• Title/Summary/Keyword: blood management program

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Availability of Statistical Quality Control of Nuclear Medicine Blood Test Using Population Distribution (모집단 분포를 이용한 핵의학 혈액검사의 통계적 품질관리의 유용성)

  • Cheon, Jun Hong;Cho, Eun Bit;Yoo, Seon Hee;Kim, Nyeon Ok
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.37-41
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    • 2016
  • Purpose The importance of quality control by the error to a minimum, which for the purpose of enhancing the reliability of the examination is not be emphasized excess. Currently, most nuclear medicine laboratory are conducting the internal and external quality control, and they are applying the Levey-Jennings or Westgard Multi-Rules by using the commercialized quality control materials. The reliability of the nuclear medicine blood test which affects the diagnosis of patients and the treatment policy is being secured through this quality control activity. Therefore, researchers will evaluate the utility of the statistic quality control using the population distribution of the nuclear medicine blood test conducted targeting the checkup examinees by the additional technique of the reliability improvement. Materials and Methods A statistic analysis was performed about 12 items of the nuclear medicine blood test targeting 41,341 peoples who used the health screening and promotion center in Asan Medical Center from January, 2014 to December, 2014. The results of 12 items of the nuclear medicine blood test was divided into the monthly percentage of three groups: within reference values, over reference, and under reference to analyze the average value of the population distribution, standard deviation, and standard deviation index (SDI). Results The standard deviation of the population distribution mostly showed a result within ${\pm}2SD$ in all groups. However, When the standard deviation of the population distribution represented a result over ${\pm}2SD$, it was confirmed SDI was showing a result of SDI > -2 or SDI > 2. As a result of analyzing the population distribution of 12 items(AFP, CEA, CA19-9, CA125, PSA, TSH, FT4, Anti-Tg-Ab, Anti-TPO-Ab, Calcitonin, 25-OH-VitD3, Insulin) of the nuclear medicine blood part basic test, when SDI of the monthly percentage which deviated from the reference values was over ${\pm}2.0$, CA19-9 September was 2.2, Anti-Tg-Ab may was 2.2, Insulin January was 2.3, Insulin March was 2.4. It was confirmed these cases were attributed to the abnormality of the test reagent (maximum combination rate of isotope reagent declined) and the decline of the test response time. Conclusion The population distribution includes the entire attribute which becomes the study object. It is expected the statistic quality management using the population distribution which was conducted targeting the checkup examinees by dividing into three groups: within reference values, over reference, and under reference by means of this characteristics will be able to play a role of complementing the internal quality control program which is being carried out in the laboratory.

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Diet Quality in Elderly Patients with Type 2 Diabetes - Focused on Demographic Characteristics and Depression - (제2형 당뇨병 노인환자의 식사의 질 - 인구학적 특성 및 우울을 중심으로 -)

  • Min-jung, Nam
    • Journal of agricultural medicine and community health
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    • v.47 no.4
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    • pp.229-241
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    • 2022
  • Purpose: This study was attempted to identify the demographic characteristics, depression, and dietary quality of elderly patients with type 2 diabetes, and to identify the difference in food quality according to these variables. Methods: The subjects of the study were 216 elderly patients with type 2 diabetes over the age of 65 visiting elderly welfare centers and senior citizens' centers in G city and H districts. Data were collected from December 2020 to July 2021. The collected data were analyzed by descriptive statistics, t-test and one-way ANOVA using IBM SPSS Statistics 21 program. Results: There were significant differences in dietary quality according to the subject's gender, education level, residential area, spouse or not, family living together or not, subject of meal preparation, calorie requirement recognition or not, exercise practice for diabetes management or not, and depression. Depression and Fasting Blood Sugar management were important influencing factors on dietary quality, and Residence and Gender were also verified as influencing factors. Conclusions: The results of this study can be provided as basic data to establish a program to improve the quality of meals for diabetic elderly patients.

Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean (한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석)

  • 김춘배;조희숙;현숙정;박애화
    • Health Policy and Management
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    • v.12 no.2
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    • pp.23-42
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    • 2002
  • The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

Effects of Telephone Hotline Counseling Program on Stroke Care (뇌졸중 환자에 적용한 핫라인 전화상담 프로그램의 효과)

  • Baik Kyun Kim;Dong-Wan Kang;Do Yeon Kim;Jung Hyun Park;Ji-Seok Woo;Young-Hee Kim;Hyun-Sook Kim;Min-Joo Moon;Jeong-Yoon Lee;Hyung Seok Guk;Nakhoon Kim;Sang-Won Choi;Hakyeu Ahn;Bosco Seong Kyu Yang;Jun Yup Kim;Jihoon Kang;Moon-Ku Han;Hee-Joon Bae;Beom Joon Kim
    • Health Policy and Management
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    • v.33 no.2
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    • pp.185-193
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    • 2023
  • Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

The Effects of 12 Weeks Combined Exercise on Brain Nerve Growth Factor, Inflammation-Related Factor in Obese High School Girls (12주 복합운동이 비만 여고생의 뇌신경세포 생성인자 및 염증인자에 미치는 영향)

  • Seo, Jeongpyo;Heo, Junhoe;Kim, Hyunjun;Park, Jangjun
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.1
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    • pp.159-168
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    • 2020
  • Purpose : To provide data on exercise prescription for obesity management and prevention of cardiovascular disease in girl's high school and to prepare basic data for more effective exercise program for lifestyle improvement and prevention of lifestyle-related diseases. This study examines the effects on brain nerve growth factor and inflammatory factors, and the relationship between obesity factor and brain neuron cell production factor and inflammatory factor changes by complex exercise. Methods : The subjects of the study were obese students with a body fat percentage of 30 % or higher after obtaining body fat percentage of high school girls in C-city. Among them, 20 students who wanted to participate in the program of this study and did not participate in special exercise and diet therapy within the last 6 months were radio-sampled into groups of exercise group and control group, but attendance rate was low and The final exercise group (9) and control group (9) were measured, except for one student who did not respond. Results : Analysis of the range of variation in body composition, BMI, lean body mass, and the interaction between the groups showed significant differences (p<.05). TC, TG, HDL-C, and LDL-C as variables of blood lipids, TC and TG were not significantly different and TG was significantly different (p<.05) in interactions. HDL-C showed a significant difference (p<.01) in interactions, an increase in exercise group, and a significant decrease in control group (p<.05). There was a significant difference (p<.05) in BDNF interaction, an increase in the exercise group and a decrease in the control group, but no significant difference. NGF tended to increase in both exercise and control groups. IL-6 had a significant difference in timing (p<.05) and significantly decreased (p<.01) in the exercise group, and TNF-α interacted with timing (p<.05), and a significant increase in the control group. Conclusion : This study confirmed 12-week compound exercise program was effective in increasing the expression of basal fitness or CNS factor, but not enough to actually improve brain function. Fat mass and obesity are also affecting vascular inflammatory factors.

Effect of 12 Hours Fasting Resistance Exercise on Metabolic Efficiency and Fatigue in Convergence Ages (융복합 시대의 12시간 공복저항운동이 대사효율성 및 피로물질에 미치는 영향)

  • Baek, Soon-Gi
    • Journal of Digital Convergence
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    • v.14 no.9
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    • pp.471-478
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    • 2016
  • The purpose of this study to examine the effect of 12 hours fasting resistance exercise on metabolic efficiency and fatigue of middle-aged female for 8 weeks. 50 middle-aged female target group pre-test exercise group(EX) and the control over the homogeneity in the control group(CON) were selected for this purpose divided into two groups. Exercise group(EX) is maintained after 8 weeks four times weeks 12 hours fasting resistance was performed for 60 minutes, the control group(CON) were compared to a normal life with the group of the exercise group(EX). Resistance applied to the exercise group(EX) were using free weights and a fixed mechanism applied around the upper and lower body exercise program for heart muscle, exercise intensity based on the 70% 1RM until 4 weeks, 5-8, which was performed by the aid program set to 80%. Through this procedure were as follows. First, 12 hours fasting resistance exercise showed the significance of the interaction effect in metabolic efficiency, blood pressure(SBP, DBP), fat, fasting glucose, fasting insulin(p<.01). Second, 12 hours fasting resistance exercise showed the significance of the interaction effect in the treatment program in which lactic acid, uric acid(p<.01).

A study on Hepatitis B and knowledge about AIDS of dental hygiene student in Korea (전국 치위생과 학생들의 B형간염과 AIDS에 관한 지식도 조사)

  • Song, Kyung-Hee;Bae, Bong-Jin
    • Journal of Korean society of Dental Hygiene
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    • v.1 no.2
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    • pp.181-192
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    • 2001
  • The purpose of this was to evaluate the level of knowledge about Hepatitis B and AIDS among dental hygiene students at six dental hygiene educational programs in nationwide, compare the findings to those of Song's study. 1703 dental hygiene students surveyed by mail and answered a questionnaire, using the questionnaire used developed by DiClemente el al., on Hepatitis B vaccination, antibody production, experience of unintentional needle stick injuries, experience of surgical operation and blood transfusion, personal risk factors for HBV and HIV, management of HBV and HIV postexposure management et al. The data indicated that dental hygiene students (79.0%) in this study had more HIV vaccination than dental hygiene(74.3%) in Song's study. As for recognition of antibody production after Hepatitis B vaccination, only 34.6% of respondents answered they knew having antibody production and 95% of respondents knew not having antibody production. Over one-half of the respondents (55%) answered they didn't even recognize having antibody production. 52.3 percent of dental hygiene students experienced unintentional needle stick injuries. The findings on the knowledge about Hepatitis B and AIDS were that dental hygienists (76.5 points) received higher mean score than those of dental hygiene students (71.0 points) and that the distribution of right answer rate also showed wider range in dental hygiene students (27.7~97.5%) than those of dental hygienist (41.2~99.5%). There were no statistical differences among dental hygiene education programs. Finding of this study support that the curriculum of dental hygiene program should include instruction on sources and methods of transmission of infectious diseases, risk of virus transmission in the workplace and principles of infection control. Furthermore, infection-control practices should be utilized routinely and their application to dental personnel, management of HBV and HIV postexposure management. Furthermore, for preventing the further spread of infectious diseases (HBV, HIV and AIDS${\cdots}$) caused by bloodborne viruses, imposing an obligation rather than recommendation on Hepatitis B vaccination to all dental personnel and routinely utilizing infection-control guidelines for all dental patients in dental practices (include dental educational programs) should be accomplished by coordination the government agency.

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A Study on Hypertension Management of Community Health Practitioner Posts (보건진료소 고혈압 관리사업의 실태)

  • Kwon, Myung-Soon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.155-169
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    • 2003
  • Objectives: The purpose of this study is to provide data for the improvement of hypertension management of community health practitioner posts through the study on hypertension management in community health practitioner posts. Methods: A questionnaire was mailed to 700 community health practitioners and 205 of them responded during the period from March 13, 2003 to May 13. The survey results were analyzed using SPSS program, version 11. Results: The results are as follows; 1. There are two major activities in a hypertension prevention project for community: health education and early detection. About 57% of community health care practitioners perform a health education for community people four times a year. The 64.5% of them used the materials for health education provided from a community health center and 22.1% of them performed a post-evaluation. The main method of early detection of hypertension was measurement of blood pressure of person to visit, which was 96.1%. Other methods included home visiting(89.3%), a referral from community hospitals and other resources(49.1%), health promotion events(39.5%), and a review of medical records(35.7%). 2. For the registration and management of patients with hypertension, about 36% of community health centers used a special form and more than 50% of them have registered patients who were managed by other health care institutions in the community. A computerized program was used for the management of patients with hypertension in 68.5% of them. More than 60% of them responded that it was used for report, treatment, and follow-up of patients with hypertension.

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Characteristics and Nursing Activities of Severe Trauma Patients Regarding the Main Damaged Body Parts (중증외상환자의 주 손상 부위별 특성과 간호활동)

  • Kim, Myung Hee;Kim, Myung Hee;Park, Jung Ha
    • Journal of Korean Biological Nursing Science
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    • v.15 no.4
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    • pp.210-218
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    • 2013
  • Purpose: The purpose of this study was to identify the characteristics and nursing activities of severe trauma patients regarding damaged body parts in Busan Regional Emergency Medical Center. Methods: A survey using a 'trauma patient information questionnaire and a list of nurse activities' was conducted with 133 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. The collected data were analyzed by the SPSS/WIN 12.0 program. Results: Almost all of the subjects were men, and the mean age was 48.8. The amount of road traffic accidents was 60.4%, and the mean RTS and ISS were 6.08, and 23.14 points. Nursing activities in common were airway management, assessment of LOC & GCS, and EKG monitoring. Most of head and neck trauma patients were cared for manasing using intracranial pressure: each patience had the following assessed: pupil size and light reflex, they were checked the leak of CSF, kept $30^{\circ}$ head elevation, and administered medications. Some of chest trauma patients were treated for chest tube and central venous catheter insertion. Partial abdominal trauma patients were administered analgesic and cared for using arterial pressure measurement. Part of the limbs and pelvis trauma patients were given a blood transfusion. Conclusion: Based on the results, the characteristics and nursing activities were specific according to the specific damaged body parts.

Validation of a Modified Early Warning Score to Predict ICU Transfer for Patients with Severe Sepsis or Septic Shock on General Wards (일반병동 내 중증 패혈증 또는 패혈성 쇼크 환자의 중환자실 전동 예측에 대한 수정조기경고점수(Modified Early Warning Score)의 타당성)

  • Lee, Ju Ry;Choi, Hye Ran
    • Journal of Korean Academy of Nursing
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    • v.44 no.2
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    • pp.219-227
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    • 2014
  • Purpose: To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards. Methods: A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program. Results: Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22-2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer. Conclusion: MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.