• Title/Summary/Keyword: Health care-associated infection

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A Systematic Review and Meta-Analysis on the Effects of Urinary Tract Infections in the Water or Antiseptic for Periurethral Cleaning Before Urinary Catheterization (도뇨관 삽입 전 소독제 또는 물의 사용이 요로감염 발생에 미치는 효과에 대한 체계적 문헌고찰과 메타분석)

  • Kim, Jin-Sook;Kim, Mi-Jung;Kim, Kuk-Hwa;Lim, Da-Hae
    • Quality Improvement in Health Care
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    • v.23 no.2
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    • pp.81-94
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    • 2017
  • Purpose:The purpose of this study was to evaluate the effects of periurethral cleaning with water or antiseptics in preventing catheter-associated urinary tract infections through systemic review Methods:The randomized clinical trials published between 2000 and 2016 were searched using domestic and international databases, and five randomized studies were selected for this study. The quality of study was assessed by assessment tool from the cochrane's Risk of Bias and meta-analysis was performed using the Cochrane Review Manager software Version 5.3 (RevMan) Results: The two groups of antiinfectants used in this study include povidone-iodine and chlorhexidine, water and chlorhexidine vs water and chlorhexidine. there was no significant difference in urinary tract infection rate between the two groups. Conclusion: Based on the findings, periurethral cleaning with water is safer and cost-efficient than using antiseptics. and it can make reduce a patient's discomfort.

Lower Urinary Tract Symptoms of Elderly Prostate Cancer Patients (전립선암 노인 환자의 하부요로증상)

  • Cho, Ok-Hee;Yoo, Yang-Sook;Cha, Kyeong-Sook;Kim, Myung-Wan
    • Journal of Home Health Care Nursing
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    • v.18 no.2
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    • pp.126-132
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    • 2011
  • Purpose: The purpose of this study was to investigate the degree of LUTS (Lower Urinary Tract Symptoms) and factors affecting LUTS in patients with prostate cancer. Methods: Fifty-four patients with prostate cancer participated and they completed a structured questionnaire at a hospital in Seoul. The LUTS level was measured by using the International prostate symptom score (1992) and the data were analyzed by Wilcoxon rank sum test and Kurskal-Wallis test. Results: Most subjects obtained a higher than moderate LUTS score. The participants who had a lower perceived health status and did not drink alcohol were more likely to had a lower LUTS score than other patients who had higher perceived health status and drink alcohol. In addition, eye diseases were significantly associated with the LUTS score. In LUTS, all the patients received higher IPSS-QOL (International prostate symptom score quality of life) and frequency, nocturia. Conclusion: For proper nursing care related to LUTS, nurses should focus on the factors identified when performing nursing assessments and should develop nursing intervention programs for symptoms management.

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The societal cost of rotavirus infection in South Korea (한국에서 로타바이러스 급성 위장관염의 질병 부담)

  • Yang, Bong Min;Jo, Dae Sun;Kim, Youn Hee;Hong, Ji Min;Kim, Jung Soo
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.977-986
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    • 2008
  • Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.

Nurse-perceived Patient Adverse Events and Nursing Practice Environment

  • Kang, Jeong-Hee;Kim, Chul-Woung;Lee, Sang-Yi
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.5
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    • pp.273-280
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    • 2014
  • Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician-nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

Risk Factors for Surgical Site Infections in Patients Undergoing Craniotomy (개두술을 받은 환자의 수술부위감염 관련요인 분석)

  • Cha, Kyeong-Sook;Cho, Ok-Hee;Yoo, So-Yeon
    • Journal of Korean Academy of Nursing
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    • v.40 no.2
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    • pp.298-305
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    • 2010
  • Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative surgical site infections (SSIs) after craniotomy. Methods: This study was a retrospective case-control study of 103 patients who had craniotomies between March 2007 and December 2008. A retrospective review of prospectively collected databases of consecutive patients who underwent craniotomy was done. SSIs were defined by using the Centers for Disease Control criteria. Twenty-six cases (infection) and 77 controls (no infection) were matched for age, gender and time of surgery. Descriptive analysis, t-test, $\chi^2$-test and logistic regression analyses were used for data analysis. Results: The statistical difference between cases and controls was significant for hospital length of stay (>14 days), intensive care unit stay more than 15 days, Glasgrow Coma Scale (GCS) score (${\leq}7$ days), extra-ventricular drainage and coexistent infection. Risk factors were identified by logistic regression and included hospital length of stay of more than 14 days (odds ratio [OR]=23.39, 95% confidence interval [CI]=2.53-216.11) and GCS score (${\leq}7$ scores) (OR=4.71, 95% CI=1.64-13.50). Conclusion: The results of this study show that patients are at high risk for infection when they have a low level of consciousness or their length hospital stay is long term. Nurses have to take an active and continuous approach to infection control to help with patients having these risk factors.

Healthcare Systems and COVID-19 Mortality in Selected OECD Countries: A Panel Quantile Regression Analysis

  • Jalil Safaei;Andisheh Saliminezhad
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.6
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    • pp.515-522
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    • 2023
  • Objectives: The pandemic caused by coronavirus disease 2019 (COVID-19) has exerted an unprecedented impact on the health of populations worldwide. However, the adverse health consequences of the pandemic in terms of infection and mortality rates have varied across countries. In this study, we investigate whether COVID-19 mortality rates across a group of developed nations are associated with characteristics of their healthcare systems, beyond the differential policy responses in those countries. Methods: To achieve the study objective, we distinguished healthcare systems based on the extent of healthcare decommodification. Using available daily data from 2020, 2021, and 2022, we applied quantile regression with non-additive fixed effects to estimate mortality rates across quantiles. Our analysis began prior to vaccine development (in 2020) and continued after the vaccines were introduced (throughout 2021 and part of 2022). Results: The findings indicate that higher testing rates, coupled with more stringent containment and public health measures, had a significant negative impact on the death rate in both pre-vaccination and post-vaccination models. The data from the post-vaccination model demonstrate that higher vaccination rates were associated with significant decreases in fatalities. Additionally, our research indicates that countries with healthcare systems characterized by high and medium levels of decommodification experienced lower mortality rates than those with healthcare systems involving low decommodification. Conclusions: The results of this study indicate that stronger public health infrastructure and more inclusive social protections have mitigated the severity of the pandemic's adverse health impacts, more so than emergency containment measures and social restrictions.

Sepsis: Early Recognition and Optimized Treatment

  • Kim, Hwan Il;Park, Sunghoon
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.1
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    • pp.6-14
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    • 2019
  • Sepsis is a life-threatening condition caused by infection and represents a substantial global health burden. Recent epidemiological studies showed that sepsis mortality rates have decreased, but that the incidence has continued to increase. Although a mortality benefit from early-goal directed therapy (EGDT) in patients with severe sepsis or septic shock was reported in 2001, three subsequent multicenter randomized studies showed no benefits of EGDT versus usual care. Nonetheless, the early administration of antibiotics and intravenous fluids is considered crucial for the treatment of sepsis. In 2016, new sepsis definitions (Sepsis-3) were issued, in which organ failure was emphasized and use of the terms "systemic inflammatory response syndrome" and "severe sepsis" was discouraged. However, early detection of sepsis with timely, appropriate interventions increases the likelihood of survival for patients with sepsis. Also, performance improvement programs have been associated with a significant increase in compliance with the sepsis bundles and a reduction in mortality. To improve sepsis management and reduce its burden, in 2017, the World Health Assembly and World Health Organization adopted a resolution that urged governments and healthcare workers to implement appropriate measures to address sepsis. Sepsis should be considered a medical emergency, and increasing the level of awareness of sepsis is essential.

Priority Areas for National Health Care Quality Evaluation in Korea (의료의 질 평가 우선순위 설정)

  • Shin, Suk-Youn;Park, Choon-Seon;Kim, Sun-Min;Kim, Nam-Soon;Lee, Sang-Il
    • Health Policy and Management
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    • v.19 no.3
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    • pp.1-26
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    • 2009
  • Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

The Association between Skin Type and Skin Care Behavior and Stress Perception during COVID-19 Pandemic

  • Tae-Oim KIM;Ki-Han KWON
    • The Journal of Industrial Distribution & Business
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    • v.14 no.4
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    • pp.33-46
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    • 2023
  • Purpose: During the coronavirus disease-19 (COVID-19) outbreak, mask-wearing is required to protect against and limit the spread of infection, but it can directly affect skin problems. Change in skin condition might be related to mental health. This study explored the association between skin conditions and behavior of skin cares and stress levels during the Covid-19pandemics. Research design, data and methodology: A survey was conducted on 516 adults who were aware of damaged skin due to continuous wearing of masks for a long time during the COVID-19 Pandemic. The study included 164 men and 352 women in the Republic of Korea. Results: Skin conditions and behavior of skin cares associated with stress perceptions. A multiple linear regression model was used adjusting for potential confounder. Conclusion: Since management so far in the COVID-19 Pandemic can cause skin concerns and change the original skin type, it is necessary to redefine and improve the use of skin care, face-washing methods, and functional cosmetics. People with high and low interest in skin type recognition and management were evenly identified, and it was confirmed that stress awareness decreases as awareness of skin care attitude increases.

Review and Current Status of Opisthorchis viverrini Infection at the Community Level in Thailand

  • Kaewpitoon, Natthawut;Kootanavanichpong, Nusorn;Kompor, Ponthip;Chavenkun, Wasugree;Kujapun, Jirawoot;Norkaew, Jun;Ponphimai, Sukanya;Matrakool, Likit;Tongtawee, Taweesak;Panpimanmas, Sukij;Rujirakul, Ratana;Padchasuwan, Natnapa;Pholsripradit, Poowadol;Eksanti, Thawatchai;Phatisena, Tanida;Loyd, Ryan A;Kaewpitoon, Soraya J
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6825-6830
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    • 2015
  • Opisthorchis viverrini is remains a public health problem in Thailand, particularly in the northeast and north regions which have the highest incidences of chonalgiocarcinoma (CCA). O. viverrini causes the disease opithorchiasis, and its has been classified as a group 1 biological carcinogen. Humans, dogs, and cats become infected with O. viverrini by ingesting raw or undercooked fish containing infective metacercariae. The first human cases of O. viverrini infection were reported in Thailand 100 years ago, and it's still a problem at the community level. Based on data for the year 2009, more than 6 million people were infected with O. viverrini. Associated medical care and loss of wages in Thailand costs about $120 million annually. This review highlights the current status of O. viverrini infection in communities of Thailand through active surveillance for the five years period from 2010 and 2015. A total of 17 community-based surveys were conducted, most in the northeast region. Some 7 surveys demonstrated a high prevalence over 20%, and the highest was 45.7%. Most commonly infection was found in age group of 35 years and older, males, and agricultural workers. Although, the national prevalence may be decreasing but the results show that the O. viverrini infection is still high in communities of the northeast region. Therefore, the focus in populations living in northeast Thailand should be screening of infection and changing their eating behavior.