Purpose: Music intervention has long been used in research of patients undergoing surgical operation in reducing anxiety level and improve surgical outcome. However, there are few studies that have considered a patient's music preference. We investigated the effect of the tailored music intervention which chose music according to the patient's preference on anxiety level and vital signs. Method: The subjects were 50 patients who received regional anesthesia for surgical operation at D hospital in Pohang city from April, 2006 to November, 2006. All of the subjects were randomly assigned either music group (30 subjects) or non-music group (20 subjects). As the patients arrived in the operating room, vital signs were monitored until the subjects were transferred to the recovery room, while Spielberger's STAI-KYZ questionnaires were applied twice to measure preoperative and intra-operative anxiety. The data were analyzed by 2-test, t-test, one-way ANCOVA and repeated measures ANOVA using SPSS 12.0/PC+. Results: There were no significant differences between the two groups on vital signs. All of the vital signs increased when the subjects arrived in the operating room, but decreased quickly once the operation began, regardless of the groups. However, the music group reported significantly less intra-operative anxiety, compared to the non-music group (F=15.208, p<.000), when preoperative anxiety was treated as a covariance. Conclusion: The findings support that the use of music which was chosen by patients during the surgery significantly reduced patient's intra-operative anxiety during regional anesthesia.
Journal of Korean Society of Occupational and Environmental Hygiene
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v.29
no.3
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pp.375-382
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2019
Objectives: This study was to examine the features of work and posture analysis outputs in assessment of exposure to musculoskeletal disorder (MSD) risk factors in general hospital nurses. Methods: Work and posture analyses were carried out using observational approaches for nurses at general hospitals across Korea. With development of a taxonomy for assessing exposure to MSD risk factors, nursing tasks were documented in frequency (%time) for 8 hours a day in work analyses. Rapid Entire Body Assessment (REBA) scores were obtained for mode and maximum risk levels, respectively, during posture analyses. Results: A total of 27 nurses were observed while conducting 7 nursing tasks at 6 general hospitals. For both the work analyses and posture analyses, the taxonomy was developed and used. In the work analyses, 'Video display terminal task' and 'Nursing examination/ treatment' were the highest as 25%time for 8 hours a day, followed by 'Patient care' and 'Room rounding' as 13%time in order. In the posture analyses, the mode REBA scores were 2 or less for all nursing tasks while the maximum REBA scores were 7 for upper limbs at 'Room rounding' and 6 for trunk/neck/legs at 'Patient care'. Conclusions: The results showed the study nurses are occasionally at a risk for MSD, a medium level as designated in the REBA risk level, suggesting that it is important to control awkward posture at the nursing tasks such as 'Room rounding' and 'Patient care', in priority, for preventing MSD in the hospital sector including the study general hospitals.
Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second- and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC injuries.
As modern science is developed and advanced, examination and number of times using radiation are increasing daily. General diagnostic X-ray generator is installed on stationary form, But X-ray generator was developed because patient who is in the intensive care unit, operation room, emergency room can not move to general x-ray room. What we examine patient by x-ray generator is certainly necessary, So patient exposure is inevitable. but reducing radiation exposure is highly important matter about radiation technology, guardian, patient in the same hospital room, nurse etc. For this reason, rule regarding safety control of diagnostic x-ray generator revised for radiation worker, patient and protector proclaim that mobile diagnostic x-ray shield must placed in case of examine different location excluding operation room, emergency room, intensive care unit. But, radiogical technologist is having a lot of difficulties to examine with mobile x-ray generator, diagnostic x-ray shield partition, image plate and lead apron. So, when we use x-ray generator, we manufacture shield tools can be attached to the mobile x-ray generator On behalf of x-ray shield partition and conduct analysis and in comparison to part of body and distribution of dose rate and find way to reduce radiation exposure through distribution of dose rate of patient within the radiogical technologist, medical team. Mobile x-ray generator aimed at SHIMADZU inc. R-20, We manufactured equipment for shielding x-ray scattered x-ray by installing shielding wall from side to side based on support beam on the mobile x-ray generator. Shielding wall when moving can be folded and designed to expand when examine. Experiment measured five times in each by an angle for dose rate of eyes, thyroid, breast, abdomen and gonad on exposure condition of upper and lower extremity, chest, abdomen which is examined many times by mobile x-ray generator. We used dosimeter RSM-100 made by IJRAD and measured a horizontal dose rate by body part. The result of an experiment, shielding decreasing rate of the front and the rear showed 77 ~ 98.7%. Therefore using self-production shielding wall reduce scattered x-ray occurrence rate and confirm can decrease exposure dose consequently. Therefore, through this study, reduction result which is used shielding wall of self-production will be a role of shielding optimization and it could be answer about reduction of medical exposure recommended by ICRP 103.
The purpose of this study is to develop a convergence inpatient medical service patient experience management model(IMSPEMM) that can help in the management strategy of a medical institution to create a patient-centered medical culture. Using the original data from the 2018 Medical Service Experience Survey, 593 people with medical services inpatient(MSI) over the age of 15 were analyzed. By using the decision tree model, we developed a prediction model for overall satisfaction(OS) with the inpatient medical service experience(IMSE) and the intention to recommend patient experience(RI), and were classified into 4 and 7 types. The accuracy of the model was 68.9% and 78.3%. The OS level of IMSE was the nurse area and the hospital room noise management area, and the RI decision factor was the nurse area. It is significant that the IMSPEMM for MSI was presented and confirmed that the nurse area and the noise management area of the hospital room are important factors for the inpatient experience. It is considered that further research is needed to generalize the IMSPEMM.
Recently a non-electronic, disposable and portable infusor, Baxter $Infusor^{(R)}$, has developed for delivering not only a continuous drug infusion but also extradoses of medication on a demand basis. The present study examined the impact of two methods of pain management on recovery in 20 patients undergoing upper abdominal surgery for stomach cancer. One group, 10 patients, received IV meperidine in the recovery room and IM meperidine on the ward on a PRN basis(PRN group). In the other group, 10 patients, a loading dose of nalbuphine 0.1mg/kg was given when the patient first complained of pain in the recovery room and patient controlled analgesia with IV nalbuphine, 0.5mg/kg day for continuous infusion, was initiated and continued for 72 hours(PCA group). The devices for PCA group was Baxter Infusor with patient control module which had flow rate 0.5ml/hr and lockout time was 15 min. As results of this study, the patients of PCA group get less pain than PRN group on operation day, the first and second days after surgery. VAPS values are $6.47{\pm}1.64$ vs $4.44{\pm}1.38$, $5.02{\pm}1.22$ vs $2.62{\pm}0.93$ and $3.22{\pm}1.47$ vs $2.02{\pm}0.71$ respectively pertaining to PRN and PCA groups(p<0.05). In conclusion, PCA group with IV nalbuphine provided more effective postoperative analgesia than PRN group with conventional meperidine IM.
Proceedings of the Korean Society of Medical Physics Conference
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2002.09a
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pp.177-179
/
2002
We have developed a scheduling system for heavy ion radiotherapy considering the condition of three treatment rooms and treatment planning for each patient. This system consists of a database (patient information, treatment method and machine schedule), a schedule for radiotherapy and WEB server. All operation of this system, such as data input, to change and to view the schedule, are performed by using a WEB browser. In order to protect personal information for the patients, access privilege to each information are limited by according to the occupational category. This system is connected with a hospital central information management system (AMIDAS) and an irradiation-managing computer for the heavy ion radiotherapy. A basic information for the patient is got from AMIDAS and the daily schedule sends to the treatment control computer at each treatment room through the irradiation-managing computer every morning. The daily, weekly, monthly schedules in the treatment room and the treatment condition of each patient are shared on the WEB browser with the all participants of the heavy ion therapy. This system could be useful to save a time to generate a treatment schedule and to inform us the most up-to-date treatment schedule and the related information at the same time.
Consultation with the patient and doctor is very important in the examination. However, if the consultation cannot be done directly, such as corona virus, it is difficult for the doctor to determine the patient's condition more accurately. Recently, an image counseling system has been developed based on the Internet, but in the case of heart disease, remote medical counseling cannot be performed because it is not possible to stethoscope the heart sounds remotely. In order to solve this problem, it is necessary to develop an interactive mobile robot capable of remote medical consultation, and a doctor and a patient should be able to set a planting sound during consultation and transmit it in real time. In this paper, we developed a robot that can remotely control a medical counseling robot to move to a hospital room where patients are hospitalized, and to consult a patient in the room remotely from a doctor's office. A remote medical imaging stethoscope system for real-time heart sound transmission is presented. The proposed system is a kind of P2P communication that transmits video information, audio information, and control signal independently through webRTC platform, so that there is no data loss. Consults and sees doctors in real time and finds it more effective than traditional methods for patient security. The system implemented in this paper will be able to perform remote medical care in the place where the spread of diseases between humans like the recent corona 19 as well as the remote medical care of heart disease patients in the future.
We developed and evaluated an algorithm to calculate the target radiation dose in cancer patients by measuring the transmitted dose during 3D conformal radiation treatment (3D-CRT) treatment. The patient target doses were calculated from the transit dose, which was measured using a glass dosimeter positioned 150 cm from the source. The accuracy of the transit dose algorithm was evaluated using a solid water phantom for five patient treatment plans. We performed transit dose-based patient dose verification during the actual treatment of 34 patients who underwent 3D-CRT. These included 17 patients with breast cancer, 11 with pelvic cancer, and 6 with other cancers. In the solid water phantom study, the difference between the transit dosimetry algorithm with the treatment planning system (TPS) and the measurement was $-0.10{\pm}1.93%$. In the clinical study, this difference was $0.94{\pm}4.13%$ for the patients with 17 breast cancers, $-0.11{\pm}3.50%$ for the eight with rectal cancer, $0.51{\pm}5.10%$ for the four with bone cancer, and $0.91{\pm}3.69%$ for the other five. These results suggest that transit-dosimetry-based in-room patient dose verification is a useful application for 3D-CRT. We expect that this technique will be widely applicable for patient safety in the treatment room through improvements in the transit dosimetry algorithm for complicated treatment techniques (including intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT).
Journal of the Korea Academia-Industrial cooperation Society
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v.12
no.12
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pp.5748-5758
/
2011
The purpose of this study was to evaluate the perceived patient safety, type of errors related to patient safety, importance awareness and compliance on patient safety for operating room nurses and to identify factors influencing compliance. Data were collected using a structured questionnaire from 191 perioperative nurses. Data were analyzed using descriptive statistics, t-test, paired t-test, ANOVA, Pearson correlation coefficients, and multiple regression. The perceived patient safety score was 6.3 as moderate level. Types of errors were mostly happened in patient injury (39.8%), counts (18.4%) and infection control (17.5%). The level of compliance on patient safety was significantly lower than that of importance awareness (t=18.01, P<.001). Compliance on patient safety showed significantly positive correlations to importance awareness (r=.56, p<.001). Experience of patient safety education, experience of errors in colleague, job position and working experience in hospital explained 13.9% of variance compliance on patient safety(F=8.407, P<.001). In conclusion, Hospital should develop education program related to patient safety, encourage nurses to manage safety protocol and ensure cultivating patient safety culture in the perioperative practice setting.
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