• 임상간호연구
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• 제23권2호
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• pp.202-210
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• 2017

Purpose: In this study an investigation was done of injuries from inpatient falls and diagnostic tests and treatment after falls to identify what factors affect the occurrence of injury from inpatient falls in a tertiary hospital. Methods: Data for this cross-sectional study were retrieved for 428 fall events from data reported between January 1 and December 31, 2015 and were retrieved from the patient-safety reporting system in the hospital's electronic health records. A multivariate logistic regression model was developed with STATA 13.0. Results: Of the patients, 197 (46.0%) had physical injuries due to falls, 119 (27.8%) were given further diagnostic tests, and 358 (83.6%) received treatment including close observation after inpatient falls. Logistic-regression results identified that age, department, and risk factors had significant impact on injuries from falls. Conclusion: Findings indicate that to reduce the severity of injury after inpatient falls, each hospital should regularly evaluate identified factors, design fall-prevention practices specialized for elders and vulnerable patients, and initiate environmental and equipment innovations.

• Journal of Korean Biological Nursing Science
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• 제21권4호
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• pp.275-282
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• 2019

Purpose: This study aimed to identify the differences in blood pressure among adults in the community according to age and time of the blood pressure measurement. Methods: This was a secondary analysis study, using data from a 2015 community health survey, conducted by the Korea Centers for Disease Control and Prevention. The data of three-time-measured blood pressure were collected from 337 subjects, 25, 35, 45, 55, 65, 75 years old, which are median ages by each age group. Results: The primary systolic pressure was significantly higher than the secondary systolic pressure (t= 3.46, p= .001) and the tertiary systolic pressure (t= 4.83, p= .001). The secondary systolic pressure was higher than the tertiary measurement (t= 2.05, p= .041). There was no significant difference between the three-time-measured values for diastolic pressure. There was a significant interaction between measurement times and age in the systoic blood pressure readings (F= 1.95, p= .036). However, there was no significant interaction between measurement times and age in the diastolic blood pressure readings (F= 1.03, p= .418). Conclusion: The findings suggest that attention must be paid to the use of blood pressure values in studies or one-time-measured clinical blood pressure values. In particular, the differences in systolic pressure readings taken at different times in the older age groups were significant. Therefore, it is more important to carefully assess blood pressure in adults over the age of 45 compared to other age groups.

• Parasites, Hosts and Diseases
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• 제47권3호
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• pp.269-273
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• 2009

A 57-year old man who was admitted to an emergency room of a tertiary hospital with hemoptysis developed malarial fever 19 days later and then died from severe falciparum malaria 2 days later. He had not traveled outside of Korea for over 30 years. Through intensive interviews and epidemiological surveys, we found that a foreign patient with a recent history of travel to Africa was transferred to the same hospital with severe falciparum malaria. We confirmed through molecular genotyping of the MSP-1 gene that Plasmodium falciparum genotypes of the 2 patients were identical. It is suggested that a breach of standard infection control precautions resulted in this P. falciparum transmission between 2 patients in a hospital environment. This is the first report of a nosocomial transmission of falciparum malaria in Korea.

• Journal of Korean Medical Science
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• 제34권11호
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• pp.87.1-87.6
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• 2019

We report 17 patients with human granulocytic anaplasmosis between January 2015 and September 2018 at two tertiary university hospitals in Korea. Monthly incidence peaked in May and June. Among these patients, we identified three who were co-infected with scrub typhus, and one patient with hemorrhagic fever with renal syndrome.

• 한국의료질향상학회지
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• 제22권2호
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• pp.43-73
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• 2016

Purpose: The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics. Methods: The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals. Results: About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators. One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals. Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated. Conclusion: The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.

• 한국임상약학회지
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• 제26권4호
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• pp.330-340
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• 2016

Objective: The outbreak of Middle East Respiratory Syndrome (MERS) started in South Korea in May 2015 and the end of crisis was declared in December 2015 by Korea Centers of Disease Control and Prevention (KCDC). However, Zika virus emerged in less than 2 months following MERS and showed higher mortality than other countries. This study is to assess the current prevention system of overseas infectious diseases, based on MERS and Zika virus outbreak and to suggest effective response system for the future. Methods: We conducted two surveys on medical specialists working at tertiary general hospitals regarding the effectiveness of responding system by KCDC against MERS and Zika virus and education in individual medical institutions using 5-Likert points. Response system was examined in three different periods as initial period, spreading period, and post disease period. Results: Although medical specialists received the notifications in initial period, no practical prevention was proven to be placed in responding stage by medical facilities (averagely 3.5/5 points in total and sub-analyses). During spreading period, there were several academic seminars conducted, which were evaluated as helpful. In post disease period, all answered that there were changes on patient treatment in all medical facilities, with mainly report system and the treatment regulations in case of suspicious patients for infection. Only 49% respondents answered positive on the possibility of initial responses. For questionnaire items regarding Zika virus, all answered that there were notifications prior to the first outbreak of the infected patient. Eighty% of respondents were aware of 'the Guideline system for traveling to dangerous areas', and answered that the system was moderately effective (averagely 3.8/5 points in total). For the effectiveness of prevention measures for foreign novel disease by KCDC, the average point was 3.0 in both of total and sub-analyses. Conclusion: There is not enough response system to prevent infectious disease in medical institutional and governmental levels in Korea. It would warrant the modification of overall medical system to improve preventive measures for initial spread of such diseases.

• 대한불안의학회지
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• 제13권2호
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• pp.74-85
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• 2017

Objective : A variety of approaches are needed to solve high suicide rates in Korean society. Although suicide prevention education has been provided for the public and suicide risk groups in Korea, a systematic discussion of simple, effective suicide prevention guidelines for the general public has yet to be made. Self-help guidelines for suicide prevention, which can help prevent suicide in at risk individuals, will be developed through expert questionnaires. Methods : In order to develop the draft guidelines, suicide prevention self-help phrases were gathered and compiled from homepages and publicity materials of domestic and international suicide prevention and related organizations. A panel of 16 suicide prevention experts conducted primary and secondary surveys using the Delphi method, which derives results from consensus among expert groups. The validity and appropriateness of the guidelines was analyzed using content validity ratios (CVR). Results : Of 33 candidate phrases selected for the suicide prevention guidelines, 9 showed high CVR after the secondary Delphi round. The highest level of support with total agreement was given to 'Do not be alone, stay with someone'. However, more than half of the panelists evaluated 14/27 of the primary Delphi round and 12/26 of the secondary Delphi round phrases as invalid. The researchers completed 10 self-help guidelines for suicide prevention, after eliminating 1 redundant phrase and including 2 additional phrases that showed relatively high CVR. Conclusion : We have developed 10 self-help guidelines for suicide prevention through the consensus of experts. Further studies on the effects of the guidleines relative to suicide rates are needed after widespread dissemination.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1909-1915
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• 2016

Background: The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. Materials and Methods: Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. Results: Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery. Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. Conclusions: Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.

• 보건교육건강증진학회지
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• 제6권1호
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• pp.11-21
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• 1989

Among disease prevention methods, health education is an excellent and effective method low cost. However, enforcing health education has the following limitations: there is little health education for the supported, health education disregards the characteristics of those educated, education materials are not specified and published satistactorily, and so on. This study suggests systemic health education planning to the Korea Medical Insurance Corporation. The special methods are as follows: 1. Health education for primary prevention a. We educate the insured who are judged to be normal by the results of health screening, dividing them into three groups:completely healthy status, emotionally disturbed status, and early pathologic status. b. We educate the insured characteristically according to occupational disease. c. In an advanced sense, we educate the insured according to their health condition and occupational status. 2. Health education for secondary and tertiary prevention We educate the insured who are judged to be inn a risk group or to be disease group according to the results of health screening. a. Health education for the risk group By health education on elimination of the risk factors, the risk group can be prevented from the disease. b. Health education for the disease group By health education on the therapeutic process and the method of rehabilitation, the disease group can return to the previous state. We conclude that: 1). Reimbursement for preventive activities{health interview, health education) must be realized. 2) A special organization for health education must be established. 3) All of the insured must be educated and managed during their lifetime by a new special organization.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3061-3064
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• 2012

Aim: An epidemiological shift has resulted in increase in the prevalence of non-communicable diseases (NCD). Unlike other NCDs which are easily and definitely preventable, the knowledge of cancer prevention is still limited at present. Various aetiological factors are difficult to control since those are habit forming. Hence an available remedy remains its secondary and tertiary prevention for which appropriate planning is of paramount importance. Evidence based planning requires careful analysis of data with a view to prioritize various cancers. Keeping in view the fact that the adaptation of smoking free status in Chandigarh city might have a far reaching positive effect on the cancer related morbidity of the people, the following study was undertaken to provide base line data to be used for future comparisons. Methods: The registers maintained in the Department of Radiotherapy were checked and those belonging to the years 1999 to 2009 were utilized to analyze the cancer morbidity in respect to age, sex, and year of presentation to health care facility. Results: A total of 4,600 cancer patients (males=2276, females=2324) demonstrated a gradual increase in the number of cancer cases from 150 in the year 1999 to 783 in the year 2009. The most common cancers amongst males were cancer of gastro-intestinal tract (GIT) and lung (including larynx) constituting 37.3% and 27.1% of the total, respectively. In females these were cancers of breast and cervix representing 33.3% & 17.6% of total cancer cases, respectively, and lung cancer constituted 5.3%. The maximum cases of bone cancer (53.8% of all bone cancers) were observed amongst children aged less than 20 years and lung cancer (48.2% of all lung cancers) among the elderly aged 60-69 years. The.