• Title/Summary/Keyword: medical direction methods

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Current Status and Future Direction of Nursing Education for Clinical Practice (간호학 임상실습교육의 현황과 발전방안)

  • Shin, Sujin;Yang, Eunbae B.;Hwang, Eunhee;Kim, Konhee;Kim, Yunju;Jung, Dukyoo
    • Korean Medical Education Review
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    • v.19 no.2
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    • pp.76-82
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    • 2017
  • The quantitative expansion of nursing schools has necessitated the qualitative improvement of nursing education, which requires the development of nursing education for clinical practice. To identify strategies for strengthening the educational capacity of clinical fields and nursing schools, this study first examined the current status of nursing education for clinical practice, and then proposed several prospective directions for education. Nursing clinical practice-related studies from several Korean and international electronic databases were reviewed. Insufficient training hospitals and lack of qualified clinical training instructors were the main problems found within nursing educational resources for clinical practice, while the simple practice contents based on observation and inadequate evaluations were the main problems found in nursing educational management for clinical practice. This study suggests better standards and educational accountability for training hospitals and programs to nurture human resources for clinical practice, as well as a variety of training methods to integrate practical training courses and the expansion of formation evaluation. Based on these results, it is necessary to establish governance for nursing education for clinical practice and clarify the role and standards of each practitioner, strengthen the educational role of the hospital, and improve the system. In addition, introducing various types of education methods and strengthening evaluation standards are needed in order to enhance nursing education for clinical practice.

Wire or Hook Traction for Reducing Zygomatic Fracture

  • Ahn, Hee Chang;Youn, Dong Hyun;Choi, Matthew Seung Suk;Chang, Jung-Woo;Lee, Jang Hyun
    • Archives of Craniofacial Surgery
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    • v.16 no.3
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    • pp.131-135
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    • 2015
  • Background: Variable methods have been introduced for reduction of the zygomatic fractures. The Dingman elevator is used widely to reduce these fractures but is inappropriate in certain types of fractures which require atypical traction vectors. We introduce and examine an alternate method of reducing zygomatic fractures using wire and hook traction. Methods: A retrospective study was performed for all zygomatic fracture patients admitted between 2008 and 2014. Medially rotated fractures were reduced by using a wire looped through an intermaxillary screw secured on the medial side of the zygoma. Laterally rotated fractures were reduced using a hook introduced through an infrazygomatic skin incision. Results: No accidental bleeding or incomplete reduction was observed in any of the cases. Postoperative imaging demonstrated proper reduction immediately after the operation. Follow-up computed tomography study at 1 month after operation also demonstrated proper reduction and healthy union across the previous site of fracture. Conclusion: The hook and wire method allowed precise application of traction forces across zygomatic fractures. The fractured bone fragment could be pulled in the direction precisely opposite to the vector of impact at the time of trauma. Soft tissue damage due to dissection was minimized. In particular, this method was effective in reducing rotated bone fragments and can be an alternative option to using the zygoma elevator.

Targeting a Safe Entry Point for C2 Pedicle Screw Fixation in Patients with Atlantoaxial Instability

  • Chun, Hyoung-Joon;Bak, Koang-Hum
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.351-354
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    • 2011
  • Objective : This investigation was conducted to evaluate a new, safe entry point for the C2 pedicle screw, determined using the anatomical landmarks of the C2 lateral mass, the lamina, and the isthmus of the pars interarticularis. Methods : Fifteen patients underwent bilateral C1 lateral mass-C2 pedicle screw fixation, combined with posterior wiring. The C2 pedicle screw was inserted at the entry point determined using the following method : 4 mm lateral to and 4 mm inferior to the transitional point (from the superior end line of the lamina to the isthmus of the pars interarticularis). After a small hole was made with a high-speed drill, the taper was inserted with a 30 degree convergence in the cephalad direction. Other surgical procedures were performed according to Harm's description. Preoperatively, careful evaluation was performed with a cervical X-ray for C1-C2 alignment, magnetic resonance imaging for spinal cord and ligamentous structures, and a contrast-enhanced 3-dimensional computed tomogram (3-D CT) for bony anatomy and the course of the vertebral artery. A 3-D CT was checked postoperatively to evaluate screw placement Results : Bone fusion was achieved in all 15 patients (100%) without screw violation into the spinal canal, vertebral artery injury, or hardware failure. Occipital neuralgia developed in one patient, but this subsided after a C2 ganglion block. Conclusion : C2 transpedicular screw fixation can be easily and safely performed using the entry point of the present study. However, careful preoperative radiographic evaluation, regardless of methods, is mandatory.

A Study on the Trend in Korean Medicine Research of Irritable Bowel Syndrome in Korea, Japan and China (한국, 일본, 중국 3국의 과민성 대장 증후군에 대한 한의학적 연구동향 분석)

  • Geoncheol, Jo;Byung Joo, Kim
    • Herbal Formula Science
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    • v.30 no.4
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    • pp.305-317
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    • 2022
  • Objectives : The purpose of this study was to analyze the papers from 2011 to 2020 to study on the trends of irritable bowel syndrome (IBS) in Korea, Japan and China. Methods : In order to analyze the research trends on IBS in Korea, Japan and China, domestic and foreign databases were selected to provide academic resources to the common use of telecommunication lines represented by the Internet. The latest research trends were determined by limiting the 10-year period from January 2011 to December 2020. Results : In the past decade, six IBS-related papers have been searched in Korea, six in Japan and 458 in China. Although not many studies have been found in Korea and Japan to understand the research trends, there have been many clinical reports, and researchers are more interested in herbal medicine than acupuncture treatment. In China, where many papers were searched, there were more papers related to herbal medicine than acupuncture treatment. Acupuncture treatment was highly interested by researchers in certain acupoints and stimulation methods, and herbal medicine was found to seek diversity in drug prescription and use. Conclusions : In this study, we were able to understand the research trends of Korea, Japan, and China, and provided information that could be useful as a basic data for establishing the direction of Korean medical research on IBS in the future.

A Study on the Policy Improvement by Means of a Historical Review of School Health Programs (학교보건사업의 역사적 고찰을 통한 정책 방향에 관한 연구)

  • Kim, Sang-Wook;Kim, Yoon-Shin;Chang, Chang-Gok
    • Journal of the Korean Society of School Health
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    • v.17 no.2
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    • pp.127-150
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    • 2004
  • Objectives: The purpose of this study is to provide a basic structure for the establishment of the direction of school health programs, an overview of the historical changes of school health programs and their results, and a conceptual framework on school health programs. Methods: The data analysis has been done using a statistical almanac, relevant laws and regulations, operation handbook of the program, theses, reports, records of public hearings, and other reports as a technical research primarily based on evidence. The methodology of this research classifies the development and growth transition of school health programs during a historical period through the investigation of regulations, organization, manpower, and its program via its development process and to provide a basic tool to design a solid school health policy. Results: A The growth and development of school health programs The development of school health programs was classified into three different periods including the forthcoming period (1945~1967), the completion period (1967~1993), and the actualization period based on the establishment of legislation for School Health Law, other relevant legislation, and the contents of school health programs (1993~present). B. Policy direction of school health programs School health programs have reestablished their goals and range based on basic direction, and developed the W1it model of information structure for school health program management and its basic structure. Finally, the stepwise support system through the building of the school health support center is recommended. (1) The basic direction of school health programs has proposed 7 basic goals to reestablish the policy direction of health improvement based on total health. (2) The W1it model of information system and the school health information system for school health program management has been developed to utilize positive management. (3) School health policy through the study of the health laws and systems has been developed. The necessity of school health support center for the policy support, functional support and operation support has also been proposed. Conclusions: It is necessary to build a school health support center that consists of health professionals in charge of policy support, functional support, and program support of school health programs in order to realize and develop new policy.

Evaluation of the Educational Efficacy of a Cadaver-based Model for Teaching a Simple Suture Technique to Medical Students (임상실습과정 의과대학생을 대상으로 카데바 모델을 이용한 단순 봉합술 교육의 효율성)

  • Do, Hyun Soo;Min, Jin Hong;Hong, Seung Woo;Han, Sang Kyoon;Kim, In Soo;Ryu, Seung;Lee, Jin Woong;Kim, Seung Whan;Yoo, In Sool
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.121-125
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    • 2006
  • Purpose: There is ongoing demand to deliver better procedural training to medical students in the emergency department. Thus, we studied the efficacy of a cadaver-based training model for teaching simple suture techniques to medical students. Methods: We investigated ten fourth-year medical students, who were rounding and being trained in the Emergency Department of Chungnam National University Hospital. They were educated with slides about a simple suture technique for 30 minutes to evaluate the efficacy of the cadaver-based training model. We prospectively measured their skill by administering a test on the cadaver-based simple suture technique in 3cm sized linar wound separately to each of them. Results: A total of ten fourth-year medical students completed the investigation. The tension, the direction of suture, the degree of cleanness, the number of sutures, the adequacy of the cutting thread length, and the suturing time in the first attempt were compared with those in the second one. The second results were compared with those in the third one, and the third results were compared with those in the fourth one. All the results had statistical significance. Conclusion: These findings support the value of the cadaver-based simple suture technique training model as a medical student teaching model. The cadaver-based simple suture technique teaching model is a good way of teaching several medical skills to medical students.

Study on the trends in Korean clinical practice guidelines development

  • An, So-Youn;Kim, Hyun Jeong;Kim, Seungoh;Kim, Jongbin;Seo, Kwang-Suk;Lee, Deok-Won;Hwang, Kyung-Gyun
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.1
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    • pp.31-37
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    • 2016
  • Background: The definition of evidence-based clinical practice guidelines (CPGs) is "statements that are systematically developed to assist in the doctors' and patients' decision-making in certain situations." This study aims to establish the concept of evidence-based CPGs and investigate the development status to seek measures to apply evidence-based methods to CPG development for dental sedation in Korea. Methods: The study conducted systematic searching methods based on evidence-based CPGs. Articles published between 1995 to 2015 were searched on a Korean database and the international database PubMed. The search was based on keywords related to four subjects (dentistry, clinical practice, guideline, recommendation). Two authors independently reviewed the searched articles to determine their analysis inclusion and the convergence stages, and to arrive at a conclusion through discussion. Results: A total of 65 Korean CPGs were included. There were 51 medical guidelines, of which seven were dental and seven were Oriental medicine. Conclusions: As a basic direction for the development of evidence-based CPGs, this work suggests the following: increased awareness; consensus on the need to supply evidence-based development methods; education, computerization, and systematic observation of evidence-based CPG development methods; continuous research development and distribution of CPGs; and creation of a database for Korean clinical dentistry practice outcomes

An Analysis of Health Counseling by the Internet (인터넷을 통한 건강 상담의 내용 분석)

  • Ahn, Ji-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.1
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    • pp.83-96
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    • 2000
  • With the increased use of computers in medical fields, we can consider introducing computer mediated communication into the area of patient care such as medical or health counseling and education. But little was known about what problems can be counseled, what is the main direction of counseling, and what difficulties are met during the computer mediated counseling. So I conducted this study. This is a fundamental study concerning the health counseling by the inter-net. In this study, medical counseling using a method of questioning -answering through a computer mediated communication system was carried out from June 1998 to May 1999. I analyzed the contents of questions and answers by the ICPC classification. The ICPC classification emerged as a standard for information categorization in Primary Health Care within a few years. One of the most prominent features of this classification is the inclusion of the complaints of the patients (symptoms & complaints) and the social problems (Chapter Z). Thus, and for the first time, the demand of patients may be assessed such as it is expressed in the reality. The ICPC list is now an international standard whose validity is not questioned any more. It is translated in more than twenty different languages. The data collected were analyzed by descriptive statistical method, c2 test by cross tabulations. Followings are the results of this study. 1. The 3,054 users composed of 64% of males and 36% of females. The highest number of users was showed in the age group of $25{\sim}29$ (39.4%). 2. During the one-year period, the average number of counseling per user was 2.5 cases and per day was 21.1 cases. 3. In classifying symptoms and complaints by 17 chapter, digestive(17.6%), general and unspecified (12.7%), skin(12.7%) and musculoskeletal system (9.6%) were most common questions. 4. The distribution of diagnosis by 17 chapter, general and unspecified (21.4%), digestive (15.3%), skin (11.9%) and mus- culoskeletal system (8.9%) were most common answers. 5. Many users wanted to know symptoms and complaints(3,609 cases), treatment principles (2,928 cases), prognosis and preventive methods for health problems which were previously diagnosed (284 cases).

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Preliminary study on contrast flow analysis of thoracic transforaminal epidural block

  • Hong, Ji Hee;Noh, Kyoung Min;Park, Ki Bum
    • The Korean Journal of Pain
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    • v.31 no.2
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    • pp.125-131
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    • 2018
  • Background: The thoracic transforaminal epidural block (TTFEB) is usually performed to treat herpes zoster or postherpetic neuralgia (PHN). Especially, multiple segmental involvements and approximate contrast medium spread range, according to volume, help to choose the proper drug volume in the transforaminal epidural block. This study investigated the contrast medium spread patterns of 1-ml to 3-ml TTFEBs. Methods: A total of 26 patients with herpes zoster or PHN were enrolled in this study. All participants received 1 ml, 2 ml, or 3 ml of contrast medium. Results were divided into Groups A, B and C based on the volume (1, 2, or 3 ml), with n = 26 for each group. After the injection of contrast medium, the spread levels were estimated in both the lateral and anteroposterior (AP) images using fluoroscopy. Results: The cephalad spread of contrast medium in the lateral image as expressed by the median (interquartile range) was 2.00 levels (1.00-2.00) for Group A, 2.50 (2.00-3.00) for Group B, and 3.00 (2.00-4.00) for Group C. The caudal spread level of contrast medium was 1.00 (1.00-2.00) for Group A, 2.00 (2.00-3.00) for Group B, and 2.00 (2.00-3.00) for Group C. There was ventral and dorsal spread of the 3-ml contrast medium injection in 88% (23/26) of cases in the lateral image. Conclusions: Injection of 3 ml of contrast medium through the foramina spread 6 levels in a cephalocaudal direction. Spread patterns revealed a cephalad preference. TTFEB resulted in dorsal and ventral spread in a high percentage of cases. This procedure may be useful for transferring drugs to the dorsal and ventral roots.

Trends Analysis of Suicidal Poisoning in Korea- Comparison before and after the IMF Crisis and the Economic Recession (IMF와 경기침체 전후 음독자살 환자에 대한 분석 -1997년부터 2004년까지 일개 대학병원 응급센터 연구조사를 중심으로-)

  • Lee Won Jae;Park Kyu Nam;Choi Seung Pil;Lee Mi Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.33-39
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    • 2005
  • Purpose: Nowadays the Korean society is in the center of time of the social change. Because of dissociation of traditional family, IMF (International Monetary Fund) crisis and economic recession, the mortality rate of suicidal attempts are increasing annually. The majority of suicidal attempts were by poisoning considering the characteristics of korean society. Therefore we studied to find out the characteristics of suicidal poisoning before and after social economic stress, and to suggest the direction for the proper management. Methods: We reviewed medical records of 547 patients of suicide by poisoning who visited the emergency medical centers of St. Mary's hospitals from 1997 to 2004. For the annual trends analysis, we analyzed the demographic and toxicologic data of these patients compared with before and after IMF crisis (1998) and the economic recession ($2003\~2004$). Results: At the time of IMF and the economic recession, the number of suicidal poisoning increased, especially in fifth decade. The refusal rate of toxicological emergency treatment increased. Also the mortality rate and the admission rate to ICU (Intensive Care Unit) increased during the same period. In the result of the comparison analysis, clinical severity and mortality of social problem group were higher. However they couldn't be treated appropriately because of financial problem and the family indifference. Conclusion: At the economic recession period, the severity of suicidal poisoned patients was high. But the refusal rate of toxicologic treatment also increased, so the patients had lost the chance for proper toxicologic treatment. Therefore they would be supported by medical institution and public health.

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