• Journal of Korean Critical Care Nursing
• /
• v.15 no.1
• /
• pp.1-12
• /
• 2022

Purpose : This study aimed to identify the status of intrahospital transport (IHT) of critically ill patients and provide baseline data to form recommendations for safer transport. Methods : Data were collected from 141 intensive care unit (ICU) nurses who attended national conferences between February and August, 2018. The collected data were analyzed using descriptive statistics and ANOVA, and post-hoc analysis was conducted with the Scheffé and Games-Howell tests. Results : Of the nurses surveyed, 61.7% answered that their workplace had a transport guideline. In terms of the experience of ICU nurses, 31.2% of respondents answered that they had received training on IHT. This result indicated that the degree of implementation of the guidelines for IHT was generally high, but some, including guidelines on personnel, equipment, and monitoring, were not. Guidelines of IHT were well observed when the institutes had specific guidelines for IHT of critically ill patients with specified transport grades, a scoring system to assess stability of a patient, a checklist and a protocol for action in case of problems, and when healthcare providers were provided with training. Conclusion : These results suggest that organized infrastructure, such as a transport guideline with transport grades, a checklist to improve the implementation of guidelines, and a protocol for coping with a problem, should be provided for safe transport. Additionally, effective education and evaluation to improve the competency of staff participating in the transport of patients will help reduce the occurrence of adverse events in intensive care transport in hospitals and promote patient safety.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.7 no.2
• /
• pp.256-270
• /
• 2000

Invasive hemodynamic monitoring has become a valuable assessment parameters in critical care nursing in patients undergoing open heart surgery patients. During cardiac surgery, the Swan Ganz catheter is placed in the pulmonary artery. Critical care nurses routinely obtain cardiac output, cardiac index, and pulmonary arterial pressure in these patients. Traditionally, patients are positioned flat and supine for cardiac output measurement. Numerous studies have dealt with the effects of changing position on the hemodynamic variables. However, there are a few studies dealing with patients who undergo cardiac surgery in Korea. Thus, the purpose of this study was to determine the effects of changing position on cardiac output, PAP, CVP, BP, HR and discomfort in patients after cardiac surgery. A sample of 21 adults who had CABG and/or valve replacement with Swan Ganz catheters in place was studied. The data were collected in the cardiac ICU of a university hospital in Seoul during the period from July 28, 1999 to August 30. 1999. In this study, the independent variable is patient position in the supine, 30 degree, and 45 degree angles. Dependent variables are C.O., C.I., CVP, PAP, MAP, HR and patients' perceived discomforts. Subject discomfort was measured subjectively by visual analogue scale. Other hemodynamic data where collected by the thermodilution method and by direct measurement. The data were analyzed by percentile, t-test, ANOVA, Linear regression analysis using SPSS-/WIN program. The results are as follows : 1) Changes in cardiac output were absent in different angle positions, 0, 30. 45 degrees(F=.070, P=.932). Changes in cardiac index were absent in different angle positions, 0. 30, 45 degrees(P>.05). 2) Changes in central venous pressure were absent in different angle positions, 0, 30, 45 degree(P>.05). 3) PAP had no change in different angle 0, 30, 45 degree positions; systolic PAP(P>.05), diastolic PAP(P>.05). 4) Changes in systolic blood pressure were absent in different angle positions, 0, 30, 45 degree(P>.05). 5) Changes in heart rates were absent in different angle positions, 0, 30, 45 degree(P>.05). 6) Patients' perceived discomfort was absent in different angle positions, 0, 30, 45 degree(p<.05). In conclusion, critical care nurses can measure C.O., C.I., PAP, BP, & CVP in cardiac surgery patients at 30 degree or 45 degree positions. This can improve the patients' comfort.

• Quality Improvement in Health Care
• /
• v.4 no.1
• /
• pp.50-63
• /
• 1997

Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

• The Plant Pathology Journal
• /
• v.23 no.4
• /
• pp.260-265
• /
• 2007

Testing a large number of samples from field monitoring and routine indexing is cumbersome and the available virus detection tools were labor intensive and expensive. To circumvent these problems we established tissue blot immunoassay (TBIA) method an alternative detection tool to detect Barley mild mosaic virus (BaMMV) and Barley yellow mosaic virus (BaYMV) infection in the field and greenhouse inoculated plants for monitoring and routine indexing applications, respectively. Initially, leaf and stem were tested to determine suitable plant tissue for direct blotting on nitrocellulose membrane. The dilutions of antibodies were optimized for more efficient and economical purposes. Results showed that stem tissue was more suitable for direct blotting for it had no background that interferes in the reaction. Therefore, this technique was referred as direct stem blot immunoassay or DSBIA, in this study. Re-used diluted (1:1000) antiserum and conjugate up to 3 times with the addition of half strength amount of concentrated antibodies was more effective in detecting the virus. The virus blotted on the nitrocellulose membrane from stem tissues kept at room temperature for 3 days were still detectable. The efficiency of DSBIA and RT-PCR in detecting BaMMV and BaYMV were relatively comparable. Results further proved that DSBIA is a rapid, reliable and economical detection method suitable for monitoring BaMMV and BaYMV infection in the field and practical method in indexing large scale of barley materials for virus resistance screening.

• Journal of Korea Water Resources Association
• /
• v.39 no.7 s.168
• /
• pp.605-615
• /
• 2006

In order to analyze movement of soil moisture, Time Domain Reflectometry(TDR) with multiplex system has been installed at the Bumreunsa hillslope of Sulmachun Watershed to configure spatial-temporal variation pattern considering seasonal characteristic. An intensive surveying was performed to build a refined digital elevation model(DEM) and flow determination algorithms with inverse surveying have been applied to establish an efficient soil moisture monitoring system. Soil moisture data were collected through an intensive and long term monitoring 380 hrs in November of 2003 and 1037 hrs in May and June of 2004. Soil moisture data shows corresponding variation characteristics of soil moisture on the up slope, buffer, main channel zones of the hillslope which were classified from terrain analysis. Measured soil moisture data were discussed in conjunction with flow characteristic through terrain analysis. Regardless season, immediate responses of soil moisture about rainfall looks similar but recession and recharge are primary characteristics of intermediate soil moisture variation for spring to summer and fall to winter season, respectively.

• Journal of Soil and Groundwater Environment
• /
• v.25 no.3
• /
• pp.1-11
• /
• 2020

In this study, leakage ratios of Jeju Island's public agricultural groundwater were calculated by utilizing field measurements of groundwater level and surface reservoir water level. The average leakage ratios were 75.6% at groundwater well A and 57.5% at well B, with the ratio inversely proportional to agricultural water usage. The level of agricultural reservoirs varied at constant intervals at night, and the amount of water leakage associated with the variation was estimated as 0.1 - 16.3 ㎥/h. The leakage ratio was also influenced by pipeline length, average slope, and number of farmhouses. Currently, the estimation of agricultural water leakage on Jeju Island is based upon field inspection which is very labor- and cost intensive. The leakage ratio estimated by monitoring the reservoirs associated with the well A and B were 73.3 and 54.7%, respectively, consistent with the values obtained by field measurements.

• Proceedings of the KSRS Conference
• /
• 2008.10a
• /
• pp.188-191
• /
• 2008

The Tonle Sap, Cambodia, is a huge lake and periodically flooded due to monsoon climate. The incoming water causes intensive flooding that expands the lake over vast floodplain and wetland consisting mainly of forests and shrubs. Monitoring the water-level change over the floodplain is essential for flood prediction and water resource management. A main objective of this study is flood monitoring over Tonle Sap area using ALOS PALSAR. To study double-bounce effects in the lake, backscattering effect using ALOS PALSAR dual-polarization (HH, HV) data was examined. InSAR technique was applied for detection of water-level change. HH-polarization interferometric pairs between wet and dry seasons were best to measure water level change around northwestern parts of Tonle Sap. The seasonal pattern of water-level variations in Tonle Sap studied by InSAR method is similar to the past and altimeter data. However, water level variation measured by SAR was much smaller than that by altimeter because the DInSAR measurement only represents water level change at a given region of floodplain while altimeter provides water level variation at the central parts of the lake.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.20 no.4
• /
• pp.359-371
• /
• 2013

Purpose: The purpose of this study was to determine the status of tuberculosis (TB) infection control in hospitals. Method: This study was a cross-sectional descriptive study in which self-administered questionnaires were used to survey 77 hospitals. Data were collected from August 12 to September 15, 2012. Results: Only 27 institutions (35.1%) were monitoring patients infected with or suspected of having TB. Most hospitals were conducting TB prevention education for patients' family and employees, and TB screening for employees along with follow-up examinations. However, private negative pressure rooms were more often available in wards and intensive care units than in outpatient departments, and in institutions with over 700 beds located in Seoul or GyeongGi Province. Most hospitals ensured that masks were placed on infected patients while transporting them. In addition, efforts to control TB infection such as placing respiratory etiquette posters in outpatient departments and airborne infection signs on the doors in the wards were also well established in most institutions. Conclusion: More efforts are needed to improve the status of TB infection control to ensure quality care, especially in terms of monitoring patients with TB infections and making private negative pressure rooms available in outpatient departments.

• The Korean Journal of Pain
• /
• v.9 no.1
• /
• pp.235-238
• /
• 1996

Hyperhidrosis is the distressing condition of abnormal sweating which affects the palm, sole and axillary region. Transthoracic endoscopic sympathectomy is recommended as the treatment of choice for hyperhidrosis, especially when the upper limbs are affected. We experienced a case of accidental cauterization of right azygos vein in a healthy 23 year old male during endoscopic transthoracic sympathectomy. We changed the single lumen endotracheal tube to a double lumen tube which made it easier to perform the explo-thoracotomy and bleeder ligation under one lung ventilation. Crystalloid and colloid solutions, and packed RBC were loaded during explo-thoracotomy. Monitoring showed the signs indicating pulmonary edema. Pulmonary arterial catheterization revealed global heart failure. The patient was transfered to ICU for intensive management for heart failure. On the 4th postoperative day, pulmonary edema and heart failure were cured; and the patient was extubated. But in the evening of the same day ST-segment elevation and Q-wave were noted on ECG monitoring. On the 13th postoperative day coronary angiography was performed. This revealed left apex focal hypokinesia, patent coronary artery and accidental right coronary spasm, treated by vasodilator. On the 14 day, after surgery, he was discharged to return to work.

• Journal of Advanced Marine Engineering and Technology
• /
• v.37 no.5
• /
• pp.520-526
• /
• 2013

As the increasing of capacity and technology of power facilities, rotating machines are getting higher at capacity and voltage scale. Thus the monitoring and diagnosis of generators for fault detection has attracted intensive interest. In this paper, we developed fault diagnosis system for monitoring the fault operations in bad power systems. In order to verify the performance of this fault diagnosis system, we made the small scaled testing system which has the same winding structure of the real synchronous generator. The magnetic flux patterns in air-gap of a small-scale generator under various fault states as well as a normal state are tested by hall sensors and the fault detection system.