• KIISE Transactions on Computing Practices
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• v.21 no.7
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• pp.464-469
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• 2015

Long-term electrocardiogram data can be acquired by linking a Holter monitor to a mobile phone. However, most systems are designed to detect arrhythmia through heartbeat classification, and not just for supporting clinical decisions. In this paper, we propose an Abstracting algorithm, and introduce an analogous pateint search system using this algorithm. An analogous patient searcher summarizes each patient's typical pattern using the results of heartbeat, which can greatly simplify clinical activity. It helps to find patients with similar arrhythmia patterns, which can help in contributing to diagnostic clues. We have simulated these processes on data from the MIT-BIH arrhythmia database. As a result, the Abstracting algorithm provided a typical pattern to assist in reaching rapid clinical decisions for 64% of the patients. On an average, typical patterns and results generated by the abstracting algorithm summarized the results of heartbeat classification by 98.01%.

• Clinical and Experimental Emergency Medicine
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• v.5 no.4
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• pp.256-263
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• 2018

Objective We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system. Methods This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma. Results Most of the patient's physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system. Conclusion The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a twotier system with special considerations would be more effective for providing optimum patient care and medical resource utilization.

• Journal of Radiation Protection and Research
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• v.44 no.3
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• pp.110-117
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• 2019

Background: This study aimed to estimate occupational doses and patient peak skin doses (PSDs) during interventional radiology procedures. Materials and Methods: We examined data from brain embolization (n = 30), hepatic chemoembolization (n = 50), and uterine embolization (n = 12). The PSDs were measured using radiochromic film around the patient's head (group 1) or abdominal/pelvic region (group 2). Acquisition technical data and kerma-area products (KAP) were also recorded. Occupational doses were measured using $Instadose^{TM}$ dosimeters near the left eye region (LER), chest, and left ankle. Results and Discussion: The third quartile (median) KAP values were $408.1(235.3)Gy{\cdot}cm^2$ for group 1 and $584.4(449.4)Gy{\cdot}cm^2$ for group 2. The average PSDs were greatest during vascular procedures, reaching 1,004.4 (786.4) mGy, and the highest PSD was 2,352.6 mGy (during hepatic chemoembolization). The third quartile (median) occupational doses were 0.35 (0.21) mSv at the LER, 0.25 (0.15) mSv at the chest, and 1.47 (0.64) mSv at the left ankle. Occupational doses at the LER were higher than at the chest, which highlights the importance of protective glasses and suspended shields. The occupational doses at the ankle region were also high, which highlights the importance of using a lead-lined curtain attached to the table. Conclusion: The results indicate that physicians can reach, for eye region, the weekly occupational dose limit after around 15 procedures, even when using proper protection. The average PSD values were below the threshold for tissue reactions, although the complexity of these procedures emphasises the importance of considering related risks.

• Journal of muscle and joint health
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• v.29 no.1
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• pp.41-49
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• 2022

Purpose: The purpose of this study was to assess the influence of nurses staffing level on patient health outcomes in intensive care units (ICUs) in Korea. Methods: The study was retrospective in nature. Information on patients and their outcomes, as well as nurse cohort data, were obtained from Korea's National Health Insurance Service Database. The observation period was from January 1, 2008 to December 31, 2018, and data for 2,964,991 patients were analyzed. Independent variables included patient' age and sex and hospital type, intensivist, and nurses staffing level. Results: The mortality rate in ICUs was significantly higher at tertiary hospitals with a level 3~4 (HR, 1.21; 95% confidence interval, 1.19~1.22) or level 5~9 nurse staffing (HR, 1.31; 95% confidence interval, 1.27~1.34) compare to that of tertiary hospitals with a 1~2 level. 28-day mortality rate was also higher at general hospitals with a level 3~4 (HR, 1.13; 95% confidence interval, 1.12~1.14), level 5~6 (HR. 1.34; 95% confidence interval, 1.32~1.36), level 7~9 nurse staffing (HR, 1.38; 95% confidence interval, 1.38~1.42), using level 1~2 as reference. Conclusion: Nurses staffing level is a key determinant of healthcare-associated mortality in critically ICUs patients. Policies to achieve adequate nurse staffing levels are therefore required to enhance patient outcomes.

• Research in Community and Public Health Nursing
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• v.33 no.4
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• pp.357-371
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• 2022

Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

• Journal of Korean Clinical Nursing Research
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• v.29 no.3
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• pp.296-311
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• 2023

Purpose: This study aimed to identify factors related to the workload of intensive care unit nurses through a systematic literature review and meta-analysis to provide basic data to explore the direction of development of nursing staffing standards. Methods: This study involved quantitative studies about nurses working in intensive care units related to nursing workload published in English or Korean since 2000. Search terms included 'intensive care unit', 'nursing workload', and their variations. Databases such as RISS, DBpia, MEDLINE(PubMed), CINAHL, PsycINFO, and Web of Science were utilized. Quality assessment was conducted using the Joanna Briggs Institute's Critical Appraisal Checklist for Analytical Cross-Sectional Studies. JAMOVI software facilitated the analysis of effect sizes, employing a meta-analysis approach for 7 studies with correlational or regression data. Results: From 16 studies on the workload of intensive care unit nurses, a total of 20 patient and nurse-related factors were identified. Patient-related factors included severity of illness, length of stay, and age. Meta-analysis was conducted for three patient-related factors: age, severity of illness measured by SAPS 3, and length of stay. Only severity of illness measured by SAPS 3 was significantly associated with nurse workload (Zr=0.16, p<.001, 95% CI=0.09-0.24). Conclusion: In previous studies, the characteristics of intensive care units and patients varied across studies, and a variety of scales for measuring workload and severity of illness were also used. Sustained research reflecting domestic intensive care unit work environments and assessing the workload of intensive care unit nurses should be imperative.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.2
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• pp.144-148
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• 2022

Backgrounds/Aims: Splenectomy in patients with non-Hodgkin lymphoma (NHL) is performed to relieve abdominal symptoms, treat hypersplenism or confirm diagnosis. Excision of a very large spleen is technically challenging and data on outcomes of surgery in patients with NHL are scanty. The aim of study was to evaluate the impact of spleen size on the surgical outcome of splenectomy in patients with NHL. Methods: Patients with NHL who underwent splenectomy, between 2006 and 2017, were included and divided into two groups: group 1, spleen ≤ 20 cm; group 2, spleen > 20 cm. Surgical approach, operative time, postoperative morbidity, mortality, hospital stay and re-admission rates were retrospectively compared between groups. Non-parametric data were evaluated with the Mann-Whitney U test. Differences in frequencies were analyzed with Fisher's exact test. Results: Sixteen patients were included (group 1, 6; group 2, 10). Laparoscopy was successful in three patients of group 1, none of group 2 (p = 0.035), the intraoperative time did not differ significantly between groups. One patient in each group developed postoperative complications. The patient in group 1 died of pneumonia. Median length of stay was 8 days (range, 3-16 days) for group 1, 5.5 days (range, 3-10 days) for group 2, showing no significant difference between the two groups. No patient was readmitted to hospital. Conclusions: Spleen size does not affect the outcome of splenectomy in patients with NHL. If a mini-invasive approach is to be chosen, laparoscopy may not be feasible when the spleen size is > 20 cm.

• Journal of the Health Care and Life Science
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• v.11 no.2
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• pp.351-360
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• 2023

2018 aged patient dataset (HIRA-APS), 33,821 patients admitted to long-term care hospitals were classified by major disease groups to identify the characteristics of medical use and provide effective policy data. First, it is necessary to operate specialized long-term care hospitals such as dementia, rehabilitation, hospice, and recovery specialization tailored to the characteristics of the patient's disease group. Second, the paralysis group, cerebrovascular disease group, and dementia group were the longest LOS and the cognitive impairment group is the longest by patient classification group, requiring medical demand and quality management for long-term patients. Third, the musculoskeletal disease group was the highest normal discharge, and support for the post-discharge home program is required in paralysis and cerebrovascular disease.

• Child Health Nursing Research
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• v.20 no.4
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• pp.283-293
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• 2014

Purpose: The patient's perspective in the assessment of quality of care has become increasingly important. The purpose of this paper was to introduce the concept of 'QUality Of care Through patient's Eyes (QUOTE)', to analyze the papers using QUOTE through an integrative review method, and to present the attributes of the QUOTE evaluation. Methods: Data were collected from electronic databases. Inclusion criteria were publication in English from 1997 to 2013, as a peer-reviewed research article, with an empirical study focused on QUOTE. Thirty two papers met the criteria and were analyzed. Results: QUOTE had been applied to various groups of patients such as those with various diseases since 1997 in the Netherlands. Four themes were retrieved from synthetic analysis of the thirty-two papers using QUOTE; 1) acceptance of individuation of the patient and family, 2) evaluation of diverse nurses' competencies, 3) evaluation of quality of nursing environments, and 4) participation of patient in the whole process of evaluation. Conclusion: The strengths of QUOTE are that it attempts to overcome the conceptual and methodological problems associated with evaluation of quality of care. Our results imply that QUOTE evaluation could be an effective strategy to improve care of patients in clinical setting.

• Journal of the Korean Society of Radiology
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• v.10 no.3
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• pp.145-152
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• 2016

This study, targeting a cancer patient undergoing radiation treatment, conducted this research with the aim of looking into the relevance between family support belonging to a patient's primary environment, social support consisting of medical personnel, and the quality of life; this study set 199 patients available for investigation from Jan. 25, 2012 until April 30, 2012 as research subjects among the cancer patients undergoing radiation treatment at the Radiation Oncology Department of a university hospital located in Seoul Metropolitan City. In the analysis of collected data, this study conducted t-test using SPSS/WIN 18.0 Statistical Program, and looked into the relevancy between independent variables including social support, and the quality of life as a dependent variable using analysis of variance, correlation analysis and multi-regression analysis. Conclusively, it was found that the higher the family support perceived by a cancer patient undergoing radiation treatment, the higher the quality of his/her life; thus, this study could learn that there exists a significant relation between family support and the quality of life. Accordingly, it is thought that it's necessary to develop an intervention strategy which makes it possible to intensify family support and social support, etc. for the purpose of improving the quality of life of cancer patients undergoing radiation treatment; further, this study thinks that it's necessary to do additional research which could analyze diverse aspects by subdividing the future quality of life by area.