• Title/Summary/Keyword: Outcome indicator

Search Result 117, Processing Time 0.029 seconds

Cardiac Troponin I Elevation in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Jeon, Ik-Chan;Chang, Chul-Hoon;Choi, Byung-Yon;Kim, Min-Su;Kim, Sang-Woo;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
    • /
    • v.46 no.2
    • /
    • pp.99-102
    • /
    • 2009
  • Objective: Cardiac dysfunction after aneurysmal subarachnoid hemorrhage (SAH) is associated with elevation of serum cardiac troponin I (cTnl) levels. Elevation of cTnl predicts cardiopulmonary and neurological complications, and poor outcome. Methods: We retrospectively reviewed the medical and radiologic records of 114 (male: 30, female: 84) patients who developed aneurysmal SAH between January 2006 and June 2007 and had no history of previous cardiac problems. We evaluated their electrocardiography and cTnl level, which had been measured at admission. A cTnl level above 0.5 $\mu$g/L was defined as an indicator of cardiac injury following SAH. We examined various clinical factors for their association with cTnl elevation and analyzed data using chi-square test, t-test and logistic regression test with SPSS version 12.0. The results were considered significant at p< 0.05. Results: The following parameters shows a correlation with cTnl elevation: higher Hunt-Hess (H-H) grade (p = 0.000), poor Glasgow Outcome Scale (GOS) score (p = 0.000), profound pulmonary complication (p = 0.043), higher heart rate during initial three days following SAH (p = 0.029), ruptured aneurysm on communicating segment of internal carotid artery (p = 0.025), incidence of vasospasm (p = 0.421), and duration of hyperdynamic therapy for vasospasm (p = 0.292). A significant determinants for outcome were cTnl elevation (p = 0.046) and H-H grade (p = 0.000) in a multivariate study. Conclusion: A cTnl is a good indicator for cardiopulmonary and neurologic complications and outcome following SAH. Consideration of variable clinical factors that related with cTnl elevation may be useful tactics for treatment of SAH and concomitant complications.

Validation of Nursing-sensitive Patient Outcomes;Focused on caregiver outcomes (간호결과분류(NOC)에 대한 타당성 검증;돌봄제공자 결과를 중심으로)

  • Yom, Young-Hee;Yee, Jung-Ae;Ahn, Soo-Yeon;Lee, Myung-Ok
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.6 no.2
    • /
    • pp.245-257
    • /
    • 2000
  • The purpose of this study was to validate caregiver outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 73 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1(indicator is not at all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follow: 1. Eight outcome label were considered to be 'supporting' and three outcome label were considered to be 'nonsupporting'. 2. 'Caregiver-Patient Relationship' attained an OCV score of 0.64 and the highest OCV score among caregiver outcomes.. 3. 'Caregiver Emotional Health' attained an OCV score of 0.54 and the lowest OCV score among caregiver outcomes. Replication study will be needed and outcomes sensitive to Korean culture need to be developed.

  • PDF

Severity-Adjusted Mortality Rates of Coronary Artery Bypass Graft Surgery Using MedisGroups (MedisGroups를 이용한 관상동맥우회술의 중증도 보정사망률에 관한 연구)

  • Kwon, Young-Dae
    • Quality Improvement in Health Care
    • /
    • v.7 no.2
    • /
    • pp.218-228
    • /
    • 2000
  • Background : Among 'structure', 'process' and 'outcome' approaches, outcome evaluation is considered as the most direct and best approach to assess the quality of health care providers. Risk-adjustment is an essential method to compare outcome across providers. This study has aims to judge performance of hospitals by severity adjusted mortality rates of coronary artery bypass graft (CABG) surgery. Methods : Medical records of 584 patients who got the CABG surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups was used to quantify severity of patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex. For evaluation of hospital performance, we calculated ratio of observed number to expected number of deaths and z score [(observed number of deaths - expected number of deaths)/square root of the variance in the number of deaths], and compared observed mortality rate with confidence interval of adjusted mortality rate for each hospital. Results : The overall in-hospital mortality was 7.0%, ranged from 2.7% to 15.7% by hospital. After severity adjustment the mortality by hospital was from 2.7% to 10.7%. One hospital with poor performance was distinctly divided from others with good performance. Conclusion : In conclusion, severity-adjusted mortality rate of CABG surgery might be applied as an indicator for hospital performance evaluation in Korea. But more pilot studies and improvement of methodologies has to be done to use it as quality indicator.

  • PDF

Exploring the Development Directions of Learning Outcome in Higher Education through the Analysis of Popular Tools: A Case of University K (주요 고등교육 학습성과 분석 도구 분석을 통한 발전 방향 모색: K대학 사례 연구)

  • Taehyung Kim;Eunjeong Jang
    • Journal of Practical Engineering Education
    • /
    • v.16 no.2
    • /
    • pp.129-141
    • /
    • 2024
  • In recent times, there has been a shift towards student-centered higher education policies, leading to a growing interest among universities to improve students' learning outcomes. To aid in this endeavor, this study aims to provide guidance for University K to enhance their learning outcome management by comparing and analyzing their learning outcome indicators with those of other domestic and foreign universities. The study examined detailed measurement questions from major learning outcome measurement tools such as AHELO, NSSE, and CLA+. Upon comparison and analysis of University K's major learning outcome indicators with those of other universities, it was found that most of the indicators overlapped. However, some indicators such as student support/facilities for learning, instructor quality, and communication were absent from University K. Therefore, it is crucial to decide whether to add these indicators to the existing learning outcomes or to confirm them through other surveys. Moreover, even for the same indicator, some indicators with different measurement need to consider changing the measurement.

Policy Fund Loans and Improvement Plans for Small Enterprise

  • Kim, Young-Ki;Kim, Seung-Hee
    • Journal of Distribution Science
    • /
    • v.13 no.10
    • /
    • pp.5-13
    • /
    • 2015
  • Purpose - This study aims to suggest appropriate policies and performance indicators for financial aid recipients. It analyzes the existing regular government policy funds support project, especially its propriety and reasonability. Research design, data, and methodology - When financial aid is effective, it should be able to predict small enterprise business results. Additionally, there should be an evaluation, checking before and after performance rates so that the rate of achievement and outcome can be measured. This study's contribution for small enterprises is in researching the best way to improve this support system. Results - The Small Enterprise and Market Service (SEMAS), currently designated as a support organization for implementing the government financial aid project, has assessment indicators. However, these focus mainly on quantitative indicators and survey results. Conclusions - In the future, there is some need to draw up measures, setting the right direction for developing policies for the small enterprise fund loans and improving the management of the plans. Eventually, this effort will dispel concerns about the present support policy, which is considered to be weakening small enterprises.

Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals (요양병원의 서비스 질 평가를 위한 요실금 결과 지표 개발)

  • Yoon, Ju-Young;Lee, Ji-Yun
    • Journal of Korean Academy of Nursing
    • /
    • v.40 no.1
    • /
    • pp.110-118
    • /
    • 2010
  • Purpose: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. Methods: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. Results: The inter-rater reliability of items was high (Kappa range: 0.66- 0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. Conclusion: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

An Exploratory Study on Outcome Variable for Educational Serious Game (교육기능성게임의 효과성 측정에 대한 연구)

  • Yoon, Clara;Choi, Hun
    • The Journal of the Korea Contents Association
    • /
    • v.16 no.3
    • /
    • pp.546-552
    • /
    • 2016
  • With the increasing popularity of computer games as a leisure activity, there has been a rise in the interest in the effectiveness of serious games. Many of the earlier researches are focused on evaluation of effects, types, developments of serious games, whereas little is known about the after effects of serious games. The aim of this paper is to examine the previous literatures on serious games in regard to their impacts and outcomes of gaming for the purpose of empirical evidence as impacts and outcomes are needed for exploratory study of variable outcomes of educational serious games. It is worth noting that current review would be used as an outcome indicator for verifying the after effects of both cognitive and educational after the usage of these educational serious games.

Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals (요양병원의 간호사와 간호조무사 확보수준과 이직률이 입원환자의 건강결과에 미치는 영향)

  • Kim, Yunmi;Lee, Ji Yun;Kang, Hyuncheol
    • Journal of Korean Academy of Nursing
    • /
    • v.44 no.1
    • /
    • pp.21-30
    • /
    • 2014
  • Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

Role of Diffusion-Weighted Imaging as a Prognostic Indicator in Acute Hypoxic Encephalopathy (급성 저산소뇌병증의 예후 예측인자로서 확산강조영상의 역할)

  • Kim, Jin-Soo;Noh, Won-Young;Lim, Jae-Sung;Kim, Seon-Jeong;Yun, Chang-Ho;Park, Seong-Ho
    • Annals of Clinical Neurophysiology
    • /
    • v.15 no.2
    • /
    • pp.42-47
    • /
    • 2013
  • Background: Diffusion-weighted image (DWI) might be useful to predict the prognosis of acute hypoxic encephalopathy. The aim of our study was to test whether the early change and extent of DWI abnormalities can be an indicator of the clinical outcome of hypoxic encephalopathy. Methods: Forty-four patients who were diagnosed as hypoxic encephalopathy due to the cardiorespiratory arrest were retrospectively identified. Clinical variables were determined, and the DWI abnormalities were counted by four areas: cortex, subcortical white matter, cerebellum and deep grey matter, and were divided into three groups by the extent of lesions. Prognosis was classified as 'poor' (Glasgow coma scale (GSC) at 30 days after arrest <9 or death) and 'good' (GSC at 30 days after arrest ${\geq}9$). Results: GCS at day 3 (p<0.001), presence of seizure (p=0.01), and presence of lesion (p<0.001) were significantly different in prognosis, but statistically there is no association with the extent of lesions and prognosis (p=0.26). Conclusions: Presence of early DWI changes could predict the clinical outcome of hypoxic encephalopathy after cardiorespiratory arrest.

Changes in Blood Pressure and Heart Rate during Decompressive Craniectomy

  • Jo, Kwang Wook;Jung, Hyun-Ju;Yoo, Do Sung;Park, Hae-Kwan
    • Journal of Korean Neurosurgical Society
    • /
    • v.64 no.6
    • /
    • pp.957-965
    • /
    • 2021
  • Objective : Rapid increase in intracranial pressure (ICP) can result in hypertension, bradycardia and apnea, referred to as the Cushing phenomenon. During decompressive craniectomy (DC), rapid ICP decreases can cause changes in mean atrial blood pressure (mABP) and heart rate (HR), which may be an indicator of intact autoregulation and vasomotor reflex. Methods : A total of 82 patients who underwent DC due to traumatic brain injury (42 cases), hypertensive intracerebral hematoma (19 cases), or major infarction (21 cases) were included in this prospective study. Simultaneous ICP, mABP, and HR changes were monitored in one minute intervals during, prior to and 5-10 minutes following the DC. Results : After DC, the ICP decreased from 38.1±16.3 mmHg to 9.5±14.2 mmHg (p<0.001) and the mABP decreased from 86.4±14.5 mmHg to 72.5±11.4 mmHg (p<0.001). Conversly, overall HR was no significantly changed in HR, which was 100.1±19.7 rate/min prior to DC and 99.7±18.2 rate/min (p=0.848) after DC. Notably when the HR increased after DC, it correlated with a favorable outcome (p<0.001), however mortality was increased (p=0.032) when the HR decreased or remained unchanged. Conclusion : In this study, ICP was decreased in all patients after DC. Changes in HR were an indicator of preserved autoregulation and vasomotor reflex. The clinical outcome was improved in patients with increased HR after DC.