• 제목/요약/키워드: Aseptic technique

검색결과 53건 처리시간 0.03초

만성폐쇄성폐질환 환자 사례에 대한 실시간 시뮬레이션 동영상 관찰기록 내용분석-간호술 수행을 중심으로 (Content analysis of real-time simulation video observation records about cases of patients with chronic obstructive pulmonary disease-focusing on nursing skills performance)

  • 홍지연;박진아
    • 융합정보논문지
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    • 제12권5호
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    • pp.40-50
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    • 2022
  • 본 연구는 간호대학생이 시뮬레이션 실습 시 동료 팀의 만성폐쇄성폐질환 환자 시나리오 구현 동영상을 실시간으로 관찰하면서 구조화된 동영상 관찰 기록지에 기록한 간호술 영역의 내용을 분석한 질적 연구이다. 4개의 세부영역으로 구분하여 기록된 내용을 효과적, 비효과적 측면으로 구분한 후 내용분석 방법을 사용하여 분석하였다. 연구결과 절차의 정확성에 있어서 효과적 측면은 필요한 물품준비와 증상완화를 위한 중재, 비효과적인 측면은 원칙 미준수, 부적절한 처방 이행, 이론과 수행의 연계 미흡으로 나타났다. 무균술 준수에 있어 효과적 측면은 내과적 무균술 적용과 외과적 무균술 적용, 비효과적 측면은 내과적 무균술 미수행과 외과적 무균술 미수행이었다. 안전과 안위 고려에 있어 효과적 측면은 심리적 안위 고려과 물리적 안전 고려, 비효과적 측면은 안위에 대한 실재감 부족과 환자안전 인식 미흡으로 나타났다. 설명 및 교육의 효과적 측면은 목적 설명과 방법 교육, 비효과적 측면은 설명 부족과 환자수준 미고려이었다. 본 연구에서 간호대학생은 관찰을 통하여 얻은 시각적 정보를 기록하는 과정을 통해 학습에 집중하고 기억을 강화시킬 수 있었을 것으로 사료된다. 또한 본 연구는 시뮬레이션 기반 실습을 통한 간호술 교육의 효율성을 높일 수 있는 요소들을 제시하였다는 점에서 의의가 있다.

Plantlet Regeneration and PLBs Propagation of Bulbophyllum auricomum Lindl.

  • Aung, Win Theingi;Lian, Thang Tung;Aung, Zaw Phyo;Bang, Keuk Soo;Baek, Seung Hwa
    • 한국자원식물학회지
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    • 제35권4호
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    • pp.508-514
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    • 2022
  • Bulbophyllum auricomum Lindl. is very popular among orchid growers due to the attractive fragrance of its flowers and has become an endangered orchid in Myanmar. In this study, we carried out an aseptic technique that can be used to conserve this endangered orchid species. The seeds of B. auricomum Lindl. were obtained from artificial pollination and cultured in MS basal medium for seed germination. The effect of coconut water and BAP in MS basal medium on callus induction was investigated. The highest callus induction was found at 2.0 mg/L BAP. The maximum growth of protocorm-like bodies (PLBs) was evaluated, and the best response was observed on MS medium supplemented with 150 mL/L coconut water at pH 5.6. MS basal medium supplemented with 150 mL/L coconut water along with 2.0 mg/L BAP and 1.0 mg/L NAA (MCBN) showed the highest number of plantlets at 15℃ at the second week of culture. At the second and third week of culture, MS medium supplemented with 2.0 mg/L BAP and 1.0 mg/L NAA (MBN) showed the best result in terms of the number of leaves and the longest leaves at 15℃ and 25℃, respectively. The present study showed evidence of successful in vitro propagation of B. auricomum Lindl.

감염병전문병원의 병동부 및 중환자부 영역 구성에 관한 연구 (A Study on the Zoning of Wards and Intensive Care Units (ICUs) in the Infectious Disease Hospital)

  • 이주랑;채철균
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제29권3호
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    • pp.17-28
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    • 2023
  • Purpose: This study aims to provide basic data for the future construction plans of the Infectious Disease Hospitals by analyzing the area composition and required room ratios in the wards and ICU of currently under-construction infectious disease hospitals. Methods: 3 Methods have been used in this paper. 1) This study conducted a literature review on major considerations and related guidelines for hospitals specializing in infectious diseases using existing data. 2) Based on the objects and activities of the hospital space, zones and areas were set for each department according to infection control. 3) Based on the established zones and areas, basic plan drawings of three hospitals specializing in infectious diseases currently under construction were collected and architectural drawing analysis was performed. Results: 1) Infectious Diseases Hospital must have a spatial organization that can accommodate patient isolation, infection control, efficiency of medical service, and changes. 2) Zones for infection control are divided into negative pressure and non-negative pressure zones based on airborne precaution isolation. It is divided into clean and contaminated zone according to class of cleanliness by Aseptic technique. Areas are classified by objects (patients, healthcare workers, supplies) and activities (access, medical treatment, support), and a system for organizing space is established based on this. 3) By analyzing the area composition of each departmental area, each required room, and each required space in the wards and intensive care units, it provides basic data for the spatial organization for architectural planning of the infectious disease hospital. Implication: It can be used as basic data when planning related facilities by analyzing the characteristics of the space plan of the required room according to the relationship between activities, movement lines, and operation plans based on user behavior.

Posterior superior alveolar nerve block alone in the extraction of upper third molars: a prospective clinical study

  • Swathi Tummalapalli;Ravi Sekhar M;Naga Malleswara Rao Inturi;Venkata Ramana Murthy V;Rama Krishna Suvvari;Lakshmi Prasanna Polamarasetty
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권4호
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    • pp.213-220
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    • 2023
  • Background: Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. Methods: A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. Results: In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. Conclusion: The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

표준화환자를 이용한 호흡기감염 시뮬레이션 교육이 간호대학생의 지식, 임상수행능력에 미치는 효과 (Effects of Respiratory Infectious Disease Simulation-based Education using Standardized Patient for Nursing Student's of the Knowledge, Clinical Nursing Competency)

  • 허정;윤영주
    • 문화기술의 융합
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    • 제9권3호
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    • pp.435-442
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    • 2023
  • 본 연구의 목적은 간호대학생의 호흡기 감염질환 지식과 임상수행에 대해 표준화 환자를 활용한 시뮬레이션 교육의 효과를 분석하는 것이다. 간호학과 4학년생 112명을 대상으로 2020년 3월 2일부터 6월 15일까지 표준화 환자를 활용하여 전염성 호흡기계 환자 간호를 위한 단일군 전후 설계이다. 호흡기 감염병 교육 프로그램 '폐 감염병 지식', '손 씻기', '마스크 착용', '환자 및 간병인에게 마스크 착용 유도', '정맥주사' '3way 주사', '외과적 무균술', '소독 의료기기', '오염된 린넨 관리', '감염자 관리 매뉴얼' 등 10개 교육 과제 수행이며 강의, 기술 훈련, 표준화된 환자를 이용한 시뮬레이션, 디브리핑으로 구성되었다. 표준화된 환자를 이용한 시뮬레이션 교육 후 호흡기 감염질환에 대한 학생의 지식과 임상수행능력이 유의미한 향상을 보였으며, 다양한 감염관리 실습에 활용될 것으로 기대한다.

6개월 미만 영아의 요로 감염 (Urinary tract infections in infants under six months of age)

  • 강민주;신혜경;임형은;제보경;은소희;최병민;박종태;은백린;유기환
    • Clinical and Experimental Pediatrics
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    • 제49권3호
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    • pp.278-286
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    • 2006
  • 목 적 : 신생아를 비롯한 어린 영아의 요로 감염에 대한 국내 보고는 많지 않으며, 특히 위양성률이 낮은 방광 천자법으로 요로 감염을 진단한 보고는 없다. 본 연구자들은 방광 천자법으로 얻은 소변으로 진단된 어린 영아의 요로 감염에 대한 임상 양상을 알아보았다. 방 법 : 2002년 1월부터 2005년 6월까지 고려대학교 의료원 안산병원 소아과에 발열과 같은 감염 증상이 있어 내원한 6개월 미만의 영아에서 방광 천자를 시행하여 요 침사 현미경 검사에서 백혈구수가 5개 이상인 농뇨가 있으면서 배양 검사에서 세균이 자란 요로 감염 환아 159명을 대상으로 연령 및 성별 분포, 임상 증상 및 징후, 임상 검사 소견, 요로계 영상 검사 소견을 후향적으로 분석하여 동반된 요로 기형, 급성 신우신염과 신반흔과 같은 신피질 손상, 그리고 병발된 균혈증과 뇌수막염 여부와 그 관련 인자를 알아보았다. 결 과 : 남아 133명, 여아 26명이었고 1개월 미만의 신생아가 35명(22.0%)이었다. 소변 배양 검사에서 158례(99.4%)에서 단일 균주가 배양되었으며, Escherichia coli 148주, Klebsiella pneumoniae 5주, Enterobacter cloacae 4주, Enterobacter aerogenes 1주, Enterococcus faecalis 1주 그리고 Streptococcus agalactiae 1주가 배양되었다. 수신증이 있었던 경우는 32.7%(49/150)로 신생아는 41.2%(14/34)였다. 방광 요관 역류가 있었던 경우는 27.7%(31/112)로 신생아는 22.7%(5/22)였다. 신 스캔검사에서 신피질 손상이 37.1%(52/140)에서 관찰되었고 이 중 신생아는 37.5%(12/32)였다. 급성 신우신염 소견을 보인 경우가 29.3%(41/140)였고 신반흔 소견을 보인 경우는 7.9%(11/140)였다. 신피질 손상이 있었던 군이 신피질 손상이 없었던 군에 비해 평균 발열기간과 입원 기간이 길었으며, ESR과 CRP 농도, 수신증과 방광 요관 역류의 빈도가 높았다(P<0.05). 균혈증이 병발된 경우는 8.3%(13/158)였으며 신생아는 11.4%(4/35)였다. 나이 등 여러 임상 인자들에 있어 균혈증이 병발된 군과 균혈증이 없었던 군 사이에 유의한 차이가 없었다. 무균성 뇌수막염이 병발된 경우는 6.7%(5/75)였으며, 신생아는 7.7%(2/26)였다. 결 론 : 신생아를 비롯한 어린 영아의 요로 감염에서는 비특이적인 임상 양상을 나타내며, 특히 패혈증과 무균성 뇌수막염이 병발하기 쉬우므로 조기에 감별 진단하는 것이 중요하겠다. 또한 고혈압이나 만성 신부전과 같이 영구적인 신손상을 일으킬 수 있는 신피질 손상이 상당수에서 발견되므로, 발열 기간이 길고 염증 반응 수치가 높은 경우 신 스캔과 요로 기형을 찾기 위한 요로계 영상 검사와 추적 관찰이 꼭 필요하겠다.

IN-LINE NIR SPECTROSCOPY AS A TOOL FOR THE CONTROL OF FERMENTATION PROCESSES IN THE FERMENTED MEATS INDUSTRY

  • Tamburini, Elena;Vaccari, Giuseppe;Tosi, Simona;Trilli, Antonio
    • 한국근적외분광분석학회:학술대회논문집
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    • 한국근적외분광분석학회 2001년도 NIR-2001
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    • pp.3104-3104
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    • 2001
  • The research described here was undertaken with the aim of monitoring, optimizing and ultimately controlling the production of heterofermentative microbes used as starters in the salami industry. The use of starter cultures in the fermented meats industry is a well-established technique used to shorten and standardize the ripening process, and to improve and control the organoleptic quality of the final product. Starter cultures are obtained by the submerged cultivation of suitable microorganisms in stirred, and sometimes aerated, fermenters where monitoring of key physiological parameters such as the concentration of biomass, substrates and metabolites suffers from the general lack of real-time measurement techniques applicable to aseptic processes. In this respect, the results of the present work are relevant to all submerged fermentation processes. Previous work on the application of on-line NIR spectroscopy to the lactic acid fermentation (Dosi et al. - Monreal NIR1995) had successfully used a system based on a measuring cell included in a circulation loop external to the fermenter. The fluid handling and sterility problems inherent in an external circulation system prompted us to explore the use of an in-line system where the NIR probe is immersed in the culture and is thus exposed to the hydrodynamic conditions of the stirred and aerated fluid. Aeration was expected to be a potential source of problems in view of the possible interference of air bubbles with the measurement device. The experimental set-up was based on an in-situ sterilizable NIR probe connected to the instrument by means of an optical fiber bundle. Preliminary work was carried out to identify and control potential interferences with the measurement, in particular the varying hydrodynamic conditions prevailing at the probe tip. We were successful in defining the operating conditions of the fermenter and the geometrical parameters of the probe (flow path, positioning, etc.) were the NIR readings were reliable and reproducible. The system thus defined was then used to construct and validate calibration curves for tile concentration of biomass, carbon source and major metabolites of two different microorganisms used as salami starters. Real-time measurement of such parameters coupled with the direct interfacing of the NIR instrument with the PC-based measurement and control system of the fermenter enabled the development of automated strategies for the interactive optimization of the starter production process.

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흡인 후 견 봉합사 거치를 통한 만성 슬개골전 점액낭염의 치료 (The Effect of Indwelling Silk Suture Material Following Aspiration in the Treatment of Chronic Prepatellar Bursitis)

  • 이봉진;이성락;김충현;김성태
    • 대한정형외과스포츠의학회지
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    • 제4권1호
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    • pp.55-59
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    • 2005
  • 목적: 낭액의 흡인 후 견 봉합사로 배액을 유도하는 방법이 만성 슬개골전 점액낭염의 조기 치료로써 효과가 있는지를 확인하고자 하였다. 대상 및 방법: 2주 이상의 병력이 있는 슬개골전 점액낭염 환자 중 1년 이상 추시가 가능했던 12명을 대상으로 하였으며, 추시기간은 평균 18.3개월이었고, 증상 발현 후 본 시술까지의 기간은 평균 2.2개월이었다. 무균적 방법으로 척수액 천자용 또는 주사용 주사침으로 점액낭을 천자하고, 주사침을 통해 7번 견 봉합사를 삽입하였다. 시술 후 최소 1년에 재발, 감염, 통증 및 관절 운동 제한 유무를 조사하였다. 결과: 전례에서 봉합사의 삽입 부위에 발적이 발견되었으나 11예에서 발사 후 소실되었고, 1예에서는 시술 5일에 감염이 발생하였다. 92%의 환자에서 만족의 결과를 얻었으며, 치료기간은 평균 14.5일이었다. 결론: 점액낭의 천자 흡인 후 견 봉합사로 배액을 유도함으로써 만성 슬개골전 점액낭염을 치료하는 방법은 효과적이고 비교적 비침습적인 방법이다.

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정맥내 주사요법시 수액세트에 연결된 3 way-stopcock의 오염정도에 관한 실태조사 (Degree of contamination in 3-way stopcock connected to infusion set on the intravenous therapy)

  • 홍해숙;김윤경;나연경;이경란;곽경숙
    • Journal of Korean Biological Nursing Science
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    • 제4권2호
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    • pp.113-125
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    • 2002
  • This study is to evaluate contamination of the 3-way stopcocks connected to infusion set, which is used to the patients admitted to emergency room in a general hospital in D city. The data were collected from Oct. 1, 2001 to Feb. 25, 2002. First of all, in order to select microorganisms, From the 50 patients were randomized, Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus, Pseudomonas aeruginosa, Acinetobacter detected. Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus were determined to be evaluated in this study. As a result, 8 of the patients were Coagulase Negative Staphylococcus positive(>15 colonies), 4 were Staphylococcus aureus positive(>15 colonies). 1 was micrococcus positive(>15 colonies). Among the patients who were Coagulase Negative Staphylococcus positive 112(average) colonies were detected on the first day, 429 were on the second day, and 563 were on the third day. In case of patients of Staphylococcus aureus positive, 85(average) colonies were detected on the first day, 151 were on the second day, and the 203 were on the third day. CNS was cultured using API kit for the 8 patients who were in CNS positive. One case was detected Staphylococcus capitis, another one case was Staphylococcus chromogenes. Two cases were Staphylococcus xylosus, another two were Staphylococcus hominis, and the remainer were Staphylococcus epidermidis. As a result, the API codes of two Staphylococcus epidermidis had shown the same pattern, and the resistance patterns of the them were the same, too. As a result of resistance test among 5 patients who have shown that the same resistance pattern in 02SAK1, 02SAK5, 02SAK2, 02SAK4. As a result of this study, aseptic technique of 3-way stopcock intravenous therapy can protect infections, and it is needed the sterilization of the 3-way stopcock just before injection using disinfectants. It needs to improve the 3 way stopcock change intervals from 48 hours.

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Effects of Lactobacilli on the Performance, Diarrhea Incidence, VFA Concentration and Gastrointestinal Microbial Flora of Weaning Pigs

  • Huang, Canghai;Qiao, Shiyan;Li, Defa;Piao, Xiangshu;Ren, Jiping
    • Asian-Australasian Journal of Animal Sciences
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    • 제17권3호
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    • pp.401-409
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    • 2004
  • Two experiments were conducted to evaluate the effects of a complex Lactobacilli preparation on performance, resistance to E. coli infection and gut microbial flora of weaning pigs. In exp. 1, twelve pigs (7.65$\pm$1.10 kg BW), weaned at 28 d, were randomly allotted into 2 groups and placed in individual metabolic cages. During the first 7 d, one group of pigs was provided ad libitum access to water containing $10^5$ colony forming units (CFU) Lactobacilli per ml and the control group was provided tap water. The Lactobacilli preparation included Lactobacillus gasseri, L. reuteri, L. acidophilus and L. fermentum, which were isolated from the gastrointestinal (GI) tract mucosa of weaning pigs. On d 8, 20 ml of $10^8$ CFU/ml E. coli solution (serovars K99, K88 and 987P at the ratio of 1:1:1) was orally administered to each pig. Diarrhea scores and diarrhea incidence were recorded from d 7 to 14. On d 14, pigs were euthanized and digesta and mucosa from the stomach, duodenum, jejunum, ileum, cecum and colon were sampled using aseptic technique to determine microflora by culturing bacteria in selective medium. The results showed that Lactobacilli treatment significantly decreased E. coli and aerobe counts (p<0.01) but increased Lactobacilli and anaerobe counts (p<0.01) in digesta and mucosa of most sections of the GI tract. A 66 and 69.1% decrease in diarrhea index and diarrhea incidence, respectively, was observed in the Lactobacilli treated group. In exp. 2, Thirty-six crossbred Duroc$\times$Landrace$\times$Yorkshire piglets, weaned at 28$\pm$2 days, were selected and randomly allocated into 2 groups. There were 18 piglets in each group, 3 piglets in one pen and 6 replicates in each treatment with 3 pens of barrow and 3 pens of female piglet in each treatment. Piglets had ad libitum access to feed and water. The initial body weight of piglet was 7.65$\pm$1.09 kg. Dietary treatments included a non-medicated basal diet with Lactobacilli ($10^5$ CFU/g diet) or carbadox (60 mg/kg) as control. On d 21, six pigs per group (one pig per pen) were euthanized. Ileal digesta was collected to determine apparent amino acid digestibility. Microflora content was determined similarly to exp.1. The results showed that Lactobacilli treatment significantly improved average daily feed intake (ADFI) of pigs compared to carbadox (p<0.05) during the first 2 wks after weaning and average daily gain (ADG) and ADFI increased significantly (p<0.05) from d 8 to 14. Nitrogen and total phosphorus digestibility also increased (p<0.05). Bacterial counts were similar to exp. 1. The results indicate that the complex Lactobacilli preparation improved performance for 2 wks after weaning, enhanced resistance to E. coli infection, and improved microbial balance in the GI tract.