rational and horizontal relationships at work', 'staying alert in the environment where lawsuits are rife', 'feeling a sense of stability from the social system that values human dignity', 'maintaining self-confidence from prominent nursing practices and senior Korean nurses' professional reputation', 'performing essential comprehensive nursing care', 'promoting self-development to be equipped with professionalism.' Conclusion: The findings indicate that the Korean immigrant nurses were able to excel in their workplace when their clinical experience at US hospitals was combined with the lived space in US politics and environment, lived time of patience, lived body to be alert, and lived others with multi cultural characteristics.

Changes in the Clerkship in Korean Medical Schools: The Prospect of a Student Internship (의과대학 임상실습의 변화: 학생인턴제도의 가능성에 대한 전망)

  • Yoon, Tai Young;Lee, Jong Keun;Oh, In Hwan
    • Korean Medical Education Review
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    • v.15 no.2
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    • pp.75-81
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    • 2013
  • The subinternship (student internship), a subtype of bedside and clinical training was first developed in the United States. Currently, some medical schools conduct a student internship and many other universities are considering the implementation of a student internship in Korea. If the intern system is abrogated beginning in 2016 as in the United States, then the importance of the student internship will be greatly emphasized for clinical training. To produce good and competent medical doctors, members of medical schools and affiliated hospitals must acknowledge the role of the educational hospital and support student internships. In addition, the effort of the medical community to develop and apply a standard curriculum to the student internship is also required. Above all, the attention of society and the nation is essential to make legal policy changes regarding the conducting of student internships and enhance understanding about the authorized practices in university hospitals. The medical community's effort to draw attention to this issue is greatly required to implement a student internship at this time.

Systemic Analysis for Research Strategy Establishment of Gastrointestinal Disease with Oriental Medicine in Korea (위장관 질환의 연구전략수립을 위한 최근 5년간 한의약논문의 체계적 고찰)

  • Kim, Byung-Joo;Hong, Jin-Woo;Hwang, Min-Woo;Chae, Han;Kwon, Young-Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1273-1281
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    • 2009
  • To research the trends of study and the guidelines of investigation and management about gastrointestinal (GI) disease in oriental medicine, we reviewed and analysed articles published in Korea from 2004 to 2009. The western medicine in medical treatments of GI tract is notorious for their side effects. But, in oriental medicine, we couldn't find any side effects. Although we treat or manage clinical practices of the GI disease every day, however, we do not have abundant evidences about scientific mechanisms of those treated with oriental medicine therapy. Therefore, we suggest that the upward of qualities of life and the improvement of health-care system through the development of oriental medicine therapies in Korea will be need.

Basic Principles of the Validation for Good Laboratory Practice Institutes

  • Cho, Kyu-Hyuk;Kim, Jin-Sung;Jeon, Man-Soo;Lee, Kyu-Hong;Chung, Moon-Koo;Song, Chang-Woo
    • Toxicological Research
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    • v.25 no.1
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    • pp.1-8
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    • 2009
  • Validation specifies and coordinates all relevant activities to ensure compliance with good laboratory practices (GLP) according to suitable international standards. This includes validation activities of past, present and future for the best possible actions to ensure the integrity of non-clinical laboratory data. Recently, validation has become increasingly important, not only in good manufacturing practice (GMP) institutions but also in GLP facilities. In accordance with the guideline for GLP regulations, all equipments used to generate, measure, or assess data should undergo validation to ensure that this equipment is of appropriate design and capacity and that it will consistently function as intended. Therefore, the implantation of validation processes is considered to be an essential step in a global institution. This review describes the procedures and documentations required for validation of GLP. It introduces basic elements such as the validation master plan, risk assessment, gap analysis, design qualification, installation qualification, operational qualification, performance qualification, calibration, traceability, and revalidation.

Development and Effects a Simulation-based Emergency Airway Management Education Program for Nurses in a Neonatal Intensive Care Unit (신생아집중치료실 간호사를 위한 시뮬레이션 기반 응급기도 관리 교육 프로그램 개발 및 효과)

  • Kim, Minjung;Kim, Sunghee
    • Child Health Nursing Research
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    • v.25 no.4
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    • pp.518-527
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    • 2019
  • Purpose: The purpose of this study was to identify the effects of an educational intervention by evaluating neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance after developing and operating a simulation-based neonatal emergency airway management education program for nurses in a neonatal intensive care unit. Methods: The participants were 30 nurses in a neonatal intensive care unit. Data were collected from June 6 to 15, 2018 and analyzed using IBM SPSS version 22.0. Results: The results of the pretest and posttest for each educational group showed statistically significant improvements in neonatal emergency airway management knowledge, critical thinking, problem-solving ability, and confidence in clinical performance. Conclusion: The simulation-based neonatal emergency airway management training program was an effective educational program that enhanced neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance among nurses in a neonatal intensive care unit. Therefore, it is suggested that the program described in this study can contribute to improving nursing quality by enhancing the ability of nurses to cope with emergencies in practice. It can also be used for education for new nurses and contribute to the development of nurses' practices.