• Title/Summary/Keyword: Clinical standards

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National utilization of rib fracture fixation in the geriatric population in the United States

  • Brewer, Jennifer M.;Aakjar, Leah;Sullivan, Kelsey;Jayaraman, Vijay;Moutinho, Manuel;Jeremitsky, Elan;Doben, Andrew R.
    • Journal of Trauma and Injury
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    • v.35 no.3
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    • pp.173-180
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    • 2022
  • Purpose: The use of surgical stabilization of rib fractures (SSRF) has steadily increased over the past decade. Recent literature suggests that a larger population may benefit from SSRF, and that the geriatric population-as the highest-risk population-may receive the greatest improvement from these interventions. We sought to determine the overall utilization of SSRF in the United States. Methods: The National Trauma Database was analyzed between 2016 and 2017. The inclusion criteria were all patients ≥65 years old with rib fractures. We further stratified these patients according to age (65-79 vs. ≥80 years old), the presence of coding for flail chest, three or more rib fractures, and intervention (surgical vs. nonoperative management). The main outcomes were surgical interventions, mortality, pneumonia, length of stay, intensive care unit length of stay, ventilator use, and tracheostomy. Results: Overall, 93,638 patients were identified. SSRF was performed in 992 patients. Patients who underwent SSRF had improved mortality in the 65 to 79 age group, regardless of the number of ribs fractured. We identified 92,637 patients in the age group of 65 to 79 years old who did not undergo SSRF. This represents an additional 20,000 patients annually who may benefit from SSRF. Conclusions: By conservative standards and the well-established Eastern Association for the Surgery of Trauma clinical practice guidelines, SSRF is underutilized. Our data suggest that SSRF may be very beneficial for the geriatric population, specifically those aged 65 to 79 years with any rib fractures. We hypothesize that roughly 20,000 additional cases will meet the inclusion criteria for SSRF each year. It is therefore imperative that we train acute care surgeons in this skill set.

The method of calculating health scores using examination data (검진자료를 활용한 건강점수 산출 방법에 관한 연구)

  • Lee, Chanjung;Jo, Brian;Woo, Hyunki;Im, Yoori;Park, Chul Hyoung
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.26 no.12
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    • pp.1777-1785
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    • 2022
  • This study confirmed the validity of the health score(HS) calculation methodology and results. HS is an index that scores the degree of personal health by applying clinical standards and statistical function to health check-up items. It's calculated by the total size of the biomarker on the health change, the influence on the health change, the weight change rate according to the degree of outlier, and the standardized value. In order to confirm the validity of the results, several diseases were selected and HS was compared between the disease occurrence group and the disease absence group. And by segmenting the ranked HS, the disease incidence rate was compared. As a result, in all selected diseases, the difference in the mean of HS was significant according to the presence or absence of disease, and the incidence of selected diseases showed a tendency to increase as HS decreased.

The Relationship Between Thiamine Intake and Long Sleep Duration: Results From the Korea National Health and Nutrition Examination Survey

  • Dongkyu, Lee;Kwanghyun, Kim;Youngrong, Lee;Kyungwon, Oh;Sun Jae, Jung
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.6
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    • pp.520-528
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    • 2022
  • Objectives: Thiamine is thought to modify sleeping patterns, while alcohol use diminishes internal thiamine levels. We investigated the association between thiamine intake and sleep duration and explored possible heterogeneity in the effect according to alcohol use. Methods: In total, 15 384 participants aged 19-64 were obtained from the Korea National Health and Nutrition Examination Survey 2012-2016. Nutrient intake, including thiamine, was measured using a food frequency questionnaire. Sleep duration was measured by a self-reported questionnaire. The highest thiamine intake quartile was set as the reference group. Participants were divided into 3 groups, with 7-8 hours of daily sleep as a reference group and those who slept more or less than that as "oversleeping" and "insufficient sleeping," respectively. Multivariate logistic regression was used, adjusting for socioeconomic, medical, and nutritional factors. Additionally, participants were stratified according to high-risk alcohol use defined by the World Health Organization standards on alcohol use. Results: Low thiamine intake was associated with oversleeping (Q3: odds ratio [OR], 1.06; 95% confidence interval [CI], 0.86 to 1.32; Q2: OR, 1.24; 95% CI, 0.99 to 1.55; Q1: OR, 1.49; 95% CI, 1.16 to 1.91) and showed a significant trend for higher ORs at lower intake levels (p-trend<0.001). The effect was stronger in the high-risk alcohol use group (Q1: OR, 1.78; 95% CI, 1.28 to 2.49). Conclusions: Low thiamine intake was associated with oversleeping, and alcohol use intensified that association. These results were found in a context where overt clinical symptoms due to thiamine deficiency are considered rare. More awareness of the potential relationship of thiamine intake with oversleeping and its related risks should be considered.

Recommendation for the Amendment of Inpatient Nursing Fee Schedules Based on Nurse Staffing Standards in General Wards of Tertiary Hospitals and General Hospitals (상급종합병원과 종합병원 일반병동의 간호관리료 차등제 간호사 배치기준 및 수가체계 개선방안)

  • Cho, Sung-Hyun;Seong, Jiyeong;Jung, Young Sun;You, Sun Ju;Sim, Won Hee
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.2
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    • pp.122-136
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    • 2022
  • Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion: The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.

The Effects of self-leadership, self-efficacy, and organizational commitment on safety Management activities in clinical nurses' (임상간호사의 셀프리더십, 자기효능감, 조직몰입이 안전관리활동에 미치는 영향)

  • Eun-Hee Park
    • Journal of Digital Policy
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    • v.2 no.3
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    • pp.9-15
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    • 2023
  • This study is a descriptive survey study for nurses in general hospitals to understand the effects of self-leadership, self-efficacy, and organizational commitment on safety management activities. The subjects of the study were nurses at three general hospitals located in G City. An online survey was conducted in consideration of the COVID-19 pandemic situation. Data collection was from August 20 to August 30, 2021. As a result of the study, self-leadership (r=.618, p<.001), self-efficacy (r=306, p<.001), organizational immersion (r=0518, p<.001) showed a positive correlation with safety management activities. In addition, self-leadership, self-efficacy, and organizational commitment explained 38.2% of safety management activities (F=20.478, p<.001). Therefore, it would be helpful to provide regular leadership education and self-efficacy education to increase patient management activities of general hospital nurses. In addition, if a positive work environment, legal standards for nurse work, and an appropriate compensation system are established to improve organizational commitment, it will have a positive effect on environmental safety management activities.

Establishing veterinary graduation competencies and its impact on veterinary medical education in Korea

  • Sang-Soep Nahm;Kichang Lee;Myung Sun Chun;Jongil Kang;Seungjoon Kim;Seong Mok Jeong;Jin Young Chung;Pan Dong Ryu
    • Journal of Veterinary Science
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    • v.24 no.3
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    • pp.41.1-41.9
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    • 2023
  • Competencies are defined as an observable and assessable set of knowledge, skills, and attitudes. Graduation competencies, which are more comprehensive, refer to the required abilities of students to perform on-site work immediately after graduation. As graduation competencies set the goal of education, various countries and institutions have introduced them for new veterinary graduates. The Korean Association of Veterinary Medical Colleges has recently established such competencies to standardize veterinary education and enhance quality levels thereof. The purpose of this study is to describe the process of establishing graduation competencies as well as their implication for veterinary education in Korea. Graduation competencies for veterinary education in Korea comprise 5 domains (animal health care and disease management, one health expertise, communication and collaboration, research and learning, and veterinary professionalism). These are further divided into 11 core competencies, and 33 achievement standards, which were carefully chosen from previous case analyses and nation-wide surveys. Currently, graduation competencies are used as a standard for setting clear educational purposes for both instructors and students. Establishing these competencies further initiated the development of detailed learning outcomes, and of a list of basic veterinary clinical performances and skills, which is useful for assessing knowledge and skills. The establishment of graduation competencies is expected to contribute to the continuous development of Korean veterinary education in many ways. These include curriculum standardization and licensing examination reform, which will eventually improve the competencies of new veterinary graduates.

A Study on Developing Safety and Performance Assessment Guideline for Electronic Warm-Acupuncture Apparatus (전기식 온침기에 대한 안전성 및 성능평가 가이드라인 개발 연구)

  • Hansol Jang;U-Ryeong Chung;Jeong-Hyun Moon;Seong-Kyeong Choi;Won-Suk Sung;Min-Seop Hwang;Seung-Deok Lee;Kyung-Ho Kim;Jong-Hwa Yoon;Eun-Jung Kim
    • The Journal of Korean Medicine
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    • v.43 no.3
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    • pp.150-163
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    • 2022
  • Objectives: This research aimed to develop a guideline for evaluating safety and performance of electronic warm-acupuncture apparatus. With the development of medical devices like electronic warm-acupuncture apparatus with improved performance, convenience and safety measures compared to traditional warm-acupuncture needling, safety and performance guideline is a necessity. Methods: By referring to existing standards and guidelines of other electronic devices for Korean medicine with heating function, guideline for safety and performance assessment of electronic warm-acupuncture apparatus was drafted Results: The guideline, presents explanation for adequate temperature and settings of the apparatus, and safety measurements providing against thermal runaway situations along with guidelines for the manual. Guideline for detailed test method for the performance of the apparatus such as accuracy of temperature increase and the timer, and safety unit was also provided. The test items and suggested test methods for the requirements of biological, electrical and electromagnetic safety were referred to Korean approval documents of ministry of Food and Drug Safety. Conclusion: We proposed the relevant items to verify performance and safety of warm-acupuncture apparatus to assure patient safety and improve the quality of currently developing devices for application in clinical field.

Assessment of acute inhalation toxicity of citric acid and sodium hypochlorite in rats

  • Jinhee Kim;Chul-Min Park;Su Hyun Choi;Mi Jin Yang;Ju-Yeon Lee;Byung-Suk Jeon;Hyun-Ok Ku;Min-Seok Kim
    • Journal of Veterinary Science
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    • v.24 no.2
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    • pp.22.1-22.12
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    • 2023
  • Background: Citric acid (CA) and sodium hypochlorite (NaOCl) have been used to disinfect animals to protect them against avian influenza and foot-and-mouth disease. Objectives: We performed a good laboratory practice (GLP)-compliant animal toxicity study to assess the acute toxic effects of CA and NaOCl aerosol exposure in Sprague-Dawley rats. Methods: Groups of five rats per sex were exposed for 4 h to four concentrations of the two chemicals, i.e., 0.00, 0.22, 0.67, and 2.00 mg/L, using a nose-only exposure. After a single exposure to the chemicals, clinical signs, body weight, and mortality was observed during the observation period. On day 15, an autopsy, and then gross findings, and histopathological analysis were performed. Results: After exposure to CA and NaOCl, body weight loss was observed but recovered. Two males died in the CA 2.00 mg/L group and, two males and one female died in the 2.00 mg/L NaOCl group. In the gross findings and histopathological analysis, discoloration of the lungs was observed in the CA exposed group and inflammatory lesions with discoloration of the lungs were observed in the NaOCl exposed group. These results suggest that the lethal concentration 50 (LC50) of CA is 1.73390 mg/L for males and > 1.70 mg/L for females. For NaOCl, the LC50 was 2.22222 mg/L for males and 2.39456 mg/L for females. Conclusions: The Globally Harmonized System is category 4 for both CA and NaOCl. In this study, the LC50 results were obtained through a GLP-based acute inhalation toxicity assessment. These results provide useful data to reset safety standards for CA and NaOCl use.

Survey of Antibiotic Resistant Bacteria in Ulleungdo, Korea (울릉도의 항생제 내성균 조사)

  • Jun Hyung Lee;Hye Won Hong;Dukki Han
    • Korean Journal of Environmental Agriculture
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    • v.41 no.4
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    • pp.344-354
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    • 2022
  • BACKGROUND: Although antibiotics have contributed to treatment of bacterial infection, the antibiotic abuse can lead to antibiotic resistant bacteria. Impact of human activities on distribution of antibiotic resistance has been intensively issued and occurrence of antibiotic resistant bacteria in contaminated environments would not be a surprise. Nonetheless, anthropogenic contamination with the dissemination of antibiotic resistance along uncontaminated environments has been less considered. The aim of this study is to investigate antibiotic resistant bacteria across Ulleungdo, known as antibiotic resistance free and anthropogenic pollution free environment in Rep. of Korea. METHODS AND RESULTS: Antibiotic resistant bacteria in coastal seawater of Ulleungdo were investigated in July 2021. Antibiotic susceptibility test using the disk diffusion method was applied with six drugs according to the Clinical and Laboratory Standards Institute (CLSI) guideline. Total 43 bacterial isolates were tested and 20 isolates among of them showed multidrug resistance. Particularly, the number and ratio of resistant bacteria were relatively high in a densely populated area of Ulleungdo. The bacterial communities were investigated using 16S rRNA gene metabarcoding approach in the coastal seawater and soils of Ulleungdo. In the bacterial communities, Firmicutes were selectively distributed only in seawater, suggesting the possibility of anthropogenic contamination in coastal seawater of Ulleungdo. CONCLUSION(S): We found antibiotic resistant bacteria in a populated area of Ulleungdo. The occurrence of antibiotic resistant bacteria in Ulleungdo seems to result from the recent anthropogenic impact. Consistent monitoring of antibiotic resistant bacteria in the uncontaminated environment needs to considered for future risk assessment of antibiotics.

Factors Related to Workload of Intensive Care Unit Nurses: Systematic Review and Meta-Analysis (중환자실 간호사의 업무부담 관련 요인: 체계적 문헌고찰 및 메타분석)

  • Jeong, Ah In;Shin, Sujin;Hong, Eunmin
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.3
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    • pp.296-311
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    • 2023
  • Purpose: This study aimed to identify factors related to the workload of intensive care unit nurses through a systematic literature review and meta-analysis to provide basic data to explore the direction of development of nursing staffing standards. Methods: This study involved quantitative studies about nurses working in intensive care units related to nursing workload published in English or Korean since 2000. Search terms included 'intensive care unit', 'nursing workload', and their variations. Databases such as RISS, DBpia, MEDLINE(PubMed), CINAHL, PsycINFO, and Web of Science were utilized. Quality assessment was conducted using the Joanna Briggs Institute's Critical Appraisal Checklist for Analytical Cross-Sectional Studies. JAMOVI software facilitated the analysis of effect sizes, employing a meta-analysis approach for 7 studies with correlational or regression data. Results: From 16 studies on the workload of intensive care unit nurses, a total of 20 patient and nurse-related factors were identified. Patient-related factors included severity of illness, length of stay, and age. Meta-analysis was conducted for three patient-related factors: age, severity of illness measured by SAPS 3, and length of stay. Only severity of illness measured by SAPS 3 was significantly associated with nurse workload (Zr=0.16, p<.001, 95% CI=0.09-0.24). Conclusion: In previous studies, the characteristics of intensive care units and patients varied across studies, and a variety of scales for measuring workload and severity of illness were also used. Sustained research reflecting domestic intensive care unit work environments and assessing the workload of intensive care unit nurses should be imperative.