• Title/Summary/Keyword: Hospitalized medical patient

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An analysis of in-patient complaints and subsequent intervention (환자호소에 대한 해결시간 단축을 위한 기초조사연구)

  • Kim, Yong-Soon;Park, Jee-Won;Park, Yon-Ok
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.64-80
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    • 1997
  • Background : An important issue in health care today is in trying to center service around the hospitalized patient. There is a "Kindness Movement" developing now, where in the focus of Health Care is being changed from simply treating the basic physical needs of the patient with sophisticated technology, to keeping emotional well being healthy with more humane and attentive treatment. In our attempt to reach the goal of a completely satisfied patient, we undertook a study of the common complaints of patients, and the subsequent nature of the interventions. Method : The study was carried out in two stages, first the patients made known their complaints by filling out questionnaires, then we collected data on the attempts to alleviate the complaints. The questionnaire provided 19 different complaints, which were then analysed for such variables as content, source of complaint, persons treating the complaint, and length of time and method used to solve the complaint. Results : 1. The Chief complaints made by patients(99.1%) were of physical discomfort, such as pain, nausea, vomiting, indigestion, diarrhea and constipation. 2. The complaints were voiced primarily by either of the patient's family, or by the patients themselves(78.4). 3. The complaints were intervened by nurses alone(53.5%), physicians alone(25.5%), or by nurses and physicians together(19.25%). 4, The method by which the complaints were resolved included the utilization of prescriptions(55.7%), further explanation and education(25. 5%) and notification after treatment(13.2%). 5. Most complaints were voiced during the dayshift(42.6%, 7:00-15:00), followed by the evening shift(36.0% 15:00~22:00), and then the nightshift(21.3 %, 22:00-07:00). 6. The time required for successful resolution of the patient's problems varied from 10~88.9min, according to the nature of the complaint. Conclusion : Hopefully by knowing beforehand the nature of both complaint and intervention, we can anticipate problems and shorten reaction time, in order to provide for a more satisfied patient.

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The Effect of Korean Medical Treatment on Imbalance and Gait Difficulty of Cerebral Hemorrhage Patient: Report of Three Cases (균형감각 및 보행 장애 뇌출혈 환자에 대한 한방치료 치험 3례)

  • Kim, Jin Youp;Jo, Hee Jin;Nam, Sang Soo;Kim, Young Suk
    • Journal of Acupuncture Research
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    • v.31 no.4
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    • pp.185-193
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    • 2014
  • Objectives : The purpose of this study is to find the effectiveness of Korean medical treatment on sense of balance by cerebral hemorrhage. Gaitview analysis and Berg balance scale(BBS) research were used to evaluate it. Methods : We selected patients who were hospitalized at the Kangnam Korean Hospital, Kyung Hee University Hospital from May 2014 to August 2014 that satisfied inclusion/exclusion criteria. Before taking treatment, we took gaitview analysis and BBS first to analyze the ability of balance and gait of patients. In gaitview analysis, we checked Center of gravity(COG), pressure ratio, ave pressure, gait time ratio, statistic score. For about 10 days, patients were given acupuncture treatment, herbal medicine and physical therapy. Afterwards, we compared patients' progression between before-treatment and after-treatment with the same evaluation scale. Results : In the period of treatment, patients showed static and dynamic index change within the normal range or increase. And in statistic score, 2 cases score are increased. In BBS, all cases score are increased. Conclusions : Korean medical treatment improves imbalance symptom of cerebral hemorrhage patient. So the ability of gait and activity of daily living is improved. But, this study has only 3 cases, and has no comparable study. Prospective and Larger study will be necessary.

Risk Factors of Carbapenem-resistant Enterobacteriaceae Acquisition at a Community-based Hospital (지역기반 상급종합병원 내 카바페넴 내성 장내세균 획득에 관한 위험인자)

  • Lee, Yeonju;Kang, Ji Eun;Ham, Jung Yeon;Lee, Ja Gyun;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.2
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    • pp.120-126
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    • 2020
  • Objective: The rising number of carbapenemase-resistant Enterobacteriaceae (CRE) cases has become a concern worldwidely. This study investigated patient characteristics with CRE and analyzed the risk factors associated with its acquisition. Methods: A retrospective review of the electronic medical records of the Kangbuk Samsung Medical Center from May 2016 to April 2019 was performed. The inclusion criterion was hospitalized patients aged ≥18 years with confirmed CRE acquisition. Patients were divided by CRE acquired and non-required patients. CRE acquired patients were those with CRE confirmed by their active surveillance cultures, while non-acquired patients were those with carbapenemase-sensitive Enterobacteriaceae (CSE). If CRE was isolated more than once during hospitalization, only the first isolation was used for data analysis. Patient characteristics, antibiotic used, and the duration of use were compared between two groups using univariate analysis, and the risk factors associated with CRE were analyzed using multiple logistic regression analysis. Results: Among the 73 CRE acquired patients, 44 (60.3%) were positive for carbapenemase-producing Enterobacteriaceae (CPE). Infection from Klebsiella pneumonia (42 cases, 57.5%), Escherichia coli (17 cases, 23.3%), and Enterobacter cloacae (5 cases, 6.8%). The risk of CRE acquisition was significantly increased by 4.99 times [confidence interval (CI), 1.40-17.78; p=0.013] with mechanical ventilation, 3.86 times (CI, 1.59-9.36; p=0.003) with penicillin administration, and 21.19 times (CI, 6.53-68.70; p<0.001) with carbapenem administration. Conclusions: Proper antibiotic use including the selection, frequency, and duration, and patients on mechanical ventilators need close monitoring.

Evaluation of Total Parenteral Nutrition in Tertiary Hospital (3차병원에서의 TPN 사용의 적정성 점토)

  • Min, Kyoung A;Sohn, Ki Ho;Suh, Ok Kyung;Choi, Kyung Eob
    • Korean Journal of Clinical Pharmacy
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    • v.8 no.1
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    • pp.35-46
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    • 1998
  • A retrospective study was conducted to evaluate the appropriateness of total parenteral nutrition (TPN) for 200 hospitalized adult patients in Samsung Medical Center from January 1st in 1995 to June 31st in 1997. Standard criteria were modified and determined from those stated by AJHP (American Journal of Health System Pharmacy) and ASPEN (American Society of Parenteral and Enteral Nutrition). The justification for indications was appropriate in $35\%,\;44\%,\;and\;32\%$ of the patient's in 1995, 1996, and 1997, respectively, without significant improvement over the last two and half years. Before and during the administration of TPN, several monitoring indicators were well documented, and monitoring frequencies were increased over two and half years period. However, the majority of the monitoring indicators were not found in the standard criteria range of $90\%$. The monitoring indicators for electrolyte balance, $PO_4$ and Mg, were not measured appropriately and resulted in the complications which could have been prevented. The indicator for lipid tolerance, triglyceride and the indicator for hemorrhagic incidence, prothrombin time (PT), were not well documented in comparison with other indicators. The indicators for the improvement in nutritional status, albumin and total protein, were appropriate in $90\%$ of the patients. Determination of TPN formula was based on the laboratory data and chart reviews, and it was appropriate in $98\%$. But the administration of lipid and vitamin K for the prevention of essential fatty acid deficiency and hemorrhage, respectively, was not carried out appropriately when the administration of TPN was prolonged, lasting more than 7 days. When a patient returned to oral or enteral feeding, TPN was terminated. However, increase in albumin level or weight was rarely observed. In conclusion, healthcare professionals should all work as a team and active participation to provide optimized nutrition support for partners.

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Decision and Practice of End-of-Life Care in Lung Disease Patients with Physicians Orders for Life Sustaining Treatment

  • Yu Mi Oh;Yoon Na Kang;Soo Jung Han;Jeong Hye Kim
    • Journal of Hospice and Palliative Care
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    • v.26 no.1
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    • pp.7-17
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    • 2023
  • Purpose: The purpose of this study was to analyze end-of-life care practices in lung disease patients with physician orders for life-sustaining treatment (POLSTs). Methods: We retrospectively analyzed data from medical records regarding the end-of-life care practices of POLST decisions for patients with lung disease hospitalized at a tertiary hospital in Seoul, South Korea. Data were collected from January 1 to June 30, 2021. Results: Of 300 total patients, 198 had lung cancer (66.0%) and 102 had non-malignant lung diseases (34.0%). A POLST was written for 187 patients (62.3%), and an advance directive was written for 20 patients (6.7%). Subsequent treatments were hemodialysis in 13 patients (4.3%), surgery in 3 patients (1.0%), and cardiopulmonary cerebral resuscitation in 1 patient (0.3%). Among cancer patients, chemotherapy was performed in 11 patients (3.7%), targeted therapy in 11 patients (3.7%), immunotherapy in 6 patients (2.0%), and radiation therapy in 13 patients (4.3%). Depending on the type of lung disease, types of treatment differed, including hemodialysis, ventilators, bilevel positive airway pressure, high-flow nasal cannulas, nebulizers, enteral nutrition, central line, inotropic agents, and opioids. Conclusion: Although the goals of hospice care are the same whether a patient has lung cancer or a non-malignant lung disease, because the characteristics of the respective diseases differ, end-of-life care practices and hospice approaches must be considered differently.

Study on the Market Segmentation of inpatients (입원환자 시장세분화에 관한 연구)

  • Lee, Eun-Whan
    • Korea Journal of Hospital Management
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    • v.17 no.2
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    • pp.21-33
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    • 2012
  • Purpose : This study aims to suggest application of patients DB to hospital marketing by performing market segmentation and selecting target market. Consequently help to establish suited strategy of marketing. Method : 14,072 patients hospitalized in a University Medical Center were recruited into this study. In order to classify the customer groups, cluster analysis was used with RFM(Recency, Frequency, Monetary) model, and 1-way ANOVA verified the differences among groups. And then, sociodemographical status, healthcare utilization and diagnosis(ICD-10) of each group were compared to draw a marketing strategy. Results : Four groups were classified through clustering analysis, and'high use and high profit' and'low use and high profit' groups were selected as a target market. The features of target market were as follows, the female proportion was high; used a private room; hospitalized through the emergency room; had operation; length of stay was long; had many comorbidity and cooperative treatment. There was difference in each feature of target market: as for the'high use and high profit' group, many patients were diagnosed with 'certain infectious and parasitic diseases'; and as for the'low use and high profit'group, the proportion of patients who purchased'industrial accident compensation insurance'and'auto insurance'was relatively high; many patients were diagnosed with'Injury, poisoning and certain other consequences of external causes'. Conclusion : It is needed to establish'positioning' strategy by monitoring and communicating with'high use and high profit' group. And for the case of'low use and high profit' group, it is necessary to make a follow-up management and lead them to have a medical check-up.

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Study on Pattern of Metabolic Syndrome about Stroke Patients in Oriental Hospital (대전지역 한방병원 중풍환자의 대사증후군 분포에 대한 연구)

  • Moon, Seung-Hee;Kang, Byung-Gab;Kang, Ji-Sun;Kim, Min-Ji;An, Joung-Jo;Jo, Hyun-Kyung;Yoo, Ho-Rhyong;Seol, In-Chan;Kim, Yoon-Sik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.4
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    • pp.903-907
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    • 2009
  • The purpose of this study is to investigate the pattern of metabolic syndrome(Mets) in stroke patients who were hospitalized in Daejeon oriental hospital. The present study was done over 445 hospitalized patient with stroke in the Daejeon University Oriental Medical Hospital in the period of November 2006 to December 2008. Stroke patients had been interviewed by residents and specialists who studied standard operation procedures in Fundamental study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. We analyzed all registered data and evaluated the prevalence of Mets and specific components of Mets. The distribution of Mets in stroke patients according to American Heart Association/National Heart Lung and Blood Institute(AHA/NHLBI) criteria is 65.63%. The distribution of Mets in stroke patients according to International Diabetes Federation(IDF) criteria is 48.05%. The distribution of female patients is higher than that of male patients. The distribution of central obesity, low HDL cholesterol and hypertension is higher in female patients. There is no significant relationship between Mets and stroke type in AHA/NHLBI criteria.. But, there is significant relationship between Mets and stroke type in IDF criteria.

Comparison between Fluid Intake and Output Measurement Methods of the Patients Hospitalized in Medical Units (내과 환자의 섭취량/배설량 측정법 비교 연구)

  • Hahm, Kyung Hee;Yun, Hye Young;Park, So Young;Kim, Eun Sung;Park, Keun Ae;Cho, Se Hyun;Kim, Min Ji;Choo, Sung Hye;Kim, Jung Yeon;Lee, Jae Gil;Lee, Hyang Kyu
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.1
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    • pp.20-27
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    • 2016
  • Purpose: The purpose of this study was to compare the fluid intake and output (I&O) measurement methods in order to figure out more effective and easier method for medical patients Methods: 71 hospitalized patients participated in the study. In "liquid only (LO)" method, all amount of water was summed up including any liquid types of food and IV fluids. In "whole food(WF) intake," all liquid and solid food intake and IV fluids were added up. Results: The average amount of fluid intake was 2105.29 ml for LO method and 2523.54 ml for WF method. The average amount of fluid output was 2148.98 ml. The intra-class correlations (ICC) between the intake and output measures by the two different methods was 0.803 and 0.826, respectively. The correlation between the differences of intake/output and body weight change in two different methods was r=.347 (p=.003), and r=.376 (p=.001), respectively. Conclusion: The results of this study indicate that both LO and WF method may be useful in monitoring patients' fluid balance. Given the comparability of using LO over WF, it is suggested that measuring just liquid only intake as the indicator of patient's intake is applicable in clinical setting.

Increase in blood glucose level and incidence of diabetic ketoacidosis in children with type 1 diabetes mellitus in the Daegu-Gyeongbuk area during the coronavirus disease 2019 (COVID-19) pandemic: a retrospective cross-sectional study

  • Lee, Mi Seon;Lee, Rosie;Ko, Cheol Woo;Moon, Jung Eun
    • Journal of Yeungnam Medical Science
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    • v.39 no.1
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    • pp.46-52
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    • 2022
  • Background: The coronavirus disease 2019 (COVID-19) outbreak in the Daegu-Gyeongbuk area in 2020 has caused difficulties in the daily life and hospital care of children with type 1 diabetes mellitus (T1DM). We detected an increase in blood sugar levels in these children and the number of patients hospitalized with more severe diabetic ketoacidosis (DKA) compared to those before COVID-19. Methods: This single-center study was conducted at Kyungpook National University Children's Hospital. The following patient groups were included; 45 returning patients diagnosed with T1DM and undergoing insulin treatment for more than 2 years and 20 patients newly diagnosed with T1DM before and after COVID-19 were selected by age matching. Returning patients before and after the outbreak were selected, and changes in hemoglobin A1c (HbA1c) levels were retrospectively reviewed. The HbA1c levels and severity of symptoms in newly diagnosed patients during hospitalization were examined. Results: HbA1c levels in returning patients with T1DM were significantly increased after COVID-19 (before, 7.70%±1.38% vs. after, 8.30%±2.05%; p=0.012). There were 10 and 10 newly diagnosed patients before and after COVID-19, respectively. The proportion of patients with drowsiness and dyspnea at the time of admission was higher after COVID-19 than before (before, 2 of 10 vs. after, 4 of 10). The HbA1c levels were higher in newly diagnosed patients hospitalized after COVID-19 than before (before, 11.15% vs. after, 13.60%; p=0.036). Conclusion: Due to COVID-19 in the Daegu-Gyeongbuk area, there was an increase in blood glucose levels in children with T1DM and in the incidence of severe DKA in newly diagnosed diabetes mellitus patients.

The Clinical Study on 120 Cases with Traffic Accident (교통사고 환자 120례에 대한 임상적 고찰)

  • Lee, Ji-Eun;Jung, Hyo-Keun;Ryu, Chung-Ryul;Cho, Myoung-Rae;Wi, Jun;Ryu, Mi-Seon;Kim, Ja-Young
    • Journal of Acupuncture Research
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    • v.25 no.6
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    • pp.135-143
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    • 2008
  • Objectives : The main purpose of this research is to make a survey of the effective way of the Oriental medical care and to enlarge the range of Oriental medical treatment about traffic accidental patients. Methods : In following research, we surveyed 120 patients of traffic accident who were hospitalized in Dong-Shin Oriental Medical Hospital from October, 1, 2007 to August, 20, 2008 according to medical chart. Results : 1. In distribution of gender and age, the rate of male was 35.8%, that of female was 64.2% and the majority of the patients were twenties and thirties. 2. In the traffic accident patterns, the most was car crash from behind(61.7%) and after traffic accident, 75 patients(62.5%) visited our hospital for oriental medical treatment in less than 5days. 3. 46 patients(38.3%) choose the oriental medical treatment for the primary care and after medical care, 36 patients(31.7%) visited our hospital due to dissatisfaction of current treatment and maintained pain. 4. Partial pain was the chief complaint and the most of painful parts was neck(76.7%), followed by low back(69.2%). 5. Though radiation test, the most was cervical spine sprain(76.7%), followed by straightening of lumbar spine(66.7%). 6. In the periods of admission, less than 7 days was the most(53.3%), followed by less than 14 days(35.9%). 7. The treatment was effective to 93 patient out of 106 who had been hospitalized for less than 14 days. Conclusions : This data suggested that the Oriental medical care could be more effective treatment about traffic accidental patients without surgical injury.

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