• Journal of the Korean Society of Clothing and Textiles
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• v.36 no.11
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• pp.1197-1207
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• 2012

This study provides information for the design of pediatric inpatient uniforms with functionality and aesthetic beauty through a questionnaire-survey of the conditions of providing, wearing, preferences and improvement requirements for pediatric inpatient uniforms. As a result of the survey, intravenous injections were mostly given on the back of the hand, and the method of changing uniforms after intravenous injections was (in most cases) to pass the injection bottle through a sleeve or pant leg while the needle is inserted. The respondents answered that the sleeve length and pant length did not match. As a result of the preference of the pediatric inpatient design survey, respondents indicated they preferred pajama type, yellow color and medium size animal patterns. A similar ratio of set-in and raglan with no collar but with 3/4 length sleeve of round neck, front end, sleeve top opening, button closing and two pockets were preferred for shirts; however, a 3/4 length with rubber string on the waist, no opening and inner opening were preferred at the same ratio for pants. As for the method to adjust the length to assign functionality to pediatric inpatient uniforms, the most preferred sleeve was a roll-up sleeve with a strap and the most preferred pants were length adjusted pants that used a strap for both shirts and pants with a both sides strap. In addition, the majority of the respondents answered that a hand wrapper that protects the injection location during intravenous injections needs be developed. As for the development type, a half glove type and glove type were preferred in sequential order.

• The Journal of Korean Academic Society of Nursing Education
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• v.23 no.4
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• pp.398-408
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• 2017

Purpose: This study aims to identify the effect of pediatric fall prevention education with leaflets and picture books on the fall-related knowledge and preventive behaviors in caregivers of inpatient children. Methods: This study is a non-equivalent control group non-synchronized design. It divided 62 caregivers of inpatient children aged 5 and under into an experimental group and a control group in P general hospital located in B City. Results: Fall related knowledge score in the experimental group was increased by 2 points after the intervention and the score in the comparison group was increased by 0.1 points. The difference after the intervention in fall related knowledge scores between the two groups was statistically significant (t=7.67, p<.001). The fall related prevention behavior score of the experimental group increased by 9.3 points after the intervention, and the score of the comparison group increased by 2.5 points. The difference in the scores of fall related prevention behaviors between the two groups was statistically significant (t=5.71, p<.001). Conclusion: Pediatric inpatient fall prevention education using leaflets and picture books can improve caregivers' fall-related knowledge and preventive behaviors. In turn, this can reduce children's falls in pediatric wards in general hospitals.

• Journal of Korean Academy of Nursing
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• v.43 no.5
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• pp.595-604
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• 2013

Purpose: The purpose of this study was to identify risk factors for pediatric inpatients falls. Methods: The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers. Results: In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls. Conclusion: These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.3
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• pp.196-202
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• 2018

Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. Methods: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. Results: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of $3.6{\pm}3.6years$ (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04-9.09); p<0.001); prematurity (OR 2.39, 95% CI 1.09-5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12-4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12-4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00-4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3-5 (p=0.04) and $13{\pm}13.7$ constipation related prior encounters (p=0.001), were significantly different from the outpatient group. Conclusion: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.1
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• pp.61-69
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• 2022

Purpose: Studies in adults have shown an increasing incidence of Clostridioides difficile infection (CDI) in patients hospitalized with acute pancreatitis (AP). There is lack of epidemiological data on CDI and its impact on hospitalized pediatric patients with AP. Methods: We analyzed the National Inpatient Sample and Kids' Inpatient Database between the years 2003 and 2016 and included all patients (age <21 years) with a primary diagnosis of AP using specific International Classification of Diseases codes. We compared clinical outcomes between children with CDI and those without CDI. Our primary outcome was severe AP and secondary outcomes included length of stay and hospital charges. Results: A total of 123,240 hospitalizations related to AP were analyzed and CDI was noted in 0.6% of the hospital. The prevalence rate of CDI doubled from 0.4% (2003) to 0.8% (2016), p=0.03. AP patients with CDI had increased comorbidities, and also underwent more invasive surgical procedures, p<0.05. AP patients with CDI had a higher in-hospital mortality rate and increased prevalence of severe AP, p<0.001. Multivariate regression models showed that CDI was associated with 2.4 times (confidence interval [CI]: 1.91 to 3.01, p<0.001) increased odds of severe AP. CDI patients had 7.24 (CI: 6.81 to 7.67, p<0.001) additional hospital days while incurring $59,032 (CI: 54,050 to 64,014, p<0.001) additional hospitalization charges. Conclusion: CDI in pediatric patients with AP is associated with adverse clinical outcomes and increased healthcare resource utilization. Further studies are needed to elucidate this association to prevent the development of CDI and to improve outcomes.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.1
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• pp.23-33
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• 2023

Purpose: The incidence and prevalence of inflammatory bowel disease (IBD) are increasing along with an increasing number of patients with comorbid conditions like psychiatric and behavioral disorders, which are independent predictors of quality of life. Methods: Non-overlapping years (2003-2016) of National Inpatient Sample and Kids Inpatient Database were analyzed to include all IBD-related hospitalizations of patients less than 21 years of age. Patients were analyzed for a concomitant diagnosis of psychiatric/ behavioral disorders and were compared with IBD patients without psychiatric/behavioral disorder diagnoses for outcome variables: IBD severity, length of stay and inflation-adjusted hospitalization charges. Results: Total of 161,294 IBD-related hospitalizations were analyzed and the overall prevalence rate of any psychiatric and behavioral disorders was 15.7%. Prevalence rate increased from 11.3% (2003) to 20.6% (2016), p<0.001. Depression, substance use, and anxiety were the predominant psychiatric disorders. Regression analysis showed patients with severe IBD (odds ratio [OR], 1.57; confidence interval [CI], 1.47-1.67; p<0.001) and intermediate IBD (OR, 1.14; CI, 1.10-1.28, p<0.001) had increased risk of associated psychiatric and behavioral disorders than patients with a low severity IBD. Multivariate analysis showed that psychiatric and behavioral disorders had 1.17 (CI, 1.07-1.28; p<0.001) mean additional days of hospitalization and incurred additional $8473 (CI, 7,520-9,425; p<0.001) of mean hospitalization charges, independent of IBD severity. Conclusion: Prevalence of psychiatric and behavioral disorders in hospitalized pediatric IBD patients has been significantly increasing over the last two decades, and these disorders were independently associated with prolonged hospital stay, and higher total hospitalization charges.

• Pediatric Infection and Vaccine
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• v.2 no.2
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• pp.180-185
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• 1995

1. Purpose The accurate diagnosis and proper treatment of group A streptococcus should be emphasized concerning about possible development of late sequelae, such as acute rheumatic fever and acute glomerulonephritis. We would like to know the recover rate of beta-hemolytic streptococci by throat swab culture at the in-patient 2. Methods The throat swab cultures and filled up flow-sheets were undertaken on 619 children who had admitted to hospital, KyungHee university hospital from may 1994 to april 1995 prospectively. At the same time on admission, throat culture was performed. 3. Results The highest recover rate of BHS(Beta-Hemolytic Streptococci)and GAS(Group A Streptococci) were seen in above 10 years old, as 9.1% and 1.9%. BHS were obtained in 39 cases(6.3%) among 619 children while GAS was obtained in 3 cases (0.4%). Among 39 specimens of BHS, 33 specimens were classified as non-grouping streptococcus. 4. Conclusion The poor recovery rate of GAS inpatient compared with normal carrier rate is likely due to possible antibiotic abuse, errors in processing samples, and epidemiologic factors such as seasons and geographic areas. It is necessary to evaluate the clinical significance of non-A,B,C,G streptococcal infections and carriers.

• Health Policy and Management
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• v.8 no.1
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• pp.1-14
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• 1998

Analysis of practice variations has been one of important issues in trying to contain costs as well as to manage quality in health care. This study was conducted to provide statistical model for analysing variations in inpatient costs by type of hospitals. Four K-DRGs including Cesarean section, appendectomy, cataract extraction, and pediatric pneumonia with CC class 0 were selected, and means and dispersions of inpatient procedure and operation costs were simultaneously compared between type of hospitals. The results indicated that joint modelling of means and dispersions by gamma distribution was a very useful analytic tool for identifying factors which might have relationship with variations in inpatient costs. This model can be expanded to test the significance of several independent variables in analysing cost variations. In surgical conditions, means and unit variations of procedure and operation costs showed consistent pattern which was tertiarty hospital, general hospital, and hospital in descending order. Different findings were identified in pediatric pneumonia, from which mean and unit variation of procedure and operation cost was the highest in general hospital. The practical implication of this difference could not be drawn from this study. It will be done by further sophisticated researches. In order to develop health policy for cost containment and quality management in Korea, it is essential to find out manageable factors affecting variations in practice patterns which include characteristics of population, providers, regions, and so on. The statistical model presented in this study will give health services researchers useful insights for future investigations in analysing cost variations.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.2
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• pp.145-151
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• 2014

The goal of this study was to describe dental consultation of pediatric inpatients to the department of pediatric dentistry at Yonsei University Severance Hospital. 391 dental consultations at Yonsei University Severance Hospital referred to pediatric dentistry in the year 2012 were included in this study. Consultations were categorized according to patients' gender, age, chief complaint, referred department and diagnosis. 288 patients (166 males and 122 females) with an average age of 5.9 were referred to the Department of Pediatric Dentistry. 129 cases (33.1%) from Department of Rehabilitation Medicine, 80 cases (20.5%) from Pediatric Hematology- Oncology, 51 cases (13.0%) from Pediatric Cardiology, and 44 cases (11.3%) from Pediatric Neurology. Chief complaints were ranked from oral examination (39.7%), dental caries (14.0%), pre-operative evaluation (12.8%) and others (33.5%); including oral pain, trauma, tooth mobility, orthodontic treatment, self-injury, fabrication of obturator and etc. Dental consultations should be encouraged as dental care and treatment could affect the control of systemic diseases of admitted patients. Pediatric inpatients have been referred to pediatric dentistry for not only comprehensive oral exam but also various chief complaints. The most frequent dental diagnosis made and treatment performed were dental caries and non-invasive/preventive care respectively.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.2
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• pp.200-208
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• 2019

The purpose of this study was to analyze the dental consultation of pediatric inpatients to the department of pediatric dentistry in Yonsei University Severance Hospital, and to investigate the change in patterns. In 2017, 268 pediatric patients (384 cases) admitted to the Severance Hospital were referred to the department of pediatric dentistry. The mean age was 6.6 years, and most of the patients were referred from the Department of Pediatric Hematology Oncology and Rehabilitation Medicine. The chief complaints were as follows: oral examination (31%), dental caries (20%), oral pain (10%), tooth mobility (10%), pre-operative evaluation (9%) and others (20%). 41% of the patients received only oral examination without treatment. Dental caries were the most frequent dental diagnosis of the patients. 28% (111 cases) of patients received operative treatments, 22 cases were treated under general anesthesia. Oral health is closely related to systemic diseases, especially for hospitalized patients. Dental consultations should be encouraged for prevention and early appropriate treatments. For this purpose, it is necessary to establish a referral system and perform dental treatment under general anesthesia.