• Title/Summary/Keyword: Admission care

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Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission (중환자실 환자의 입실 시 욕창 유병률과 위험요인)

  • Kwak, Hye Ran;Kang, Jiyeon
    • Korean Journal of Adult Nursing
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    • v.27 no.3
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    • pp.347-357
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    • 2015
  • Purpose: This study was conducted to assess the prevalence rate of, and the risk factors for pressure ulcers in critical patients at the time of intensive care unit (ICU) admission. Methods: We reviewed the electronic medical records of 2,107 patients who were admitted to the intensive care units in D university hospital between January 1 and December 31, 2012. The collected date were analyzed by ${\chi}^2$-test, t-test, and multi-variate logistic regression with forward stepwise selection using the SPSS program version 21. Results: The prevalence rate of pressure ulcers at the ICU admission was 23.7%. Risk factors significantly affecting pressure ulcers carrying were the age of 80 years or older (OR=3.70, 95% CI: 1.80~7.60), body weight less than 50 kg (OR=2.82, 95% CI: 1.74~4.56), sedated consciousness (OR=6.10, 95% CI: 3.57~10.40), use of ventilator (OR=1.60, 95% CI: 1.02~2.49), use of vasopressors (OR=1.53, 95% CI: 1.09~2.14), ICU admission via operation room (OR=0.49, 95% CI: 0.29~0.85), and hospital admission from nursing homes (OR=13.65, 95% CI: 3.02~61.72). Conclusion: The findings of this study suggested that the prevention efforts for pressure ulcers should be given in prior to ICU admission. Further research is necessary for developing nursing interventions for preventing pressure ulcers in the pre-ICU stage.

Study on the Aseptic Care during Labor and Delivery, and their Effects to Peripheral Morbidity (분만시 무균처치와 산후감염의 이환율과의 관계에 대한 연구)

  • 이경혜
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.141-157
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    • 1971
  • The peripheral infection is one of the major causes of maternal death, and although it is preventable through an effective prenatal as well as postnatal care its morbidity is increasing due to bacterial resistant to an effective antibiotics. The primary purpose of this study was to investigate the peripheral morbidity of 949 parturients who were admitted to the Obstetrics and Gynecologic department of Ewha Woman's University Hospital from January 1971 to September 1971. Among the 949 parturients, especially 40 normal parturients were selected (20, control soup was given complete aseptic care during labor and delivery and post delivery: 20, compare group was given the ordinary care practiced during labor and delivery and maternal ward of Ewha Woman's University Hospital) for bacteriologic test on vaginal flora twice, on admission and on complete cervical dilatation of each parturient. The results obtained from this study were as follows; 1. Majority of parturients age were 21 to 35 years old(90.83%), and educational level of 949 parturients was above high school. A large number of parturients socioeconomic level (according to their husbands' job) were moderate. 2, Among the 949 parturients, multipara (55.9%) were a little more than primipara (44. 1%) and 38.84% of parturients had experienced aborition. 3. In deliverty types, normal deliveries (804 cases) were more than cesarean section deliveries (145 cases) The peripheral morbidity after normal deliveries was 0.5%, and cesarean section deliveries, 23.45%. 4. Among 949 parturients incidence of hemorrhage eases (500cc or more bleeding) showed the higher peripheral morbidity (24.86%) than other cases (bleeding less than 500cc, 7.83%). 5. The majority of parturients (81.03%) had teen taking antenatal care, but most of them were taken irregular antenatal care. On the other hand, on admission, the parturients with complication were 30.32%, and their peripheral morbidity showed much higher (7.02%) than those with no complication (2.71%). 6. The incidence of peripheral morbidity in premature ruptured membrane was higher (10.91%) than normal parturienta (1.73%). 7. In the result of aseptic care during labor and delivery and post delivery, the number of cultured bacteria was legs in control group than Compare group (in control group, on admission 17, on complete cervical dilatation 12: in compare group, on admission 21 on complete cervical dilatation 21) . The most common bacteria were Staphylococcus (control group 14 on admission, compare group 16 on admission), and next Streptococcus, E- Coil, Bacillus Subtilis, in order. Also in control group the number. of colony were reduced (43%) more than in Compare group. Transient temperature elevation from 37℃ to 37.4℃ were noted in compare group (50%) than in control group (30%), and there was no one indicated above 38℃. In conclusion, the aseptic care is the test way of preventing peripheral infection as well as decreasing the puerperal morbidity. Therefore the most important nursing care is the aseptic care for each parturient during labor and delivery and peat delivery and also all the instruments must be cleaned and sterilized.

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Experience of Surgical Treatment through Ambulatory Care Unit (일 병원에서 통원병실을 이용한 수술적 치료의 경험)

  • Sohn, Jong-Min;Ha, Nan-Kyung
    • Quality Improvement in Health Care
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    • v.8 no.1
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    • pp.84-94
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    • 2001
  • Background : in order to adapt to changes of the medical environm interests that is drawn in ambulatory surgery are increased as a method of approaching a patients' satisfaction and cost-effective management. The purpose of this study is to a assess the operation which is able to perform through ambulatory care unit, to identify the problem in ambulatory surgery, and to increased the opportunity of ambulatory surgery with safety. Methods : Between May 13th, 1998 and June 30th, 2000, we performed surgical treatment through ambulatory care unit, and evaluate the results of them. The sorts of operation, duration of stay in the hospital, total cost of treatment, satisfaction of patients and safety if anesthesia were assessed. Results : We performed ambulatory surgery without serve complications and the patients were satisfied with surgical treatment through ambulatory care unit. In comparison of ambulatory and admission surgery, there was a reduction of cost to 16.7~25.3% in ambulatory surgery. Also, the duration of admission was 2 days shorter than admission surgery. Conclusions : According to our results, the surgical treatment through ambulatory care unit is safe and useful method that increase the quality of medical service, satisfaction of patients and reduce the cost of treatments.

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The Here and Now of Admission Counseling at Child-Care Centers - With a Focus on the Episodes and Metaphors as Used by the Principals - (어린이집 입학상담의 지금-여기(here and now) : 원장들의 에피소드와 은유를 중심으로)

  • Kim, Soo-Hyang;Kwon, Eun-Joo;Chung, Kyung-Hwa;Lee, Young-Rim
    • Korean Journal of Child Studies
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    • v.32 no.3
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    • pp.221-239
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    • 2011
  • The purpose of study is to understand how a principal of a child-care center and parents accept different episodes and experiences in admission counselling and their use of metaphorical expressions about this, and to illuminate the current state of play by examining the requirements of parents in selecting a child-care center. The subjects were 10 principals of private child-care centers located in the Gyeongsangbuk province of Korea, and the research materials for episodes and metaphors were collected and analyzed by means of in-depth and telephone interviews during an application period. In terms of the overall climate of the admission counselling, as shown in the various episodes, our results indicated that an increase of parents' demands occurred through a primarily consumer-centered environment, and the sudden increase in a fathers' participation, the inside circumstances of admission counselling in progress throughout the year, the non-existence of respect and credibility and the continuity of conflicts and were all observed to co-exist. In terms of the emotional meaning of counselling via metaphors, the following emotions could be inferred; hopelessness, anger, lethargy, stress, fear and eagerness. It is anticipate that this study will make a meaningful contribution to better illuminating and improving the current climates of here and now admission counselling.

Development of Performance Measures Based on Nursing Process for Admission and Discharge Care (간호과정 적용 평가도구 개발 -입원 및 퇴원 시 간호를 중심으로-)

  • Kim, Keum Soon;Kim, Jin A;Choi, Yun Kyoung;Kim, Eun Man;Kim, Yu Jeong;Kim, Mi Ae;Kim, Kyoung Ok;Kim, Eul Soon
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.2
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    • pp.123-137
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    • 2011
  • Purpose: This study was conducted to develop standards ensuring nursing process-based care of patient admission and discharge, to develop a performance measurement tool evaluating the care applied according to the standards, and finally to determine validity of the standards and the tool. Methods: The standards and the tool were reviewed by a panel of experts and refined based on the panel's suggestions. Validity of the standards and the tool were examined through surveying a total of 302 hospital nurses. Results: The mean validity scores of the performance measurement standards and the tool were 4.11 and 4.09, respectively, out of 5.00. So the performance measurement standards and the tool in this study were found to be acceptable in evaluating quality of nursing care provided at patient admission and discharge. Conclusion: This result indicates that the performance measurement standards and the tool developed in this study are valid instruments to monitor and improve quality of nursing care for patient admission and discharge.

A Study of the Factors Causing Delayed Reimbursement of Medical Insurance Benefit (의료보험 진료비 지급 지연요인 - 병원요인과 보험자 요인을 중심으로 -)

  • Sohn, Myong-Sei;Lee, Young-Doo;Chun, Ki-Hong
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.259-267
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    • 1989
  • The objective of this study was to analyze the influence of the hospital and insurer in causing delayed reimbursement of medical insurance benefits. We analyzed major variables at three different sized hospitals to examine the effect of the hospital and insurer using the two-way ANOVA method. The results were as follows: 1. The time interval between claim by hospitals and payment of the benefit was statistically different according to hospital in both admission and outpatient care. 2. The time needed by the insurer for investigating the claims was statistically different according to hospital and insurer in both admission and outpatient care. There was interaction between the hospital and insurer factors in outpatient care. 3. Although there was interaction between the hospital and insurer factors in admission care, the time interval between claim and payment was statistically different. In outpatient care, the payment interval between claim and payment was also statistically different according to the hospital and insurer.

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The evaluation of admission-discharge module system by OCS (입.퇴원 module 시스템의 효과 분석 -ocs 입원 관리 시스템 효과 분석-)

  • Song, Jung Hup
    • Quality Improvement in Health Care
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    • v.12 no.1
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    • pp.62-76
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    • 2006
  • Background : There were so many patients who are waiting for admission in Emergency room in spite of more than one hundred empty beds everyday. This study was conducted to evaluate admission-discharge module system by OCS which reduce empty beds. Methods : The data of bed utilization in general beds from 2004 were reviewed. For evaluation of performance at admission-discharge module system by OCS, the change of Occupancy of bed were calculated. Results : The percentage of Average Bed Emptiness was changed from 13.8% to 9.2%. The residents in surgery(100%) and in internal medicine(75.5%) approved this system. Conclusion : The personnel in hospital recognized that it was very important to manage bed. The management of beds by OCS was helpful to reduce empty beds and was important.

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Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network

  • Lee, Na Hyun;Nam, Soo Kyung;Lee, Juyoung;Jun, Yong Hoon
    • Clinical and Experimental Pediatrics
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    • v.62 no.10
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    • pp.386-394
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    • 2019
  • Background: Preterm infants have difficulty maintaining body temperature after birth. However, clinical guidelines advocate that neonatal body temperature should be maintained at 36.5℃-37.5℃. Purpose: We aimed to investigate the incidence of admission hypothermia in very low birth weight (VLBW) infants and to determine the association of admission temperature with in-hospital mortality and morbidities. Methods: A cohort study using prospectively collected data involving 70 neonatal intensive care units (NICUs) that participate in the Korean Neonatal Network. From registered infants born between January 2013 and December 2015, 5,343 VLBW infants born at less than 33 weeks of gestation were reviewed. Results: The mean admission temperature was 36.1℃±0.6℃, with a range of 31.9℃ to 38.4℃. Approximately 74.1% of infants had an admission hypothermia of <36.5℃. Lower birth weight, intubation in the delivery room and Apgar score <7 at 5 minutes were significantly related to admission hypothermia. The mortality was the lowest at 36.5℃-37.5℃ and adjusted odd ratios for all deaths increased to 1.38 (95% confidence interval [CI], 1.04-1.83), 1.44 (95% CI, 1.05-1.97) and 1.86 (95% CI, 1.22-2.82) for infants with admission temperatures of 36.0℃-36.4℃, 35.0℃-35.9℃, and <35.0℃, respectively. Admission hypothermia was also associated with high likelihoods of bronchopulmonary dysplasia, pulmonary hypertension, proven sepsis, pulmonary hemorrhage, air-leak, seizure, grade 3 or higher intraventricular hemorrhage and advanced retinopathy of prematurity requiring laser therapy. Conclusion: A large portion of preterm infants in Korea had hypothermia at NICU admission, which was associated with high mortality and several important morbidities. More aggressive interventions aimed at reducing hypothermia are required in this high-risk population.

Medications at the End of Life Care for Terminal Cancer Patients during Their Last Admission (말기 암 환자의 마지막 입원 동안 임종돌봄시의 약제들)

  • Kim, Do-Yeun
    • Journal of Hospice and Palliative Care
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    • v.13 no.1
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    • pp.7-12
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    • 2010
  • Purpose: To evaluate medications at the end of life care for terminal cancer patients during their last admission. Methods: Medical records of terminal cancer patients during their last admission from July 2003 to April 2008 at a district academic hospital were evaluated. Patient's characteristics, therapeutic drug classification during their last admission and on the patient's day of death, and the administrated route and number of medications on the patient's day of death were analyzed. Results: Total 81 patients were included. The median patient age was 63 years. The median length of admission was 18 days (range: 1~101). 54% of the patients had more than one comorbidities. The most frequently prescribed drugs during the last admission were opioid analgesics (63%), followed by antibiotics (58%) and antacids (53%). On the day of death, common medications were antibiotics (59%), antacids (58%), and opioid analgesics (46%). Intravenous injection was given to 81% of the patients and intramuscular injection was given to 16% of the patients on the day of patient's death. Number of medications prescribed to patients was between 0 and 11 (median: 3) and 12% (10/81) of the patients took over 8 medications including intravenous and oral drugs on the day of death. 6% (5/81) of the patients took potentially futile medications, like multivitamin or statin until the day of death. Conclusion: This study suggests that potentially futile medications and uncomfortable care were given to terminal cancer patients. Multicenter-based studies are necessary to diminish futile medications by essential medication at the end of life care for terminal cancer patients.

Study on the Experience of Mother-Daughter Relationship through the Process of Admission to Nursing Care Facilities (요양보호시설 입소 과정을 통해 본 모녀관계 경험연구)

  • Seo, Seung-Hui;Kim, Min-Ji
    • The Journal of the Korea Contents Association
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    • v.18 no.12
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    • pp.161-172
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    • 2018
  • The purpose of this study is to investigate the experience of the mother-daughter relationship among middle-aged women in depth through the process of admission to nursing home facilities of their dementia mother. For the purpose, 8 middle-aged women whose dementia mothers were admitted to nursing care facilities were selected as research subject, and data collection was carried out through individual interviews. As a result of this research based on the phenomenological method of Colazzi, 3 categories, 6 sub-categories, and 17 subject bundles were derived. Research results can be summarized as follows: First, the mother-daughter relationship was dramatically reversed in the process of mother's admission to the nursing care facilities. Second, in the process of dementia mother's admission to the nursing care facilities, it was confirmed that daughters rather than sons were in an independent position regarding care and management. Third, in the process of dementia mother's admission to the nursing care facilities, it turned out that the entire family experiences depression, anxiety, and feeling of loss due to a sudden change in mother-daughter relationship as well as further transformation in family relationship, suggesting that there is a need to operate education or consultation programs for the family members to help them accommodate and deal with the sudden change.