• 제목/요약/키워드: Admission Method

검색결과 517건 처리시간 0.03초

간호·간병 통합서비스 병동 간호사의 역할 모호성 개념분석 (Role Ambiguity of Comprehensive Nursing Care Unit Nurses: A Concept Analysis)

  • 이지선;김윤아;문세미;정은영;박하영
    • 보건행정학회지
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    • 제29권4호
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    • pp.502-512
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    • 2019
  • Background: The purpose of this study was to identify role ambiguity of comprehensive nursing care unit nurses. Methods: A concept analysis method by Walker and Avant was used to understand role ambiguity of comprehensive nursing care unit nurses. Results: The antecedents of role ambiguity of nurses at comprehensive nursing units were shortage of nurses, unclear admission criteria, and demands for customized nursing care according to severity. Attributes include ambiguity in role delegation, patient placement ambiguity, and professional ambiguity among nursing staff. The consequences were diminished job satisfaction due to excessive workload, difficulty in resolving role ambiguity due to the lack of work analysis studies, and poor outcome of nursing indicators. Conclusion: Improvement of nationwide awareness for comprehensive nursing care unit is required. Clear division at scope of practice for nursing staff in accordance of each medical institution's characteristics is essential. Nurses at comprehensive nursing care unit should understand nature of role ambiguity that occurs as they work in large groups. Nurses should promote communications between nursing staff and they must have volition to improve status quo. An additional research of comprehensive nursing care on the causes of role ambiguity in the practice of nursing care for ward nurses is needed, and management measures should be sought at the organizational level.

형방지황탕(荊防地黃湯)으로 증상 호전을 보인 성인형 스틸병 후유증 소양인(少陽人) 환자 1례(例) (A Case Study of 1 Soyangin patient with sequence of Adult type Still's disease who reported symptomatic improvement after being treated with Hyeongbangjihwang-tang)

  • 강미정;이지원;장현수;김윤희;이준희;이의주;고병희
    • 사상체질의학회지
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    • 제21권2호
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    • pp.144-152
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    • 2009
  • 1. Objective : This study aims to report symptomatic improvement of a Soyangin patient reporting general weakness, dizziness, gait disturbance, cold sensitivity, nocturnal sweating, and anorexia after treatment with Hyeongbangjihwang-tang. 2. Method : The patient's subjective and objective symptoms were observed daily, and the VAS scores for the main symptoms were recorded daily throughout the hospitalization period. 3. Result : The general condition of the patient improved by the end of the hospitalization period, where the VAS score dropped from VAS 10 to VAS 5 and the symptoms of dizziness, general weakness, cold sensitivity, and nocturnal sweating disappeared by day 4 of admission without recurrence. 4. Conclusion : Although the patient did not report diarrhea, one of the main Mangeum symptoms, the general symptoms improved with Hyeongbangjihwang-tang medication. This indicates that Hyeongbangjihwang-tang can be used to treat chief and subsidiary symptoms related to Mangeum symptomatic pattern when applied to the appropriate base and manifesting symptomology.

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세명대학교 부속한방병원 야간 진료실 내원환자의 실태분석 (Survey on the Actual Conditions of Patients in Semyung University Attached Oriental Medical Hospital Night Clinic.)

  • 민웅기;남창규
    • 대한한의학회지
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    • 제20권4호
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    • pp.50-61
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    • 2000
  • This study on the visits of the oriental medical night clinic of patients, was made to be used as reference data by examining and analyzing statistically the many actual conditions of patients who had been visited in Semyung University Attached Oriental Medical Hospital during the period from April, 1998 to March, 1999. The purpose of this survey was to understand the characteristics of patients, to evaluate the roles of Night Clinic of oriental medical hospital, and contribute to the systemic and efficient management of night clinic service. The results obtained were as follows: I. Distribution of sex: male 53% (421 cases), female 47% (379 cases) 2. The age distribution of patients showed the highest in under ten, followed by the thirties and fifties, forties and twenties in order. 3. The monthly distribution of patients showed the highest in October 1998, followed by May 1998 and February 1999 in order. 4. The daily distribution of patients showed the highest in Sunday, followed by Saturday, Monday, Friday and Tuesday in order. 5. The regional distribution revealed the highest in Jecheon with 76% of all patients, followed by Danyang in order. 6. The distribution of arrival time showed the highest in 7:00 pm~0:00 am (27%), followed by 5:30 pm~7:00 pm (23%) in order. 7. The admission rate in patients was 17%. Among them direct visiting rate was 85%. Circulatory systemic disease was the highest. 8. The highest incidences by disease were of motor system with 48% (394cases), followed by diseases in circulatory system with 19% (l48cases). The majority of the patients 67% was connected with two diseases. 9. The chief complaint of pediatric diseases was febrile seizure with 64% (32cases), digestive disease was abdominal pain with 44% (90cases), circulatory diseases was motor disturbance with 43% (83cases), motor system disease was leg pain with 37% (l19cases), respiratory disease was fever with 46% ( 41 cases). 10. In the treatment method, a major portion of treatment methods was acupuncture treatment with 32% (373cases), followed by acupuncture & herbal medicine treatment with 23% (275cases). The most commonly used herbal medicines were Hangsapyunguisan(l6%) and Ojeoksan(l4%).

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한방병원 산후조리센터 내 신생아의 Rota Virus 감염증에 대한 임상적 고찰 (A Clinical Study for Rota Virus Infection of Neonates in Oriental Medicine Hospital Postpartum Care Center)

  • 이정림;하광수;하수연;송인선;김선미
    • 대한한방소아과학회지
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    • 제19권2호
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    • pp.115-126
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    • 2005
  • Objective : The aim of this study is to investigate rota virus infection of neonates In the Postpartum care center. Methods : This clinical study was carried out with the 205 neonates who admitted to the Postpartum Care Center of ${\bigcirc}{\bigcirc}$ Oriental Medicine Hospital, from July, 2004 to July, 2005. Stools were examined daily with Rotazyme ELISA tests(Bio Line Rota Virus, SD Standard Diagnostics, INC.) for 3 days from the day of admission. Supplementary test was examined when change was found in stools. Results : Among 205 newborn babies, 58 cases turned out to be positive. The positive rate of rota virus was not significantly related to sex, birth weight, gestation age. But, it was significantly related to delivery method and it was higher in caesarean section group. The manifestation rates of symptoms were 51.7% in Rotazyme positive neonates. In the Rotazyme positive 58 cases, 30 cases(51.7%) had diarrhea, 8 cases had fever(13.8%), 1 case(1.7%) had vomiting. The positive rate of rota virus was higher during from october to march. There were 190 cases(92.2%) of mixed feeding and 15 cases(7.8%) of artificial feeding. There was significance between breast feeding and the positive rate of rota virus. There was no significance between hospital of birth and the rate of positive rotazyme test. Conclusions : A further study of neonates in postpartum care center is necessary as preference of postpartum care center was increased. And the oriental medicine treatment of rota virus IS expected to be effective, so a further study is necessary.

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Comparative validity of microalbuminuria versus clinical mortality scores to predict pediatric intensive care unit outcomes

  • Nismath, Shifa;Rao, Suchetha S.;Baliga, B.S.;Kulkarni, Vaman;Rao, Gayatri M.
    • Clinical and Experimental Pediatrics
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    • 제63권1호
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    • pp.20-24
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    • 2020
  • Background: Predicting the prognosis of patients admitted to the pediatric intensive care unit (PICU) is very important in determining further management and resource allocation. The prognostication of critically ill children can be challenging; hence, accurate methods for predicting outcomes are needed. Purpose: To evaluate the role of microalbuminuria at admission as a prognostic marker in comparison to standard Pediatric Risk of Mortality (PRISM) and Pediatric Logistic Organ Dysfunction (PELOD) mortality scores in children admitted to the PICU. Methods: This cross-sectional study was conducted from January 2015 to October 2016. Eighty-four patients aged 1 month to 18 years admitted to the PICU of teaching hospitals for more than 24 hours were enrolled by convenience sampling method. Microalbuminuria was estimated by spot urinary albumin-creatinine ratio. PRISM and PELOD scores were calculated using an online calculator. Outcome measures were PICU length of stay, inotrope usage, multiorgan dysfunction, and survival. ACR was compared with mortality scores for predicting survival. Results: Microalbuminuria was present in 79.8% with a median value of 85 mg/g (interquartile range, 41.5-254 mg/g). A positive correlation was found between albumin-creatinine ratio and PICU length of stay (P=0.013, r=0.271). Albumin-creatinine ratio was significantly associated with organ dysfunction (P=0.004) and need for inotropes (P=0.006). Eight deaths were observed in the PICU. The area under the curve for mortality for albumin-creatinine ratio (0.822) was comparable to that for PRISM (0.928) and PELOD (0.877). Albumin-creatinine ratio >109 mg/g predicted mortality with a sensitivity of 87.5% and specificity of 63.2%. Conclusion: Microalbuminuria is a good predictor of PICU outcomes comparable with mortality scores.

관절병증 질환자의 의료이용에 따른 의료비 및 생산성 손실비용 연구 (Medical expenses and lost productivity costs due to the medical use of research arthropathy disease)

  • 유인숙
    • 문화기술의 융합
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    • 제2권2호
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    • pp.51-63
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    • 2016
  • 본 연구는 관절병증질환자의 의료이용에 따른 의료비와 생산성손실비용 조사하고자 하였다. 본 연구를 위하여 2012년 한국의료패널 총 5,434가구, 15,872명을 이용하여 만19세 이상 관절병증질환자는 1,370명을 대상으로 하였다. 연구방법은 응급의료이용, 입원의료이용, 외래의료이용에 대한 평균의료이용횟수와 의료비를 구하였고, 연간관절병증 질환자의 응급생산성손실비용은 2012년 1일 평균임금 ${\times}$ N ${\times}$ 평균의료비를 곱하여 산출하였다. 연간응급 의료이용횟수는 1회, 의료비는 42,128,870원, 생산성손실비용은 98,640,000원이였다. 연간입원의료이용횟수는 4.79회, 의료비는 42,128,870원, 생산성손실비용은 945,036,820원이였다. 연간외래의료이용횟수는 12.7회, 의료비는 42,128,870원, 생산성손실비용은 91,252,728,000원이였다. 이상과 같은 결과를 바탕으로 다음과 같은 결론을 얻었다. 관절병증의 발생은 의료비증가와 생산성저하에 영향을 미칠 수 있으며 가구 및 환자에 있어 큰 부담이며 삶의 질도 저하될 것이다, 관절병증질환의 감소를 위한 운동 및 관리에 철저한 검토가 필요하다.

패킷 손실을 허용하는 가중치 기반 공정 패킷 스케줄링 (A Weighted Fair Packet Scheduling Method Allowing Packet Loss)

  • 김태준
    • 한국통신학회논문지
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    • 제35권9B호
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    • pp.1272-1280
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    • 2010
  • 대표적 가중치 기반 공정 패킷 스케줄링 방식인 WFQ(weighted Fair Queuing)는 자원의 공정한 배분과 더불어 개별 트래픽 흐름이 요구하는 품질을 보장할 수 있어 RSVP(resource reservation protocol) 라우터에 널리 이용되어 왔다. RSVP는 패킷의 손실 없이 트래픽 흐름의 요구속도와 종단간 지연한계를 보장할 수 있는 자원을 예약하고, WFQ 스케줄러는 예약된 자원을 이용하여 흐름의 품질보장을 실현한다. 그러나 품질 보장형 서비스라 하더라도 실제적으로 몇 %까지의 패킷 손실이 허용된다. 따라서 패킷 손실을 허용하도록 RSVP와 WFQ를 개선할 필요가 있다. 본 연구에서는 패킷 손실을 허용하는 WFQ 방식에 대해 연구하고, 그의 성능을 평가한다. 성능평가 결과 0.4%의 패킷 손실을 허용할 경우 40% 정도의 흐름 수용 능력이 개선되는 효과를 관찰하였다.

집중치료 후 증후군의 신체적 장애 측정도구에 관한 체계적 고찰 (Instruments to Assess Physical Impairments in Post-Intensive Care Syndrome: A Systematic Review)

  • 강지연;이민주;정연진;김수경;조영신;박정훈;이순영;홍지원
    • 중환자간호학회지
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    • 제11권1호
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    • pp.46-66
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    • 2018
  • Purpose : The purpose of this study was to systematically review the instruments utilized to assess physical impairment in post-intensive care syndrome (PICS) of intensive care unit (ICU) survivors. Method : Online databases searched were MEDLINE, Cochrane, CINAHL, and Embase. Studies that met the following criteria were included: 1) the study population exclusively had experience with ICU admission; 2) the study assessed pulmonary, neuromuscular, and physical functions; and 3) the study was published in English language journals after 2007. Results : A total of 56 instruments (2 pulmonary, 25 neuromuscular, 29 physical function) from 94 studies were reviewed. They were classified into self-report, observation, and measurement according to the type of assessment. No instrument measured all 3 areas of physical impairment. Five instruments were originally developed for the ICU patients. The most frequently applied instruments were the Medical Research Council and the 36-item Short Form Survey (physical component summary), which were used in 23 studies each. Only 13.8% of reviewed studies reported the reliability or validity of the instruments. Conclusion : Our results suggest that the appropriateness of instruments assessing physical impairment in PICS cannot be guaranteed. Despite the multidimensional concept of physical disabilities, most studies measured only one area, and studies that reported psychometric properties were limited. Accordingly, we propose to develop a unique and multifaceted instrument for ICU survivors.

랜덤 포레스트를 이용한 심전도 기반 생체 인증 (ECG-based Biometric Authentication Using Random Forest)

  • 김정균;이강복;홍상기
    • 전자공학회논문지
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    • 제54권6호
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    • pp.100-105
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    • 2017
  • 본 논문은 개인 인증 알고리즘에 관한 것으로 심전도를 이용한 생체 인증 방식은 특정 보정기준점을 추출하는 방법과 그렇지 않은 방법으로 분류할 수 있으며 본 논문에서 제안하는 방법은 특정 보정기준점을 추출하지 않는 방법으로 이산 코사인 변환과 랜덤 포레스트 분류기를 사용하였다. 심전도 신호는 R-Peak 점을 기준으로 단일 심박으로 나누었으며 각 심박의 특징 추출을 위해 이산 코사인 변환을 적용하였다. 이산 코사인 변환 계수는 정보가 저주파에 집중되는 특성이 있으므로 초기 저주파에 해당하는 40까지 값을 특징으로 랜덤 포레스트 분류기를 구성하였다. 랜덤 포레스트는 의사결정 트리의 앙상블 분류기로 결정 트리를 기본으로 하고 있으므로 빠른 학습 속도와 많은 양의 데이터 처리 능력, 다양한 클래스를 분류할 수 있어 실생활에 적용 가능하며 무엇보다 ID의 승인과 거절을 위한 임계값을 분류기 내부에서 조절할 수 있어 오 분류에 강건한 알고리즘을 구성할 수 있다. 18개의 심전도 파일로 구성된 MIT-BIT Normal Sinus Rhythm 데이터베이스를 선정하여 성능을 평가하였으며 99.99%의 심전도 인식률을 보였다.

소아 심경부 감염의 임상적 고찰 (Clinical Features and Treatment Outcomes of Pediatric Deep Neck Infection)

  • 문태현;이도준;박병건;이상준;정필상
    • 대한기관식도과학회지
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    • 제16권2호
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    • pp.115-120
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    • 2010
  • Background: Pediatric deep neck infection can cause critical complications in that they are seldom able to verbalize symptoms or cooperate with physical examination. The objective of this study is to identify the clinical characteristics according to age. Material and Method: A retrospective study was performed on 26 cases with pediatric deep neck infection during 12 years. Patients were classified infancy group (1-7 yr, 19.2%), preschool age group (7-15 yr, 30.8%) and school age group (15 yr-, 50%). We analyzed the age, sex, sites of abscess, predisposing factors, symptoms and compared onset, hospital date, laboratory and outcomes at each group. Results: In pediatric patients with deep neck infection, the age distribution was 18 males (69.2%) and 8 females (30.8%), the mean age was 7.4 years. The most common infection site was the anterior cervical triangle and submandibular space (19.2%). The most commonly known associated preceding disease was upper viral infection (34.6%), but we could not find the preceding diseases in most of cases (50%). Neck swelling (69.2%) was the most frequent symptom. The mean age of patients who performed neck CT was 8.23 years and neck US was 2.75 years. The younger patients were preferred to perform the neck US than the neck CT (p=0.022). The mean time from disease onset to admission was 9 days in the infancy, 5.5 days in the preschool aged and 5 days in the school aged group. The surgical treatment was performed in 30.8% of school aged, 62.5% of preschool aged and 100% of infancy group. Surgical treatment was preferred to younger patients (p=0.026). Conclusion: Abscess sites, size, and antibiotics susceptibility and especially patient age should be carefully considered in treating pediatric deep neck infection.

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