• 제목/요약/키워드: Patient falls

검색결과 114건 처리시간 0.026초

Effect Analysis of Virtual-reality Vestibular Rehabilitation based on Eye-tracking

  • Lee, Sungjin;Hong, Min;Kim, Sungyeup;Choi, Seong Jun
    • KSII Transactions on Internet and Information Systems (TIIS)
    • /
    • 제14권2호
    • /
    • pp.826-840
    • /
    • 2020
  • Vertigo is one of the most common complaints encountered by physicians and the patients are steadily increasing. These patients are exposed to the risk of secondary accidents such as falls due to vertigo. There are two ways to improve this symptom: medication and rehabilitation. Although temporary symptomatic improvement may be expected in patients treated with medication, vertigo may recur and medication can delay central compensation. In contrast vestibular rehabilitation exploits central mechanisms of neuroplasticity to increase postural stability and enhance visual-vestibular interactions in situations that generate conflicting sensory information. However, vestibular rehabilitation may be compromised by incorrect performance of exercises, and there is a need for active effort and interest from the patient during rehabilitation. To solve these problems, we decided to apply FOVE HMD for eye-tracking and Unity3D to create virtual reality. The proposed eye-tracking based algorithm calculates the concentration of users with eye tracking data and calculates the motion width of the patient with nystagmus, thus the severity of the patient according to the score can be determined. According to our experimental test against healty group and patients group, this result showed the meaningful data to use define the contents result.

개흉술 후 경막외 통증자가조절을 설시한 환자에서 Hydromorphone-Bupivacaine과 Fentanyl-Bupivacaine 투여의 비교 (A Comparison of Hydromorphone-Bupivacaine and Fentanyl-Bupivacaine in Patient Controlled Epidural Analgesia after Thoracotomy)

  • 심우석;여진석
    • The Korean Journal of Pain
    • /
    • 제18권2호
    • /
    • pp.181-186
    • /
    • 2005
  • Background: Hydromorphone has an intermediate lipid solubility range that falls between morphine and fentanyl. Lipophilic activity during opioid epidural administration is important in relation to both the side effects and analgesic efficacy. The purpose of this study was to compare epidural hydromorphone and fentanyl when concomitantly infused with bupivacaine in patients undergoing a thoracotomy. Methods: Seventy-seven thoracotomy patients, with patient-controlled epidural analgesia (PCEA), were blindly allocated into two groups [group F (n = 34); 0.1% bupivacaine and fentanyl $5{\mu}g/ml$, group H (n = 34); 0.1% bupivacaine and hydromorphone $16{\mu}g/ml$)]. The basal PCEA rate and demand dose were 4 ml/hr and 3 ml, respectively. The visual analogue scale (VAS) for pain, and pruritus, sedation and nausea were measured at 6, 12 and 24 hours after the operation. Results: There were no significant differences in the VAS pain scores and the incidences of pruritus, nausea and sedation between the two groups. The total infused volume after 24 hours was lower in H compared to that of F group (P < 0.05). Conclusions: We conclude that epidural hydromorphone or fentanyl administration has a similar analgesic efficacy and shows similar incidences of side effects, when concomitantly infused with bupivacaine, in the management of acute pain following a thoracotomy.

요양병원 간호사의 낙상예방행위에 미치는 영향요인 (Factors Affecting Fall-Prevention Behavior of Long-Term Care Nurses)

  • 최주연;이가언;전혜정
    • 한국직업건강간호학회지
    • /
    • 제31권4호
    • /
    • pp.157-166
    • /
    • 2022
  • Purpose: The purpose of this study was to identify factors influencing fall-prevention behaviors of nurses working in long-term care hospitals. Methods: Participants included 147 nurses working in 10 long-term care hospitals in B city. Data were collected from September 20-October 12, 2016. SPSS/WIN 21.0 was used for analysis with t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression. Results: It was found that attitude toward fall (r=.29, p<.001) and patient safety culture (r=.25, p=.002) had a significant positive correlation with fall-prevention behaviors of nurses working in long-term care hospitals. The factors influencing fall-prevention behaviors in participants were clinical career and patient safety culture (β=.21, p=.012), contributing to 19% of the total variance in fall- prevention behaviors. Conclusion: The findings showed that systematic delivery of differentiated fall prevention education is preferred to nurse's clinical career as a private factor to improve fall-prevention behaviors of nurses in long term care hospital. Particularly, it is imperative to conduct periodical and practical fall-prevention education for nurses to prevent career discontinuity. An independent report system and open communication system as well as a scheme that can disseminate patient safety culture in individual departments to implement patient direct nursing are required to encourage patient safety culture in organizations.

1개 종합병원 환자의 낙상에 관한 조사 (A Study on Fall Accident)

  • 이현숙;김매자
    • 대한간호
    • /
    • 제36권5호
    • /
    • pp.45-62
    • /
    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

  • PDF

외부자료 입력방법에 따른 업무의 효율성 비교평가 (Evaluation the external data import methods assess the effectiveness of the work)

  • 신승희;이승진;정재은;이종웅
    • 대한디지털의료영상학회논문지
    • /
    • 제15권1호
    • /
    • pp.39-45
    • /
    • 2013
  • PACS Import external image of the thread of the tasks and duties of hospital revenue and business efficiency falls over time. 500 beds or more medical imaging import work outside of the hospital, most hospitals use a PC, KIOSK, and was used in 15 hospitals where, CD Autoloader where use was the only one. Working hours compared to CD and DVD media to test the results of the Import target PC, KIOSK, CD Autoloader Import spent less time in the order, and also the greater capacity of CD Autoloader four times the PC, KIOSK 2 times Import could be implemented quickly. In addition, the waiting time of the patients was measured using the PC's time to Import, 2011 14.5 minutes and the average patient waiting time, KIOSK and later use CD Autoloader 2012 average patient wait time of 8.25 minutes, 43% of the existing average waiting time was 5.25 minutes to reduce. However, KIOSK case of a patient in a way that directly Import latency time was soon. Import of three ways: in terms of efficiency and excellent CD Autoloader way, the patient waiting time in terms of ease of use and KIOSK was excellent. In addition, with the introduction of CD Autoloader with KIOSK Joint of the items waiting time of patients and patient satisfaction rating is considered to be a major contribution.

  • PDF

Traumatic lumbar hernia: clinical features and management

  • Park, Youngeun;Chung, Min;Lee, Min A
    • Annals of Surgical Treatment and Research
    • /
    • 제95권6호
    • /
    • pp.340-344
    • /
    • 2018
  • Purpose: Traumatic lumbar hernia is rare, thus making diagnosis and proper treatment challenging. Accordingly, we aimed to investigate the clinical manifestations and proper management strategies of traumatic lumbar hernias. Methods: The medical records of patients with traumatic lumbar hernia treated at Gachon University Gil Hospital from March 2006 to February 2015, were retrospectively reviewed. Results: We included 5 men and 4 women (mean age, 55 years; range, 23-71 years). In 8 patients, most injuries were caused by motor vehicle collisions, including those wherein a pedestrian was struck (5 cases of car accidents, 2 falls, and 1 involving penetrating materials); in 1 patient, the probable cause was severe cough. Eight patients underwent hernia repair surgery (5 open and 3 laparoscopic), and a prosthetic mesh was used in 7 patients. Hernia repairs were elective in 7 patients; emergency hernia repair was performed with right hemicolectomy in 1 patient. No severe complication or recurrence was observed. Only 2 patients had mild complications, such as postoperative seroma. Conclusion: Traumatic lumbar hernia is a relatively rare injury of the posteriolateral abdominal wall. Lumbar hernia should be suspected in patients with high-energy injuries of the torso, and all such patients should undergo abdominopelvic computed tomography. After diagnosis, hernia repair can be electively performed without complications in most cases.

병원안전을 위한 입원실 음향패턴 인식 관한 연구 (A study on Recognition of Inpatient Room Acoustic Pattern for Hospital safety)

  • 류한술;안종영
    • 한국인터넷방송통신학회논문지
    • /
    • 제21권3호
    • /
    • pp.169-173
    • /
    • 2021
  • 현재 병원에서의 안전사고가 꾸준히 발생하고 있다. 특히, 요양병원 등 면역력이 약한 고령환자의 안전사고가 지속적으로 발생하고 있으며 이에 대한 대책이 필요하다. 대부분의 사고는 거동이 불편한 환자의 움직임에 의해 일어나고 있다. 이에 환자의 움직임에 따른 입원실 음향을 분석하고 인식하여 관리자가 사전대처 하여 안전사고를 줄이는 방법으로 본 논문에서는 시계열 패턴인식에 적용 가능한 알고리즘인 DTW (Dynamic Time Warping)을 사용하여 병원 입원실 음향인식을 위한 음향패턴을 분류하여 병원 입원실 환경에 적용하여 분석 하였다.

우울증으로 내원한 진행성 핵상 마비 환자 1례 (A Case of a Depressed Patient With Progressive Supranuclear Palsy)

  • 한서윤 ;장진구 ;이수영
    • 대한불안의학회지
    • /
    • 제19권2호
    • /
    • pp.56-60
    • /
    • 2023
  • Progressive supranuclear palsy (PSP) is rare atypical Parkinsonism accompanied by various psycho-behavioural problems. In this case report, we describe the diagnostic and treatment progress of a 65-year-old PSP patient who visited the psychiatric clinic with a depressed mood and lumbar pain resulting in a suicide attempt. Over the course of 30 months of treatment, typical characteristics of PSP, such as postural instability, dyskinesia, cognitive dysfunction and supranuclear gaze palsy, became prominent, and magnetic resonance imaging and the F-18 FP-CIT positron emission tomography revealed midbrain atrophy and reduced dopamine uptake in the basal ganglia. When treating elderly patients with depression, parkinsonism symptoms such as gait disturbances, frequent falls, tremors, and rigidity should be closely examined.

The relationship between disability and clinical outcomes in maintenance dialysis patients

  • Kang, Seok Hui;Do, Jun Young;Kim, Jun Chul
    • Journal of Yeungnam Medical Science
    • /
    • 제38권2호
    • /
    • pp.127-135
    • /
    • 2021
  • Background: Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients. Methods: This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization. Results: The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend). Conclusion: Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

Autonomic dysfunction in patients with orthostatic dizziness

  • Hyung Lee;Hyun Ah Kim
    • Annals of Clinical Neurophysiology
    • /
    • 제25권1호
    • /
    • pp.27-31
    • /
    • 2023
  • Orthostatic dizziness is feeling dizzy or lightheaded when standing up. Hemodynamic orthostatic dizziness can be caused by autonomic dysfunction such as orthostatic hypotension or postural tachycardia syndrome. The interpretation of the autonomic function test results in patients with orthostatic dizziness is crucial for diagnosing and managing the underlying condition. The head-up tilt and Valsalva tests are especially important for evaluating adrenergic function in patients with hemodynamic orthostatic dizziness. However, it is important to note that autonomic function tests do not cover the entire diagnostic process, since their findings need to be considered along with the detailed history and physical examination results of the patient because various differential diagnoses exist for orthostatic dizziness. Ensuring appropriate treatment by interpreting the autonomic function test results can help to determine the improvement of and prevents falls from orthostatic dizziness.