The purpose of this study was to develop Intensive Care Unit (ICU) admission and discharge criteria that would lead to the appropriate utilization of ICU resources and nursing services. For this study, a conceptual framework was developed through a review of the literature. Then in order to identify the overall health condition of patients in the ICU, and to draw up preliminary criteria, the medical records of 58 patients who were admitted to the ICU of Y Medical Center in Seoul between March, 1999 to February, 2000 of were analyzed. Two expert validity tests were done for the preliminary criteria for admission and discharge with 21 patients over 18 years of age who were admitted patients and for 12 patients who were discharged between May 30, 2000 and June 5, 2000 a clinical validity test was also done. After this process, the final admission and discharge criteria were developed. The results of this study are summarized as follows: 1. After a review of the literature, there were 9 categories for admission criteria cardiologic, gastrointestinal, neurologic, endocrine, post-op care of major surgery, vital signs, laboratory values, and a category of miscellaneous items. Discharge criteria had 3 categories which were vital signs, laboratory values, and a category of miscellaneous items. 2. From the medical records of the 58 patients who were admitted to the ICU, 45 items for preliminary criteria for admission and 17 for discharge were identified. 3. The two expert validity tests showed that of the 45 items 29 admission items received over 75 percent agreement. The 16 admission items which received less than 75 percent agreement were revised or deleted from the admission criteria. Of the 17 discharge items, 11 had over 75 percent agreement and 6 less then 75 percent agreement. These were revised or deleted from the discharge criteria. 4. In the clinical validity test, 14 admission items showed more than 75 percent agreement and 11 discharge items more than 83 percent agreement. 5. The final criteria consisted of 29 items for admission and 11 items for discharge. Since patients being considered for admission to the ICU have complex problems, there is a need to make the decision based on more than a single issue. This tool will insure that the ICU nursing care and treatment resources are appropriately used by allowing a multi-professional health team to make admission and discharge decisions.
Kim Nam-Cho;Kim Hee-Seung;Choi So-Eun;Park Hyun-Jeong
Journal of Korean Public Health Nursing
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v.14
no.2
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pp.191-202
/
2000
This study was conducted for 39 patients who are recipients of allogeneic hemopoietic stem cell transplantation at BMT ward of St. Mary's hospital affiliated to Catholic University of Korea from April to September 1999. The subjects were devided into two groups; those who received both TEl and chemo therapy as conditioning regimen (TEl group). and those who used chemo agents as singular conditioning regimen (chemo group). The oral intake status of the two groups were compared through physical assessment and blood chemistry exam of the subjects, and factors influencing their nutritional change and oral intake were explored in each stage of the transplantation (six stages: admission, conditional stage, date of transplantation, one week after transplantation, two weeks after transplantation, and three weeks after transplantation). The prior aim of the study was to provide baseline data to minimize delayed treatment from nutritional deficiency of the subjects. The results were as follows: 1. TBI group was significantly decreased of oral calorie intake in two weeks after transplantation compared to admission and conditioning stage while that of chemo group was significantly decreased on the date of transplantation. 2. TBI group was significantly decreased of protein intake in two weeks after transplantation compared to admission and conditioning stage. In chemo group, protein intake was significantly decreased on the date of transplantation compared to admission. It was remarkable that TBI group showed lesser protein intake than chemo group. 3. Both group were significantly decreased of BMI in one week and three weeks after transplantation compared to admission. TBI group showed significantly higher BMI than chemo group. 4. Both group were significantly decreased of Triceps Skinfold Thickness (TST)on the date of transplantation compared to admission stage. 5. TBI group was significantly decreased of mid-arm muscle circumference (MAMC) in two weeks after transplantation compared to admission, conditioning, date of transplantation. 6. TBI group was significantly decreased of albumin level in two weeks after transplantation compared admission stage. In chemo group, it was significantly decreased on the date of transplantation compared to admission, three weeks after the transplantation. 7. TBI group was significantly decreased of transferrin level in two weeks after transplantation compared admission, conditioning, date of transplantation and one week after transplantation. In chemo group, it was decreased of transferrin level in 3 weeks after transplantation. 8. Oral intake of TEl group was impacted by vomiting before transplantation and gingivitis after transplantation. In chemo group, it was impacted by vomiting before transplantation and by two factors, gingivitis and nausea, after transplantation. The results showed oral calorie intake was not different between the two groups while protein intake was significantly lower in TBI group than chemo group. Oral intake was significantly impacted by vomiting before transplantation in both groups, but affected by oral gingivitis in TBI group and gingivitis and nausea in chemo group after transplantation. This findings present that standardized strategies to manage nutrition and gingivitis more effectively are desperately needed to enhance oral intake and protein intake of patients who receive TBI as conditioning regimen.
Purpose: Prolonged stay in the emergency department (ED), which is closely related with the time interval from the ED visit to a decision to admit, might be associated with poor outcomes for trauma patients and with overcrowding of the ED. Therefore, we examined the factors affecting the delay in the decision to admit severe trauma patients. Also, a multidisciplinary department system was preliminarily evaluated to see if it could reduce the time from triage to the admission decision. Methods: A retrospective observational study was conducted at a tertiary care university hospital without a specialized trauma team or specialized trauma surgeons from January 2009 to March 2010. Severe trauma patients with an International Classification of Disease Based Injury Severity Score (ICISS) below 0.9 were included. A multivariable logistic regression analysis was used to find independent variables associated with a delay in the decision for admission which was defined as the time interval between ED arrival and admission decision exceeded 4 hours. We also simulated the time from triage to the decision for admission by a multidisciplinary department system. Results: A total of 89 patients were enrolled. The average time from triage to the admission decision was $5.2{\pm}7.1$ hours and the average length of the ED stay was $9.0{\pm}11.5$ hours. The rate of decision delay for admission was 31.5%. A multivariable regression analysis revealed that multiple trauma (odds ratio [OR]: 30.6, 95%; confidence interval [CI]: 3.18-294.71), emergency operation (OR: 0.55, 95%; CI: 0.01-0.96), and treatment in the Department of Neurosurgery (OR: 0.07, 95%; CI: 0.01-0.78) were significantly associated with the decision delay. In a simulation based on a multidisciplinary department system, the virtual time from triage to admission decision was $2.1{\pm}1.5$ hours. Conclusion: In the ED, patients with severe trauma, multiple trauma was a significant factor causing a delay in the admission decision. On the other hand, emergency operation and treatment in Department of Neurosurgery were negatively associated with the delay. The simulated time from triage to the decision for admission by a multidisciplinary department system was 3 hours shorter than the real one.
Cyber education fields have been changed a lot with the internee development. One of them is the field of consultation for university admission. As for the business of university admission, there were two ways applicants handed in their applications directly to school which they applied to and to each place to receive applications or sent them through FAX. Recently, highlighted is the internee environment to receive the application for admission which integrated organically the two ways. This paper aims to design and implement a multi-consulting-agent system having intelligence which helps applicants make their right applications for colleges or universities through internet system after guiding a proper department to them.
Objective : The aim of this study was to assess the effects of admission care on Bell's palsy by case control study. Method : 27 patients who diagnosed as Bell's palsy were shared 13 inpatients group treated by early admission care, and 14 outpatients group. They were equally treated with acupuncture, herb medicine and western medicine. The groups were evaluated by Yanagihara,s unweighted grading system at pre-treatment, after 5 days, after 10 days and after 15 days. Results : The Yanagihara,s scores of 2 groups showed stastically significant improvement in comparison with pre-treatment. In improvement index after treatment, the Yanagihara,s scores of 2 groups increased but were not stastically significant the difference. Conclusion : These results provided that the admission care may not be a valuable treatment for Bell's palsy. Further study is needed to evaluate the effect of early admission care on Bell's palsy.
Kim, Hye-Jo;Choi, Dong-Won;Park, Ho-Ran;Sohng, Kyeong-Yae
Journal of Korean Academy of Fundamentals of Nursing
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v.13
no.3
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pp.428-436
/
2006
Purpose: To investigate the levels of uncertainty and anxiety at admission and discharge to the isolation unit for patients undergoing hematopoietic stem cell transplantation (HSCT). Method: The data were collected from 60 patients who were admitted to the department of HSCT. Uncertainty and anxiety were assessed using the Mishel Uncertainty in Illness Scale (MUIS) and Anxiety Inventory (STAI). Collected data were analyzed using the SAS program. Results: The mean score for anxiety at admission was 2.20, and at discharge 2.10. The mean score for uncertainty at admission was 2.19, and at discharge 2.07. The anxiety at admission the group with physical discomfort was higher than that of group without physical discomfort. A positive relationship was found between anxiety and uncertainty at admission and at discharge. The major variables were expectation for cure and physical discomfort, explaining 25.87% of the anxiety at admission. The major variable was expectation for cure, explaining 20.94% of the uncertainty at admission. Conclusion: Front the above results, it can be concluded that support and consideration are required to reduce anxiety of the inpatient in single room.
Purpose: This study was conducted to assess the prevalence rate of, and the risk factors for pressure ulcers in critical patients at the time of intensive care unit (ICU) admission. Methods: We reviewed the electronic medical records of 2,107 patients who were admitted to the intensive care units in D university hospital between January 1 and December 31, 2012. The collected date were analyzed by ${\chi}^2$-test, t-test, and multi-variate logistic regression with forward stepwise selection using the SPSS program version 21. Results: The prevalence rate of pressure ulcers at the ICU admission was 23.7%. Risk factors significantly affecting pressure ulcers carrying were the age of 80 years or older (OR=3.70, 95% CI: 1.80~7.60), body weight less than 50 kg (OR=2.82, 95% CI: 1.74~4.56), sedated consciousness (OR=6.10, 95% CI: 3.57~10.40), use of ventilator (OR=1.60, 95% CI: 1.02~2.49), use of vasopressors (OR=1.53, 95% CI: 1.09~2.14), ICU admission via operation room (OR=0.49, 95% CI: 0.29~0.85), and hospital admission from nursing homes (OR=13.65, 95% CI: 3.02~61.72). Conclusion: The findings of this study suggested that the prevention efforts for pressure ulcers should be given in prior to ICU admission. Further research is necessary for developing nursing interventions for preventing pressure ulcers in the pre-ICU stage.
Journal of Fisheries and Marine Sciences Education
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v.24
no.5
/
pp.643-652
/
2012
The admission officer system that is discussed by research topic was introduced just six years ago. So, domestic journals for research trends analysis of admission officer system are not enough. From the time of the end of 1st government financial support project (2007~2012) for admission officer system, it is important things that to summarize the results of study and to look at the implications. The contents of this study will help that other researchers search the study directions. The implication of the research are as follows. First, we can see that range of research is widening and research is advancing. Second, the journals that related to high school will be come out more frequently. Finally, after accumulation of data, in-depth study analysis will be also come out.
Journal of Korean Society of Industrial and Systems Engineering
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v.35
no.2
/
pp.113-123
/
2012
In this paper, it is examined how the amount of review time per applicant to a college admission officer system is connected with the performance of the selected students after they enter the college. About five years ago, college admission officers system has been introduced to Korea as a government policy. Thus, for most Korean college, there is not enough number of admission officers, while it takes substantial time to find out whether an applicant has potential ability or not. Thus, it is required to find out some policy alternatives to solve this discrepancy. In this paper, a simulation model is built using System Dynamics theory and simulated to understand the relation between the amount of review time and the performance of the selected students. Finally, some implications and policy suggestions are derived from the simulation results.
Proceedings of the Korean Society of Propulsion Engineers Conference
/
2004.03a
/
pp.391-397
/
2004
The performance characteristics of partial admission supersonic turbines are analyzed by using the commercial CFD program FLUENT6.0. The governing equations were discretized with Euler implicit method in time and 2nd-order upwind scheme of FVM in space. The k-$\varepsilon$ turbulence model was utilized to describe the turbulent flow field. In order to investigate the nozzle--rotor interactions and the effect of partial admission, the flows in supersonic turbine rotor cascades with a nozzle are computed. Extensive computations of partial admission supersonic turbines provide the shock structures and flow patterns in the nozzle and rotor. It is clearly shown that the nozzle flow is highly affected by the shocks or expansion waves propagated from the rotor leading edge. And the rotor flow is also affected by the shocks or wakes originated from the nozzle.
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