• Journal of The Korea Institute of Healthcare Architecture
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• v.26 no.3
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• pp.17-26
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• 2020

Purpose: This paper presents research evidence that the environmental design of the doffing area in a biocontainment unit (BCU) can have a measurable impact on increasing the safety of frontline healthcare workers (HCW) during doffing of high-level personal protective equipment (PPE), and proposes optimized biocontainment unit design. Methods: From 2016 to 2019, The SimTigrate Design Lab conducted 3 consecutive studies, focusing on ways in which the built environment may support or hinder safe doffing. In the first study, to identify the risky behaviors, we observed 56 simulation exercises with HCWs in 4 BCUs and 1 high-fidelity BCU mockup. In the second study, we tested the effectiveness of a redesigned doffing area on improving the HCWs performance and used simulation, observation, and rapid prototyping in 1 high-fidelity mockup of a doffing area. In a follow-up study, we used simulation and co-design with HCWs to optimize the design of a safer doffing area in a full-size pediatric BCU mock-up. Results: We identified 11 specific risky behaviors potentially leading to occupational injury, or contamination of the PPE, or of the environment. We developed design strategies to create a space for safer doffing. In the second study, in a redesigned doffing area, the overall performance of HCW improved, and we observed a significant decrease in the number of risky behaviors; some risky behaviors were eliminated. There was a significant decrease in physical and cognitive load for the HCWs. Finally, we propose an optimized layout of a BCU for a safer process of PPE doffing. Implications: The proposed BCU design supports better staff communication, efficiency, and automates safer behaviors. Our findings can be used to develop design guidelines for spaces where patients with other highly infectious diseases are treated when the safety of the patient-facing HCWs is of critical importance.

• Journal of Home Health Care Nursing
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• v.5
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• pp.32-46
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• 1998

Cancer is a leading cause of death, and the number of cancer patients is increasing in Korea. The needs for the home care of cancer patients are increasing recently, but the standardized home care protocols are not developed yet. This study was designed to develop nursing assessment -intervention algorithms for the cancer chemotherapy patients at home. These algorithms suggest guidelines when we assess the patient's condition, and find appropriate nursing interventions, so that standardization and quality control of home care can be attained. The algorithms were processed by yes-no tree. Eleven common problems of cancer chemotherapy patients were identified by the literature review and oncology nurses' experience. These were digestive dysfunction, pain, fatigue, infection, respiratory difficulties, activity intolerance, hemorrhage, sensory disorder, edema, skin problem, and mucosal problem. The algorithm needs to be validated and modified by using for the cancer chemotherapy patients at home.

• Journal of Korean Clinical Nursing Research
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• v.21 no.1
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• pp.31-42
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• 2015

Purpose: This study was done to develop evidence-based nursing practice guidelines to prevent complications related to indwelling urinary catheterization (IUC) in patients in Korea. Methods: A guideline adaptation process was conducted according to the guideline adaptation manual which consists of three main phases, and 9 modules with a total of 24 steps. Results: The newly developed IUC guideline consisted of an introduction, urinary catheterization, summary of recommendations, recommendations, references, and appendices. There were 110 recommendations in 8 sections including assessment, equipment, catheter insertion, catheter maintenance, catheter change, catheter removal, management of complications, and education/consultation. For the grade of recommendations, there were 6.4% for A, 22.7% for B, 67.3% for C. Conclusion: The IUC guideline was developed based on evidence and therefore it is recommended that this guideline be disseminated and utilized by nurses nationwide to improve the quality of care for patients with IUC and decrease complications related to IUC and that it be revised regularly.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.22-28
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• 2012

Purpose: In accordance to an increased interest in facial appearance and the popularization of computed tomography scanning, the number of diagnosis and treatment of blowout fractures has been increased. The purpose of this article is to review pure blowout fracture surgery through transconjunctival incision focusing on complications and their management. Methods: In this retrospective study, 583 patients, who had been treated for pure blowout fracture through transconjunctival incision from 2000 to 2009, were evaluated. Their hospital records were reviewed according to their sex, age, fracture site, preoperative presentations, time interval between trauma and surgery, and postoperative complications. Results: According to postoperative follow-up results, there were early complications that included wound dehiscence and infection (0.2%), hematoma (insomuch as extraocular movement is limited) (0.7%), lacriminal duct injury (0.5%), and periorbital nerve injury (0.7%). In addition, there were late complications that lasted more than 6 months, that included persistent diplopia (1.7%), extraocular movement limitation (0.9%), enophthalmos (1.0%), periorbital sensation abnormalities (1.0%), and entropion (0.5%). Conclusion: We propose the following guidelines for prevention of postoperative complications: layer by layer closure; bleeding control with the epinephrine gauzes, Tachocomb, and Tisseel; conjunctival incision 2 to 3 mm away from punctum; avoidance of excessive traction; performing surgical decompression and high dose corticosteroid therapy upon confirmation of nerve injury; atraumatic dissection and insertion of Medpor Barrier implant after securing a clear view of posterior ledge; using Medpor block stacking technique and BioSorb FX screw fixation; performing a complete resection of the anterior ethmoidal nerve during medial wall dissection; and making an incision 2 to 3 mm below the tarsal plate.

• Women's Health Nursing
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• v.25 no.3
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• pp.239-257
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• 2019

Purpose: To analyze the job of nursing unit managers working at women's hospital, using DACUM (developing a curriculum), DACUM is a method for analyzing job-focused competency. Methods: This study involved a descriptive survey. A DACUM workshop was held to define women's hospital nursing unit managers' role and identify their duties and tasks. For the workshop, a committee was formed consisting of 5 women's hospital nursing unit managers. Finally, after validation, the developed contents were made into a survey asking about nursing unit manager's duties and tasks. Results: Sixteen duties and 83 tasks were identified on the DACUM chart. The importance, difficulty, and frequency of the tasks were ranked in terms of A, B, and C, with A being the highest degree. Eight tasks received A's all in importance, difficulty, and frequency of performance. The 8 tasks were: 'taking over', 'taking care of seriously ill patients on handover', 'ward rounding', 'analyzing and resolving demands identified during handover and patient tour', 'reporting patient status during rounding', 'promoting breast-feeding', 'uterine contraction, and training for breast-feeding'. The duty with the biggest determinant coefficient (DC) was 'patients complaint management' (DC=7.09). Based on tasks, the one with the biggest DC was 'solving patient and patient guardian's complaints' (DC=7.53), followed by 'making infection control guidelines' (DC=7.5). Conclusion: When expanding the nursing staff of the hospital, women's hospitals nursing unit managers also need to use administrative functions as intermediaries to focus on the operation management of the entire hospital rather than direct nursing to suit their role.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.201-210
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• 2016

Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

• Journal of Environmental Health Sciences
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• v.46 no.5
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• pp.495-503
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• 2020

Objective: This study aimed to compare the characteristics of humidifier disinfectant-like products (HD-like products) and humidifier disinfectant products (HD products) and introduce actual cases of the usage of HD-like products in hospitals based on an on-site investigation. Methods: The characteristics, chemical components, and usage of HD-like products (Hichlor or Biospot) and HD products (N-with) containing NaDCC (sodium dichloroisocyanurate) were compared. In the process of conducting the on-site investigation, four hospitals were identified as previously using HD-like products. Each on-site investigation to identify the use of HD-like products was composed of four parts: 1) hospital infection control guidelines, 2) manual for humidifiers in patient's rooms, 3) interviews with nursing staff, infection managers, and purchase managers, 4) searching on the product purchase system. Results: Although HD-like products (Hichlor and Biospot) and HD products (N-with) were sold for different usage purposes, they were all white-colored and coin-shaped foaming tablets with the same chemical component, NaDCC. The manual for using HD-like products and HD products was similar (inserting the tablet in a humidifier container with water). Among the four hospitals, one had used Hichlor in the same manner as HD (N-with) by inserting a tablet in 1L of water in a filled humidifier container and Biospot as a kind of detergent for humidifier container cleaning. Another two hospitals had used Biospot and/or Aniosyme as a kind of detergent for humidifier container cleaning. The other hospital had used unknown product in the same manner as N-with, so we thus assumed it was either an HD products (N-with) or HD-like products (Hichlor, Biospot). Conclusion: This study raises the possibility of the development of adverse health effects similar to exposure to an HD-products when exposed to an HD-like products and the possibility of further use in other medical institutions or multi-use facilities. Therefore, an expansion of the investigation is needed in order to confirm whether there have been similar cases in the past.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7251-7256
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• 2013

Objectives: To estimate the proportion of liver cancer cases and deaths due to infection with hepatitis B virus (HBV), hepatitis C virus (HCV), aflatoxin exposure, alcohol drinking and smoking in China in 2005. Study design: Systemic assessment of the burden of five modifiable risk factors on the occurrence of liver cancer in China using the population attributable fraction. Methods: We estimated the population attributable fraction of liver cancer caused by five modifiable risk factors using the prevalence data around 1990 and data on relative risks from meta-analyses, and large-scale observational studies. Liver cancer mortality data were from the 3rd National Death Causes Survey, and data on liver cancer incidence were estimated from the mortality data from cancer registries in China and a mortality/incidence ratio calculated. Results: We estimated that HBV infection was responsible for 65.9% of liver cancer deaths in men and 58.4% in women, while HCV was responsible for 27.3% and 28.6% respectively. The fraction of liver cancer deaths attributable to aflatoxin was estimated to be 25.0% for both men and women. Alcohol drinking was responsible for 23.4% of liver cancer deaths in men and 2.2% in women. Smoking was responsible for 18.7% and 1.0%. Overall, 86% of liver cancer mortality and incidence (88% in men and 78% in women) was attributable to these five modifiable risk factors. Conclusions: HBV, HCV, aflatoxin, alcohol drinking and tobacco smoking were responsible for 86% of liver cancer mortality and incidence in China in 2005. Our findings provide useful data for developing guidelines for liver cancer prevention and control in China and other developing countries.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.3
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• pp.47-54
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• 2022

Purpose: This study presents the analysis on space usage of delivery departments in regional public hospitals. The results intention is to achieve improvement of the delivery environment for the mothers and newborns regarding exposure prevention and efficient infection control. The purpose of this study is to provide fundamental data for architectural plans and guidelines for the delivery department. Method: The investigation and analysis were based on research papers, legal systems, public medical statistical data, and the architectural floor plan drawing. For research, 20 regional public hospitals with an operating delivery room were excluded. Regarding data accessibility, 15 regional public hospitals were selected. Results: To overcome the increased vulnerability of the delivery department, the research results of basic data is provided for the establishment to address urgent needs and rapid response. Thus, the research results are as follows: Firstly, the delivery department needs to respond promptly according to the type of patients. For example, in a case of emergency surgery, a connected circulation plan with the related departments is needed. Secondly, for the environment of the delivery area, alleviating anxiety is imperative for pregnant patients and guardians, labor, childbirth, and recovery. Therefore, these needs must be addressed for treatment space and circulation. Lastly, the delivery department is classified into three areas for analysis: access area, treatment area, and support area. In most of the delivery departments of the 15 selected hospitals, there is no space for the access and support area except for the labor and delivery rooms in the treatment area. For the access area, a waiting area, changing room for pregnant women and guardians, and a storage space for contaminated linens are required for infection prevention, safety, and efficiency. For the treatment area, childbirth processes and circulation should have space reserved for labor, delivery, recovery, examination, and treatment. In preparation for an emergency during childbirth, emergency response measures and supporting space needs to be established. For the support area, circulation and rooms are to be designed for medical staff support, activity space, storage and transportation of equipment, and urgent medical treatment. Implications: Along with the low fertility rate and the decrease of medical institutions that operate delivery departments, for the purpose of establishing a public medical service system and a healthy medical environment for mothers and newborns, the researched information demonstrates basic data on space plan of delivery departments in regional public hospitals.

• Research in Plant Disease
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• v.30 no.3
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• pp.256-267
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• 2024

We have developed FBcastS (Fire Blight Forecasting System), a cloud-based information system that leverages the K-Maryblyt forecasting model. The FBcastS provides an optimal timing for spraying antibiotics to prevent flower infection caused by Erwinia amylovora and forecasts the onset of disease symptoms to assist in scheduling field scouting activities. FBcastS comprises four discrete subsystems tailored to specific functionalities: meteorological data acquisition and processing, execution of the K-Maryblyt model, distribution of web-based information, and dissemination of spray timing notifications. The meteorological data acquisition subsystem gathers both observed and forecasted weather data from 1,583 sites across South Korea, including 761 apple or pear orchards where automated weather stations are installed for fire blight forecast. This subsystem also performs post-processing tasks such as quality control and data conversion. The model execution subsystem operates the K-Maryblyt model and stores its results in a database. The web-based service subsystem offers an array of internet-based services, including weather monitoring, mobile services for forecasting fire blight infection and symptoms, and nationwide fire blight monitoring. The final subsystem issues timely notifications of fire blight spray timing alert to growers based on forecasts from the K-Maryblyt model, blossom status, pesticide types, and field conditions, following guidelines set by the Rural Development Administration. FBcastS epitomizes a smart agriculture internet of things (IoT) by utilizing densely collected data with a spatial resolution of approximately 4.25 km to improve the accuracy of fire blight forecasts. The system's internet-based services ensure high accessibility and utility, making it a vital tool in data-driven smart agricultural practices.