• Title/Summary/Keyword: 신생아실

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Readmission of late preterm infants after discharge from nursery (신생아실에서 퇴원한 후기 조산아들의 재입원에 대한 고찰)

  • Kim, Myo-Jing
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.888-892
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    • 2009
  • Purpose : To evaluate the risk factors for hospital readmission during the neonatal period among late preterm infants who were discharged after nursery care. Methods : In this retrospective study, we reviewed medical records of 135 late preterm infants readmitted to the neonatal intensive care unit (NICU) during the neonatal period, after discharge from nursery of IL Sin Christian Hospital from January 2003 to December 2008. We compared the risk factors of the hospital readmission group with the control group. Results : The gestational age and birth weight of 135 study infants were $36^{+1}{\pm}0.5$ weeks and $2,718.4{\pm}296.9gm$, respectively. Identified risk factors of hospital readmission were breastfeeding (71.9% vs. 44.4%), short duration of nursery stay ($3.3{\pm}1.6$ days vs. $4.1{\pm}2.0$ days), firstborn (60.0% vs. 45.3%), and maternal pregnancy complication (31.9% vs. 18.8%). Jaundice accounted for the majority of hospital readmissions (83.7%), and the age at hospital readmission was $6.2{\pm}3.6$ postnatal days, mostly at 5-6 postnatal days (40.7%). Identified risk factors of hospital readmission due to jaundice were spontaneous normal vaginal delivery (43.4% vs. 1.8%), younger maternal age ($29.8{\pm}3.4$ yrs vs. $32.1{\pm}4.2$ yrs), and lower maternal pregnancy complication (28.3% vs. 50%). Conclusion : Identified risk factors of hospital readmission were breastfeeding, short duration of nursery stay, firstborn, and maternal pregnancy complication. Jaundice accounted for the majority of hospital readmissions, and the age at hospital readmission was $6.2{\pm}3.6$ postnatal days.

Characteristics of Methicillin-resistant Staphylococcus aureus Nasal Colonization Among Neonatal Unit Staff and Infection Control Measures (일개 병원 신생아실 근무 의료인에서 시행한 비강 내 MRSA 집락의 특성 및 전파예방에 관한 보고)

  • Kim, Dong Hwan;Kim, Sun Mi;Park, Ji Young;Cho, Eun Young;Choi, Chang Hee
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.131-141
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    • 2009
  • Purpose : In February 2007, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections occurred in two newborns in the neonatal unit of Sahmyook Seoul Hospital. We performed this study to investigate the characteristics of MRSA nasal carriage among neonatal unit staffs and the effective infection control measures. Methods : Nasal swab specimens were obtained from the neonatal unit staff for the presence of MRSA. MRSA-colonized staffs were offered decolonization therapy with oral trimethoprim-sulfamethoxazole or 2% mupirocin ointment. Every 2-4months after decolonizaton, repeat nasal swab specimens were obtained. Also, samples from the neonatal unit environment and room air were collected. Results : Successful decolonization was achieved in 92% of the cases in 2 weeks after decolonization therapy, but most of the staffs were recolonized after several months. The nature of antibiotic susceptibility was changed from multi-drugsusceptible to multi-drug-resistant. The most frequently contaminated objects were dressing carts, computer keyboards, bassinets and washbowls. In environmental cultures using the settle microbe count method, the colony counts were decreased significantly at the last study period compared with the first study period in the neonatal room, breastfeeding room, service room, and dressing room (P <0.05). Conclusion : Effective control of sustained MRSA transmission within an institution may require prompt identification, treatment, and monitoring of colonized and/or infected staffs. However, nasal decolonization therapy may induce multi-drugresistant MRSA infection and had no effect on decreasing the MRSA nasal carriage rate in our study. Other factors might be more important, such as improving staff education, increasing hand hygiene practices, and environmental sterilization for controlling MRSA infections.

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Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care (신생아실 의료인력의 적정성 및 신생아관리료의 타당성 분석)

  • Park, Jung-Han;Kim, Soo-Yong;Kam, Sin
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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    • pp.531-548
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    • 1991
  • To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

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Nursing infection : Apparent and Inapparent (신생아실 감염)

  • Thompson Laverne R.
    • The Korean Nurse
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    • v.5 no.3 s.23
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    • pp.89-95
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    • 1966
  • 아기들은 출생 첫날부터 모르는 사이에 미생물에 대해서 숙주로써의 역할을 하게된다. 이들 미생물 중의 어떤 것은 아기의 가장 좋은 친구가 되기도 한다. 왜냐하면 아기를 병들게 하는 대신에 아기로 하여금 병에 대해서 저항력을 갖게 하기 때문이다. 반면 병원성균은 드물게 존재하며, 항상 위험하다. 여기 세균학자인 간호원이 널리 퍼지고 위험한 미생물, 그들의 습성, 침입해오는 방법을 서술하였고, 안전한 신생아 실을 유지하는 방법을 서술했다.

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Perspective Patterns of Male Nurse Students on Practice Experience in the Newborn Baby Room (신생아실 실습경험에 대한 남자 간호학생의 인식유형)

  • Lee, Ji-Won;Baek, Kyoung-Seon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.11 no.2
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    • pp.232-239
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    • 2005
  • Purpose: This study is to use perspective patterns of male nurse students in new born room practice experience as a fundamental data which can be helpful to use theories with technique in the science of nursing for children. Method: The study was using the Q-methodology. Q-methodology was used 33 Q-samples selected, This study was analyzed by personal interviews from July to Nov 2005. 20 male students of nursing Dept. in J college were selected as p-samples based on 33 Q-samples. Result: The first type is the positive receivers ; they accept environmental changes positively in practice of new born baby room. The second is the life respecter ; they learn the mysteries and importance of life. The third type is the sexual identity founder ; they set up identify the sexual roles. Conclusion: As stated above, their newborn baby room practicing experience can be divided into 3 types. we suggest as follows: 1. qualitative research about practice experience of male nurse students should be needed. 2. newborn baby room practice of male nurse students teaching program should be developed.

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The Relation Between the Occupational Stress and Fatigue Level of Neonatal Nurses (신생아실 간호사의 직무 스트레스와 피로도와의 관계)

  • Park, Eun-A;Park, Jeong-Eon
    • Korean Journal of Occupational Health Nursing
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    • v.20 no.3
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    • pp.261-269
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    • 2011
  • Purpose: The purpose of this study was to investigate occupational stress and fatigue level of neonatal nurses and to assess relationship between the two of them. Methods: Subjects were 109 neonatal nurses working at 2 university hospitals and 9 women's hospitals in D city, and the data were analyzed using descriptive statistics and binary logistic regression analysis by the SPSS/WIN 15.0. Results: The mean score of nurses' occupational stress level was 3.22, and the highest was 'night shift' among the 7 subcategories, and fatigue level was 62.0, and the highest was physical fatigue in configuration field. In logistic regression analyses, 'heavy workload' and 'inadequate physical environment' led to most occupational stress. Conclusion: In addition to significantly higher levels of occupational stress of neonatal nurses, the cumulative fatigue also resulted in decreased quality of nursing, job satisfaction and nursing productivity; therefore, appropriate number of nurses and improvement of work environment is necessary. Furthermore, to reduce the occupational stress and fatigue, we should try to develop adequate clinical guidelines and intervention strategies and apply them in neonatal care unit.

Health-Related Quality of Life in the Early Childhood of Premature Children (미숙아로 출생한 유아의 건강 관련 삶의 질 정도와 영향요인)

  • Lim, Eun-Hee;Ju, Hyeon-Ok
    • Child Health Nursing Research
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    • v.21 no.1
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    • pp.37-45
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    • 2015
  • Purpose: In this study, a comparison was done of the extent of health-related quality of life (HRQoL) for preterm and fullterm children during early childhood, and factors affecting HRQoL in the early childhood of premature children were analyzed. Methods: Eighty mothers of children born prematurely and 83 mothers of children born at fullterm listed on two Internet cafes were sampled for this study. The major instrument used for the study was the TNO-AZL Preschool Quality Of Life (TAPQOL) questionnaire. Results: Total score for HRQoL in the premature group was 80.5 (${\pm}9.9$) and for the full term group, 85.0 (${\pm}8.3$), on a 100-point scale. A comparison of the premature group and full term group showed that the domains which scored relatively lower with respect to HRQoL included the stomach, motor function, anxiety, liveliness and communication. Among the factors that have an impact on HRQoL were 'length of stay in neonatal intensive care unit (${\geq}7$ days)' and 'birth weight (<1,000 gm)'. The explanation power of the model was 17%, which was statistically significant. Conclusion: These findings indicate that a differentiated premature infant follow-up program for children who are hospitalized over 7 days in NICU or weighed under 1,000g at birth is urgently needed.

Analysis of newborn hearing screening using automated auditory brainstem response (자동화 청성뇌간반응을 이용한 신생아 청력선별검사 결과 분석)

  • Park, Sung Won;Yun, Byung Ho;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon;Hong, Sung Hwa
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1056-1060
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    • 2006
  • Purpose : As hearing ability affects language and cognitive development, early detection and intervention of congenital hearing defects is very important. We analyzed the result of newborn hearing screening using automated auditory brainstem response and estimated the incidence of congenital hearing defects in newborn infants in Korea. Methods : Hearing screening tests were done on 7,218 newborn infants who were delivered at Cheil General Hospital from July 1, 2004 to June 30, 2005. The first screening test was done on the second day of life with automated auditory brainstem response(AABR) using $ALGO{\bigcirc}^{(3)}$ Newborn hearing screener($Natus^{(R)}$ Medical Incorporated, San Carlos, USA) with 35 dB sound level. The newborn infants who did not pass the initial screening test took the second screening AABR test before discharge from the nursery. Infants who did not pass these screenings at the nursery were followed up at the Department of Otorhinolaryngology, Samsung Seoul Hospital. Results : Total 7,218 infants(83.3 percent of total 8,664 live births of the Cheil General Hospital) were screened in the nursery, and 55 of them failed to pass the newborn screening. Among 55 infants who were referred, six were lost during follow-up, and 14 were confirmed as hearing impaired. Six of them(42.8 percent) do not have any risk factors for hearing impairment. We can estimate that the incidence of hearing defects is about 1.9-2.8 per 1,000 live births. Conclusion : Automated auditory brainstem response is an effective tool to screen the hearing of newborn infants. Congenital hearing loss is more frequent than metabolic diseases on which screening tests are available in the newborn period. About 40 percent of infants who have hearing defects do not have any risk factors for hearing impairment. Therefore, universal newborn hearing screening must be recommended to all neonates.