• Korean Journal of Clinical Pharmacy
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• v.32 no.2
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• pp.116-124
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• 2022

Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.

• Journal of Chest Surgery
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• v.55 no.2
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• pp.118-125
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• 2022

Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

• Perspectives in Nursing Science
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• v.12 no.1
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• pp.33-41
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• 2015

Purpose: This study attempted to describe hospital nurses' pre-diabetes knowledge, performance and expectation of patient. Methods: The total of 204 hospital nurses were administered the questionnaires. The questionnaire comprises general background information (including sex, age, religion, education and career), ten researcher-generated questions regarding knowledge about pre-diabetes, performance of patient education (including how many people encounter in workplace, how often teaching, how many minutes required to teach and course contents) and expectation (including need improvement of teaching, barrier to education and desirable course contents and teaching methods) Results: The average score of hospital nurses' pre-diabetes knowledge was as low as 0.82 (82% correctness). On comparison of the knowledge levels among ten pre-diabetes knowledge dimensions, the highest score was 0.95 for necessary of medical check-up. The lowest score was 0.57 for complication can rarely happen. Significant correlations were observed for education, career and knowledge regarding pre-diabetes. Moreover, 49.5% of the nurses did not instruct patients about pre-diabetes, 24.5% taught prevention skills to a third of the pre-diabetes patients they encountered, and 61.2% nurses disseminated information under 5 minutes. Improvement was necessary for 78 nurses (75.8%). Conclusion: Pre-diabetes awareness among nurses is necessary.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.5
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• pp.313-321
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• 2024

Purpose: For neonates admitted to the neonatal intensive care unit (NICU), appropriate nutritional assessment and intervention are important for adequate growth. In this study, we aimed to determine whether there were changes in the nutritional supply and growth status of premature infants hospitalized in the NICU after the introduction of the Nutrition support team (NST). Methods: This study retrospectively analyzed premature infants admitted to the NICU for over 14 days. The average daily calorie, protein, and fat supply at 1 and 2 weeks after birth were compared before and after NST, and growth was evaluated by changes in length, weight, and head circumference z-scores at birth and 28 days after birth. Results: A total of 79 neonates were included in the present study, with 32 in the pre-NST group and 47 in the post-NST group. The average daily energy supply during the first (p=0.001) and second (p=0.029) weeks postnatal was significantly higher in the post-NST group than in the pre-NST group. Lipid supply for the first week was significantly higher in the post-NST group than in the pre-NST group (p=0.010). The change in the z-score for length was significantly higher in the post-NST group than in the pre-NST group (p=0.049). Conclusion: Nutrient supply and length z-score change increased significantly at 28 days after birth in the post-NST group. These results suggest that calorie calculators and NST activity can promote adequate growth and development in neonates.

• The Korean Journal of Emergency Medical Services
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• v.16 no.2
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• pp.53-66
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• 2012

Purpose : Emergency medical services in China are increase in demand by people and under the greater pressure than ever before. So it is, necessary to advance the pre-hospital system in order to promote the development of emergency medical services. Methods : This is based on China-related articles, books, journals, reports, statistical data and other literature. Results : First, pre-hospital emergency medical care with the introduction of specialist training program should be established. Second, to strengthen pre-hospital emergency services and to develop the EMS guidelines. Third, the "120" reporting systems unification and awareness activation. Fourth, the preparation of the EMS facilities equipment system. Fifth, the rapid transport system establishment to the selected medical institutions. Conclusion : It is necessary to strengthen the emergency medical personnel at the scene, rapid transport, rapid patient triage and to improve the survival rate of the patients.

• Journal of Korean Clinical Nursing Research
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• v.21 no.1
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• pp.43-52
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• 2015

Purpose: This study was aimed to develop the multicomponent intervention for preventing delirium among postoperative patients in a surgical intensive care unit (SICU). Methods: Using a quasi-experimental pre & post-test design with a non-equivalent control group, a total of 88 hospitalized patients in a SICU participated in this study. The 44 patients were allocated in each experimental and control group. The experimental group received the multicomponent intervention for delirium prevention including a delirium assessment and nursing intervention using a checklist, whereas the control group was provided with a standard care. The primary outcome of this study was the delirium incidence during the course of hospitalization. Results: There were no significant differences in the demographic and clinical characteristics between the two groups. The delirium occurred in 19.2% in the experimental group, whereas 38.6% in the control group ($x^2=4.526$, p<.05). Conclusion: The findings of the study demonstrated an effect of the multicomponent delirium prevention intervention in decreasing the delirium incidence rate over the standard care among the patients in SICU.

• Korean Journal of Health Education and Promotion
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• v.11 no.2
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• pp.18-32
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• 1994

The purpose of this study was to analyze the effectiveness of injury prevention education on elementary school students. We are selected two elementary school in Tejeon, one was intervention school, the other was control school. Surveys were completed before the begining of the interventions in February in 1994 and again after their completion in July 1994. Intervention group was 284 students in pre-test and 218 students in post-test. And control group was 253 students in pre-test and 208 students in post-test. The results of this study was followed. 1. In the general characteristics of subjects studied, sex, mother education, father education, economic status, number of household, and traffic environment were not significant difference between intervention and control group(p>0.05). 2. The contents of injury prevention education that subjects wished to learn, were not significant difference between intervention and control group(p>0.05). Also the mothods of that were significant difference between intervention and control group in pre-test(p<0.05) but not in post-test(p>0.05). 3. Education in knowledge, attitude and practice of injury prevention was slightly effectiveness. Change in attitude of injury prevention was higher than in knowledge and attitude of that we guess that they require a lot of education in the pedestrian prevention. 4. Reative risk between intervention and control group in injury incidence was 1.53 in hospital-care students, and 1.43 in home-care children. Also relative risk of total injury incidence was 1.38, therefore we knew that injury incidence after education was reduced. 5. In the analysis of injury causes, pedestrain injury was remarkably reduced at hospital-care students in two group. At home-care students, two groups were high proportion in play injury. 6. In the analysis of injury places, intervention group was high proportion at near-the house in pre-test(35.4%) and at school in post-test(36.4%). And control group was high at inside-the house in pre-test(31.5%) and at near-the house in post-test(28.2%).

• Journal of Hospice and Palliative Care
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• v.22 no.4
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• pp.166-173
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• 2019

Purpose: High-quality hospice and palliative medicine curricula are necessary in Korean medical schools. This study evaluated changes in students' knowledge and attitudes toward both hospice and palliative care following the completion of a course on these topics, as well as the course's overall role in the basic medical education curriculum. Methods: Questionnaires measuring knowledge and attitudes were collected before and after the course from 76 fourth-year medical students, who had received instructions integrating both hospice and palliative care in 2016. Results: The questionnaire item "Select the correct answer on the use of opioid pain control in hospice and palliative care" changed the most in terms of number of correct answers pre- and post-course (3.50 and 5.32, respectively; P<0.001). Pre- and post-course, the numbers of students who answered "Strongly Agree" and "Agree" to questions concerning their attitudes toward hospice and palliative care ("I know the purposes and roles of hospice and palliative care") were 17 (22.4%) and 65 (85.6%), respectively (P≤0.001). Affirmative responses also increased for "As a pre-physician, I know when to describe and advise hospice and palliative care to patients", from 22 (28.9%) to 65 (85.6%; P≤0.001). Conclusion: This study showed that comprehensive hospice education in the form of an integrated educational course might promote changes in medical students' knowledge and attitudes toward hospice and palliative medicine.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.29-38
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• 2005

The purpose of this study was to provide the basic data for improvement of Emergency Medical Service System in Kwangju. The EMSS can be defined as the complete chain of human and physical resources that provides patient care in cases of sudden illness and injury. To provide effective emergency care through the EMSS in a region, the issue of training especially as it relates to EMT in EMSS delivery is more important than emergency medical equipment and facilities for pre-hospital emergency care. The transport of emergency medical patients carried out almost by 119 Emergency Medical Services. But out of all the employees at 119 EMS only 19.0% have graduated with a major in Emergency Medical Technology. It would seem prudent then that the graduates of EMT programs should gradually replace employees working at 119 EMS that do not have an EMT degree to ensure the best possible pre-hospital care for emergency medical patients. Therefore it can be expected that in the future there should an enormous demand for qualified EMT professionals to meet the growing needs for a superior level of emergency medical care for civilian.

• The Journal of Korean Academic Society of Nursing Education
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• v.18 no.3
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• pp.403-412
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• 2012

Purpose: This study compared the effects of three oral care methods on thirst and oral status in patients after general anesthesia surgery. Methods: Sixty five surgical patients were prospectively randomized into three groups. Each group received one of three oral care methods: wet water gauze, frozen water gauze, or frozen normal saline gauze. The outcomes of thirst and oral status were assessed three times by trained investigators blinded to the oral care methods. Assessment times were right after a participant's arrival to his/her room, and at 30 and 60 minutes after the pre-test. Results: The levels of thirst and oral status were significantly improved as time passed in all three oral care methods. While the level of thirst was not significantly different between the three groups, the level of oral status was significantly better with wet water gauze than frozen gauze groups, soaked in either water or normal saline. Conclusion: We recommend nurses choose one of three oral care methods based on patients' preferences since all three oral care methods showed similar effects in improving postoperative patients' levels of thirst and oral status.