• Title/Summary/Keyword: Trauma team

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Development and Application of Critical Pathway for Nasal Bone Fracture Patients (코뼈골절 환자에서 표준진료지침의 개발과 적용)

  • Hwang, Kun;Shin, Jung Yae;Lee, Hye Kyung;Lee, Hwan Jun
    • Quality Improvement in Health Care
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    • v.10 no.2
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    • pp.154-163
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    • 2003
  • Purpose: The aim of this study is to develop and apply the critical pathway to the nasal bone fracture patients and to elucidate its effect. Methods: Critical pathway (CP) sheet and questionnaire were developed by a team approach. Critical pathway were applied to 30 nasal bone fracture patients (CP group) from June 2001 to November 2001. Length of hospitalization, cost for hospitalization and bed turnover rate of CP group were compared to those of the 30 patients who had same disease entities and treated by conventional regimen (control group). Results: Length of hospitalization in the CP group (4.20 day) were significantly shorter than that of control group (6.21 day). Mean cost for hospitalization of the CP group (492,106 won) were significantly lower than that of control group (678,376 won). Bed turnover rate in CP group (2.5) were higher than that of control group. The patients satisfaction for the medical personnel, explanation regarding operation procedure, therapeutic operation fee, and length of hospitalization were all affirmative. Conclusion: Critical pathway that we developed for nasal bone fracture definitely improved the quality of treatment and lowered cost of medical service. Furthermore, other critical pathways should be developed for another facial trauma patients.

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Nursing Interventions Classification(NIC) Use in Korea : Oriental Medicine Hospitals and General Hospitals (간호중재분류(NIC)에 근거한 간호중재수행분석 II -한방병동과 일반병동 간호사를 중심으로-)

  • 염영희;김성실;김인숙;박원숙;김은주
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.802-816
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    • 1999
  • The purposes of this research were to identify nursing interventions performed by Korean nurses and to compare the interventions performed by nurses working in the oriental medicine hospitals and with those performed by nurses working in the general hospitals. The samples consisted of 144 Korean nurses working in three hospitals, 70 nurses working in the oriental medicine hospitals and 74 nurses working in the general hospitals. The Nursing Interventions Classification (NIC) Use Questionnaire developed by the Iowa Intervention Project team was translated to Korean and verified using the method of back-translation. The questionnaire consists of 433 intervention labels and definition. Thirteen interventions were used at least daily by nurses working in the oriental medicine hospitals, while twenty-one interventions were used at least daily by nurses working in the general hospitals. The most frequently used interventions by nurses working in the oriental medicine hospitals were Documentation, Shift Report Vital Signs Monitoring, Pressure Ulcer Prevention, Positioning, Fall Prevention, Exercise Promotion, Intravenous (IV) Therapy, Pressure Ulcer care, and Bed Rest Care in that crder. For nurses working in the general hospitals the most frequent intervention was Analgesic Administration, followed by the interventions of Medication Administration : Parenteral and Intravenous Therapy (IV) Therapy, Documentation, Intravenous(IV) Insertion, Shift Report, Fall Prevention, Vital Signs Monitoring, Medication Adnninistraction : and, Fluid Monitoring, and Medication Maragement in that order. The interventions performed least often by nurses working in the oriental medicine hospitals were Hemodialysis Therapy and Bleeding Reduction : Antepartum Uterus, while the interventions performed least often by nurses working in the general hospitals were Rape Trauma Treatment and Contact Lens Care. The nurses working in the oriental medicine hospitals performed the interventions in the Physiological : Complex domain significantly more often than the nurses working in the general hospitals, while the nurses working in the general hospitals performed the intervention in the Behavior domain significantly more often than the nurses working in the oriental medicine hospitals. This study suggests that further study will be needed to developed and validate more interventions sensitive to Korean culture.

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MANAGEMENT OF ORAL COMPLICATIONS IN THE PEDIATRIC POPULATION WITH CANCER (소아의 종양성 질환에 동반된 구강합병증 관리)

  • Kim, Sung-Ki;Kim, Min-Jeong;Lee, Dong-Soo;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.157-167
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    • 2009
  • The incidence of childhood cancer is greatest in the first year of life. Early diagnosis and advances in medicine have significantly improved outcomes of treatment resulting in higher survival rate; however, this progress comes at the expense of a higher incidence of adverse side effects because of more aggressive antineoplastic treatment strategies. The oral cavity, a trauma-prone environment, is extremely sensitive to toxicities from antineoplastic agents. Oral health care specialists, including pediatric and hospital dentists can support the oncology team by providing basic oral care, implementing oral care protocols, delivering emergency dental treatment, and assisting and/or managing oral complications from cancer therapy. This article covers the considerations in the dental management of pediatric patients undergoing cancer treatment, specifically chemotherapy, radiotherapy, and hematopoietic stem cell transplantation.

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Direction of Development of Reaction to Bio-terrorism (생물테러리즘 대응을 위한 기술적 측면의 발전방향)

  • Lee, Kwang-Iyeol;Kim, Chang-Ho
    • Korean Security Journal
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    • no.14
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    • pp.311-336
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    • 2007
  • This study examines the concepts of counter-act against the Bio-terrorism and the reaction system in advanced countries, thereby to find out reaction system necessary to Korea. Acts on anti-Bio-terrorism is divided to detection stage, protection stage, diagnosis stage and detoxication and neutralization stage according to flow of event occurrence. As for detection stage, Korea is developing it as contact type, while advanced countries are under development of the devices that may detect the terrorism from the remote distance. It is necessary for Korea to develop the remote-distant detection system as well as the contact type of device that may promptly operate. Among the protection gears, the quality of Korea's gas mask is recognized worldwide, but that of other outfits should be improved by applying the state-of-art science technology. The diagnosis device also should be developed to the extent that the dispatched initial action team may make immediate decisions necessary in the field. As the current trends for detoxication materials worldwide require the improvement to new materials harmless to human body and equipment, Korea is also required to acquire those materials. The technology for neutralization means the development of vaccine and antibiotics and it requires the development made by shared efforts worldwide. For this purpose, it is necessary to further develop Korea's medical technology. In addition, the further efforts are required in terms of reaction manual, training model, public communication efforts and preparation for trauma syndrome.

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The Pattern of Trauma and Level of Understanding to the Physical Therapy of Amateur Ssirum Player (아마추어 씨름 선수들의 부상 발생 양상과 물리치료 이해도에 관한 연구)

  • Kim Jong-Ryul;Park Rae-Joon;Kim Chul-Yong
    • The Journal of Korean Physical Therapy
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    • v.12 no.2
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    • pp.107-119
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    • 2000
  • This study is fulfilled from September 1st to December 31st in 1999 and the object of investigation are all 289 students belong to 5 universities managing amateur Ssirum team in Kyungnam, Kyungpook. Pusan and Seoul(158 people) and 6 high schools(131 people). And these results were derived from percentage and cross analysis of Person Chi-square test ann interview and 47 questioned paper based on this purpose of study. 1. There were no significant differences between high school students and university students in the comprehension of physical therapy and injury occurrence by technique. 2. According to the relation between satisfaction of life as a player and injured part, the injury of soft tissue ranked high among satisfied and unsatisfied people. and the satisfaction or unsatisfaction of practicing place also derived same result. 3. $46.8\%$ of Ssirum players got the injury of soft tissue during practice. the articular injury and bone injury in regular sequence. But there were no relations between the time of injury and the sort of injury. 4. There were no statistical differences ortho sort of injury by technique.(p=0.399). 5. According to the part of injury by using techniques, the injury of soft tissue ranked high$(50.0\%)$, articular injury ranked high$(42.6\%)$ in the leg technique, bone injury ranked high in the leg technique, and nerve injury ranked high in hand technique. 6. The injury of soft tissue ranked high during the practice$(46.8\%)$, practice on the purpose of a match$(50.0\%)$ and match$(41.7\%)$ but there were no relations between the time of injury and son of injury. 7. The part of injury by technique ranked high in the soft tissue$(50.0\%)$, articular injury by leg technique$(42.6\%)$, bone injury in leg and waist technique and nerve injury in hand technique high. 8. The time of injury ranked high during the practice$(65.7\%)$, and $66.1\%$ of injury occurred in the afternoon. 9. During the practice, the cold weather ie related on the rate of injury because $67\%$ of injury occurred in winter, but there are no statistical significance. 10. There were no relations between the satisfaction of place far practice and time of injury. 11. The particular part of injury occurred very much during the match between defense and offense. 12. In the relation between the degree of understanding of physical therapy and the experience of physical therapy, the people who know physical therapy had much experiences of physical therapy(p=.000) And independent of the physical therapy experiences, the effectiveness of physical therapy therapy to players was $48.8\%$, no idea was 42.65 and no effectiveness was $8.7\%$(p=.000). 13. $59.6\%$ of the people admitting the physical therapy effectiveness answered they would follow the order of the doctor and $56.6\%$ of the people not admitting the physical therapy effectiveness answered no.

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Study on function evaluation tools for stroke patients (뇌졸중(腦卒中) 환자(患者)의 기능평가방법(機能評價方法)에 대(對)한 연구(硏究))

  • Ko, Seong-Gyu;Ko, Chang-Nam;Chox, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Lee, Kyung-Sup
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.48-83
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    • 1996
  • Our conclusions for function evaluation tools of Stroke patients are as follows. 1. Evaluating tools of Activities of Daily Living, Katz Index, Barthel Index, Modified Barthel Index have high validity and reliability because of ease of measuring, high accuracy, consistency, sensitivity and sufficient stastistics, but they mainly measure motor function except sense, mentation, language, and social conception. Therefore cerebrovascular disease and brain injury in trauma patients with lacked acknowledgement and sensation, we are not able to apply these tools. 2. PULSES Profile is a useful scale for measuring the patient's over-all status, upper and lower limb functions, sensory components, excretary functions, and intellectual and emotional adaptabilities. It is recognized as a good, useful tool to evaluate patient's whole function. 3. Motor Assessment Scale was designed to measure the progress of stroke patients. The scale was supplemented with upper arm function items. We believe that the Motor Assessment Scale could be a useful evaluation tool with inter-rater reliability ,test-retest reliability. 4. The existing evaluation tools, Katz Index, Barthel Index, Modified Barthel Index, PULSES Profile, Motor Assessment Scale, mainly measured the rehabilitational motor function of sequela of cerebrovascular patients. On the other hand CNS & INH stroke scale can measure cerebrovascular disease patient's neurologic deficits and over-all stautus, which are recognition ability, speech status, motor function, sensory function, activities of daily living. Those scales have been recognized as useful tools to measure function of cerebrovascular disease patients and have increased in use. 5. Every function evaluation tool was recognized to have some validity and inter-rater, test-retest reliability in items of each evaluation tool and total scores of each evaluation tools, but it is thought that none of these scales have been fully validated and proved reliable. Therefore afterward, the development of a highly reliable rating system may best be accomplished by a careful comparison of several tools, using the same patients and the same observers in order to choose the most reliable items from each. 6. Ideal evaluation tools must have the following conditions; (1) It should show the objective functional statues at the same time. (2) It should be repeated consecutively to know changed function status. (3) It should be easy to observe the treatment program. (4) It should have the same result with another rater to help rater exchange information with treatment team members. (5) It should be practical and simple. (6) The patient should not suffer from the observer.

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결장루형성술 환자 간호를 위한 일 연구

  • 모경빈
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.27-43
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    • 1970
  • This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

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