• Title/Summary/Keyword: 중증도 분류

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Estimation of Nurse Staffing Based on Nursing Workload with Reference to a Patient Classification System for a Intensive Care Unit (중환자의 중증도에 따른 적정 간호인력 수요 산정)

  • Park, Young Sun;Song, Rhayun
    • Journal of Korean Critical Care Nursing
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    • v.10 no.1
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    • pp.1-12
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    • 2017
  • Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.

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Evaluation of Stage of Liver Fibrosis by Ultrasonography : Based on Pathologic Results of Biopsy (초음파검사를 통한 간 섬유화 병기단계 평가 : 조직검사결과 기준으로)

  • An, Hyun;Lee, Hyo-Yeong;Im, In Chul
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.547-555
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    • 2019
  • The purpose of this study was to evaluate the usefulness of routine liver ultrasonography on the basis of the scoring system according to the morphological parameters of liver ultrasound images and the histopathological results of liver biopsy. The morphological parameters of the liver through ultrasonography were divided into liver surface, liver edge and liver parenchyma. Pathologic results of liver biopsy were classified as mild fibrosis(F1), significant fibrosis(F2), severe fibrosis(F3), and cirrhosis(F4). In conclusion, routine ultrasound examination showed a sensitive predictive factor for fibrosis with mild fibrosis (F1) to severe fibrosis (F3) were liver edge>liver parenchyma>liver surface. However, the predictive factors for detecting cirrhosis (F4) were liver parenchyma>liver surface>liver edge. The use of three variable combinations rather than individual variables in routine ultrasonography may be useful in evaluating the degree and progress of liver fibrosis.

Comparison with in-hospital Korean Triage and Acuity Scale (KTAS) and prehospital triage system in a metropolitan city (일개 대도시의 병원전 단계와 병원 단계의 중증도 분류체계 간의 결과 분석)

  • Choi, Hyo Jeong;Kim, Ho Jung;Lee, Hyo Ju;Lee, Bo Ra
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.391-398
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    • 2018
  • Objective: This study was conducted to analyze and compare the classifications of a prehospital triage system and an in-hospital triage system. Methods: The records of patients transferred from the '119' emergency service for 5 months (from January 1 to May 31, 2016) were collected and records of first aid activities were assessed. We examined cases classified as four (urgent, semi-urgent, potentially urgent, and non-urgent) of five stages, excluding death. In the hospital, data were collected from medical records and classifications made using the five Korean Triage and Acuity Scale (KTAS) stages (1, resuscitation; 2, emergency; 3, urgent; 4, less urgent; and 5, non-urgent) were analyzed. Results: The number of patients enrolled in the study was 3,457. Of them, 2,301 were discharged after treatment and 1,156 were hospitalized. According to the prehospital triage classification, 726 of the 3,457 cases were urgent, 593 were semi-urgent, 1,944 were potentially urgent, and 194 were non-urgent. The results of the in-hospital triage were as follows: 114 KTAS 1 (3.3%), 491 KTAS 2 (14.2%), 1,345 KTAS 3 (38.9%), 1,227 KTAS 4 (35.5%), and 280 KTAS 5 (8.1%). The odds ratio trend for hospitalization showed a larger decrease according to in-hospital staging (95% CI, 0.32-0.39) than according to prehospital staging (95% CI, 0.50-0.60). The odds ratio trend for intensive care unit (ICU) admission also showed a larger decrease according to in-hospital staging (95% CI, 0.16-0.22) than according to prehospital staging (95% CI, 0.37-0.48). Conclusion: We found little correspondence in classifications made according to the KTAS and prehospital triage systems. However, the tendencies toward decreases in the hospitalization and ICU admission rates were similar.

A Study on the Demand of K-Nursing in Southeast Asian Nursing Colleges to Activate International Exchange Convergence in the Untacked Era (언택드 시대에 국제교류융합 활성화를 위한 동남아시아 간호대학에서 한국 간호에 대한 수요도 조사연구)

  • Kim, Seon Jeong;Kim, Kyung-yong;Choi, Byung Hwan;Song, Mei Ling
    • Journal of the Korea Convergence Society
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    • v.11 no.12
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    • pp.429-438
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    • 2020
  • The purpose of this study was to investigate the demand of K-nursing in Southeast Asian nursing colleges, and to promote international exchange convergence. In this study, we surveyed the professors and students who were living in Thailand, Vietnam, and the Philippines. For investigating the demands of the topics, two times of surveys were conducted using the google form In the first survey, the emergency care and infectious control showed the most frequent. In the second survey, the classification of emergency patients, showed the most, according the highest priority of emergency department. In infectious control department, management of new infectious diseases, such as COVID-19, showed the most, according to the highest priority. Based on the result, we make a suggestion to develop the contents, according to the highest priority, and to utilize them in international exchange programs.

Comparison of triage and treatment results of abdominal pain patients of pre-hospital and in-hospital conditions (병원전과 병원내의 복통환자 중증도 분류 및 진료결과 비교)

  • Kim, Dong-Hyeon;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.7-22
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    • 2021
  • Purpose: This study aimed to identify the differences in pre-hospital and in-hospital triage (pre-hospital triage and KTAS(Korean Triage and Acuity Scale)) of patients with abdominal pain and the characteristics of high hospitalization probability in the treatment results. Methods: We analyzed 941 people who visited the area C emergency center for 2 years from January 2017 to December 2018. The collected data were analyzed using SPSS 26. Results: Among the transfer hospitals, 84.8% (798) of patients were selected by the 119 rescue service, and the most common diagnosis was simple abdominal pain (46.5%, 438 patients). A total of 50.7% (477) of patients classified as severe pre-hospital cases changed to mild in-hospital cases. There was a difference of 5.3% (50 cases) in cases where patients classified as mild pre-hospital were changed to severe in-hospital cases. The Kappa coefficient did not match with 0.04 (p=.051). Pre-hospital overtriage was 58.2% (548 cases), and 71.2% (670) of patients were discharged from the emergency room as a result of the treatment. Conclusion: The results of this study showed that pre-hospital and in-hospital triage were not consistent. The rates of pre-hospital overtriage were quite high. Most patients with abdominal pain were classified as mild cases, and pre-hospital triage classifiers should be trained to reduce errors in selecting transfer hospitals.

Perceived Usefulness and Attitude toward Smart-glass for First-aid Remote Support among Coast Guards in Korea (응급처치 원격지도용 스마트글래스 사용에 대한 한국 해양경찰의 인지된 유용성 및 태도)

  • Choi, Jongmyung;Kim, Sun Kyung;Lee, Youngho;Yoon, Hyoseok;Go, Younghye;Byun, Kyung Seok
    • Journal of Korea Society of Industrial Information Systems
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    • v.26 no.4
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    • pp.1-9
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    • 2021
  • This study was to investigate the types of emergencies transported by the Southwestern Coast Guard, the need for telemedicine guidance, and the perception and attitude of smart glasses as a communication method targeting 31 coast guards. A relatively high frequency and training requirement were confirmed for bleeding, abrasion, and abdominal pain. The demand for telemedicine guidance on medication and triage was higher, and the perceived usefulness and attitude scores for the use of smart glasses were 3.76±0.61 and 3.64±0.45, respectively. A moderate correlation between perceived usefulness and attitude toward smart glasses was confirmed (r=.630, p<.01). With the development of technology, it is time to actively introduce new devices such as smart glasses.

Clinical Significance of the Degree of Fatty Liver Diagnosed by Ultrasonography (초음파검사로 진단된 지방간 정도의 임상적 의의)

  • Kim, Yong-Kyun
    • Journal of radiological science and technology
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    • v.31 no.2
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    • pp.135-140
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    • 2008
  • Purpose: Fatty liver is one of the most commonly found disease by abdominal ultrasonography. The status of fatty liver is classified into mild, moderate and severe degrees. The study was conducted to investigate the clinical significance of fatty liver using ultrasonography. Materials and method: Test set consisted of 2,185 patients who visited D healthcare center in Daejeon to receive an abdominal ultrasonic test from January to December 2007. Out of the 2185 patients, 524 patients was diagnosed as fatty liver (290 male and 234 female patients). They were divided into three groups, group I for mild degree. II for moderate degree, and III for severe degree, depending on the echo of liver parenchyma, the sound attenuation, and the visibility of intrahepatic blood vessels and diaphragm. Then the correlation of obesity indices, liver function tests and metabolic syndrome was analyzed for males and females separately. Results : As for the degree of fatty liver, 350 cases (66.8%) were classified as group I, 153 cases (29.2%) as group II, and 21 cases (4.1%) as group III. In addition, severe degree of fatty liver was more frequently found in males than in females. The mean ages of three groups for males were 46.1, 44.5, and 39.1, and those for females were 48.8, 50.2, 52.4, respectively. Males with lower mean ages have severely of fatty liver for both males and females. Conclusion: The results in this study show that the classification into three degrees of fatty liver in ultrasonography practice is helpful to treat and observe the progress of fatty liver. In addition, careful examination is required to measure the severity of fatty liver as well as detection of it. A standardized method to classify the degree of fatty liver is also needed for more objective measurement.

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Acute Adverse Reactions to Gadolinium-based Intravenous Contrast Agents for MRI : Retrospective Analysis Using Computed Reporting System (자기공명영상검사용 가돌리늄 경정맥 조영제의 급성 부작용: 부작용 전산 체계를 이용한 후향적 분석)

  • Choi, Moon-Hyung;Choi, Joon-Il;Jung, Seung-Eun;Ahn, Kook-Jin;Lee, Hae-Giu
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.2
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    • pp.139-145
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    • 2011
  • Purpose : To assess the frequency and severity of acute adverse reactions to intravenous administration of gadolinium-based contrast agents using computerized reporting system at a single large academic institution. Materials and Methods : We assessed data from electronic hospital information system from October 2008 to December 2010. Reactions were classified as mild, moderate, or severe. We compared the frequency of adverse reactions among three contrast agents (Gd-BT-DO3A, Gd-DTPA and Gd-EOB-DTPA). Results : The total number of administrated contrast agents was 33,600, and the number of administration of Gd-BT-DO3A, Gd-DTPA and Gd-EOB-DTPA were 20,824 (62%), 10,417 (31%) and 2,359 (7%), respectively. Total 39 adverse reactions were reported accounting for 0.1161% of all administrations. The incidences of adverse reactions were 0.1248% (26/39, 67%) for Gd-BT-DO3A, 0.0768% (8/39, 21%) for Gd-DTPA, and 0.2120% (5/39, 13%) for Gd-EOB-DTPA. The difference of frequencies of adverse reaction among three contrast agents was not significant. Most cases of the adverse effect were mild (35/39, 89.7%). Moderate and severe adverse reactions were encountered in two patients, respectively. Conclusion : Among Koreans, adverse effects were rare, and especially, moderate to severe adverse reactions were much rarer. There was no difference among the frequencies of adverse reactions caused by three different contrast agents.

Relationship between usage of removable denture and depression in Korean adults with loss of multiple teeth: A cross-sectional study using the seventh Korea National Health and Nutrition Examination Survey (다수 치아를 상실한 한국 성인에서 가철성 의치의 장착 여부와 우울증의 연관성: 국민건강영양조사 제 7기 자료를 활용한 단면 연구)

  • Shim, Jaeseung;Lee, Younghoo;Hong, Seoung-Jin;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock;Paek, Janghyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.1-10
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    • 2021
  • Purpose: The purpose of this study is to evaluate the relationship between removable denture and depression. This study aims to investigate the relationship between depression and each group by dividing them into a group that were using removable dentures and a group that needed removable dentures but were not using removable dentures. Materials and methods: This study was conducted using raw data from the 7th Korea National Health and Nutrition Examination Survey (KNHNES). By using variables related to the state of the prosthesis and the need for prosthesis among oral examination data, the oral examination data were classified into two groups; group using removable denture and group in need of removable dentures. In addition, the variables of depression were classified into normal (0-4), mild depression (5-9), moderate depression (10-19), and severe depression (20-27) using the values of PHQ-9. For statistical analysis, logistic regression analysis was performed using SAS 9.4. Results: In the group in need of removable dentures, the risk of severe depression was statistically and significantly higher than the group using removable dentures. Conclusion: In patient who have lost multiple teeth, rehabilitation of the missing area with removable dental prosthesis is expected to decrease the occurrence of severe depression.

Association Between Cognitive Impairment and Oral Health Related Quality of Life: Using Propensity Score Approaches (인지기능과 구강건강관련 삶의 질의 연관성에 대한 연구: 성향점수 분석과 회귀모델을 중심으로)

  • Cha, Suna;Bae, Suyeong;Nam, Sanghun;Hong, Ickpyo
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.61-77
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    • 2023
  • Objective : This study analyzed the correlation between cognitive function and oral health-related quality of life (OHQoL). Methods : Demographic and clinical characteristics were extracted and utilized for subjects aged 45 years or older who participated in the 8th Korean Longitudinal Study on Aging in 2020. The dependent variable was the Geriatric Oral Health Assessment Index, and the independent variable was the level of cognitive function classified by the Mini-Mental State Examination scores. The analysis method used inverse probability of treatment weighting (IPTW). Then, the association between cognitive function and OHQoL was analyzed by multiple regression analysis. Results : Among the participants, 4,367 (71.40%) had normal cognition, 1,155 (18.89%) had moderate cognitive impairment, and 594 (9.71%) had severe cognitive impairment. As a result of analysis by applying IPTW, there was a negative correlation between the cognitive function group and OHQoL (normal vs. moderate: β = -2.534, p < .0001; normal vs. severe: β = -2.452, p < .0001). Conclusion : After propensity score matching, mild cognitive impairment showed a more negative association than severe cognitive impairment. Therefore, patients with cognitive impairment require oral health management education to improve OHQoL regardless of the level of cognitive impairment.