• 한국임상약학회지
• /
• 제24권3호
• /
• pp.219-228
• /
• 2014

Objectives: This paper was aimed to investigate the adhesion control standards of pain relieving patch (PRP) drugs and to survey it's adverse effects on the skin of patients for safe use of PRP drugs. Methods: In this study, the related documents of PRP drugs of Korea pharmacopoeia (KP), United States pharmacopoeia (USP), Japanese Pharmacopoeia (JP), European pharmacopoeia (EP), and information web sites of the Ministry of Food and Drug Safety (MFDS) were surveyed. Also, the past and current labeling of PRP drugs marketed in the pharmacy was investigated and compared. Results: In KP and JP, the lower limit standard for PRP's adhesion control is established, but the upper limit standard is not designated. In USP and EP, neither the lower nor upper limit standard is established. The main reasons of skin adverse effects are considered as inherent adverse reactions of the applied drugs for PRP. Another reason is involved in patient's medication mistakes related to PRP's adhesion control, respiratory depression of skin according to physical skin closure, and microbial growth, etc. Conclusion: For safe use of PRP drugs, we proposed ensured guidelines like additional instructions of pharmacist's prescription and detailed labeling systems for usage of PRP drugs applied on skin.

• 한국임상약학회지
• /
• 제24권3호
• /
• pp.183-192
• /
• 2014

Purpose: This study was aimed to identify the status of utilization of healthcare services and self-care behaviors, knowledge level and influencing choice factors of non-prescription drugs (OTCs) on consumers since sales of OTCs at the outside of pharmacy in Korea, and to confirm the changes in perception of consumers for OTCs policy through check of perception level for current OTCs policy. Methods: Data was collected from April 2014 to May 2014 from questionnaires by 418 adults who are in university located in Seoul or live in Seoul Metropolitan area but not health science major and healthcare providers. Results: The female gender was 56.6% and University students were 73.9%. The ratio by age was as follows: below 25 (60.9%), 26-30 (18.2%), 30-40s (14.9%) and 50-60s (6.0%). The knowledge level of OTCs for use of medicine, dose and side effects was generally low and especially they knew little how to deal with side effects after taking OTCs on sale at the outside of pharmacy, even though over one year has passed since the policy. The proportion of those who thought the current OTCs policy has problems regarding safety issues since the policy was very high and it was also high that the study group thought there are problems with the current way to sale OTCs and educate employees. Conclusion: After selling OTCs at the outside of pharmacy, the consumers still lacked knowledge of OTCs and did not get correct information properly. Especially, they had little information about the way to deal with side effects after taking OTCs. Public policy should be based on the health of the people and the public health is a national health priority. When all these things are taken into consideration, the government has to strengthen the OTCs policy and provide a safer environment with the accurate drug information for people than developing OTCs policy in the future.

• 한국임상약학회지
• /
• 제28권1호
• /
• pp.51-56
• /
• 2018

Objective: An automated process for medication preparation and dispensing is essential to improve the quality of work. To reduce night pharmacy workload, a new automated dispensing cabinet system was implemented in a hospital emergency medical center. The purpose of this study is to verify that implementation of an automated dispensing cabinet system will influence the efficiency of night pharmacy work. Methods: To evaluate the new system implementation, a retrospective study and survey was performed in the Ewha Womans University medical center. We compared the dispensing and near-miss error rates between the automated dispensing cabinet system and a night pharmacy. The degree of satisfaction of night shift workers with the new system was surveyed. Results: This study showed significantly reduced dispensing rates of night medications (56.1% and 37.3%; p < 0.01) and near-miss night medications (0.27% and 0.17%; p<0.01). Thirty-two persons responded to the survey, and the satisfaction score for the new system was 4.0 (${\pm}0.8$). The scores were high in order of efficiency, management, and convenience. Time requirement was also reduced because of the simple step of only reviewing in the pharmacy with the new system. Conclusion: Due to system implementation, workload was reduced and time was saved for not only night shift workers but also patients receiving emergency discharge medicine. It was suggested that this will have a positive effect on pharmacist medical service and patient safety.

• 한국임상약학회지
• /
• 제30권3호
• /
• pp.149-160
• /
• 2020

Background: Basiliximab is used as an alternative to tacrolimus in patients with decreased renal function. However, studies on basiliximab as a maintenance immunosuppressant, particularly in patients with lung transplantation, are limited. Therefore, here, we investigated the efficacy and safety of basiliximab in patients with lung transplantation. Methods: Adult patients with acute kidney injury (AKI) who received lung transplantation at a single general hospital between July 1, 2014 and June 30, 2018, were selected and classified in tacrolimus and basiliximab groups. Both groups received a triple-drug regimen (tacrolimus, mycophenolate mofetil, and steroids). However, tacrolimus was discontinued in the basiliximab group when AKI occurred, and two or more repeat basiliximab doses were administered within 3 months after transplantation. The electronic medical records were analyzed retrospectively. Results: Of the 85 patients who met the selection criteria, 61 and 24 were assigned to the tacrolimus and basiliximab groups, respectively. Significant improvement in renal function was observed in the basiliximab group (p <0.001). However, there were no differences in acute and chronic rejection rates in both the groups. No difference was observed in the incidence rate of complications between the groups, except for chronic kidney disease, which showed higher incidence in the basiliximab group (25.0% vs. 4.9%; p =0.013). Conclusions: We suggest the use of basiliximab as an immunosuppressant alternative to tacrolimus in patients with acute renal failure after lung transplantation. Basiliximab demonstrated effectiveness as an immunosuppressant and improved renal function. Therefore, basiliximab can be used in patients with decreased renal function.

• 기본간호학회지
• /
• 제10권3호
• /
• pp.427-436
• /
• 2003

Purpose: The purpose of this study was to identify nurses' perceptions of the importance of concrete items as a basis for nursing practice. A total of 179 concrete items for basic nursing, which clinical nurses must know in order to practice appropriately, were identified. Method: The participants in this study were 225 nurses who had worked for two to five years in university hospitals. The nurses were asked to rate the importance of the 179 items (in 39 middle range categories) on a 5 point scale. Result: The mean age of the nurses was 26 and about 54% were university graduates. Of the 39 middle range categories those rated as the top ten were transfusion (4.682), IV injection (4.492), po medication (4.476), surgery (4.469), infection control (4.438), IM injection (4.413), safety (4.388), oxygenation (4.376), diagnostic test (4.366), and fluid & electrolyte balance (4.359). The categories that had the lowest scores were sexuality (3.449), conceptual nursing (3.465), spirituality (3.527) and personal hygiene (3.548). Conclusion: The results of this study show that most nurses evaluate items which they use frequently in their practice as important.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권4호
• /
• pp.2329-2336
• /
• 2016

Background: Despite the existence of established guidelines advocating the use and value of chemotherapy order templates, chemotherapy orders are still handwritten in many hospitals in Lebanon. This manuscript describes the implementation of standardized chemotherapy order templates (COT) in a Lebanese tertiary teaching hospital through multiple steps. Initial Assessment: An initial assessment was conducted through a retrospective appraisal of completeness of handwritten chemotherapy orders for 100 adult patients to serve as a baseline for the project and identify parameters that might afford improvement. Choice of solution: Development of over 300 standardized pre-printed COTs based on the National Comprehensive Cancer Network templates and adapted to the practice culture and patient population. Implementation: The COTs were implemented, using Kotter's 8-step model for leading change, by engaging health care providers, and identifying and removing barriers. Evaluation: Assessment of physicians' compliance with the new practice (122 orders assessed) was completed through two phases and allowed for the identification of areas of improvement. Lessons Learned: Overall, COT implementation showed an average improvement in order completion from 49.5% (handwritten orders) to 77.6% (phase 1-COT) to 87.6% (phase 2-COT) reflecting an increase of 38.1% between baseline and phase 2 and demonstrating that chemotherapy orders completeness was improved by pre-printed COT. As many of the hospitals in Lebanon are moving towards standardized COTs and computerized physician order entry (CPOE) in the next few years, this study provides a prototype for the successful implementation of COT and demonstrates their role in promoting quality improvement of cancer care.

• Journal of Korean Neurosurgical Society
• /
• 제63권6호
• /
• pp.814-820
• /
• 2020

Objective : Trigeminal neuralgia (TN) is a severe neuropathic condition that affects several elderly patients. It is characterized by uncontrolled pain that significantly impacts the quality of life of patients. Therefore, the condition should be treated as an emergency. In the majority of patients, pain can be controlled with medication; however, other treatment modalities are being explored in those who become refractory to drug treatment. The use of the trigeminal nerve block with a local anesthetic serves as an excellent adjunct to drug treatment. This technique rapidly relieves the patient of pain while medications are being titrated to effective levels. We report the efficacy and safety of percutaneous trigeminal nerve block in elderly patients with TN at our outpatient clinic. Methods : Twenty-one patients older than 65 years with TN received percutaneous nerve block at our outpatient clinic. We used bupivacaine (1 mL/injection site) to block the supraorbital, infraorbital, superior alveolar, mental, and inferior alveolar nerves according to pain sites of patients. Results : All patients reported relief from pain, which decreased by approximately 78% after 2 weeks of nerve block. The effect lasted for more than 4 weeks in 12 patients and for 6 weeks in two patients. There were no complications. Conclusion : Percutaneous nerve block procedure performed at our outpatient clinic provided immediate relief from pain to elderly patients with TN. The procedure is simple, has no serious side effects, and is easy to apply.

• 대한한방소아과학회지
• /
• 제32권2호
• /
• pp.43-63
• /
• 2018

Objectives The purpose of this study is to evaluate the efficacy and safety of herbal medication for the treatment of nocturnal enuresis in children by analyzing randomized controlled trials conducted in China. Methods We searched literatures from China National Knowledge Infrastructure published up to 19 January, 2018. Selected literatures were collected and analyzed in order of publication year, and then demographic information, treatment method, duration of illness, duration of treatment, follow-up period, outcome measurement and adverse events. Results A total of 34 studies were selected for the analysis. In most studies, the total efficacy of the treatment group was reported to be higher than that of the control group, and the recurrence rate and complete cure rate were also found to be more effective in the herbal medicine treatment group. The most frequently used medical herb was Alpiniae Fructus (益智仁), and the use of medical herbs belong to tonifying yang (補陽藥), tonifying qi (補氣藥), and astringing essence strengthening collapse medicine (澁精縮尿止帶藥) were relatively high. The adverse events rate for the herbal medicine treatment group were significantly lower than those in the Western medicine treatment group. Conclusions This study showed that a herbal medicine treatment can be effective and safe option for treating pediatric nocturnal enuresis. However, additional well-designed clinical studies need to be performed to establish a basis.

• 한국의료질향상학회지
• /
• 제21권1호
• /
• pp.66-76
• /
• 2015

Objectives: The purpose of this study is to develop a case review form for detecting adverse events through a medical records review in hospitalized patients in South Korea. Methods: To develop the case review form, several literatures were reviewed, first. Through the clinical expert meeting, screening criteria were selected and case review form was developed. Result: The Korean version of case review form consisted of the review form-1 for adverse event screening and form-2 for adverse event identification. The applied methodology for the case review form is determined according to the previous studies. For example, the method used in the first stage review is nurse review. Furthermore, the National Coordinating Council for Medication Errors Reporting and Prevention index is used to categorize disability, and a scale of 1 to 6 was used in the causation scores and preventability scores, respectively. Through the clinical expert meeting, a total of 41 screening criteria were selected. Conclusion: The Korean specific case review form was developed for detecting adverse events in hospitalized patients. The results from this study can be used in a large-scale study regarding the nationwide incidence of adverse events.

• Archives of Plastic Surgery
• /
• 제43권4호
• /
• pp.360-364
• /
• 2016

Background Venous thromboembolism, a spectrum of diseases ranging from deep venous thrombosis to pulmonary embolism, is a major source of morbidity and mortality. The majority of cases described in plastic surgery involve abdominoplasty. Risk assessment and prophylaxis are paramount in such patients. General recommendations were recently developed, but the evidence in the literature was insufficient to prepare exhaustive guidelines regarding the medication, dosage, timing, or length of the prophylaxis. Methods A thromboprophylaxis protocol was developed for patients undergoing abdominoplasty. The protocol consisted of preoperative, intraoperative, and postoperative measures. Enoxaparin was administered as chemoprophylaxis in selected patients. The study involved 253 patients. The patients were analyzed for age, body mass index, enoxaparin dosage, risk factors, and complications. Results Deep venous thrombosis was documented in two cases (0.8%). No pulmonary embolism occurred. Three patients (1.2%) presented mild subcutaneous abdominal hematoma within the first postoperative week that spontaneously resorbed with neither aesthetic nor functional complications. Two patients (0.8%) presented severe hematoma requiring surgical re-intervention for drainage and hemostasis revision. Statistical analysis showed no significant correlation between enoxaparin dosage and hematoma (P=0.18) or deep venous thrombosis (P=0.61). Conclusions The described thromboprophylaxis protocol proved to be effective in the prevention of thrombotic events, with an acceptable risk of hemorrhagic complications. Furthermore, it provides new evidence regarding the currently debated variables of chemoprophylaxis, namely type, dosage, timing, and length.