• Title/Summary/Keyword: Patient group

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Comparison of the effects of target-controlled infusion-remifentanil/midazolam and manual fentanyl/midazolam administration on patient parameters in dental procedures

  • Lobb, Doug;Ameli, Nazila;Ortiz, Silvia;Lai, Hollis
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.2
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    • pp.117-128
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    • 2022
  • Background: Moderate sedation is an integral part of dental care delivery. Target-controlled infusion (TCI) has the potential to improve patient safety and outcome. We compared the effects of using TCI to administer remifentanil/manual bolus midazolam with manual bolus fentanyl/midazolam administration on patient safety parameters, drug administration times, and patient recovery times. Methods: In this retrospective chart review, records of patients who underwent moderate intravenous sedation over 12 months in a private dental clinic were assessed. Patient indicators (pre-, intra-, and post-procedure noninvasive systolic and diastolic blood pressure, respiration, and heart rate) were compared using independent t-test analysis. Patient recovery time, procedure length, and midazolam dosage required were also compared between the two groups. Results: Eighty-five patient charts were included in the final analysis: 47 received TCI-remifentanil/midazolam sedation, and 38 received manual fentanyl/midazolam sedation. Among the physiological parameters, diastolic blood pressure showed slightly higher changes in the fentanyl group (P = 0.049), respiratory rate changes showed higher changes in the fentanyl group (P = 0.032), and the average EtCO2 was slightly higher in the remifentanil group (P = 0.041). There was no significant difference in the minimum SpO2 levels and average procedure length between the fentanyl and remifentanil TCI pump groups (P > 0.05). However, a significant difference was observed in the time required for discharge from the chair (P = 0.048), indicating that patients who received remifentanil required less time for discharge from the chair than those who received fentanyl. The dosage of midazolam used in the fentanyl group was 0.487 mg more than that in the remifentanil group; however, the difference was not significant (P > 0.05). Conclusion: The combination of TCI administered remifentanil combined with manual administered midazolam has the potential to shorten the recovery time and reduce respiration rate changes when compared to manual administration of fentanyl/midazolam. This is possibly due to either the lower midazolam dosage required with TCI remifentanil administration or achieving a stable, steady-state low dose remifentanil concentration for the duration of the procedure.

Effects of a Nursing Simulation Learning Module on Clinical Reasoning Competence, Clinical Competence, Performance Confidence, and Anxiety in COVID-19 Patient-Care for Nursing Students (코로나19 간호시뮬레이션 학습모듈이 간호대학생의 임상추론역량, 임상수행능력, 간호수행자신감 및 불안에 미치는 효과)

  • Kim, Ye-Eun;Kang, Hee-Young
    • Journal of Korean Academy of Nursing
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    • v.53 no.1
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    • pp.87-100
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    • 2023
  • Purpose: This study aimed to develop a nursing simulation learning module for coronavirus disease 2019 (COVID-19) patient-care and examine its effects on clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient care for nursing students. Methods: A non-equivalent control group pre- and post-test design was employed. The study participants included 47 nursing students (23 in the experimental group and 24 in the control group) from G City. A simulation learning module for COVID-19 patient-care was developed based on the Jeffries simulation model. The module consisted of a briefing, simulation practice, and debriefing. The effects of the simulation module were measured using clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient-care. Data were analyzed using χ2-test, Fisher's exact test, t-test, Wilcoxon signed-rank test, and Mann-Whitney U test. Results: The levels of clinical reasoning competence, clinical competence, and performance confidence of the experimental group were significantly higher than that of the control group, and the level of anxiety was significantly low after simulation learning. Conclusion: The nursing simulation learning module for COVID-19 patient-care is more effective than the traditional method in terms of improving students' clinical reasoning competence, clinical competence, and performance confidence, and reducing their anxiety. The module is expected to be useful for educational and clinical environments as an effective teaching and learning strategy to empower nursing competency and contribute to nursing education and clinical changes.

A Study on the Space Program of Ward applying to 4 Patient Bedroom in Provincial Medical Center (공공의료원의 4인병실 적용에 따른 병동부 스페이스 프로그램에 관한 연구)

  • Kim, Khilchae;Lee, Hyunjin;Kwun, Joonbum
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.21 no.2
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    • pp.67-73
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    • 2015
  • Purpose: This study examines areal composition of ward applying to 4 bedroom in provincial medical center. Methods: The existing five-bed patient rooms, general type of multiple-bed rooms in Korea causes many problems for the amenity of patients. We should reconsider their inconvenience carefully and try to provide the right to keep their privacy and enjoy amenity. The number of patients of multi-bed rooms is very critical point to improve the environmental condition of the patient rooms. This study separate 5 bedroom group and 4 bedroom group. Net area from space program was surveyed and analyzed. Results: The result of this study can be summarized into two points. The first one is that Group-4(4 bedroom) ward has more 23% patient's area and -23% convenience area than Group-5(5 bedroom). The second one is that Group-4 has more single bedroom and Group-5 has more dayroom. Implications: Consideration Should be taken into account for the effective bedroom composition and allocation in ward. This Study hopefully may serve as a stepping stone for the standard design of space program in ward.

Effects of Education on Knowledge and Practice of Caregivers of the Stroke Patient (뇌졸증 환자 돌보기 교육이 보호자의 지식과 실천에 미치는 효과)

  • Choi, Jae-Sun;Seo, Young-Mi;Kwon, In-Soo
    • Journal of Korean Academy of Nursing
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    • v.36 no.7
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    • pp.1175-1182
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    • 2006
  • Purpose: This study was conducted to evaluate the effects of stroke patient care education on the knowledge and practice of caregivers of stroke patients. Method: Data was collected from December 15, 2004 to March 30, 2005. The research design was a non-equivalent control group non-synchronized design. The subjects were forty primary caregivers of stroke patients who were hospitalized in a neurology unit of a university hospital. Forty caregivers, twenty in the experimental group and twenty in the control group were assigned. The experimental group participated 2 times in an education class given by the researcher Data analysis included -test, and t-test using the SPSS program. Result: Knowledge(t=5..87, p=0.00) and practice(t=5.53, p=0.00) of the experimental group were significantly different from the control group. Conclusion: The stroke patient care education developed in this study shows a significant promotion of knowledge and practice of caregivers. Thus this program can be recommanded as an intervention model for stroke patients and caregivers.

Utilizing Video vs Simulation Practice for Handoff Education of Nursing Students in Pediatric Nursing (간호대학생을 위한 시뮬레이션 기반의 아동간호 인수인계에 관한 동영상 실습교육과 시뮬레이션 실습교육의 효과)

  • Park, Sun-Nam;Im, Young Soon
    • Child Health Nursing Research
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    • v.24 no.1
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    • pp.27-36
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    • 2018
  • Purpose: The purpose of this study was to develop a model for handoff education for nursing students based on simulation using video and to identify educational effects of a simulated situation in pediatric care units. Methods: Data were collected from May 1 to 30, 2016. Participants were 84 senior nursing students in Seoul (video group: 43, simulation group: 41). Both groups were given a lecture and pre-briefing on handoff education. The simulation group had nursing practice on resolving health issues for respiratory distress using a high-fidelity baby simulator. The video group watched a video recording of a scenario based simulation, and used a summarized handoff situation to practice patient handoff to another student. Results: There was no significant difference between the two groups for handoff self-confidence, problem solving ability, handoff competence (self-assessment of students), or learning satisfaction. Self-confidence increased significantly in both groups. Handoff competency evaluated by the instructor was higher in the video group compared to the simulation group (t=2.33, p=.022). Conclusion: Nursing student education for handoff practice utilizing a video in the pediatric unit was more cost effective. Therefore, it could be a useful educational method for students in learning patient handoff practices and helpful for related research.

The Effect of Horse-Riding Exercise on Pain and Body Flexibility for the Patient with Chronic Low Back Pain (승마 운동이 만성요통환자의 통증 및 체간 유연성에 미치는 영향)

  • Lee, Chaewoo;Lee, Insil;Kim, Hyeonsu
    • Journal of The Korean Society of Integrative Medicine
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    • v.1 no.3
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    • pp.111-118
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    • 2013
  • Purpose : The purpose of this study was to investigate the effect of horse riding exercise for pain and body flexibility in the patient with chronic low back pain. Method : 26 subjects in H-equestrian were randomly divided two group, ball exercise(BE) group and horse-riding exercise(HE) group. Each group carried out 40 minutes exercise three times a week for 8 weeks. VAS were measured for pain, and evaluation of body flexibility in position with forward and backward. Result : The results were as follows, the pain scales of VAS(visual analog scale) between ball exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). The flexibility scales of body between ball exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). Conclusion : These finding revealed that horse-riding exercise was effective on pain and body flexibility of patient with chronic low back pain so that these exercise can be new altematives exercise for pain and body flexibility in the patient with chronic low back pain.

A Clinical Study of Tension Headache Patients using Depression & Anxiety Scales (우울(憂鬱), 불안(不安) 척도(尺度)를 이용(利用)한 긴장성(緊張性) 두통(頭痛) 환자(患者)의 임상고찰(臨床考察))

  • Jung, In-Chul;Lee, Sang-Ryong;Park, Ji-Un
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.2
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    • pp.145-154
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    • 2003
  • Objective : The aims of this study were to show the clinical state and to investigate depression and anxiety by BDI and STAI scale in tension headache patients. Method : The patient group was consisted of the 20 patients with Tension Headache who were treated in Department of Neuropsychiatry, Daejeon University Oriental Hospital from 3 March 2003 to 30 September 2003. The control group was consisted of the 20 patients on physical therapy with cerebaral vascular disorder in the Daejeon University Cheonan Oriental Hospital. The patient group was investigated by various characteristics, and compared with the control group by BDI and STAI scores. Result : 1. The ratio of female was higher, the 40 aged were higher frequence, in distribution of the period of the clinical history, short term within 1 week was the most.. 2. Tension headache was most frequent at whole portion, neck stiffness, shoulder pain, general body weakness were mainly coexited, and the prescription invigorating spleen supplementing qi and tonifying qi and blood. 3. The BDI score was higher in patient group, but there was no significant difference 4. The STAI score was higher in patient group, but there was no significant difference.

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A STUDY ON THE POSITION OF CONDYLAR HEAD ON COMPUTED TOMOGRAM (전산화 단층 촬영법을 이용한 하악과두의 위치에 관한 연구)

  • Lee Jong Bok;Kim Jae Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.17 no.1
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    • pp.151-162
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    • 1987
  • The author obtained the computed tomograms around the condylar head from 10 normal subjects and 5 patients having clicking condylar head from 10 normal subjects and 5 patients having clicking sound or limitation of mouth opening by using a Hitachi-W 500. And then. the author had the axial analysis of condyle position and sagittal analysis of that after sagittal reformation on centric occlusion and 18㎜ interincisal opening. Transcranial view and submentovertex view were taken and compared with computed tomographic view. The obtained results were as follows: 1. Median angle of long axis of condylar head was 17 degrees on centric occlusion and the angles of long axis of both condylar heads were reduced symmetrically on 18㎜ interincisal opening in normal group. however. in the patient group, the affected side of condyle heads showed greater change in the angle on 18㎜ interincisal opening. 2. In the patient group, the condyle head of affected side was located superiorly to that of normal side on centric occlusion and the discrepancy of condular positional height was increased after 18㎜ interincisal opening. 3. The distances from medial pole of condylar head to triangular fossa of temporal bone were same on both right and left side in normal group, however, in the patient group, the distance of affected side was wider than that of opposite side on centric occusion and became narrower than the opposite side on 18㎜ interincisal opening. 4. The distances of posterior joint space were same on both right and left side. The distance t lateral pole 1/3 of condyle head was similar to that on transcranial view on centric occlusion in normal group. 5. The distances of posterior joint space were narrower in patient group than in normal group. 6. Conclusively, the affected condylar head of patient showed postero-latero-superior displacement on centric occlusion and larger range of rotational movement on 18㎜ interincisal opening.

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Effects of Surgery Information Service on One-Day Surgery Patients' Anxiety and Satisfaction with Nursing Care (간호정보 제공이 당일수술 환자의 불안과 간호만족도에 미치는 효과)

  • Lim, Yean-Ho;Suh, In-Sun;Chung, Seung-Hee
    • Korean Journal of Adult Nursing
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    • v.22 no.1
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    • pp.1-10
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    • 2010
  • Purpose: The purpose of this study was to determine the effects of surgery information service on one-day surgery patients' anxiety and satisfaction with nursing care. Methods: The study used the nonequivalent control group time difference design. Sampling and measurement of the control group participants (n=30) was completed first. Later, participants in the experimental group (n=30) were sampled, intervened, and measured. The experimental group participants received the surgery information services twice: before and after the surgery, 20~30 minutes for each of the sessions. The anxiety was measured with the State-Trait Anxiety Inventory developed by Spielberger (1975), and modified by Kim & Shin (1978). The patient satisfaction with nursing care was measured with the Patient Satisfaction with Nursing Care Scale developed by La Monica and colleagues (1986), and modified by Shin (1999). The data was collected between February 1 and May 30, 2006. Results: The results were as follows: 1) The level of anxiety in the experimental group was not significantly different from that in the control group. 2) The level of patient satisfaction with nursing care in the experimental group was significantly higher than in the control group (t=-4.53, p=.00). Conclusion: These findings suggested that the one-day vocal cord surgery information service could be a useful nursing intervention to improve patient satisfaction with nursing care, but not for controlling the anxiety of one-day surgery patients.

A Study on the Educational Needs of the Kidney Transplant Patients and Educational Importance perceived by Their Nurses (신장이식 환자의 교육요구와 간호사가 지각하는 교육의 중요성 비교)

  • Ahn, Jae Hyun
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.678-689
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    • 2000
  • The purpose of this study was to explore the educational needs of kidney transplant patients and educational importance perceived by their nurses to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to July 30, 1999 with interviews using a structured questionnaire. The subjects for this study were 173, of whom 107 were patients who had had a kidney transplant and had visited the out-patient department and 66 were transplant ward nurses who were taking care of the kidney transplant patients at six general hospitals located in Seoul. The questionnaire used for this study was developed by the investigator through a literature review and collected and modified by 11 professional personnel and 3 kidney transplant patients. The data were analyzed using the SAS program for numbers, percentiles, mean, standard deviation, t-test, ANOVA, and $Scheff{\acute{e}}$ test. The results were as follows; 1) In the patient group, the total mean score for educational needs was 154.61 and the item mean score was 3.96. In the nurses group, the total mean score for perceived educational importance was 166.26 and the item mean score was 4.26. In the nurses group, perceived educational needs were scored higher than by the patient group. With regard to domains, both patient and nurses group had the highest educational needs and perceived educational importance in the domain of physical condition and the top five items in the educational needs and perceived educational importance were also in the domain of physical condition. 2) In the patient group, women and the divorce/bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than 4 weeks from their kidney transplant time had higher educational needs in the domains of physical condition and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the nurses group, those who were married had higher perceived educational importance in the domain of physical condition.

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