• Child Health Nursing Research
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• v.21 no.2
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• pp.98-106
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• 2015

Purpose: This study was done to develop and evaluate an algorithm-based simulation scenario for emergency measures for high-risk newborns presenting with apnea. Methods: A one shot case study design was used to evaluate the algorithm-based simulation scenario. Effects of the developed simulation scenario were evaluated using the Simulation Effectiveness Tool (SET) and the Lasater Clinical Judgement Rubric (LCJR). From March to November 137 senior nursing students completed the simulation using this scenario. Results: The eight-frame simulation scenario was developed based on the Neonatal Resuscitation Program (NRP) and the nursing clinical judgment process. After use of the scenario, overall scores for SET and LCJR were 21.0 out of 26.0 and 32.4 out of 44.0 respectively. There were no significant differences in scores according to general characteristics. Positive correlation coefficients were identified among overall and subcategories of SET and LCJR. In addition, students provided positive feedback on the simulation experience. Conclusion: Considering that nursing students have limited access to high-risk newborns during their clinical experience and that newborns presenting apnea are common in the neonatal intensive care unit, the simulation scenario developed in this study is expected to provide nursing students with more opportunities to practice emergency measures for high-risk newborns.

• Neonatal Medicine
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• v.17 no.1
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• pp.13-20
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• 2010

Purpose : Because infants who have been hospitalized in the neonatal intensive care unit (NICU) are usually ill or premature, they are hospitalized repeatedly after their discharge. We intended to survey the frequencies and the medical costs of those rehospitalizations. Methods : The NICUs of 7 major hospitals were included. The subjects were 3,451 infants that were admitted to the NICU from July 2005 to June 2006, and discharged to home. The frequency, causes, mean cost and distribution and proportion of National Health Insurance coverage and non covered costs were analyzed. Results : The rate of rehospitalization after discharge from the NICU over 1 year was 14.8%. If multiple cases are considered as individual cases, it is 21.7%. The major causes of admission were pneumonia (15.8%), bronchiolitis (14.5%), gastroenteritis (10.4%), urinary tract infection (6.3%) and sepsis (6.3%). The mean cost for each admission was 1,652 thousand won. The mean cost of National Health Insurance coverage was 1,170 thousand won and non covered coat were 472 thousand won 70.9% and 28.6% respectively. Conclusion : The ratio of rehospitalization of infants after their discharge from the NICU over 1 year was approximately 20% and it means that follow-up management of these infants is very important and meticulous concerns after discharge should be given. However the rehospitalization and the non-coverage proportion of National Health Insurance cost is considerably high. It strongly implies that National Health Insurance should cover much more proportion, and personal cost exemption should be proceeded in case of rehospitalization of infants after discharge from the NICU.

• Korean Parent-Child Health Journal
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• v.6 no.1
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• pp.31-45
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• 2003

This study is designed to produce basic data on the nursing intervention between infants and mothers after discharge from hospitals. This research is carried by investigating the nursing intervention during their after-delivery staying in the hospitals located in Pusan. The object of this study includes the neonatal wards of 51 hospitals. Data collection was carried from the 3rd of September, 2001 to the 4th of October in the same year. Tools for measurement using in this research is the nursing checklist designed by these researchers. The data were analyzed by using SPSS and the output was produced in frequency and percentage considering general characteristics and nursing activities. On the course of investigation, it was revealed that the average number of items checked are as follows; total beds in one hospital came up to 360.1, the beds in each newborn infant ward came up to 36.1, in each ward the numbers of incubators came up to 9.2 and intensive care unit to 1.7. In each ward 8.4 nurses and 2.9 nurse aids were working at that time. In each hospital, secure of air way, physical examination, eye care, umbilical cord care, maintenance of body temperature, identification of infant, nutritive condition, safety and danger management, infection management, mother-infantile interaction, medical assistant to doctor, medication and discharge education were comparatively well done. But, in case of emotional, social and cognitive aspect of nursing activities through interactions between newborn infants and nurses as substitutes are not reached to the adequate level. In the end, this study hereby suggests that further investigation on the device to facilitate the interaction between newborn infant and nurse as a nursing intervention of high quality.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.3
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• pp.245-255
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• 2021

Necrotizing enterocolitis (NEC) is a disease with high morbidity and mortality that occurs mainly in premature born infants. The pathophysiologic mechanisms indicate that gastrointestinal dysbiosis is a major risk factor. We searched for relevant articles published in PubMed and Google Scholar in the English language up to October 2020. Articles were extracted using subject headings and keywords of interest to the topic. Interesting references in included articles were also considered. Network meta-analysis suggests the preventive efficacy of Bifidobacterium and Lactobacillus spp., but even more for mixtures of Bifidobacterium, Streptococcus, and Bifidobacterium, and Streptococcus spp. However, studies comparing face-to-face different strains are lacking. Moreover, differences in inclusion criteria, dosage strains, and primary outcomes in most trials are major obstacles to providing evidence-based conclusions. Although adverse effects have not been reported in clinical trials, case series of adverse outcomes, mainly septicemia, have been published. Consequently, systematic administration of probiotic bacteria to prevent NEC is still debated in literature. The risk-benefit ratio depends on the incidence of NEC in a neonatal intensive care unit, and evidence has shown that preventive measures excluding probiotic administration can result in a decrease in NEC.

• Clinical and Experimental Pediatrics
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• v.54 no.5
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• pp.219-223
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• 2011

McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy which confirmed HMC with a transverse vaginal septum. X-rays of the hand and foot showed bony fusion of the left third and fourth metacarpal bones, right fourth dysplastic metacarpal bone and phalanx, right PAP and hypoplastic left foot with left fourth and fifth dysplastic metatarsal bones. In addition, she had soft palate cleft, mild hydronephroses of both kidneys, hypoplastic right kidney with ectopic location and mild rotation, uterine didelphys with transverse vaginal septum and low-type imperforated anus. She was temporarily treated with ultrasound-guided transurethral aspiration of the HMC. Our patient with HMC and PAP was diagnosed with MKS because she has two typical abnormality of MKS and she has no definite complications of retinal disease, learning disability, obesity and renal failure that develop in Bardet-Biedl syndrome, but not in MKS until 33 months of age. Here, we describe a case of a Korean patient with MKS.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.289-295
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• 1998

Group B Streptococcal sepsis and/or meningitis is one of the most serious and common diseases in the neonatal period with high mortality and frequent complications. We have experienced a case of late onset type group B streptococcal sepsis and meningitis with a complication of subclavian vein catheterization catheterization. This 29-day-old male neonate was admitted to intensive care unit with the presentation of fever and septic shock. He was born with Cesarean delivery at 36 weeks and 3 days of gestational age. He showed multiple episodes of seizure after admission and group B streptococcus was isolated from blood. CSF profiles 10 days after admission showed the features of bacterial meningitis without organism isolated. Diffuse cerebral infarction was detected on brain CT 24 days after admission. In the 13th hospital day, the complication of subclavian vein catheterization occurred; Guide wire was cut during insertion and the distal portion of it(2.5cm) was retained in the left subclavian vein. We removed the retained guide wire with goose-neck snare catheter via right femoral vein. This case was presented with a brief review of the literatures.

• Child Health Nursing Research
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• v.8 no.3
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• pp.344-356
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• 2002

This study was conducted to analyse the current clinical education of pediatric nursing in baccalaurate nursing program, then to give basic data for enhancing the quality of future clinical education of pediatric nursing. Data were collected through self-reported questionnaire by mail from December 2001 to February 2002. The subjects were 29 schools of 50 baccalaurate nursing education programs. The data were analysed by double raters, researcher and assistant researcher. The results were summarized as follows: 1. Twenty-eight schools had the objectives of the clinical education of pediatric nursing, and 28 schools in pediatric ward, 23 schools in nursery, 22 schools in neonatal intensive care unit(NICU), 15 schools in objectives related to profession by clinical site. 2. Credits on clinical education of pediatric nursing were most 15 schools of 3 credits. 3. The clinical sites were mainly the hospital that sick children were admitted in. 4. The clinical teacher were 9 types including pediatric professor and field nurse. 5. On teacher's role, the professor instructed the case study and conference, and field nurse instructed the patient assignment and nursing procedures. 6. All of schools used explanation and conference as a method of clinical education, 1 or 2 schools used PBL or role play or field study. 7. On clinical education content, most of school included Apgar scoring system, physical examination in newborn assessment, respira- tion maintenance, temperature maintenance, infection prevention, nutrition, and bath in newborn care. 8. On clinical education content, most of school included care of incubator, phototheraty, infusion, gavage feeding and how to use the instruments in NICU. Eighteen schools included attachment promotion, and 20 schools case study. 9. On clinical education content, most of school included a checklist of nursing procedures, case study, assessment of growth and development in pediatric ward and other sites. 10.There were various evaluation types in scores, measuring items. In conclusion, the results of this study revealed that there were some discrepancy in the objectives and contents, clinical sites on hospital focused, teacher's role, and diversity of measurement items and ratings in clinical education of pediatric nursing. There is a need for a standardization of content, clinical site, and evaluation tool to improve a quality of clinical education of pediatric nursing based on this study.

• Journal of Genetic Medicine
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• v.16 no.2
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• pp.85-89
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• 2019

Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare autosomal recessive urea cycle disorder. HHH is caused by a deficiency of the mitochondrial ornithine transporter protein, which is encoded by the solute carrier family 25, member 15 (SLC25A15) gene. Recently, government supported Korean newborn screening has been expanded to include a tandem mass spectrometry (MS/MS) measurement of ornithine level. We report a case of a neonate with HHH syndrome showing a normal MS/MS measurement of ornithine level. A female newborn was admitted to neonatal intensive unit due to familial history of HHH syndrome. Her parents were consanguineous Parkistani couple. The subject's older sister was diagnosed with HHH syndrome at age of 30 months based on altered mental status and liver dysfunction. Even though the subject displayed normal ammonia and ornithine levels based on MS/MS analysis, a molecular test confirmed the diagnosis of HHH syndrome. At 1 month of age, amino acid analysis of blood and urine showed high levels of ornithine and homocitrulline. After 11 months of follow up, she showed normal growth and development, whereas affected sister showed progressive cognitive impairment despite no further hyperammonemia after protein restriction and standard therapy. Our report is in agreement with a previous Canadian study, which showed that neonatal samples from HHH syndrome patients demonstrate normal ornithine levels despite having known mutations. Considering the delayed rise of ornithine in affected patients, genetic testing, and repetitive metabolic testing is needed to prevent patient loss in high risk patients.

• Quality Improvement in Health Care
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• v.8 no.1
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• pp.44-55
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• 2001

Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.

• Child Health Nursing Research
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• v.22 no.4
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• pp.336-345
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• 2016

Purpose: This study was conducted to describe health in optimal fitness (HOF) in young children born prematurely and to analyze factors affecting HOF in health status, investment resources, and anthropological values, based on HOF theory. Methods: A case-control study of 76 children with preterm births (PTB) was conducted at 24 to 42 months of corrected age. Their HOF status was evaluated based on height, weight, head circumference, and the Korean-Bayley Scale of Infant Development-II and classified as either HOF-achieved or HOF-uncertain in the domain of growth, development, and all together. Results: For growth, development, and all, 26.3%, 27.6%, and 47.4% of children, respectively, belonged to the HOF-uncertain group. Logistic regression analysis showed that longer length of hospital stay (${\geq}21days$; OR=7.8; 95% CI [1.5, 40.5]), worse scores on the Home Observation for Measurement of the Environment (HOME) (${\geq}38$; OR=0.1; 95% CI [0.0, 0.4]), having a working mother, (OR=5.7; 95% CI [1.2, 27.6]), and an older mother (${\geq}35years$; OR=8.8; 95% CI [2.1, 37.3]) were statistically significant contributors of HOF-uncertain in the domain of all. Conclusion: Findings show that young children born prematurely with prolonged stays in a neonatal intensive care unit and insufficient socioeconomic resources at home are more likely to exhibit delayed growth and development.