• Title/Summary/Keyword: Clinical Practices

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Body-Images and Visualization Technologies in the Field of Plastic Surgery: Making Scientific Objects, Making Scientific Disciplines (성형외과의 몸-이미지와 시각화 기술: 과학적 대상 만들기, 과학적 분과 만들기)

  • Leem, So-Yeon
    • Journal of Science and Technology Studies
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    • v.11 no.1
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    • pp.89-121
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    • 2011
  • The majority of previous researchers on body management practices including plastic surgery has agreed that there is a strong connection between social demands of plastic surgery and public exposures of beautiful body-images, which this research intends to analyze further. This study, on the one hand, discovers how body-images are produced and consumed through clinical practices of plastic surgery, particularly, surgeon-patient consultation processes based on the researcher's participant observation on a plastic surgery clinic in Korea, and shows how visualization technologies are mobilized to reconstruct not only boundaries of patients' bodies but also those of medical disciplines by viewing plastic surgery practices as knowledge production activities, on the other hand. While revealing that surgeon-patient consultation is the process to transform patient's bodies to "scientific" objects and visualization technologies have been made to help plastic surgeons to make their disciplines "scientific" ones, this article also pays attention to complicated effects of new imaging technology beyond a mere means of "scientification" of plastic surgery.

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Study on Legal Issues and Scope of Medical Technologist's Practice (임상병리사 업무 범위와 법률적 고찰)

  • Shim, Moon-Jung;Koo, Bon-Kyeong;Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.2
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    • pp.55-68
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    • 2017
  • In recent years, medical practice has seen a drastic change due to the rapid, exponential expansion of scientific and medical technologies. Specially, the role of medical technologists (also known as medical laboratory scientists and/or clinical laboratory scientists) are increasing in the development of science of medical technology. As such, their responsibility has also been increasing. Therefore, given their highly specialized knowledge and skills, they are not regarded solely as doctor's assistants. Their independence and deeper specialization have been increasing, as they perform medial practices under the guidance of doctors or dentists pursuant to the "Act on Medical Service Technologists." From a legal point of view, medical guidance and scope of work were examined. As a conclusion, the definition of doctor's superintendency on the "Act on Medical Service Technologists" is required, and the qualification for the Korean license examination and their roles should be stated clearly. Moreover, communications among health professions regarding the roles of medical technologists are necessary to further facilitate clarification of their role. There is a need for independent legislation to expand the field of medical technologists and to strengthen their professionalism.

A Study on Acute Kidney Injury Caused by Intravenous Colistimethate in Critically Ill Patients (중환자에서 Colistimethate 정맥내 투여와 관련된 급성 신손상에 대한 연구)

  • Oh, Myunghyun;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.4
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    • pp.307-315
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    • 2013
  • Objective: Colistimethate was first became available in 1950s and used until the early 1980s to treat infections caused by gram-negative bacteria and was abandoned due to its nephrotoxicity and neurotoxicity. However, it was recently reintroduced into the clinical practices due to emergence of multidrug-resistance gram-negative bacteria, particularly Pseudomonas aeruginosa and Acinetobacter baumanii. Therefore, it is increasingly used in the intensive care unit settings as a salvage therapy. This study was designed to investigate the incidence rates and risk factors of acute kidney injury associated with colistimethate by using the standardized definition in critically ill patients. Methods: This study retrospectively reviewed the electronic medical records of 71 adult patients above 18 years old receiving intravenous colistimethate at least 48 hours at intensive care unit, university-affiliated hospital from Nov 2012 to Aug 2013 and excluded patients with end-stage renal disease (ESRD) and required renal replacement therapy before initiation of the colistimethate therapy. Acute kidney injury (AKI) was determined by using the standardized RIFLE criteria, classified with risk, injury, failure, loss and ESRD according to serum creatinine (Scr) levels. Results: Among the 71 patients included in the analysis, AKI developed in 40 patients (56.3%) and 6 patients (8.4%) had irreversible kidney injury. AKI occurred within 5 days in 20 patients (50.0%). Maximum Scr level showed a significant increase in the patients with AKI ($1.92{\pm}0.86mg/dL$ vs. $1.12{\pm}0.46mg/dL$ p=0.001), maximum BUN also increased ($64.2{\pm}28.7mg/dL$ vs. $48.4{\pm}24.9mg/dL$ p=0.017) and minimum creatinine clearance (CLcr) was significantly decreased in the patients with AKI than non-AKI ($34.5{\pm}18.6ml/min$ vs. $64.4{\pm}33.7ml/min$ p=0.185). The patients with AKI had significantly longer duration of colistimethate therapy ($21.1{\pm}17.0$ days vs. $13.0{\pm}11.5$ days, p=0.020) and larger cumulative doses of colistimethate ($6465.9{\pm}4717.0mg$ vs. $4438.1{\pm}3426.7mg$, p=0.040). Conclusion: The incidence and severity of AKI associated with colistimethate in critically ill patients was high and serious. Drug monitoring program should be performed to shorten duration of therapy and reduce cumulative dose from initiation of colistimethate therapy for minimizing AKI of colistimethate.

Trends and Future Direction of the Clinical Decision Support System in Traditional Korean Medicine

  • Sung, Hyung-Kyung;Jung, Boyung;Kim, Kyeong Han;Sung, Soo-Hyun;Sung, Angela-Dong-Min;Park, Jang-Kyung
    • Journal of Pharmacopuncture
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    • v.22 no.4
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    • pp.260-268
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    • 2019
  • Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

The Effect of Simulation Training applying SBAR for Nursing Students on Communication Clarity, Self-Confidence in Communication, and Clinical Decision-Making Ability (SBAR를 적용한 시뮬레이션 교육이 간호대학생의 의사소통명확성, 의사소통자신감, 임상의사결정능력에 미치는 효과)

  • Cho, Hun-Ha;Nam, Keum-hee;Park, Jung-Suk;Jeong, Hyo-Eun;Jung, Yu-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.73-81
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    • 2020
  • This study is a single-group study to check the effectiveness of nursing students on their communication credibility, communication confidence and clinical decision-making ability by implementing SBAR-applied simulation training to improve the difficulty of delivering clear information to medical personnel during transition. By combining simulation practices and SBAR training based on emergency situations of mothers and newborns, programs were developed and applied to communicate clearly and briefly to the medical staff about emergencies and to enhance communication skills. The subjects were 91 fourth-year nursing college students from one university in B metropolitan city. The data were collected from Feb. 18, 2019 to Feb. 28, 2019 and were analyzed using the SPSS/WIN 18.0 program as a paired t-test. The results revealed that the communication clarity measured after the simulation exercise (t=-3.99, p<.001), Communication Confidence (t=-8.60, p<.001), Clinical Decision Capacity (t=-4.66, p<.001) Statistically, it has increased significantly. Therefore, the purpose of this research is significant in that it seeks to promote the expertise of nursing college students by developing and applying simulation practical education programs to enhance the communication skills and clinical decision-making skills of nursing college students as prospective medical personnel.

Single Intravenous-dose Toxicity of Water-soluble Carthami-flos Pharmacopuncture (WCF) in Rats

  • Jung, Da-Jung;Choi, Yoo-Min;Kim, Seok-Hee;Kim, Jong-Uk;Yook, Tae-Han
    • Journal of Pharmacopuncture
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    • v.17 no.3
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    • pp.31-39
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    • 2014
  • Objectives: This study was performed to analyze the toxicity and to find the lethal dose of the test substance Water-soluble Carthami-flos pharmacopuncture (WCF) when used as a single intravenous-dose in 6-week-old, male and female Sprague-Dawley rats. Methods: The experiment was conducted at Biotoxtech according to Good Laboratory Practices. 20 female and 20 male Spague-Dawley rats were divided into 4 groups of 5 female and 5 male animals per group. The rats in the three experimental groups received single intravenous injections with 0.125-mL, 0.25-mL and 0.5-mL/animal doses of WCF, Groups 2, 3, and 4, respectively, and the control group, Group 1, received a single intravenous injection with a 0.5-mL dose of normal saline. Clinical signs were observed and body weight measurements were carried out for 14 days following the injections. At the end of the observation period, hematology, clinical chemistry, histopathological tests and necropsy were performed on the injected parts. Results: No deaths occurred in any of the groups. Also, no significant changes in body weight, hematological parameters or clinical chemistry test results between the control group and the experimental groups were observed. Visual inspection after necropsy showed no abnormalities. Histopathological tests on the injected parts showed no significant differences, except for Group 1 females; however, the result was spontaneous generation and had no toxicological meaning because it was not dose-dependent. Therefore, this study showed that WCF had no effect on the injected parts in terms of clinical signs, body weight, hematology, clinical chemistry, and necropsy. Conclusion: As a result of single intravenous-dose tests of the test substance WCF in 4 groups of rats, the lethal dose for both males and females exceeded 0.5 mL/animal. Therefore, WCF is a relatively safe pharmacopuncture that can be used for treatment, but further studies should be performed.

Study on validity of the National Examination based on smart device based test(SBT) by 7 types of healthcare occupation (보건의료직종별 SBT 국가시험체제에 대한 타당성 연구)

  • Yoou, Soon-Kyu;Won, Jong-Soon;Lee, Koon-Ja;Han, Dong-Kyoon;Sung, Ho-Joong;Lee, Han-Suk;Chung, Lim-Hee;Kim, Eun-Joo;Choi, Hea-Kyung
    • The Korean Journal of Emergency Medical Services
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    • v.22 no.3
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    • pp.7-34
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    • 2018
  • Purpose: The purposes of this research were to study the validity of the National Examination based on smart based test(SBT) by 7 types of healthcare occupation. Methods: We conducted a questionnaires survey among 1,219 people including 210 professors for all 7 types of healthcare occupation and 573 clinical specialists ; 436 students from random sampling participated and the reliability of the questionnaire was tested using Cronbach's alpha. Results: Professors from 7 types of healthcare occupation were investigated for their opinions on the introduction of the SBT system ; 65.9% of the professors answered positively on the introduction of the SBT National Examination System, while 40.1% of the clinical experts answered likewise. In particular, professors and the clinical experts recognized altogether that the multimedia questionnaire, being effective for the evaluation of clinical and practical competence of the subjects, enabling the evaluation of various areas and strengthening the school education in clinical practices, the 42.0% of the students from 7 departments answered that the future direction of the national test is in the SBT test system with significant difference (p=.000) found in students majoring in order of Emergency Medical Services, Radiology and Physical therapy, compared to students from other majors, showing the positive response to the SBT system. Conclusion: The results of this study comprehensively evaluated the positive recognition of development of multimedia items and SBT system in national examination of 7 types of healthcare occupation in professors, field specialists and students.

Evaluation of Present Curriculum for Devlopment of Dept. of Radiological Science Curriculum (방사선학과 교육과정 개선을 위한 현 교육과정 평가)

  • Kang, Se-Sik;Kim, Chang-Soo;Choi, Seok-Yoon;Ko, Seong-Jin;Kim, Jung-Hoon
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.242-251
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    • 2011
  • A curriculum of study demands a change as period of time and society evolve. Therefore, at this point where changes are required, this study is to analyze and evaluate the curriculums which will enhance and improve current studies as a preceding stage. The research was based on the survey by groups of education experts and 19 universities with current curriculum of study in radiologic science, and their references. The study was focused on the scope of work by radiologic technologist, change of college systems, academic research about radiologic science, and the improvement and the future of radiologic science field in perspective to globalization and the digital era. In terms of work scope, angiography and interventional radiology at 6 to 8 schools, fluoroscopy at 4 schools, ultrasound and practices at 6 schools, magnetic resonance image at 2 schools were found to be unestablished. The basic medical subjects, humuan physiology, human anatomy and practices, medical terminology courses were set up at most schools; however, pathology at 5 schools, image anatomy at 6 schools, clinical medicine at 11 schools were yet opened. Among the basic science and engineering subjects, general biology and its practices at 11 schools, general physics and its practices at 14 schools, and general chemistry and its practices at 8 schools were established which is about a half from a total number of schools. Only 4-5 schools established digital subjects such as, health computer, computer programming, PACS which are the basic major subjects. In order to provide academic improvement in radiologic science, digitalized education and globalization, and basis for future-oriented education for the field of radiologic science, including expanded scope of work, it is acknowledged that curriculums that are opened and run at each school need to be standardized. Therefore, the need for introduction of certificate for the radiologic science education courses are suggested.

Factors Related to Breast Cancer Screening using Mammography and Clinical Breast Examination of Korean Women Over 40 Years of Age (한국 도시여성의 유방촬영술과 유방임상검사 관련요인)

  • Eun, Young;Gu, Mee-Ok;Lee, Eunice L.;Choi, Kyung-Sook;Jun, Myung-Hee
    • Korean Journal of Adult Nursing
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    • v.21 no.6
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    • pp.580-592
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    • 2009
  • Purpose: The purpose of this study was to investigate the factors related to Breast cancer Screening using Mammography and CBE of Korean women over 40 years of age. Methods: The participants for this study were 183 Korean women living in 3 urban cities and aged from 40 to 75. The data were collected using structured questionnaires which included sociodemographic factors (11 items), frequency and regularity of mammography and clinical breast examination (7 items), knowledge (16 items), health belief model scale (28 items), and family support (4 items) about breast cancer and breast cancer screening. Frequencies, Chronbach's alpha for reliability, Chi-square, t-test and logistic regression with the SPSS/WIN 12 program were used to analyze the data. Results: The percentages of Korean women who had a mammography and CBE for breast cancer screening were 60.1 and 31.1, respectively. Logistic regression analyses demonstrated that regular check ups and perceived barriers were significant predictors of mammography and CBE use for breast cancer screening. Conclusion: In order to increase the frequency of breast cancer screening practices, educational support and a health care delivery system is needed to improve the chance of regular health check ups.

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Study on patients of infectious diseases administered with vancomycin or teicoplanin - Assessment of fitness of antimicrobial administration - (감염증 환자에서 vancomycin, teicoplanin 투여례에 대한 연구 - 항균제 투여의 적응증 평가 -)

  • Chang, Chul Hun;Son, Han Chul;Hwang, Kyu Yon;Park, Kwang Ok;Yang, Ung Suk
    • Quality Improvement in Health Care
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    • v.3 no.2
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    • pp.26-35
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    • 1997
  • Background : Glycopeptide antibiotics are the only drugs for treatment of infections due to beta-lactam-resistant Gram-positive bacteria. As the incidence of infection and colonization with vancomycin-resistant enterococci(VRE) rapidly increases, the hospital infection control practices advisory committee(HICPAC) recommends prudent vancomycin use to detect, prevent and control infection and colonization with VRE. Methods : The inpatients admitted from September to December, 1996 in Pusan National University Hospital, with Gram-positive bacterial infections were evaluated retrospectively to see whether the administrations of glycopeptide antibiotics were appropriate or not, upon comparison with the recommendations for preventing the spread of vancomycin resistance by HICPAC. Results : Teicoplanin has been chosen more frequently than vancomycin of the glycopeptide antibiotics. The indications of administration of glycopeptides in patients with pneumonia, wound infections, sepsis, and in febrile or neutropenic patients with malignancies were appropriate, but the use of glycopeptides for elimination of merely colonized bacteria in the oral cavity could not be excluded. Inappropriate use of glycopeptides was 10.6%, and inappropriately long-term use without positive culture for beta-lactam-resistant Gram-positive organisms was about 40% of total days of drug use. Conclusion : It seems essential for the quality assurance committee to make a plan in teaching the HICPAC recommendations to the medical practitioners who prescribed the glycopeptides inappropriately or used for irrelevantly long to his patient, monitor and survey their use of glycopeptides prospectively and periodically, and if there are repeated inappropriate prescriptions, a certain penalty would be given to the practitioners.

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