• Title/Summary/Keyword: medication consultation

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A Clinical study on the pediatric patients who visited Emergency Room of Oriental Medical Hospital (한방의료기관내 응급실에 내원한 소아환자에 관한 임상적 고찰)

  • Chang, Gyu-Tae;Kim, Jang-Hyun;Kang, Mi-Sun
    • The Journal of Pediatrics of Korean Medicine
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    • v.17 no.1
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    • pp.117-129
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    • 2003
  • We made a clinical analysis of 135 pediatric patients who visited Emergency Room of Dongguk University Oriental Hospital, during 1 year from March 2002 to February 2003. The results were as follows ; 1. Whether they received medical examination and treatment or not : new patients were 95(70.4%) and pediatric patients who received medical examination and treatment were 40(29.6%). 2. Seasonal distribution: Spring(March, April, May) was 45(33.3%), Summer(June, July, August) was 35(25.9%), Autumn(September, October, November) was 32(23.7%) and Winter(December, January, February) was 23(17.0%). 3. The time interval between onset and arrival : within 6 hours were 68(50.4%), 6-12 hours were 14(10.4%), 12-24 hours were 26(9.3%), 24-48 hours were 17(12.6%), 48-72 hours were 6(4.4), over 72 hours were 4(3.0%). 4. Whether they went through other hospitals or not : pediatric patients who didn't go through other hospitals were 105(77.8%), pediatric patients who went through other hospitals were 30(22.2%). 5. Systemic distribution of diseases: Infectious diseases were 1(0.7%), Physique diseases were 4(3.0%), Digestive diseases were 73(54.1), Nervous also Mental diseases were 32(23.7%), Cardiovascular diseases were 2(1.5%), Skin disorders were 1(0.7%), Respiratory diseases were 22(16.3%). 6. Medical care : Acupuncture and moxibustion were 1(0.7%), moxibustion and medication were 1(0.7%), acupuncture, moxibustion and medication were 1(0.7%), venesection was 24(17.8% ), venesection and medication were 17(12.6%), consultation was 16(11.9%), medication was 44(32.6%), acupuncture was 3(2.2%), acupuncture and medication were 14(10.4%) and transferred out patients were 14(10.4%). 7. Revisit: revisit patients were 30(22.2%).

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An investigational study on telephone calls to the pediatric nursing unit (외래 및 퇴원환아 부모의 전화상담요구와 간호중재에 대한 조사연구)

  • Kang Hwa Ja;Han Kyung Ja;Choe Myoung Ae;Park Seung Hyun;Kim Young Mi;Kwon Won Kyoung;Kim Sun Gu;Ahn Hye Young;Heo Mi Young
    • Child Health Nursing Research
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    • v.2 no.1
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    • pp.112-126
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    • 1996
  • The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.

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Effect of Lifestyle Modification Program on Blood Pressure Improvement in Patients with Hypertension (고혈압 환자에서 생활습관 개선 프로그램의 혈압개선효과)

  • Lee, Sang-Uk;Oh, Chang-Mo;Oh, In-Hwan;Yoon, Tai-Young;Choi, Joong-Myung
    • Korean Journal of Health Education and Promotion
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    • v.27 no.4
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    • pp.105-112
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    • 2010
  • Objectives: The purpose of this study was to know different effect with uncontrolled hypertension patients after providing health promotion program which consisted with medicine, exercise, nutrition. Methods: The subjects of this study was comprised by uncontrolled hypertension patients in spite of medication and didn't care the pressure by medication. The health promotion program was progressed by group exercise three times a week, nutrition education once a week and medical consultation once a month for 12 weeks. Subjects were measured for body composition(weight, fat mass, % body fat and body mass index), hemo-dynamics(systolic blood pressure(SBP), diastolic blood pressure(DBP), and resting heart rate), and physical fitness (cardiopulmonary endurance, muscular strength, muscular endurance, balance, and flexibility). Results: Groups showed significant improvement in every measure except resting heart rate. SBP is decreased both taking drug group about 18.4mmHg and without taking drug group about 19.4mmHg.(p<0.001) DBP is decreased both taking drug group about 8.7mmHg and without taking drug group about 9.0 mmHg.(p<0.001) Conclusion: There are no statistical significant differences of SBP and DBP decreasing effects by medication, Since effects of decreasing pressure are not different by medication, I think the health promotion program is effective to uncontrolled hypertension patients to decrease pressure.

Evaluation of an Individualized Education before Discharge and Follow-up Telephone Consultation on Self-efficacy for Kidney Transplant Patients (신장이식환자의 자기효능전략을 이용한 퇴원 시 개별교육과 추후 전화상담의 효과)

  • Hwang, Young-hui;Yi, Myungsun
    • Journal of Korean Biological Nursing Science
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    • v.17 no.4
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    • pp.331-340
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    • 2015
  • Purpose: This study was to develop and evaluate an individualized education program based on self-efficacy for patients with kidney transplantation in Korea. Methods: A nonequivalent control group pretest-posttest design was used. The participants consisted of 43 patients who underwent kidney transplants at one hospital in Seoul, from July 2012 to April 2013. The experimental group received an individualized education based on self-efficacy in the hospital and follow-up telephone consultation in the 2nd and 3rd week after discharge. The control group received a routine discharge education. Knowledge, self-efficacy, and compliance related to kidney transplant were measured and analyzed by frequency, average, Mann-Whitney U test, Fisher's exact test, independent t-test, and ${\chi}^2$-test using SPSS WIN 20.0. Results: Significant differences were found in self-efficacy between the experimental group and the control group. But no significant differences were found in knowledge and compliance between two groups. The scores of several items on monitoring health status in compliance were higher in the experimental group than those of the control group. Conclusion: The results of this study demonstrate the fact that an education program based in self-efficacy for patients with kidney transplant would be effective in improving self-efficacy and the ability to monitor their health status.

A Clinical Study of Collaboration between Western and Korean Medicine for the Treatment of Peripheral Facial Palsy in a Korean Medicine Hospital

  • Kim, Jaewon;Kim, Yongsuk
    • Journal of Acupuncture Research
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    • v.37 no.3
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    • pp.161-166
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    • 2020
  • Background: The purpose of this study was to investigate the characteristics and direction of treatment for peripheral facial palsy (PFP) based on medical collaboration between Western and Korean medicine departments. Methods: There were 195 outpatients with PFP identified retrospectively by examining electronic medical records. These patients were treated with Korean and Western medicine from January 1st, 2018 to December 31st, 2018 at the Kyung Hee University hospital. Records were analyzed according to the patients' demographic characteristics and clinical features of the collaborative combined treatment. Results: According to the collaborative treatment pathway, the number of patients consulted from Western medicine departments was more than consulted from Korean department for the first time. The time taken by the Western medicine departments to consult with the patients at the Korean center for the first time was 14.9 days from the onset of symptoms. Acupuncture was the most frequently used Korean medicine treatment. The total treatment period for Korean medicine sessions and intervals were 91.9 days, 23 times and 3.6 days, respectively. When the Korean medicine center consulted with Western medicine departments, the time taken until the first consultation was 8.5 days from the onset of symptoms. Medication was the most used treatment, prescribed after 3.1 days. The most frequently used clinical test was an electromyogram, and this was performed after 20.5 days. The total treatment period, sessions and intervals were 21.2 days, 2.8 times and 5 days, respectively. Conclusion: The clinical status of collaborative treatment for PFP was determined including the timing and interval of consultation according to treatments.

A Cost-effectiveness Analysis of the Medication for Osteoporosis (골다공증 치료약제의 비용-효과 분석)

  • 임지영;권순만
    • Health Policy and Management
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    • v.11 no.3
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    • pp.71-88
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    • 2001
  • The purpose of this study is to analyze the cost-effectiveness of four medications for treating and preventing osteoporosis -HRT therapy(conjugated equine estrogen 0.625mg for 25 days and medroxyprogesterone acetate 5mg for 01112 days), Alendronate(10mg and 5mg), Active Vitamin D(Calcitriol), and Calcium. Total costs include the direct medical cost -examination fee, consultation fee, prescription fee, fee for preparing medications, and the price of pharmaceuticals- and the indirect cost of patients such as traffic expenses and time cost. In addition, the costs of monitoring in adverse reactions are added. The effects of four medications are expressed as BMD(Bone Mineral Density) percent change measured by DEXA(Dual Energy X-ray Absorptiometry) in lumbar spine(L2-L4) and femoral neck site. A mixed model based on meta analysis provides the estimates of effectiveness, which are then appled to the hypothetical cohort consisting of postmenopausal women at the age of 50-59. HRT therapy is the most cost-effective medication at 172,433.64 won (lumbar spine site) and 546,328.28 won (femoral neck site) per BMD percent change for osteoporosis. Alendronate 10mg is more cost-effective than Alendronate 5mg as 345,971.23 won and 378,441.63 won per lumbar BMD percent change at 0.991g/$cm^2$, respectively. Alendronate 10mg is more cost-effective than Alendronate 5mg as 1,329,257.89 won and 1,467,291.23 won per femoral neck BMD percent change at 0.834g/$cm^2$, respectively.

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Comparison of Case Management between Tele Care Regions and General Care Regions in Korean Medicaid (의료급여 수급자의 건강관리 및 의료이용에 대한 텔레케어 사례관리의 효과)

  • Lee, Hyun-Joo;Oh, Jin-Joo;Choi, Jeong-Myung
    • Journal of Korean Academy of Nursing Administration
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    • v.16 no.4
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    • pp.381-388
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    • 2010
  • Purpose: The purpose of the study was to compare recipients' health behavior, attitude to using medicaid, medication compliance, and the changes in hospital cost and visit-day of in-patient and out-patient care between tele-care regions (TCR) and general care regions (GCR) in Korean medicaid. Method: The design of the study was ex-post facto comparing recipients in TCR and GCR. The sample included 625 persons in TCR and 410 persons in GCR. To collect materials, the case manager interviewed recipients of medicaid and filled out questionnaires which were analyzed through SAS/PC 9.1. Results: In studying health behavior and medication, compliance was not significant. However, the attitude to using medicaid was significantly more positive in TCR than in GCR. In out-patients, the change of hospital visit-day was not significant between TCR and GCR, but TCR showed a reduction in hospital cost compared to GCR. For in-patient recipients, GCR showed a greater reduction in changes in hospital cost and visit-day compared to TCR. Conclusions: The results of the study show that attitudes to using medicaid via telephone are positive and results are more effective than hospital visit consultation, and the cost of out-patient care could be reduced.

The Analysis of Dental Hospital Patients with Trigeminal Neuralgia (치과병원에 내원한 삼차신경통환자의 치험예 (34예 분석))

  • Kim, In-Jung;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.25 no.2
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    • pp.235-240
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    • 2000
  • This study was carried out among 34 patients who visited Yonsei Dental Hospital from 1996. 1. to 1999. 5 for trigeminal neuralgia. By studying the patient's treatment prior to visiting our hospital, features of trigeminal neuralgia, treatment process of trigeminal neuralgia, prognosis of treatment, consultation with other professions and involvement of surgery, etc., the results are as follows: 1. 67.7% of onset age range from 40s to 60s, and average age is 50.2. 2. Ratio of right to left involvement is 1:2.1, male to female ratio is 1:1.9. 3. Occurrence rate of each branch is V3(44.1%), V2(11.8%), V1+V2+V3(11.8), V1+V2(8.8%). 4. Treatments prior to admission to our hospital are extraction(5.9%), endodontic treatment(5.9%), medication(11.8%), Oriental Medicine treatment(5.9%). 5. Routes of admittance to our hospital are by their preference(55.9%), local clinic referral(32.4%), E.N.T referral(5.9%), Neurology referral(5.9%). 6. 70.6% of patients treated at our hospital who were relieved of symptoms, were referred to Neurology(66.7%) and Pain Clinic(33.3%) for the reason of relapse, side effects of the drug itself, incomplete relief of pain. 7. 2 patients who were referred to medical part showed brain vessels contacting trigeminal nerve root on Brain MRangiography. But pain is being controlled by medication and no specific surgical procedure was carried out. The results show that 17.7% of patients admitted received inappropriate early treatment. In order to relieve tooth loss and patient's psychologic stress due to inappropriate treatment, precise differential diagnosis must be made among local teeth disease and idiopathic facial pain. Medication may show side effects of the drug itself, incomplete relief of pain or relapse of symptoms. Therefore, to treat trigeminal neuralgia appropriately by drug injection, surgery or radiation therapy, consultations among dentists, neurologists and anesthesiologists are required.

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Development of a Critical Pathway for Patients with Lumbar Laminectomy (요추척추궁 절제술 환자의 표준관리지침서 개발)

  • Park, Jae Jung;Park, Hyoung Sook
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.517-532
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    • 2000
  • The purpose of this study was to develop a critical pathway for case management of patients who have received Lumbar Laminectomy because of low back pain, arm and leg numbness, and radiating pain in the leg. For this study, a preliminary critical pathway was developed through a review of the literature including five critical pathways which are currently being used in the USA. In order to identify the overall service contents required by these patients, 30 cases were analyzed. These cases were taken from medical records of those with Lumbar Laminectomy between January, 1998 and December, 1998 in the department of neurosurgery at the Pusan National University Hospital in Pusan. An expert validity test was done for the preliminary critical pathway, a clinical validity test was also done using 12 patients with Lumbar Laminectomy between October 1, 1999 and January 31, 2000. After these processes, the final critical pathway was developed. The results are summarized as follows. 1. The vertical axis of the critical pathway includes the following eight items: assessment, consultation, diet, test, medication, treatment, activity, education/ discharge planning. The horizontal axis includes the time from the start of hospitalization to discharge. Analysis of the 30 medical records was done. analysis of the service contents showed the horizontal axis of the preliminary critical pathway was set from hospitalization to the 12th post operation day and the vertical axis was set to include eight items, the contents which should have occurred, according to the time frames of the horizontal axis. 2. As a result of the expert validity test, it was found that among the 233 items, 203 showed over 88% agreement and 30 of them showed less than 88% agreement, which were then revised or deleted from the critical pathway. At the preliminary meeting for the clinical validity test, the time of hospitalization on the horizontal axis was shortened to the 10th post operation day. A clinical validity test was done with 12 patients with Lumbar Laminectomy. All the cases progressed according to the critical pathway although some variances were noted in assessment, consultation, test, medication, and treatment. 3. Based on these results, a final critical pathway was determined. In conclusion, this critical pathway is partially applicable to the care of patients with Lumbar Laminectomy and needs further investigation.

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Development of a Mini-OCS System for Voluntary Medical Services in the Challenged Regions

  • Park, Junghun;Oh, Dongik;Shin, Wonhan
    • Journal of Internet Computing and Services
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    • v.19 no.5
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    • pp.97-105
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    • 2018
  • In this paper, we present our recent effort on the development of a portable OCS system (SCH-mOCS), which provides minimal but essential functionalities of conventional OCS systems. SCH-mOCS is targeted for the environment where Internet connection is not available and fast processing of essential patient information is needed. The main usage could be found at the outdoor environment, such as voluntary medical services at challenged regions. The target of the first usage of the system is in the rural area of Cambodia where medical service and ICT infrastructure is poor. We have been conducting voluntary medical services for 15 years in Cambodia, where the services usually run for 3 days and include outpatient diagnosis/consultation, medication, and simple surgeries. This medical service started in 2002, where about 20 SoonChunHyang University Bucheon Hospital staffs (doctors, nurses, and pharmacists) participated. We realized that a system like SCH-mOCS is needed: we have to consult many patients in a short period, so that a prompt response and prescription to the patients are very important. However, the conventional OCS system is not suitable, because the service is usually conducted outdoor environment where Internet connected computers cannot be installed. Moreover, since the service needs only a subset of the conventional hospital information system and fast system response, application of a full OCS is not practical. The adequate system is a bare minimal OCS system, with very simple and quickly manageable patient admission, consultation, and prescription functionalities. In this paper, we describe hardware as well as the software aspect of a mini-OCS we have developed for the purpose. We named the system SCH-mOCS (SoonChunHyang mini-OCS). We also describe the usage scenario of SCH-mOCS in order to demonstrate that the system is general enough to apply for other similarly challenged regions.