• Title/Summary/Keyword: 중환자실 환자

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Duodenal Complication After Open Heart Surgery Report of Three cases (개심술후 발생한 십이지장궤양 합병증 -3례 보고-)

  • Heo, Jae-Park;Kim, Gi-Bong
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1251-1253
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    • 1997
  • Gastrointestinal complications, especially duodenal complication after cardiopulmonary bypass are rare, but often fatal. We experienced 1 case of duodenal ulcer bleeding and 2 cases of duodenal ulcer perforation developing after cardiopulmonary bypass from August 1994 to April 1996. In the case of duodenal ulcer bleeding, palpitation, dizziness, tachycardia and melena were the clues leading to diagnosis, and in the cases of perforation, abdominal distension with pain, tachycardia, hypotension, oliguria were the clues. Duodenal perforations were diagnosed by abdominal paracentesis. The patient with duodenal bleeding was treated by H-2 receptor antagonist, antacids and transfusion. And emergency laparotomy was required for the patients with duodenal perforation. In addition to ulcer prophylaxis including H-2 receptor antagonist and antacids, a high index of suspicion and timely surgery are necessary for early diagnosis and appropriate treatment of duodenal complication developing af er cardiopulmonary bypass.

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The Development and Effects of a Tailored Simulation Learning Program for New Nursing Staffs in Intensive Care Units and Emergency Rooms (중환자실과 응급실 초보간호사를 위한 맞춤형 시뮬레이션 학습프로그램 개발 및 효과)

  • Kim, Eun Jung;Kang, Hee-Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.21 no.1
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    • pp.95-107
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    • 2015
  • Purpose: The purpose of this study was to develop a tailored simulation learning (SL) program and to evaluate the effects of the program on the clinical competency, clinical decision-making competency, and communicative competency of new nursing staffs in intensive care units (ICU) and emergency rooms (ER). Methods: In this quasi-experimental study, fifteen nurses were assigned to the experimental group and fifteen to the control group. The experimental group was given the SL program of four sessions, whereas the lectures of four sessions were given to the control group. Data were analyzed using a $x^2$-test, Mann-Whitney U test, and Kruskal-Wallis test with an SPSS program. Analysis of covariance was used to treat the covariate of pre communicative competency between the experimental and control groups. Results: Based on the education needs of new nursing staffs in ICUs and ERs, three learning scenarios and one evaluating scenario were developed for the SL program. The score for clinical competency, clinical decision-making competency, and communicative competency were significantly higher in the experimental group compared with the control group. Conclusion: The SL program is an effective learning strategy for new nursing staffs in ICUs and ERs. These findings suggest that an SL program be offered as an alternative for new nurse orientation and continuing nurse education.

Nutritional Assessment of ICU Inpatients with Tube Feeding (경관급식을 공급한 중환자실 환자의 영양상태 평가)

  • Kim, Yu-Jin;Seo, Jung-Sook
    • Journal of the Korean Dietetic Association
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    • v.21 no.1
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    • pp.11-24
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    • 2015
  • This study investigated the general status of tube feeding for intensive care unit (ICU) inpatients and evaluated the consequent nutritional status of patients. This study was approved by the Institutional Review Board (IRB) of a general hospital located in Daegu metropolitan city. The subjects of this study were 80 adult patients who had been admitted to the ICU of a hospital, received fed tube feeding, and then been discharged. The differences in nutrition screening indicators, including percentage ideal body weight (PIBW), serum albumin, hemoglobin, total lymphocyte count, and total cholesterol, before and after tube feeding according to body mass index (BMI) or nutrient feeding levels were investigated. The ratios of actually provided amounts to calorie and protein requirements of patients were $72.8{\pm}15.8%$ and $72.6{\pm}19.8%$, respectively. The change in PIBW before and after tube feeding was significantly different among the BMI groups (P<0.01). The change in hemoglobin concentration before and after tube feeding was also significantly different among the BMI groups (P<0.01). When subjects were divided into three groups (<60%, 60~79%, ${\geq}80%$) according to the ratio of actually provided calories to required calories, there was no significant difference in nutrition screening indicators before and after tube feeding. When the subjects were divided into three groups (<60%, 60~79%, ${\geq}80%$) according to the ratio of actually provided protein to required protein, serum albumin concentration showed a significant difference among the groups before and after tube feeding (P<0.05). Therefore, an intensive nutrition intervention program would be needed for the nutritional improvement of ICU inpatients receiving tube feeding.

The Relationship among Dementia care Knowledge, Attitudes toward to dementia and Approach to dementia care of Nurses (간호사의 치매케어 관련 지식, 치매에 대한 태도 및 치매간호 접근법과의 관계)

  • Lee, Mi-Ra
    • Journal of Digital Convergence
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    • v.14 no.12
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    • pp.357-367
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    • 2016
  • The purpose of this study was to examine the relationships among dementia care knowledge, attitudes toward to dementia and approach to dementia care of nurses. The participants were 202 nurses in G hospital of P city. The mean score of dementia care knowledge was 11.02, attitude toward dementia was 40.15 and approach to dementia care was 7.90. The dementia care knowledge was significant difference for sex(t=-2.424, P<.05), education level(F=2.932, P<.05) and work unit(F=2.268, P<.05). The dementia care knowledge was positively correlated with attitude toward to dementia(r=.162,P<.05 ). The predictors of dementia care knowledge were Emergence Room(${\beta}=-1.568$, p<.05) and Intensive Care Unit(${\beta}=-1.682$, p<.05). The result suggest that it is necessary to develop convergence education program to improve dementia care knowledge and attitudes toward to dementia to give high quality nursing care for patients with dementia.

Study for the sampling method using simulation in clinical data (시뮬레이션을 이용한 임상자료의 샘플링 방법 연구)

  • Sohn, Ki-Cheul;Kim, Dal-Ho
    • Journal of the Korean Data and Information Science Society
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    • v.23 no.4
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    • pp.677-682
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    • 2012
  • There are lots of sampling design which is determined for sample survey in various fields. Especially, it is important problem for clinical data because basic characteristic variables by group which consist of experiment group and control group in population should be reflect to sample. Therefore, frequencies, center scales and dispersion scales of variables by group in population should be similar in sample. But usual sampling design is very complicate so it is difficult to use in practice for researcher. In this paper, we consider the sampling method using simulation. We applied the proposed method to colon cancer data from a hospital. We compare basic characteristic variables between population and sample with mean, frequency and statistic hypothesis test.

Risk Factors of Delirium in ICU Patients with Acute Poisoning (중환자실 급성중독환자에서 섬망의 위험인자)

  • Kim, Hee Yeon;Cha, Kyung Man;So, Byung Hak
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.14-20
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    • 2019
  • Purpose: This study estimated the incidence of delirium and associated risk factors and outcomes in ICU patients with acute poisoning. Methods: Data were collected from ICU patients over 18 years of age that were admitted via the emergency center after presenting with poisoning from 2010 to 2015. Delirium was assessed retrospectively using the Intensive Care Delirium Screening Checklist (ICDSC). Risk factors were evaluated by univariate and multivariate analysis. Results: A total of 199 patients participated in this study and 68 (34.2%) were diagnosed with delirium based on the ICDSC score. The delirium group showed a significantly higher association with prolonged length of stay in the hospital and ICU in comparison with the non-delirium group. The delirium group was associated with greater use of physical restraint. A statistically greater number of patients with pharmaceutical substance poisoning developed delirium over a short period of time than those with non-pharmaceutical substance poisoning. There was no significant difference between the two groups with respect to age, sex, past history, GCS score, vital signs, application of ventilator care and renal replacement therapy. Conclusion: The finding that the delirium group had a greater length of stay in both the hospital and the ICU is consistent with the results of previous worldwide studies of the effects of delirium on the prognosis of patients who were admitted to the ICU, suggesting the possibility for domestic application. Additionally, use of physical restraint was positively related to the incidence of delirium. Thus, interventions for minimizing the use of physical restraints and considering alternatives are needed.

Effects of Nurse Staffing Level on In-hospital Mortality and 30-day Mortality after Admission using Korean National Health Insurance Data (간호사 확보수준이 입원 환자의 병원사망과 입원 30일 이내 사망에 미치는 영향)

  • Kim, Yunmi;Lee, Kyounga;Kim, Hyun-Young
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.1
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    • pp.1-12
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    • 2022
  • Purpose: The purpose of this study is to investigate the association between the nurse staffing level and the patient mortality using Korean National Health Insurance data. Methods: The data of 1,068,059 patients from 913 hospitals between 2015 and 2016 were analyzed. The nurse staffing level was categorized based on the bed-to-nurse ratio in general wards, intensive care units (ICUs), and hospitals overall. The x2 test and generalized estimating equations (GEE) multilevel multivariate logistic regression analyses were used to explore in-hospital mortality and 30-day mortality after admission. Results: The in-hospital mortality rate was 2.9% and 30-day mortality after admission rate was 3.0%. Odd Ratios (ORs) for in-hospital mortality were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.72, 95% CI=0.63~0.84) and in ICUs with a bed-to-nurse ratio of less than 0.88 compared to that with 1.25 or more (OR=0.78, 95% CI=0.66~0.92). ORs for 30-day mortality after admission were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.83, 95% CI=0.73~0.94) and in ICUs with a bed-to-nurse ratio of less than 0.63 compared to that with 1.25 or more (OR=0.85, 95% CI=0.72~1.00). Conclusion: To reduce the patient mortality, it is necessary to ensure a sufficient number of nurses by improving the nursing fee system according to the nurse staffing level.

The Effectiveness of Environmental Management through Environmental Surveillance (환경감시를 통한 환경관리의 효과)

  • Mi Hyang Lee;Jae Yeun Kim;Sang Ha Kim
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.6
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    • pp.557-561
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    • 2023
  • This study aims to assess how effective environmental management can be accomplished through monitoring of environmental conditions in patient discharge rooms within healthcare facilities through direct observation and the use of fluorescent markers. From March to July 2013, this study evaluated 448 check-out beds in wards and intensive care units before and 494 after intensive environmental monitoring activities. The collected data were analyzed using the SPSS 21.0 program. According to the study's findings, direct observation increased from 95.2% prior to the implementation of intensive environmental monitoring activities to 98.9% following the implementation, which was statistically significant. The non-detection rate of fluorescent markers exhibited an increase from 96.1% prior to the commencement of intensive environmental monitoring activities to 98.0% following their implementation. However, it should be noted that this observed increase was not deemed statistically significant. In light of the results of this research, it is imperative to evaluate the effectiveness of environmental management by employing a variety of assessment methods, including direct observation and fluorescent markers.

A Systematic Review of Nursing Interventions in Patients with Extracorporeal Membrane Oxygenation (ECMO) (체외막산소공급(ECMO) 치료 환자의 간호 중재에 대한 체계적 고찰)

  • Su-Min Park;Guan-Woung Jo
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.3
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    • pp.237-247
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    • 2024
  • Purpose : This study aimed to systematically review the effectiveness of nursing interventions for patients receiving extracorporeal membrane oxygenation (ECMO). As the use of ECMO increases in critical care settings, it is important to understand how nursing interventions affect patient outcomes, survival, and complication rates. Methods : This systematic review followed the preferred reporting items for systematic reviews and meta-analysis guidelines. A literature search was performed using terms related to ECMO and nursing interventions in several international electronic databases including CINAHL, Embase, MEDLINE, and Web of Science. Studies were screened and selected according to predefined eligibility criteria, focusing on those that evaluated the impact of nursing interventions on adult. Data extraction and risk-of-bias assessment were independently performed by two researchers. Results : A total of 647 studies were identified, and seven met the inclusion criteria for qualitative analysis. The included studies demonstrated that high-quality nursing care significantly improves clinical outcomes and reduces complications in patients receiving ECMO. Effective nursing interventions included prone positioning combined with ECMO for patients with acute respiratory distress syndrome, meticulous infection control, comprehensive and continuous nursing protocols, skilled nursing, and multidisciplinary management. These interventions have been shown to improve oxygenation, reduce complications, such as bleeding, manage blood pressure, and enhance overall clinical outcomes. Conclusion : High-quality nursing interventions are critical to improve survival and reduce complications in patients receiving ECMO. Implementing a multidisciplinary approach and comprehensive nursing protocols, including infection control and psychological support, is essential for the effective management of these patients. The findings of this study provide a foundation for the development of practical guidelines and educational programs to improve the quality of care for patients undergoing ECMO, ultimately enhancing the effectiveness of ECMO treatment and patient outcomes.

Review of Music Interventions for Family Caregivers of Patients in Medical Settings (국내·외 의료 환경 내 가족 참여 음악 중재 연구 고찰)

  • Choi, Da In
    • Journal of Music and Human Behavior
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    • v.14 no.1
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    • pp.17-39
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    • 2017
  • This study aimed to review Korean-written and English-written studies on music interventions for family caregivers of patients in medical settings. Electronic databases were searched for studies published through 2016, using the keywords of music intervention, family caregivers, and specified settings. A total of 43 studies, five Korean-written and 38 English-written studies, were selected. The results showed that caregivers were the sole participants in five studies (family-only), and caregivers and patients co-participated in 38 studies (family-patient). While diversified types of family participation were included in the English-written studies dating back to the late 1980s, the Korean-written studies were the only ones to include patients as co-participants with their caregivers. Studies with family-only participation tended to be conducted in palliative care units and usually included the spouses of the patients. Meanwhile, studies with family-patient participation tended to be conducted in NICU or cancer units and usually included the parents of the patients. Furthermore, studies with family-only participation tended to apply passive music activities, and those with family-patient participation tended to use active music activities. The results of this study present baseline data on how family-centered care can be included in music interventions in medical settings in Korea, suggesting future studies to systematically analyze music interventions for family caregivers in terms of diversified patient- and caregiver-related factors.