• 제목/요약/키워드: In-school clinical practice

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Current Status of Patient Safety Regulations, Guidelines and Support Mechanisms in Korean Hospitals

  • Lee, Jae Ho;Kim, Jeong Eun;Kim, Suk Wha;Lee, Sang Il;Jung, Yoen Yi;Kim, Moon Sook;Jang, Seon Mi
    • Perspectives in Nursing Science
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    • 제10권2호
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    • pp.158-166
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    • 2013
  • Purpose: This study was conducted to investigate patient safety regulations and guidelines in order to understand their current status, and to examine support measures to improve patient safety in Korean hospitals. Methods: The participants were the safety officers from hospitals with 200 or more beds and 112 hospitals responded to the online survey. The questions covered patient safety regulations, the performance level of patient safety activities, patient safety incident reporting systems, the dedicated professional, training, support mechanisms, and expectations of reporting systems. Results: Among preventative measures, fall prevention and hand hygiene were reported to be most widely practiced (92% and 91%, respectively). Time-out for invasive procedures showed a relatively low practice rate at 70%. Among patient care activities, transfusion, surgery and sedation, medication, and infection management were performed by 84, 74, 93 and 93% of the hospitals, respectively. Patient safety activities included patient safety committee, patient safety cooperation between decision-making bodies, patient safety workshops, seminars, lectures, and training for employees. Conclusion: Patient safety regulations and guidelines have not yet been sufficiently prepared, and a public institution such as a certification authority is of crucial importance to enforce these guidelines.

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가정용 인공호흡기 적용 환자의 가정간호서비스 이용실태 (A Survey of Hospital-Based Home Healthcare Utilization in Patients using Home Mechanical Ventilator)

  • 이미경;송종례;오은경;윤영미
    • 가정∙방문간호학회지
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    • 제24권2호
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    • pp.210-220
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    • 2017
  • Purpose: The study aimed to describe the utilization of home healthcare in patients using home mechanical ventilator(HMV) Method: A descriptive cross-sectional design was used in this study. A Questionnaires were sent to nation wide home healthcare agencies to assess their utilization status of home healthcare. A convenience sample of 158 patients data was reviewed. Result: A total of 88(55.7%) men with the mean age of 51.94(${\pm}19.52$) years were included in the study. Approximately 55.1% of patients at the outpatient department were referred to the home healthcare services after discharge. The underlying diseases were as follows : 129 amyotrophic lateral sclerosis and 27 muscular dystrophies. A total of 155 patients have invasive HMV. Efficient home healthcare nursing activities provided by a highly skilled home healthcare advanced practice nurses(HHCAPN) were tracheotomy and gastrostomy tube management and urinary catheterization. The average frequency of home visit for one patient was 2.52times per month. The duration of home healthcare utilization with >1 year was 82.9%. HHCAPNs have limited knowledge and skill for HMV. Conclusion: The government support is required to provide sufficient home healthcare services to the patients discharged with HMV. HHCAPNs should be properly educated on the effective HMV care.

Adult vaccine-related knowledge, attitudes, and behaviors in Turkey

  • Sinem Aslan Karaoglu;Beray Gelmez Tas;Dilek Toprak
    • Clinical and Experimental Vaccine Research
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    • 제11권2호
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    • pp.133-140
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    • 2022
  • Purpose: Adult vaccination, which is among the duties of family physicians, is an important issue that reduces morbidity and mortality. In this study, it was aimed to evaluate knowledge, attitudes, and behaviors of adults about adult vaccines. Materials and Methods: This study is a descriptive, cross-sectional research; which was performed by a questionnaire including sociodemographic data and questions about adult vaccination to the patients and their relatives who applied to Şişli Hamidiye Etfal Training and Research Hospital Family Medicine Polyclinics for any reason. Mean, standard deviation and chi-square tests were used for the analysis; p<0.05 was considered significant. Results: The study included 182 people, 93 of them were women (51.1%) and 89 (48.9%) were men. The mean age was 32.9±12.8 years; most of them (n=144, 79.1%) were high educated and 38.5% were married. The most known vaccine was tetanus (n=154, 84.6%), the least known was zona vaccine (n=30, 16.5%). Health care professionals and television (n=60, 33%) were the most information sources about vaccines (n=78, 42.9%). Vaccination was mostly (26.9%) recommended by family physicians 144 (79.1%). The students had more knowledge about human papilloma virus (HPV), zoster, and measles, mumps, and rubella vaccines (p≤0.05), and mostly the information was got from internet and school (p≤0.05). As education status increased, knowledge about tetanus, hepatitis A, pneumonia, and HPV vaccines increased significantly, whereas only tetanus vaccination was performed in practice (p≤0.05). As the income increased, knowledge about pneumonia and HPV vaccines increased, but vaccination was not performed as expected. Conclusion: Age, occupation, education, and income level are directly related to knowledge and attitudes about adult vaccination. Adult vaccines are still not known and performed enough in Turkey. It is important to encourage and increase the number of trainings via media on this subject.

CBCT 기반 디지털 안궁이전과 아날로그 안궁이전의 위치 편차: 증례보고 (Positional deviation between CBCT-based digital facebow transfer and analog facebow transfer: case series)

  • 박명현;손큰바다;안휘균;이두형;김소연;이규복
    • 구강회복응용과학지
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    • 제39권3호
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    • pp.176-185
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    • 2023
  • 조절성 교합기에 모형을 부착하기 위하여 안궁이전이 필요하다. 아날로그 안궁이전에서는 장비의 정확도와 작업자의 숙련도가 모형 부착 결과에 영향을 미칠 가능성이 있다. 더불어 편차가 큰 방법으로 부착된 작업 모형에서는 정확한 치과 보철물의 제작이 어려우므로, 아날로그 안궁이전으로 부착된 작업 모형의 위치 편차를 파악하는 것이 중요하다. 본 증례에서는 아날로그 안궁이전으로 부착된 상악 모형의 위치와 cone beam computed tomography 데이터를 기반으로 위치된 상악 모형의 위치를 거리 편차와 교합 평면의 각도 편차를 평가하였다. 이를 토대로 아날로그 안궁이전으로 부착된 상악 모형의 편차를 보고하였다. 아날로그 안궁이전 방법은 3 - 16 mm의 선형 편차와 5 - 7도의 교합평면 각도 편차를 가지는 상악 모형의 부착 결과를 나타내었다. 아날로그 안궁이전은 환자별로 위치 편차가 다를 수 있음을 확인했으며, 치과 보철물 제작에서의 부정확성을 초래할 가능성이 있다. 이러한 결과는 임상에서 아날로그 안궁이전 방법이 상악 모형을 부착하는 과정에서 큰 편차가 있을 수 있음을 나타내었기에 이를 보고하는 바이다.

Interpretation of Complete Tumor Response on MRI Following Chemoradiotherapy of Rectal Cancer: Inter-Reader Agreement and Associated Factors in Multi-Center Clinical Practice

  • Hae Young Kim;Seung Hyun Cho;Jong Keon Jang;Bohyun Kim;Chul-min Lee;Joon Seok Lim;Sung Kyoung Moon;Soon Nam Oh;Nieun Seo;Seong Ho Park
    • Korean Journal of Radiology
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    • 제25권4호
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    • pp.351-362
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    • 2024
  • Objective: To measure inter-reader agreement and identify associated factors in interpreting complete response (CR) on magnetic resonance imaging (MRI) following chemoradiotherapy (CRT) for rectal cancer. Materials and Methods: This retrospective study involved 10 readers from seven hospitals with experience of 80-10210 cases, and 149 patients who underwent surgery after CRT for rectal cancer. Using MRI-based tumor regression grading (mrTRG) and methods employed in daily practice, the readers independently assessed mrTRG, CR on T2-weighted images (T2WI) denoted as mrCRT2W, and CR on all images including diffusion-weighted images (DWI) denoted as mrCRoverall. The readers described their interpretation patterns and how they utilized DWI. Inter-reader agreement was measured using multi-rater kappa, and associated factors were analyzed using multivariable regression. Correlation between sensitivity and specificity of each reader was analyzed using Spearman coefficient. Results: The mrCRT2W and mrCRoverall rates varied widely among the readers, ranging 18.8%-40.3% and 18.1%-34.9%, respectively. Nine readers used DWI as a supplement sequence, which modified interpretations on T2WI in 2.7% of cases (36/1341 [149 patients × 9 readers]) and mostly (33/36) changed mrCRT2W to non-mrCRoverall. The kappa values for mrTRG, mrCRT2W, and mrCRoverall were 0.56 (95% confidence interval: 0.49, 0.62), 0.55 (0.52, 0.57), and 0.54 (0.51, 0.57), respectively. No use of rectal gel, larger initial tumor size, and higher initial cT stage exhibited significant association with a higher interreader agreement for assessing mrCRoverall (P ≤ 0.042). Strong negative correlations were observed between the sensitivity and specificity of individual readers (coefficient, -0.718 to -0.963; P ≤ 0.019). Conclusion: Inter-reader agreement was moderate for assessing CR on post-CRT MRI. Readers' varying standards on MRI interpretation (i.e., threshold effect), along with the use of rectal gel, initial tumor size, and initial cT stage, were significant factors associated with inter-reader agreement.

오행침자법(五行鍼刺法) 원리 및 임상응용에 관한 연구 - I 원리에 관한 연구

  • 안창범;장경전;윤현민;김철홍;민영광;문혁철;구성태
    • 대한약침학회지
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    • 제11권3호
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    • pp.17-31
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    • 2008
  • Objective: To review the theoretic basis of the Sa-Ahm 5 Element acupuncture devised about 360 years ago, papers and books were researched. Methods: Total of 59 books and papers ranging from ancient Huang Di nei jing to modern Bio Medical Acupuncture for Pain Management were researched to study the basic theory of it in relation to the 5 Shu points, Results: Gao-mu in Chinese Ming dynasty, for the 1st time, had used 5 Shu points based on creation cycle as tonification and sedation treatment respectively and named it as 'tonification and sedation treatment of self meridian' but since then, this method, without special reasons, has been rarely used until Sa-Ahm's new doctrine that include the concept of destruction cycle was asserted. Conclusions: Sa-Ahm 5 Element acupuncture is a method which uses 5 Shu points from the viewpoints of simultaneous tonification and sedation methods which are based on promotion and control cycles. Though it is nowadays mostly-used method in accordance with practitioner's points, it needs to be set guidelines by which to effectively practice Sa-Ahm acupuncture.

이동원(李東垣) 내외상변맥법(內外傷辨脈法)의 유래와 이론적 근거에 대한 고찰 (Study on the origin and theoretical foundation of I Dong-won(李東垣)'s pulse diagnosis distinguishing internal and external injuries(內外傷辨脈法))

  • 장우창
    • 대한한의학원전학회지
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    • 제20권2호
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    • pp.137-145
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    • 2007
  • Pulse diagnosis that distinguishes internal injury from external injury by comparing the left and right of the chon pulse was formed in the process of Naegyoung's pulsation theory of ST9 and LU9 being assimilated into diagnostic method by taking chon pulse. The founder of school of internal injury, I Dong-won, expanded the horizon for this method to be widely used in clinical practice by especially explaining the specific application and theoretical background. According to him, pulse at ST9 which means chon pulse at the left hand, is bigger than the chon pulse at the right hand, it reflects external injury. Bigger "entrance pulse", a chon pulse at the right hand means internal injury. The reason is the left side of the body is a path for Yanggi so it controls the exterior part and the right side of the body is a path for Eumgi to descend so it controls the interior part. Internal injury develops as the spleen and stomach get injured. If the spleen and stomach is damaged essence derived from food cannot ascend to the stomach and will flow back to the lower part. As a result, fire of Eum type formed at the lower part will shoot up to the upper part and manifests external injury-like exterior syndromes. In this case, evidence distinguishing between internal and external injury is the fact that right hand pulse is bigger than the left hand. The important reason for distinguishing between internal and external injury is because when treating external injury caused by excess syndrome, pathogenic Gi should be dispelled. However, treating internal injury cased by deficiency syndrome, requires promoting the primordial Gi.

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Effect of activation and preactivation on the mechanical behavior and neutral position of stainless steel and beta-titanium T-loops

  • de Castro, Saul Matos;Moreira, Rui;Braga, Ana Cristina;Ferreira, Afonso Pinhao;Pollmann, Maria Cristina
    • 대한치과교정학회지
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    • 제45권4호
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    • pp.198-208
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    • 2015
  • Objective: To quantify, for each activation, the effect of preactivations of differing distribution and intensity on the neutral position of T-loops (7-mm height), specifically the horizontal force, moment to force (M/F) ratio, and load to deflection ratio. Methods: A total 100 loops measuring $0.017{\times}0.025$ inches in cross-section were divided into two groups (n = 50 each) according to composition, either stainless steel or beta-titanium. The two groups were further divided into five subgroups, 10 loops each, corresponding to the five preactivations tested: preactivations with occlusal distribution ($0^{\circ}$, $20^{\circ}$, and $40^{\circ}$), gingival distribution ($20^{\circ}$), and occlusal-gingival distribution ($40^{\circ}$). The loops were subjected to a total activation of 6-mm with 0.5-mm iterations. Statistical analysis was performed using comprised ANOVA and Bonferoni multiple comparison tests, with a significance level of 5%. Results: The location and intensity of preactivation influenced the force intensity. For the M/F ratio, the highest value achieved without preactivation was lower than the height of the loop. Without preactivation, the M/F ratio increased with activation, while the opposite effect was observed with preactivation. The increase in the M/F ratio was greater when the preactivation distribution was partially or fully gingival. Conclusions: Depending on the preactivation distribution, displacement of uprights is higher or lower than the activation, which is a factor to consider in clinical practice.

뇌졸중 이차예방 교육프로그램이 급성기 허혈성 뇌졸중환자의 자가간호수행에 미치는 효과 (An Effect of the Secondary Stroke Prevention Education Program on Self-care of Acute Ischemic Stroke Patients)

  • 강선미;윤은자
    • 성인간호학회지
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    • 제17권4호
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    • pp.646-655
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    • 2005
  • Purpose: This study was conducted to examine the effects of the secondary stroke prevention education program to inhibit the recurrence of the acute ischemic stroke patients, and to maintain and promote knowledge about stroke, self-efficacy and self-care. Method: This study was designed to take a quasi-experimental pre- and post-test with the nonequivalent control group. The experimental group consists of 20 patients and control group consists of 20 patients. The experimental group was applied the secondary stroke prevention education program. In order to verify the effects of the secondary stroke prevention education program, knowledge about stroke, self-efficacy and self-care scale were measured before the intervention and 4 weeks, 12 weeks after discharge. The tools for measuring knowledge about stroke, self-efficacy and self-care are developed by the researcher. The data was analyzed by SPSS win 10.0 program using $x^2-test$, Fisher's Exact Test, t-test, Kolmogorov-Smirnov Z, and Repeated Measures ANOVA. Result: There was a statistically significant difference in knowledge about stroke (F=4.021, p=.026), self-efficacy(F=6.096, p=.018), and self-care(F=8.026, p=.007) between the experimental and the control group after intervention. Conclusion: It is considered that the program can be used as an effective nursing intervention in clinical practice.

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간호대학생의 환자안전에 대한 지식 및 태도가 자기효능감에 미치는 영향 (The Effect of Nursing Students' Knowledge and Attitudes about Patients' Safety on Self-Efficacy)

  • 김혜옥;조혜지
    • 디지털융복합연구
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    • 제19권5호
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    • pp.489-500
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    • 2021
  • 본 연구의 목적은 간호대학생의 환자안전에 대한 지식 및 태도가 자기효능감에 미치는 영향을 확인하기 위함이다. 연구대상은 C시 간호대학교 3, 4학년 186명이고, 자가설문지를 이용하여 자료를 수집하였다. 자료수집은 2020년 09월 22일부터 10월 24일까지이다. 자료분석은 SPSS 25.0 Program을 통해 기술통계, Independent t-test, One way ANOVA, Pearson's correlation coefficient, Multiple regression으로 분석하였다. 간호대학생의 환자안전에 대한 지식은 총 16점 만점에 평균 10.62±1.86점, 환자안전에 대한 태도 및 자기효능감은 5점 만점에 각각 평균 3.72±0.45점, 평균 3.71±0.65점이었다. 환자안전에 대한 지식 및 태도가 자기효능감의 관계에서 양의 상관관계로 나타났다. 자기효능감에 영향을 미치는 요인은 환자안전에 대한 태도, 전공만족도, 교내·임상실습 만족도였고, 설명력은 14.4%였다. 결론적으로 간호대학생의 환자안전에 대한 자기효능감 증진을 위해서 스마트기술을 활용한 교육 프로그램을 개발할 필요가 있다.