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

검색결과 92건 처리시간 0.026초

우리나라 병원의 환자안전 향상을 위한 활동 현황 (Patient safety practices in Korean hospitals)

  • 황수희;김명화;박춘선
    • 한국의료질향상학회지
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    • 제22권2호
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    • pp.43-73
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    • 2016
  • Purpose: The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics. Methods: The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals. Results: About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators. One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals. Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated. Conclusion: The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.

임신기 치주질환과 자간전증 발생간의 연관성 (Association between Periodontitis and Preeclampsia: a Systematic Review)

  • 하정은
    • 대한통합의학회지
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    • 제6권1호
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    • pp.55-62
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    • 2018
  • Purpose : Preeclampsia(PE) is a pregnancy-specific disease which is characterized by hypertension and proteinuria. This disease occurs in about 2-8 % of pregnancies in developing countries and remains among the major causes of maternal and neonatal mortality and morbidity throughout the world. Although the causes of PE are not fully understood, the infection has been considered as the main risk factor for this diseases. Periodontal disease may provide a chronic burden of endotoxin and inflammatory cytokines and the disease has been considered as risk factors of systemic illnesses including cardiovascular disease, atherosclerosis, and cerebrovascular ischemia. So, studies performed over the last 15 years have suggested that periodontal disease may be associated with adverse pregnancy outcomes such as PE. However, this association has not been found in all populations. The aim of this review article was to evaluate whether periodontal status and the presence of specific periodontal pathogens may influence the incidence of PE. Methods : Many research articles searched at the electronic databases(MEDLINE; 2000 to July 2017) including search term as periodontal disease and preeclampsia. Result : There were 10 case-control studies and 5 cohort studies meeting our inclusion criteria. The results showed that maternal periodontitis (adjusted odds ratio: 1.5 to 9.3) was associated with preeclampsia in 15 epidemiological studies. Conclusion : It is clear that maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.

Helicobacter pylori Infection and Risk Factors in Relation to Allergy in Children

  • Daugule, Ilva;Karklina, Daiga;Remberga, Silvija;Rumba-Rozenfelde, Ingrida
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제20권4호
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    • pp.216-221
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    • 2017
  • Purpose: To analyze presence of Helicobacter pylori infection and environmental risk factors among children with and without allergy. Methods: Parents of children at primary health care centres/kindergartens and allergologist consultation were asked to answer a questionnaire and to bring a faecal sample. H. pylori infection was detected by monoclonal stool antigen test. Prevalence of H. pylori infection and risk factors were compared between individuals with and without allergy using ${\chi}^2$ test, ANOVA test and logistic regression. Results: Among 220 children (mean age, 4.7 years; ${\pm}standard$ deviation 2.3 years) H. pylori positivity was non-significantly lower among patients with allergy (n=122) compared to individuals without allergy (n=98): 13.9% (17/122) vs. 22.4% (22/98); p=0.106. In logistic regression analysis presence of allergy was significantly associated with family history of allergy (odds ratio [OR], 8.038; 95% confidence interval [CI], 4.067-15.886; p<0.0001), delivery by Caesarean section (OR, 2.980; 95% CI, 1.300-6.831; p=0.009), exclusive breast feeding for five months (OR, 2.601; 95% CI, 1.316-5.142; p=0.006), antibacterial treatment during the previous year (OR, 2.381; 95% CI, 1.186-4.782; p=0.015). Conclusion: Prevalence of H. pylori infection did not differ significantly between children with and without allergy. Significant association of allergy with delivery by Caesarean section and antibacterial therapy possibly suggests the role of gastrointestinal flora in the development of allergy, while association with family history of allergy indicates the importance of genetic factors in the arise of allergy.

Fluconazole prophylaxis against invasive candidiasis in very low and extremely low birth weight preterm neonates: a systematic review and meta-analysis

  • Anaraki, Mahmoud Robati;Nouri-Vaskeh, Masoud;Oskoei, Shahram Abdoli
    • Clinical and Experimental Pediatrics
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    • 제64권4호
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    • pp.172-179
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    • 2021
  • Background: Evidence shows that fluconazole prophylaxis is an effective treatment against invasive fungal infections in preterm neonates, however, the most efficient schedule of fluconazole prophylaxis for the colonization and mortality of invasive candidiasis (IC) is unknown. Purpose: This systematic review and meta-analysis aimed to assess the efficiency of different prophylactic fluconazole schedules in controlling IC colonization, infection, and mortality in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in neonatal intensive care units. Methods: We searched the PubMed, Scopus, Embase, and Cochrane databases using the keywords "candida," "invasive candidiasis," "IC," "fluconazole prophylaxis," "preterm infants," "very low birth weight infants," "VLBW," "extremely low birth weight," and "ELBW." Results: Mortality was significantly decreased in a meta-analysis of studies using different fluconazole prophylaxis regimens. The meta-analysis also indicated a significant decrease in the incidence of IC-associated mortality in ELBW infants using the same fluconazole prophylaxis schedules. Conclusion: Future studies should explore the effectiveness of other different fluconazole prophylaxis schedules on IC colonization, infection, and mortality.

Knowledge, Perceptions, and Self-reported Performance of Hand Hygiene Among Registered Nurses at Community-based Hospitals in the Republic of Korea: A Cross-sectional Multi-center Study

  • Oh, Hyang Soon
    • Journal of Preventive Medicine and Public Health
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    • 제51권3호
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    • pp.121-129
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    • 2018
  • Objectives: To assess the nurses' hand hygiene (HH) knowledge, perception, attitude, and self-reported performance in small- and medium-sized hospitals after Middle East Respiratory Syndrome outbreak. Methods: The structured questionnaire was adapted from the World Health Organization's survey. Data were collected between June 26 and July 14, 2017. Results: Nurses showed scores on knowledge ($17.6{\pm}2.5$), perception ($69.3{\pm}0.8$), self-reported HH performance of non-self ($86.0{\pm}11.0$), self-reported performance of self ($88.2{\pm}11.0$), and attitude ($50.5{\pm}5.5$). HH performance rate of non-self was $Y_1=36.678+0.555X_1$ (HH performance rate of self) (adjusted $R^2=0.280$, p<0.001). The regression model for performance was $Y_4=18.302+0.247X_{41}(peception)+0.232X_{42}(attitude)+0.875X_{42}(role model)$; coefficients were significant statistically except attitude, and this model significant statistically (adjusted $R^2=0.191$, p<0.001). Conclusions: Advanced HH education program would be developed and operated continuously. Perception, attitude, role model was found to be a significant predictors of HH performance of self. So these findings could be used in future HH promotion strategies for nurses.

Situation Analysis of Existing Facilities for Screening, Treatment and Prevention of Cervical Cancer in Hospitals/Primary health Centers of Delhi-NCR Region, India

  • Chawla, P. Cheena;Chawla, Anil Kumar;Shrivastava, Richa;Shrivastava, Anju;Chaudhary, Seema
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5475-5482
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    • 2014
  • Cervical cancer, the second most common malignancy all over the world, is associated with HPV infection. In a developing country like India, lack of early detection and treatment facilities is the main cause for its high burden. Therefore, through our study we e tried to present the current scenario of existing facilities for the detection and treatment of cervical cancer in hospitals and primary health centers (PHCs) of Delhi-NCR region. Data were collected from 312 healthcare facilities including public and private hospitals and PHCs of all nine districts from Delhi-NCR region. Healthcare providers including gynecologists, medical officers, women health care providers and paramedical staff were interviewed, using a questionnaire; the facilities for screening, diagnosing, and treating cervical cancer in each institution were recorded, using a previously designed checklist. Our study has shown that the basic facilities for the detection and treatment of cervical cancer are abhorrently lacking in Public hospitals and PHCs as compared to the Private hospitals in Delhi-NCR region. This study demonstrates that there is an urgent need for more investment in the diagnosis and treatment of cervical cancer facilities in public and rural healthcare facilities of Delhi-NCR region.

의료기관 간호사 확보수준이 수술환자의 사망, 폐렴, 패혈증, 요로감염에 미치는 영향 (Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients)

  • 김윤미;조성현;전경자;신순애;김지윤
    • 대한간호학회지
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    • 제42권5호
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    • pp.719-729
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    • 2012
  • Purpose: This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance. Methods: Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes. Results: An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)=2.99, 95% CI (confidence interval)=1.94-4.60], those with Grades 4-5 (OR=1.78, 95% CI=1.24-2.57) and those with Grades 2-3 (OR=1.57, 95% CI=1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis. Conclusion: Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.

일부 치위생과 학생들의 AIDS에 대한 지식 및 태도 (Knowledge and Attitudes about AIDS among Dental Hygiene Students)

  • 최성숙;이윤희
    • 한국학교ㆍ지역보건교육학회지
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    • 제14권3호
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    • pp.77-87
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    • 2013
  • Objective: The purpose of this study was to obtain the basic data for the establishment of the curriculum from the analysis of knowledge and attitudes about AIDS among dental hygiene students. Methods: Data was collected from the students of two colleges majoring in dental hygiene in Daegu, using questionnaire. They were the students of total 390. The analysis was made using t-test, (one-way ANOVA), and multiple linear regression analysis. These were conducted using SPSS 14.0 version. Results: The horizontal and vertical transmission in percent correct knowledge of HIV infection, most of the questions asked of respondents knew the correct answer, AIDS attitudes in the community education hours to receive AIDS education is important then the response was highest at 88.2 percent. AIDS knowledge is based on clinical practice, and AIDS attitudes in accordance with the educational experience of the average difference between groups investigated showed statistically significantly. HIV knowledge and attitudes, no oil, depending on the educational experience of the average difference between groups investigated showed statistically significantly. The grade, the higher knowledge of HIV was found to be lower in a statistically significant negative relationship showed (p<0.001), clinical experience, the more experience, knowledge of HIV was higher statistically significant positive showed a relationship (p<0.001), a higher attitude about HIV AIDS knowledge was higher showed a statistically significant positive relationship (p<0.001). Conclusion: Dental hygiene to prevent infection associated with AIDS in the curriculum and hands-on curriculum to enhance patient care through the AIDS patients in clinical management after graduating as a dental hygienist at the ethical responsibility is considered to be very strong.

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Seropositivity Rates of Strongyloides stercoralis Antibody in the Southeastern Region of Republic of Korea: A Single-Center Retrospective Study

  • Kim, Taehwa;Lim, Seungjin
    • Parasites, Hosts and Diseases
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    • 제60권3호
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    • pp.181-185
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    • 2022
  • Strongyloides stercoralis infection is not endemic in the Republic of Korea (Korea) with a positivity rate of <1% in stool examination. However, there is a risk of hyperinfection in immunosuppressed individuals. It is necessary to determine the seropositivity of S. stercoralis antibodies in Korea. This study investigated the seropositivity of S. stercoralis antibodies in the southeastern area of Korea. From January 2019 to June 2021, serum samples were collected from participants who visited the study center in the southeastern region of Korea for routine health check-ups. We determined serum levels of specific anti-Strongyloides IgG antibodies in 834 samples by enzyme-linked immunosorbent assay. We observed that 92 samples (11.0%) tested showed a positive response. The age of the participants was 51±10.7 years, and 43.4% of them were men. The antibody positivity rate based on the location of the participants' residence were 12.3% (Gyoungsangnam-do), 10.2% (Busan), and 10.1% (Ulsan), respectively. Total eosinophil count was associated with positive test results (154.8±152.0 per mm3 versus 202.1±178.9 per mm3, P=0.006). Logistic regression analysis revealed that blood eosinophil count, age above 50 years, and residence in Sacheon were factors associated with the positive status of S. stercoralis antibody. Our finding suggests that it is necessary to test for S. stercoralis in actual clinical settings in Korea.

COVID-19 사회적 거리두기 실천의도에 영향을 미치는 요인: 손실과 이득 메시지 프레이밍 광고상황 (Factors Associated with Behavioral Intention to COVID-19 Social Distancing in Loss versus Gain Advertising Context)

  • 최자인;최자윤
    • 한국융합학회논문지
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    • 제13권5호
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    • pp.463-471
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    • 2022
  • COVID-19 사회적 거리두기 실천의도에 영향을 미치는 요인을 확인하였다. 본 연구는 2021년 3월 초 대한민국에 거주하는 19세 이상 성인 379명을 대상으로 COVID-19 감염예방을 위한 손실과 이득 메시지 프레이밍 광고중 1개를 무작위 할당하여 본 후 조사된 자료의 2차 분석연구이다. COVID-19 사회적 거리두기 실천의도에 광고태도(𝛽=.03, p<.001), COVID-19에 대한 관여(𝛽=.14, p=.006) 및 감정적 낙인(𝛽=-0.17, p<.001)이 영향을 미쳤으며 이들 변수의 설명력은 19%였다(Adjusted R2=.19). 따라서 보건의료전문가는 현장에서 대중과 소통하고 정책을 보급할 때 제공된 정보에 대한 관여를 높여 긍정적 광고태도를 유도하며 정확한 정보에 의해 낙인의 감정을 갖지 않도록 효과적인 메시지를 제시함으로써 건강관리 리더로서 역할을 충실히 해야 할 것이다.