• Quality Improvement in Health Care
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• v.8 no.1
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• pp.44-55
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• 2001

Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.

• Journal of Korean Academy of Nursing
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• v.25 no.3
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• pp.441-456
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• 1995

This study was done to determine direct and in-direct nursing time in nursing units in hospital to ap-plied computer system and expect that those results contribute to measure efficiency of nursing practice and planning of nursing manpower. The design for study was a descriptive study. The study results are as follows. 1. Patients admitted to the Internal Medicine and General Surgery units were grouped into four. Group Ⅰ, 32.9% of the total patients, consisted patients whose condition was considered minor Group Ⅱ, 26.1%, was of those whose condition was considered moderate, Group Ⅲ, 41. 8%, moderate severe and Group Ⅳ, 29.2% the most severe. 2. Nursing intervention times by care type were as follows four minutes spent for suction eight minutes, for simple position change, ten minutes, for sheet change, seven minutes for a hot or cool compress, six minutes for dressing change, four minutes for Ⅰ.M. injection, six minutes for patient health education and five minutes for body temperature check. 3. Direct care time by patient group revealed the following : Group Ⅰ rquired 191.4 minutes, Group Ⅱ required 331.1 minutes, Group Ⅲ rquired 499.4 minutes, and Group Ⅳ rquired 1328.0 minutes. 4. The ratio of time for adequate nursing care and direct care time in the Internal Medicine and Goneral Surgery units was 67.4%-83.4% and 94.7%-99.3% in the Intensie Care Unit. 5. Average daily direct care time per patient was 5.5 hours in the Internal Medicine unit and 11.5 hours in the Intensive Care Unit. 6. Time spent in indirect care was 48.3 minutes for computer recording,34.8 minutes for giving and receiving patient information for shift duty, 28.0 minutes for eating and resting time, 26.6 minutes for transfering and identifying patients, 25.6 minutes for identifying Doctor's order, 23.9 minutes for recording vital signs. 7. Time spent in indirect care was 282.2 minutes by head nurses (charge nurses), 258.7 minutes by nurses and 261.6 minutes by nurse aids. 8. The average nurse's workload was 9.3 hours and daily indirect nursing time required 46.3%-50. 5% of above mentioned workload time. .9. The average daily indirect care time per patient was expected to be 57.7 minutes in the Internal Medicine unit and 3.3 hours in the Intensive Care Unit.

• Journal of Korean Clinical Nursing Research
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• v.19 no.1
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• pp.1-19
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• 2013

Purpose: This study was conducted to develop standards to ensure nursing process-based care of oxygen therapy and airway suctioning and to develop a performance measurement tool to evaluate the care applied according to the standards, and finally to determine validity of the standards and the tool. Methods: The standards and the tool were reviewed by a panel of experts and refined based on the panel's suggestions. Validity of the standards and the tool were examined through surveying a total of 366 hospital nurses. Results: The mean validity scores of the performance measurement standards and the tool were 3.58 and 3.55, respectively, out of 4.00. So the performance measurement standards and the tool in this study were found to be acceptable in evaluating quality of nursing care provided at patient admission and discharge. Conclusion: This result indicates that the performance measurement standards and the tool developed in this study are valid instruments to monitor and improve quality of nursing care for oxygen therapy and airway suctioning.

• Journal of Korean Academy of Nursing
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• v.23 no.3
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• pp.325-338
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• 1993

This study was conducted to evaluate the methods used in nursing procedures for infection control. Skilled nursing procedures are related to prevention of hospital infection. The sample consisted of 301 nurses’ response to the questionnaire. Data were collected from Feb. to March, 1993 from 35 hospitals located in five major cities. The findings of the study are as follows : 1) Rotatively unsafe nursing procedures were reported for preperation of IV therapy, change of IV site and aseptic dressing on IV site, hand wash-ing and use of paper towels, use of sterile urine bottle with indwelling urinary catheter, management of dressing cart, disinfection of transfer forcep, ambu respirator, laryngoscope, humidifier and handling of incubator. 2) Relatively safe nursing procedures were reported for management of suction tube, marking for contaminated materials and waste collection. The rate of participation in education programs for infection control by the nurses was higher than in other research results. 3) Further study on procedures for IV site in-fusion and care of dressing cart are recommended.

• The Journal of the Korea Contents Association
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• v.9 no.5
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• pp.145-155
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• 2009

There is a great deal of merit in CR system but artifact not produced in old system of film or screen newly is created. we studied 3 cases of artifact with CR system in one hospital, Gwangju. In the first case of the delay time and density, As the time was delayed, the density of the artifact was increased up to 67 percent in the natural radiation. The Second, Fading of the artifact decreased 33 percent in the rate of the emission after 10 hours, and the more the time was delayed, the less the quality of image was deteriorated. Third, Artifact was produced by the collimation when the radiologic technologist was performed, and by the Guiding plate and Suction cup when the radiation equipment was done. Therefore, when health care provider have to understand the artifact exactly and check regularly, the quality of the picture and the satisfaction of the medical examination is increased.

• The Korean Journal of Emergency Medical Services
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• v.2 no.1
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• pp.26-35
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• 1998

This study was to exhibit the effective emergency care method for the drowning and non-drowning who are reached two-thousand peoples every year in our country. For investigate the effective emergency care, this study was discussed as follows ; Pathophysiology of the water submersion, Fresh-water & sea-water drowning, Factors affecting survival, and Prehospital management. The conclusions from this study were summarized as follows; 1. Remove the patient from the water. If you suspect neck or spinal injuries, Always support the head and neck level with the back and, begin rescue breathing. 2. Maintain the airway and support ventilation in the water use the jaw-thrust technique to avoid farther injury to the neck or spine. We might encounter more resistance to ventilations than you expect because of water in the airway. Once you have determined that there are no foreign objects in the airway, apply ventilations with more force; adjust ventilations until you see the patient's chest rise and fall but not until you see gastric distention. Do not attempt to remove water from the patient's lungs or stomach. 3. If there is no pulse, begin CPR. 4. Administer high-flow supplemental oxygen; suction as needed. 5. Once the patient is breathing and has a pulse, assess for hemorrhage; control any serious bleeding that you find. 6. Cover the patient to conserve body heat, Handle the patient very gently, and, Transport the patient as quickly as possible to Emergency Department, Continuing resuscitative measures during transport. If the patient have the hypothermia, follow hypothermia management.

• Fire Science and Engineering
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• v.26 no.3
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• pp.14-20
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• 2012

This study analyzes the influencing factors of prehospital 119 Emergency Medical Service for Stroke Patients in prehospital. From July, 2010 to June, 2011, 123 patients were diagnosed with Stroke in Emergency Medical Center. Among 123 patients, the prehospital assessment rates were as follows : blood pressure checked 73.2 %, pulse checked 73.2 %, respiratory checked 64.2 %, $SpO_2$ checked 79.7 %, pupil reflex test 88.6 %, Electrocardiogram checked 14.6 %, blood sugar checked 19.5 %. Prehospital emergency medical care, Oropharyngeal airway insertion 2.4 %, Manual airway maneuvers 17.1 %, endotracheal intubation 2.7 %, oxygen supply 35.4 %, and suction and intravenous fluid therapy 0 %. The property of mental status evaluation by 119 Emergency Medical Service was nearly perfect, but the patients assessment and emergency medical care were not.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.121-126
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• 2018

The oral hygiene of patients admitted to the ICU (Intensive Care Unit) is very important. Critically ill patients are basically immunocompromised ones because of the high risk of infection by various pathogenic bacteria. The mouth is not only the primary site of infection, but also the site of systemic infections. The purpose of this study was to design a mouthpiece type vacuum oral cleaner for the oral care of seriously ill patients. A 3D CAD modeling and flow analysis model were established for a double structure type cleaner and standard tooth model, and their pressure and flow characteristics were analyzed. The pressure inside the oral cleaner was almost constant, but the velocity distribution showed a large difference between the inside and outside of the teeth. The velocity at the center region inside of the teeth was the highest, and the speed decreased as the distance from the center increased. In the analysis of the case where the suction tube was replaced by the drainage tube, the velocity at the center of the outer portion of the teeth was the highest. In order to increase the effectiveness of the oral cleaner, alternating between suction and drainage is proposed, and a design complement to increase the speed of the molar region is required.

• Child Health Nursing Research
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• v.19 no.1
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• pp.1-11
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• 2013

Purpose: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. Methods: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. Results: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. Conclusion: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed.

• Journal of Korean Neurosurgical Society
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• v.41 no.2
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• pp.100-104
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• 2007

Objective : Despite the widespread use of preoperative ventriculostomy in aneurysmal subarachnoid hemorrhage [SAH], there is no general consensus regarding the risk of bleeding associated with its use before aneurysm repair. This study was conducted to define the efficacy and rebleeding risk of ventriculostomy in aneurysmal SAH. Methods : The authors reviewed 339 consecutive patients with aneurysmal SAH who were treated at our hospital between January 1998 and December 2004. Results : Preoperative ventriculostomy was performed on 73 patients for acute hydrocephalus after aneurysmal SAH. The Hunt-Hess[H-H] grades of patients who underwent ventriculostomy were higher. Out of the 73 patients who underwent preoperative ventriculostomy, 58 [79%] demonstrated immediate clinical improvement after ventriculostomy. Of those same 73 patients 22 [30%] suffered aneurysmal rebleeding, whereas only 11 [4%] of the 266 patients who did not undergo ventriculostomy showed preoperative aneurysm rebleeding. The causes of rebleeding in the 22 patients who underwent ventriculostomy before surgery were related to the ventriculostomy procedure itself, subsequent cerebrospinal fluid [CSF] drainage, angiography and patient care procedures, such as endotracheal suction and nursing care. The mean time interval between SAH and surgery in the patients who underwent ventriculostomy was not statistically different from those who did not receive preoperative ventriculostomies [44.66 compared with 42.13 hours; p=0.73]. Conclusion : The preoperative ventriculostomy improved patients' clinical condition but increased the risk of rebleeding after aneurysmal SAH. When necessary, however, rapid change in transmural pressure during ventriculostomy must be avoided, careful management during ventricular drainage is needed, and surgery should be performed as soon as possible to prevent or reduce the incidence of rebleeding.