• Title/Summary/Keyword: CARE guideline

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Development of Evidence-based Guidelines for Nursing Home's Infection Control in Korea (한국형 노인요양시설 근거중심 감염관리 가이드라인 개발)

  • Park, Yeon-Hwan;Lee, Seong Hyeon;Yi, Yu Mi;Lee, Chi Young;Lee, Min Hye
    • Journal of muscle and joint health
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    • v.25 no.2
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    • pp.135-147
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    • 2018
  • Purpose: The purpose of this study was to develop evidence-based guidelines for infection control in nursing homes in Korea (ENIK). Methods: Three steps were planned for the development which were developing a draft and testing the content validity. First, the draft was based on evidence and developed through focus group interviews with nurses in nursing homes, a comprehensive review of international guidelines and literature, and systematic reviews of interventions for infection control and outbreaks in long-term care facilities. Clinical applicability was established through reviews of nursing records and job assignments in one nursing home. The final step consisted of experts evaluating the content validity. The ENIK was revised to fit Korean nursing homes. Results: The ENIK consisted of recommendations in 9 compositions and a one-page practical algorithm. The principles of infection control were presented by statements and specific strategies were recommended in resident care programs. The infection control practical algorithm was organized into 3 steps: screening at admission, prevention, and control at the early stage. The practice to control infection was composed of a 5-step process. Conclusion: The ENIK will contribute to improving the competency of infection control practice because it provides standardized practice and is tailored to Korean nursing homes.

Role of Microbiologic Culture Results of Specimens Prior to Onset of Ventilator-Associated Pneumonia in the Patients Admitted to Intensive Care Unit (인공호흡기연관 폐렴의 경험적 항생제 선택 시 이전 호흡기검체의 유용성)

  • Kim, Ji-Hye;Yoon, Sung-Chul;Lee, Yu-Mi;Son, Ji-Woong;Choi, Eu-Gene;Na, Moon-Jun;Kwon, Sun-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.1
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    • pp.30-36
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    • 2012
  • Background: Patients with ventilator-associated pneumonia (VAP) in intensive care unit (ICU) have a high mortality rate. The routine surveillance cultures obtained previously or an ATS guideline for hospital-acquired pneumonia was used in selecting initial antimicrobials. The object of this study was to compare the respiratory samples before VAP and bronchoalveolar lavage (BAL) culture. Methods: 54 patients underwent fiberoptic bronchoscopy to obtain BAL samples. We reviewed microbiologic specimen results of prior respiratory specimens (pre-VAP) and BAL. Results: Among 51 patients with 54 VAP episodes, 52 microorganisms of pre-VAP and 56 BAL samples were isolated. Pre-VAP included 21.2% of MRSA, and 32.6% of multidrug resistant-Acinetobacter baumannii (MDR-AB). BAL samples comprised 25.0% of MRSA, 26.7% of MDR-AB, 14.3% of Stenotrophomonas maltophilia and 3.6% of Klebsiella pneumonia in order. In pre-VAP samples compared to BAL samples, only 35.2% were identical. In BAL samples compared to pre-VAP samples obtained in 5 days before the onset of VAP, only 43.6% were identical. However, among BAL samples compared to pre-VAP samples obtained after more than 5 days, 13.3% were identical (p=0.037). Conclusion: Based on these data, pre-VAP samples obtained prior to 5 day onset of VAP may help to predict the causative microorganisms and to select appropriate initial antimicrobials.

A Grounded-theory Approach to the Process of Life Adaptation in Women with Cervical Cancer (자궁경부암 여성의 삶의 적응에 관한 근거이론적 접근)

  • Lee, Sook-Hee;Kim, Jeung-Im;Lee, Hae-Kyung;Kang, Nam-Mi;Kim, Hae-Won;Lee, Eun-Hee;Hur, Myung-Haeng;Park, Young-Sook
    • Women's Health Nursing
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    • v.10 no.1
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    • pp.32-41
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    • 2004
  • Purpose: The purpose of this study was to explore and describe the process of life adaptation in women with cervical cancer. Method: A grounded theory method with guided data collection and analysis was used. Fifteen women with cervical cancer who had some kind of treatment at the hospital were asked open-ended and descriptive questions with a guideline. All interviews were tape-recorded and transcribed verbatim. Result: The core category that emerged from the comparative analysis was "overcoming cancer" named as a process of life adaptation in the participants. The process of overcoming cancer evolved three stages - "admitting reality", "attempting health-care" and "continuing health-care". Depending on the paradigm model, the central phenomena of the experiences was "powerlessness". The internal factors motivating women to overcome cancer were "denial of cancer" and "desire for life". Strategies of overcoming cancer included "living as a cancer patient," "selective food eating," "steady exercising," "getting rid of stress," and "preparing for death". The intervening conditions, "supportive system," "forms of life," and "burden on family," influenced overcoming cancer. Conclusion: The results of this study could help clinical nurses to understand life adaptation in cervical cancer patients and establish efficient coping strategies in dealing with the problems they face.

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A Study on the Hygiene Management of Ultrasound Probe (초음파 탐촉자의 위생관리에 관한 연구)

  • Ha, Myeong-Jin;Kim, Jeong-Koo
    • Journal of radiological science and technology
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    • v.43 no.2
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    • pp.87-96
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    • 2020
  • This study examined the hygiene management of ultrasound probes by examining the cleaning tools for hygiene management of ultrasound probes, the presence or absence of wearing glove as a personal protective equipment, and the awareness of ultrasound probe hygiene. Parts 154 questionnaire about people working in the ultrasound room were surveyed and analyzed. The single gel removal tool of the ultrasound probe was most frequently used with a 48.7% cotton towel, and for double gel removal tools, the first gel removal tool was 42.4% cotton towel and the second gel removal tool was used with 57.6% wet tissue. Antimicrobial wipes were the most commonly used drug and instrument used in ultrasound hygiene management at 58.4%. According to the survey of the presence or absence of wearing glove during ultrasound examination, 46.8% were found to be unworn. When examining the intracavity ultrasound, 30.9% of those who do not wear glove and 61.0% of hygiene awareness of ultrasound probes are 'normal'. According to age, ultrasound probe gel removal tool was not significant difference(p>0.05). According to the working organization and the working department, it was significant difference to wearing gloves during ultrasound examination(p<0.05). Therefore, in order to properly sanitize the ultrasound probe, it is considered that a guideline for hygiene management of the ultrasound probe that fits the situation in Korea is necessary, and it is considered that thorough hygiene management training for inspector is necessary for efficient hygiene management of the ultrasound probe.

Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 3. Idiopathic Nonspecific Interstitial Pneumonia

  • Lee, Jongmin;Kim, Yong Hyun;Kang, Ji Young;Jegal, Yangjin;Park, So Young;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.277-284
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    • 2019
  • Idiopathic nonspecific interstitial pneumonia (NSIP) is one of the varieties of idiopathic interstitial pneumonias. Diagnosis of idiopathic NSIP can be done via multidisciplinary approach in which the clinical, radiologic, and pathologic findings were discussed together and exclude other causes. Clinical manifestations include subacute or chronic dyspnea and cough that last an average of 6 months, most of which occur in non-smoking, middle-aged women. The common findings in thoracic high-resolution computed tomography in NSIP are bilateral reticular opacities, traction bronchiectasis, reduced volume of the lobes, and ground-glass opacity in the lower lungs. These lesions can involve diffuse bilateral lungs or subpleural area. Unlike usual interstitial pneumonia, honeycombing is sparse or absent. Pathology shows diffuse interstitial inflammation and fibrosis which are temporally homogeneous, namely NSIP pattern. Idiopathic NSIP is usually treated with steroid only or combination with immunosuppressive agents such as azathioprine, cyclophosphamide, cyclosporine, and mycophenolate mofetil. Prognosis of idiopathic NSIP is better than idiopathic pulmonary fibrosis. Many studies have reported a 5-year survival rate of more than 70%.

Transarterial Chemoembolization for Hepatocellular Carcinoma: 2023 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association

  • Yuri Cho;Jin Woo Choi;Hoon Kwon;Kun Yung Kim;Byung Chan Lee;Hee Ho Chu;Dong Hyeon Lee;Han Ah Lee;Gyoung Min Kim;Jung Suk Oh;Dongho Hyun;In Joon Lee;Hyunchul Rhim;Research Committee of the Korean Liver Cancer Association
    • Korean Journal of Radiology
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    • v.24 no.7
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    • pp.606-625
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    • 2023
  • Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

Clinical Dilemmas for the Diagnosis and Treatment of Helicobacter pylori Infection in Children: From Guideline to Practice

  • Susanne Jenneke Van Veen;Elvira Ingrid Levy;Koen Huysentruyt;Yvan Vandenplas
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.5
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    • pp.267-273
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    • 2024
  • Helicobacter pylori infection is often acquired in early childhood. While most infected children remain asymptomatic, H. pylori can cause chronic gastritis, gastric ulceration, and, in the long term, gastric cancer. This article aimed to review different diagnostic and treatment options and discuss the challenges associated with applying the current guidelines in the real world. Relevant articles published from 2015 to August 2023 in the English language in PubMed and Medline electronic databases were extracted using subject headings and keywords of interest to the topic. References of interest in the selected articles were also considered. Invasive and noninvasive diagnostic tests have advantages but also disadvantages and limitations according to the clinical setting and age of the child. Guidelines recommend not performing diagnostic testing in children with long-lasting or recurrent abdominal complaints or cases of a family history of severe disease caused by H. pylori. However, parents regularly consult with the explicit demand to test for H. pylori because of them or a close family member experiencing severe gastric disease caused by H. pylori. In some situations, it may be challenging for the healthcare professional to stick to evidence-based guidelines and not consider "patient-centered care," with the risk of putting a trustful relationship in danger. Physicians may find it challenging not to perform diagnostic tests for H. pylori and prescribe eradication treatment in specific clinical settings when maintaining a trusting patientphysician relationship by applying this "patient-centered care" method when evidence-based guidelines recommend differently.

Knowledge and Management of Tracheal Tube Cuffs Among ICU Nurses in Korea (중환자실 간호사의 기관 내관 기낭관리의 지식과 수행정도)

  • Chang, Sun-Ju;Song, Mi-Soon
    • Korean Journal of Adult Nursing
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    • v.21 no.6
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    • pp.570-579
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    • 2009
  • Purpose: The aim of this research was to determine knowledge and management of tracheal tube cuffs among nurses of ICU. Methods: This descriptive survey recruited 150 nurses working at 8 different adult ICUs within 2 tertiary hospitals in Seoul. A survey questionnaire was developed to measure cuff management. The internal reliability of the tool was examined by Cronbach's ${\alpha}$. Descriptive statistics and multiple regressions were used to analyze data. Results: Among the 150 nurses, 94.0% replied that they would measure the pressure themselves. With regard to nurses' knowledge about tracheal tube cuffs, only 6% answered that they knew 'the appropriate cuff pressure'. The existence of a measuring device (p < .001), a guideline (p < .001), the level of knowledge on its related complications(p = .003), and clinical experience (p < .001) together accounted for 35.0% of the total variation in cuff management. They pointed out that the lack of time and the lack of education were major barriers to appropriate management; whereas education update was the most imperative factor for good management. Conclusion: ICU nurses have inappropriate knowledge and practice in cuff management. Therefore continuing education is necessary for better practice of tracheal tube cuff management.

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Design Characteristics of Nursing Home Environment Created by Care Professional Based on Practical Experience (케어전문가의 실천적 경험에 입각한 노인요양시설 환경디자인 노력특성연구)

  • Lee, Yeun-Sook;Yoon, Hye-Gyung;Park, Eun-Ji
    • Journal of the Korean housing association
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    • v.22 no.5
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    • pp.21-28
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    • 2011
  • This thesis aims to identify the design guidelines for environmental plans for the facilities for the aged people with a focus on the users' needs and the concept of aging in place. For this purpose major environmental design factors were researched by analyzing spaces and interviewing the managers and supervisor of W nursing home in Jeju Island that was opened in 1980s. Surveyed factors were divided into five categories, and by applying the design guideline theory of age friendly environment and nursing home facilities to them, five municipal composition factors of Kevin Lynch, universal design, environmental behavior model of John Zeisel principles were found. On the other hand, the environmental changes and development process of W nursing home is a showcase that reveals the importance of narrowing the gap in the opinions of the space users, the experts of architecture and administration which is emphasized in the principles of Inquiry by Design of John Zeisel. This research is expected to be used effectively for the researchers who study the space designs for the age-friendly environment.

A Study on Folk-Belief Related to Korean Traditional Costume Culture (한국 전통 의생활문화에 나타난 속신 고찰(I))

  • 박덕미;황춘섭
    • The Research Journal of the Costume Culture
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    • v.6 no.2
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    • pp.77-91
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    • 1998
  • The present study collected and analyzed the Korean's folk-belief related to Koran traditional costume culture which are handed down from ancestor and are known to present Korean society as of 1990's. The purpose of the present study is to understand emotion and the view of Korean people, and to understand the social roles of the costumes in Koran traditional society more deeply and more comprehensively. The study was conducted by document analysis and interview. The results of the study are summerized as follows: Folk-belief related to spinning(gilssam), sericultural industry and weaving are mostly enduced from the hope for god quality of work and acquisition of good skill of weaving. There has been also a belief hat gilssam has a magic power to easy delivery and fecundity. Most Folk-belief of taboo related to clothing constraction proposed to people pay great care while they are sawing. Some ways of management of clothing has been related to the manners of which are associated with the differentiation between high and low level and predominance of men over women that was originated fro m confucianism. Socks(busun) and shoes are also considered to have magic power to prevent from exorcism and demon of ill health. This study suggests that folk-belief give us the wisdom a guideline and lessons for better life, high quality arts and techniques which are handed down from ancestors. Therefore, folk-beliefs having a great value, non-shaped treasures of traditional culture heritage should be collected as many as possible, recorded, and preserved.

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