Purpose: The purpose of this study was to examine the effects of delirium care training program on the nurses' knowledge of delirium, self-confidence and performance levels in caring patients with delirium. Methods: The study was used a quasi-experimental design. The participants were 131 nurses in general nursing units in B and J hospitals. Sixty four nurses in B hospital were allocated into the experimental group and 67 nurses from J hospital into the control group. The delirium care training program was composed of lecture and clinical practice. Clinical practice of delirium care was applied everyday for 4 consecutive weeks starting from the admission day of the older adults(${\geq}70$ years old), using 'short CAM' and 'nursing checklist for delirium prevention'. Results: The knowledge of delirium, self-confidence in caring patients, and performance levels of nursing care were significantly increased in the experimental group compared to the control group. Conclusion: The findings of this study provided the evidence for the potential utility of the delirium care training program and underscored the needs of broader application of the training program of delirium care for nurses in general nursing units.
Objectives : Anemia is the center of interest in every maternity, both during pregnancy and lactation. The oriental postpartum care has one principle : to invigorate Qi and blood greatly. In this study, we seek to confirm that most sufferers of anemia recover under oriental postpartum care. To assure that this study had significance in non-iron supplement, we made a comparative study between oral iron supplement and non-iron supplement groups in oriental postpartum care. Methods : A comparative study was conducted to discern the difference in hemoglobin change between admission and after 2 weeks under the circumstances of 30 oral iron supplemented and 38 non-iron supplemented women who were admitted to the hospital attached to Woosuk University Oriental Medical College from April to August 2001 for postpartum care. Results : The mean hemoglobin level of after 2 weeks was 11.95 mg% (p<0.001). The mean hemoglobin level after 2 weeks was 11.65 mg% and 12.18 mg% in the iron supplemented and non-iron supplemented women respectively. The difference between the two groups was not significant. Conclusions : Oriental postpartum care overcomes anemia significantly in postpartum maternity. This is confirmed significantly under the non-iron supplement.
This study aimed to clarify any factors that may have effect on the appropriateness of hospital admission and hospitalization with the intention of facilitating more efficient occupancy of hospital beds and better medical services in the aspect of their quality, minimizing unnecessary occupancy of beds, and ultimately helping patients requiring acute treatments to use immediately hospitals. This paper selected 154 Stroke patients who left neurology department of one general hospital from March, 1, 2006 to September, 31, 2010 as targets to meet the rate according to medical care security and to see the trend of recent 4 years. As study method, this paper analized medical treatment record with AEP to evaluate the appropriateness of hospital admission and stay and the collected data was computerized through SPSS 12.0. Based upon the results above, the conclusion was drawn that the higher appropriateness of hospital admission and the shorter length of hospital stay will lead to the higher appropriateness of hospitalization. In other words, it is required to provide hospitalized patients with all kinds of behaviors including medical treatments and nursing care service, management of pharmaceuticals, tests, rehabilitation and symptoms, as well as instructions and information for patients. Meanwhile, as it was found that the length of hospital stay may affect the appropriateness of hospitalization, the longer length of hospital stay may result in reduced bed turnover rate. In this light, it is necessary to organize a task force team responsible for evaluation and control of the appropriateness of hospitalization and hospital stay length to improve the quality of medical service in a medical center, so that patients can leave the center timely. Ultimately, governmental supports such as expansion of long-term care facilities will reduce the necessary length of hospital stay so that patients with stroke can receive rehabilitative treatments and long-term care service shortly after completion of acute treatments.
Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.
Kim, Se Joong;Seo, Jeong-Su;Son, Myeung-Hee;Kim, Soo-Youn;Jung, Ki Hwan;Kang, Eun-Hae;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je-Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Yoo, Se Hwa;Kang, Kyung Ho
Tuberculosis and Respiratory Diseases
/
v.61
no.1
/
pp.46-53
/
2006
Background: Intra-abdominal hypertension (IAH) is defined as the presence of either an intra-abdominal pressure (IAP) ${\geq}12mmHg$ or an abdominal perfusion pressure (APP = mean arterial pressure - IAP) ${\leq}60mmHg$. Abdominal compartment syndrome (ACS) is defined as the presence of an IAP ${\geq}20mmHg$ together with organ failure. The purpose of this study was to investigate the prevalence of IAH and ACS on the day of admission and the effects of these maladies on the prognosis of critically ill patients in the ICU. Methods: At the day of admission to the ICU, the IAP was recorded by measuring the intravesicular pressure via a Foley catheter. The APACHE II and III scores were checked and SAPS II was also scored during the days the patients were in the ICU. The primary end point was the prevalence of IAH and ACS at the day of admission and the correlation between them with the 28-days mortality rate. The measurement of IAP continued until the 7th day or the day when the patient was transferred to the general ward before 7th day, unless the patient died or a Foley catheter was removed before 7th day. Patients were observed until death or the 28th day. Results: A total of 111 patients were enrolled. At the day of admission, the prevalence of IAH and ACS were 47.7% and 15.3%, respectively and the mean IAP was $15.1{\pm}8.5mmHg$. The rates of IAH for the survivor and the non-survivor groups were 56.5% and 71.4%, respectively, and these were not significantly different (p=0.593). Yet the rates of ACS between these two groups were significantly different (4/62, 6.5% vs. 13/49, 26.5%; Odds Ratio = 5.24, 95% CI = 1.58-17.30, p=0.004). Conclusion: In the present study, the prevalence of IAH was 47.7% and the prevalence of ACS was 15.3% on the day of admission. ACS was associated with a poor outcome for the critically ill patients in the ICU.
Ki Sung-Ho;Park Hyun-Joo;Choi Woong-Gil;Roh Hyung-Keun
Journal of The Korean Society of Clinical Toxicology
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v.2
no.2
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pp.151-153
/
2004
Causes of rhabdomyolysis can be divided into traumatic and nontraumatic, Among the nontraumatic rhabdomyolysis, it is known that ingestion of drugs is one of the common causes. However, there have been few reports that benzodiazepine overdose causes rhabdomyolysis, moreover there was no report about rhabdomyolysis after alprazolam overdose. We experienced a case of rhabdomyolysis after alprazolam overdose. A 51-year-old woman was brought to the emergency room 11 hours after ingestion of 30 tablets (15 mg) of alprazolam in a suicidal attempt. On admission she was comatose and her CK level was 8,290 lUlL. The CK level increased up to 25,598 IU/L 10 hours after admission, but she became alert on the third day. Subsequently the CK level decreased gradually with supportive care without renal impairment and she discharged from the hospital on the $10^{th}$ day. Although a pressure effect on the dependent portion of the body due to mental alteration before admission might have caused the rhabdomyolysis, the alprazolam, per se, cannat be ruled out for the cause.
The purpose of this study is to examine the feeding and nutritional status of enteral tube-fed elderly patients. Subjects included 77 elderly hospitalized patients who had received enteral nutrition more than one week before admission. Medical records on admission and actual feeding volume were used to assess anthropometric, biochemical, and nutritional status. Most patients manifested disorders of the nervous system (93.5%) and the average duration of tube feeding was 13.9 months. The average feeding volume of formula was 1,107 mL per day and the mean ratios of calorie and protein (supplied vs. required) were 81.7% and 80.9%, respectively. At admission, 57.4% of the patients were malnourished according to the institutional criteria. Patients receiving less than 80% of the required calories were in worse nutritional status compared with those receiving more than 80% of the required calories. Body mass index, percent ideal body weight, serum albumin level and blood lipid levels (total cholesterol, HDL-cholesterol, triglyceride) were significantly lower in patients receiving less than 80% of the required calories. These results indicate the high prevalence of malnutrition and the need for increased attention and nutritional care of elderly patients undergoing long-term enteral nutrition.
Chung, Mee Hye;Yun, Sun Ok;Park, Jeong Hee;Chu, Soon Ok;Oh, So Young;Kim, Mi Young
Journal of Korean Clinical Nursing Research
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v.17
no.3
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pp.443-454
/
2011
Purpose: The purpose of this study was to investigate the predictors of delirium in patients after orthopedic surgery. Methods: Participants were 121 orthopedic surgery patients from one university affiliated hospital located in Seoul. The instrument of Delirium Observation Screening Scale (DOS) developed by Schuurmans et al. (2003) was utilized. Data were collected from September 1st, 2010 to March 31st, 2011 and analyzed using SPSS 12.0 with descriptive statistics, t-test, chi-square test and logistic regression. Results: The delirium in patients after orthopedic surgery was occurred in 9 (7.4%) out of 121 patients. Several factors were associated with the delirium occurrence age, admission route, preadmission Activity of Daily Living (ADL), preadmission hearing aid use, preadmission walking degree, diagnosis, type of surgery, Intensive Care Unit (ICU) stay after surgery, restraint, drainage tube, time of admission to surgery, preoperative albumin and preoperative sodium. Preadmission ADL, preoperative sodium and time of admission to surgery were the significant predictors of the delirium occurrence. Conclusion: Study results may help nurses predicting and detecting delirium early and providing preventive measures to the patients with high risk of delirium after orthopedic surgery.
Journal of Korean Academy of Fundamentals of Nursing
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v.19
no.2
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pp.168-178
/
2012
Purpose: The purpose of this study was to compare self-care behavior, diabetes-related stress and stress coping style among 3 blood glucose control groups (good, inadequate, and poor blood glucose control groups). Methods: Participants were 102 type 2 diabetic patients (good group: 41, inadequate group: 31, poor group: 30). Data were collected from Feb 19 to Mar 24, 2010 and were analyzed using Chi-square, Fisher's exact test and ANCOVA with SPSS/WIN 12.0. Results: Using ANCOVA with frequency of admission, and illness duration as covariates, significant differences were found among the 3 groups in self-care behavior (total score) and the exercise subscale. Using ANCOVA significant differences were found among 3 groups in diabetes-related stress (total score), emotional burden subscale and regimen distress subscale. Using ANCOVA no difference in stress coping was found among the 3 groups, but there was a significant difference in the problem-oriented coping subscale. Conclusions: Self-care behavior, diabetes-related stress, and stress coping style are factors influencing blood glucose control. The results of this study suggest that for improving blood glucose control, self care education program focused on diet and exercise in addition to stress management program for promoting problem oriented coping capability are recommended.
Purpose : This study aimed to identify the prevalence and risk factors of cognitive impairment in survivors discharged from the intensive care unit (ICU). Methods : This secondary analysis study utilized data from a multicenter prospective cohort of post-ICU patients. We analyzed the data of 175 patients enrolled in the primary cohort who completed the cognitive function evaluation three months after ICU discharge. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. The cut-off points for cognitive impairment were < 23 for face-to-face evaluation and < 18 for telephone evaluation. Results : The prevalence of cognitive impairment three months after ICU discharge was 32.6%. Significant risk factors for cognitive impairment were age ≥ 60 years (OR=10.52, 95% CI=3.65~30.33, p<.001), education < high school graduation (OR=2.53, 95% CI=1.07~6.01, p=.035), unplanned ICU admission (OR=4.01, 95% CI=1.45-11.14, p=.008), and delirium in the ICU (OR=4.33, 95% CI=1.08-17.23, p=.038). Conclusion : ICU nurses should use preemptive strategies to reduce post-ICU cognitive impairment of patients with risk factors. It is necessary to frequently assess and detect early delirium in critically ill patients, while attempting various non-pharmacological interventions.
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