• 제목/요약/키워드: Clinical indicator

검색결과 421건 처리시간 0.03초

급성기 뇌경색 환자에 있어 변증형별 유의한 임상지표의 분석 (Analysis of Clinical Indicators related to Pattern-Identification in Acute Cerebral Infarction Patient)

  • 이은찬;현상호;곽승혁;우수경;박주영;정우상;문상관;조기호;박성욱;고창남
    • 대한중풍순환신경학회지
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    • 제13권1호
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    • pp.33-42
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    • 2012
  • Object : The aim of this study was to assess the clinical indicators related to Pattern-Identification(PI) in acute cerebral infarction patients. Methods : We studied hospitalized patients within 30days after ictus, who admitted at Korean Medicine Center of Kyung-Hee University from January 2010 to October 2012.(n=290) Two Traditional Korean Medicine(TKM) physicians evaluated the patients independently and diagnosed PI. Inter-rater reliability was measured using simple percentage agreement and the Cohen's kappa(κ) coefficient. To assess the clinical indicators closely related to each PI, we analysed average score of each indicator in each group. Results : Simple percentage agreement of PI between raters was 64.83% and Cohen's kappa(κ) coefficient was 0.526(95% CI: 0.451-0.600). Inter-rater reliability level was fair to good. We analysed the clinical indicators in each group. Significant indicators for Fire-Heat Pattern(FHP) were reddened complexion and strong pulse power, and meaningful indicators for FHP were halitosis and thick tongue fur. Significant indicator for Dampness-Phlegm Pattern(DPP) was overweight and there was no meaningful indicator. Significant indicator for Yin-Deficiency Pattern(YDP) was dry tongue fur and meaningful indicator for YDP was thirst. There was no significant indicator for Qi-Deficiency Pattern(QDP) and pale complexion and faint low voice were meaningful indicators for QDP. Conclusions : This study reveals the significant and meaningful clinical indicators related to each Pattern-Identification in acute cerebral infarction patients. It will contribute to standardization of Korean Medical Diagnosis and Treatment in acute cerebral infarction patients.

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응급실 간호사의 임상 등급(clinical ladder)에 따른 간호역량 및 행동지표 개발 (Nursing Competency And Indicator Development By Emergency Nurse's Clinical Ladder)

  • 육신영
    • 간호행정학회지
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    • 제9권3호
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    • pp.481-494
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    • 2003
  • Purpose: This study was to develop nursing competencies, sub-competencies and behavior indicators according to the clinical ladder of emergency nurses. Method: index of content validation was used by 21 clinical experts. Results: This study had three phases to develop nursing competencies, sub-competencies and behavior indicators. In first phase: 12 nursing competencies and 33 sub-competencies were developed through the literature review on nursing competency and emergency nurses' job description. The content of 12 competencies and 33 sub-competencies were reviewed by 3 nursing professors. The 12 competencies and 33 sub-competencies were followed: clinical judgement and measures(6 sub-competencies), processing ability of ward works(2 sub-competencies), flexibility(2 sub-competencies), resources management(2 sub-competencies), confidence(3 sub-competencies), cooperation(2 sub-competencies), professional development power(2 sub-competencies), patient service orientation(3 sub-competencies), inclination toward ethical value(5 sub-competencies), influence power(2 sub-competencies), developing others(2 sub-competencies), self control(2 sub-competencies). In second phase, 132 behavior indicators were developed according to nurse clinical ladder: novice, advanced novice, competent, proficient. In Third phase, content validity was examined on 132 behavior indicators by 21 clinical experts. 126 among 132 indicators had over 70% agreement among experts and 6 indicators under 70% were revised. Conclusion: nursing competencies, sub competencies and behavior indicators can be used nurses' clinical performance as well as establishing proper directions for professional growth related to reward system.

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미국, 캐나다, 영국의 재입원율 활용 현황 (Readmission Rate: Experience in USA, Canada and UK)

  • 이상아;주영준;신재용;박은철;이후연
    • 한국의료질향상학회지
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    • 제22권1호
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    • pp.29-37
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    • 2016
  • Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.

소음인 소증 진단평가지표 개발 연구 (A Study on the Development of Diagnosis and Assessment Index by Soeumin's Ordinary Symptoms)

  • 황사비;이준희
    • 사상체질의학회지
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    • 제33권1호
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    • pp.38-56
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    • 2021
  • Objective This study was devised to create a new diagnosis and an assessment index by Soeumin's Ordinary Symptoms. Method First, a Working Committee and an Advisory Committee were formed for development, and the development goals were set. Then, the Soeumin's disease diagnosis indicators were extracted from the previous Clinical Practice Guidelines for Sasang Constitutional Medicine. To increase the clinical applicability, the extracted diagnosis indicators were focused on ordinary symptoms, and translated into Korean. The translated diagnosis and assessment indicators for Soeumin were surveyed to the Advisory Committee using the Delphi technique, and the inclusion, importance, and validity of each indicator were investigated accordingly. Result The translated diagnosis and assessment indicators were finally revised based on the surveyed inclusion and translation validity opinions, and the weight of each indicator was set based on the investigated importance, and a draft of the diagnosis and assessment index was developed. Conclusion This developed index can help to make effective diagnose about Soeumin's diseases by clinical doctor. In the future, a clinical study of this index can be conducted to consider the reliability, validity, and cut-point, and through this process, the actual clinical applicability will be improved.

중환자의 경관영양 공급 지표로서 위 잔여량의 임상적 효용성: 체계적 문헌고찰 (Clinical Usefulness of Gastric Residual Volume as An Indicator to Provide Approximately Enteral Nutrition for Patients in Intensive Care Units: A Systematic Literature Review)

  • 김현정;장선주
    • Journal of Korean Biological Nursing Science
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    • 제16권4호
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    • pp.267-275
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    • 2014
  • Purpose: The practice of enteral nutrition with gastric residual volumes (GRVs) as a clinical indicator is poorly standardized in intensive care units. This study aims to summarize the results from studies that evaluated the clinical outcomes related to the GRVs. Methods: This systematic review study analyzed 11 studies consisting of four randomized controlled trials, one non-randomized controlled trial, and six observational studies. Results: No consistent relationship between GRV thresholds and clinical outcomes was observed. Higher GRVs were not consistently correlated with clinical outcomes such as higher gastrointestinal complications, aspiration pneumonia, or mortality. Higher GRVs significantly generate complications more often. Findings show that a single GRV more than 200 mL or two consecutive GRVs more than 150 mL should raise concern about negative consequences. Conclusion: Critical care nurses need to monitor GRVs closely during their practice of enteral nutrition. For critically ill patients receiving enteral nutrition, a GRV threshold of 200 ml would be a desirable limit to provide safe and adequate nutrition with a conservative approach.

시설입소 노인환자 부양가족의 만족도 영향요인 (Factors related to Family Caregiver Satisfaction with Elderly in Nursing Facilities)

  • 김영애;김순애;이주영;황문숙;윤희상
    • 한국노년학
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    • 제29권2호
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    • pp.395-405
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    • 2009
  • 본 연구는 노인요양시설에 입소한 노인 환자들의 부양가족을 대상으로 만족도, 가족지지, 성과지표의 관계를 파악하고, 만족도에 영향을 미치는 요인을 파악하는 것이다. 본 연구의 대상은 서울, 경기지역에 위치한 노인요양 시설 5개소에 입소한 노인환자의 부양가족 126명을 대상으로 하였으며 만족도, 가족지지, 성과지표 측정도구로 자료수집 하였다. 만족도는 가족지지와 성과지표와 유의한 순상관 관계가 있었으며(r=.250, p=.008; r=.356, p=.000), 관련변인들의 만족도에 대한 설명력은 23%였고, 만족도에 유의한 영향을 미치는 요인으로는 경제수준, 가족지지, 성과지표로 나타났다. 본 연구결과는 노인요양시설에 입소한 노인환자 및 부양가족의 만족도 향상 향상시키는데 필요한 기초자료로 활용될 수 있을 것이다. 사회복지 정책적 함의 및 향후 연구 방향을 제안하고 있다.

효율성 측정지표를 활용한 전자적 임상시험프로세스 효과분석 (Effect Analysis of Electronic Clinical Trial Systems)

  • 이현주;최인영
    • 한국콘텐츠학회논문지
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    • 제11권1호
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    • pp.350-356
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    • 2011
  • 본 연구의 목적은 전자적 임상시험 데이터 관리를 위한 설계 시 시간적 요인에 주목하여 시스템의 효율성을 검증해 보고자 함이다. 임상시험 데이터 관리에 대한 관심이 커지고 있고 시스템 도입이 활발한 데 반해, 실제 효율성 측정에 관한 실증연구는 많지 않다. 특히 국내의 경우 임상시험 데이터 관리를 위한 전산화 도입률 조차 낮은 실정이다. 본 연구는 전자적 임상시험 데이터 관리에 대한 중요성 인식 확산을 위하여 전자적 시스템의 효과에 대한 실증연구를 시도하였으며, 시간효율성 측정지표를 활용하여 다기관 임상시험 사례의 자료를 분석하였다. 연구결과로서 전자적 시스템으로의 전환이 임상시험 전체 프로세스에 제공할 수 있는 시간 측면에서의 효율성을 검증하였으며 전자적 임상시험 데이터 관리 시스템의 활용 효과를 분석하기 위한 국내 첫 실증연구의 시도라는 의미가 있다. 나아가 전략적 데이터 관리 수립 및 임상단계 별 비교연구 등 향후 다양한 비교 연구들의 초석이 될 것이다.