• 중환자간호학회지
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• 제9권2호
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• pp.1-12
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• 2016

Purpose: This study aimed to develop a nursing handoff protocol for intensive care units and test its relevance. Methods: This is a methodological research to develop a protocol. A preliminary protocol was developed by composing items and testing content validity through literature review and experts' review. We revised and complemented the preliminary protocol following practical relevance assessment of 38 intensive care unit nurses at a university hospital to test content validity and to assess practical relevance of the final protocol. Results: On the basis of the content validity test for the final protocol, 40 items were adopted. The scores for the practical relevance of the final protocol increased significantly for items such as accuracy of handoff, reduction of handoff-related errors, convenience in using the protocol, reduction in handoff time, and simplification of handoff. Conclusions: The nursing handoff protocol for intensive care units in this study is expected to improve nursing performance with a standardized handoff in intensive care units, promote patient safety, and improve communication among the medical staff.

• 문화기술의 융합
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• 제9권5호
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• pp.185-192
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• 2023

현재 우리나라 요양병원은 노인인구 증가와 함께 지속적으로 증가하고 있다. 요양병원에 입원하는 환자는 주로 만성질환을 가진 노인들로서 장기요양을 목적으로 하기 때문에 요양병원에서 임종하는 경우가 많아 요양병원에서의 임종간호 중요성이 점점 커지고 있다. 이러한 특징에도 불구하고 요양병원 간호사를 대상으로 임종간호에 대한 연구로는 주로 양적연구들로서 임종간호 경험에 대해 심층적으로 파악하기에 제한이 있다. 따라서 본 연구의 목적은 현상학적 방법을 통해 요양병원 간호사의 임종환자 간호경험의 의미가 무엇인지 이해하고 그 현상의 의미를 심층적으로 기술하고 이해하고자 함이다. 본 연구의 대상자는 C 시에 위치한 요양병원에서 6개월 이상 근무하고 있는 간호사 7명을 선정하였다. 연구방법은 심층 인터뷰로 2021년 12월부터 2022년 3월까지 자료를 수집하였다. 인터뷰 자료는 Giorgi의 현상학적 방법으로 분석하였다. 연구 결과 '임종간호에 대한 간호사의 태도', '연명에 대한 양가 감정', '요양병원의 임종간호에 대한 현실', '삶과 죽음에 대한 성찰'으로 나타났다. 따라서 요양병원 간호사의 임종간호 태도를 변화시키고 대처능력을 향상시킬 수 있는 임종간호 보수교육 및 중재 교육프로그램이 개발되어야 할 것으로 사료된다.

• Journal of Trauma and Injury
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• 제30권3호
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• pp.107-111
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• 2017

The fat embolism syndrome (FES) represents a condition, usually with traumatic etiology, which may pose challenges to diagnosis while its treatment usually requires supportive measures in the intensive care units (ICUs). The clinical criteria, including respiratory and cerebral dysfunction and a petechial rash, along with imaging studies help in diagnosis. Here we present three case reports of young male who developed FES and were admitted to our ICUs after long bones fractures emerging after vehicle crashes and we briefly review FES literature. All patients' treatment was directed towards: 1) the restoration of circulating volume with fresh blood and/or plasma; 2) the correction of acidosis; and 3) immobilization of the affected part. All patients recovered and were released to the orthopedic wards. The incidence of cases of patients with FES admitted in our ICUs records a significant decrease. This may be explained in terms effective infrastructure reforms in Greece which brought about significant improvement in early prevention and management.

• 보건행정학회지
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• 제16권1호
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• pp.117-139
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• 2006

The role of medical service quality to provide patients enhances influence on the hospital performance under being severe competition among the large size hospitals and increasing the right of patients. When a large hospital perceived factors of quality that a customer expects and feels value of care and it invests its resources to improve the factors of quality, it can get successful performances. Therefore, the purpose of the study explores the factors of quality affecting the trust of care and the patient satisfaction, and tests relationship among the trust of care, patient satisfaction and revisit intention. When considering the factors, a large size hospital can increase the trust of care and the patient satisfaction, through this process the hospital can assure patients' revisit and increase its revenue. This study uses interview data on outpatients visiting clinics in about 1000 beds sized training hospital located in Seoul. This study uses casual relationship model for the analysis. This study finds that 1) the trust of care and the procedure of care significantly influence the value of care felt by patients, 2) the trust of care, quality of doctors' care, procedure of care significantly influence the patient satisfaction, 3) the trust of care increases the patient satisfaction, and 4) the value of care and the patient satisfaction increase revisit intention.

• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.618-631
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• 2023

The brain houses vital hormonal regulatory structures such as the hypothalamus and pituitary gland, which may confer unique susceptibilities to critical illness-related corticosteroid insufficiency (CIRCI) in patients with neurological disorders. In addition, the frequent use of steroids for therapeutic purposes in various neurological conditions may lead to the development of steroid insufficiency. This abstract aims to highlight the significance of understanding these relationships in the context of patient care and management for physicians. Neurological disorders may predispose patients to CIRCI due to the role of the brain in hormonal regulation. Early recognition of CIRCI in the context of neurological diseases is essential to ensure prompt and appropriate intervention. Moreover, the frequent use of steroids for treating neurological conditions can contribute to the development of steroid insufficiency, further complicating the clinical picture. Physicians must be aware of these unique interactions and be prepared to evaluate and manage patients with CIRCI and steroid insufficiency in the context of neurological disorders. This includes timely diagnosis, appropriate steroid administration, and careful monitoring for potential adverse effects. A comprehensive understanding of the interplay between neurological disease, CIRCI, and steroid insufficiency is critical for optimizing patient care and outcomes in this complex patient population.

• Tuberculosis and Respiratory Diseases
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• 제84권4호
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• pp.317-325
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• 2021

Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but the epidemiological data pertaining to HAP/VAP is limited in Korea. The objective of this study was to investigate the characteristics, management, and clinical outcomes of HAP/VAP in Korea. Methods: This study is a multicenter retrospective cohort study. In total, 206,372 adult patients, who were hospitalized at one of the 13 participating tertiary hospitals in Korea, were screened for eligibility during the six-month study period. Among them, we included patients who were diagnosed with HAP/VAP based on the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) definition for HAP/VAP. Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients. Among them, 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. Most of the patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 patients (40.1%). Furthermore, multidrug resistant (MDR) pathogens were isolated in 138 patients; the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 patients with HAP (28.2%) had to be admitted to the ICU for additional care. The hospital mortality rate was 28.1% in the cohort of this study. Among the 378 patients who survived, 54.2% were discharged and sent back home, while 45.8% were transferred to other hospitals or facilities. Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1,000 patients. In tertiary hospitals in Korea, patients with HAP/VAP were elderly and had a risk of aspiration, so they were often referred to step-down centers.

• 가정간호학회지
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• 제10권2호
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• pp.158-169
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• 2003

Purpose: This study is to investigate the recognition regarding Hospital - Based Home Care Service among physicians and nurses in a G University Hospital. Method: Data were gathered from 92 physicians and 257 nurses. working at G University Hospital. from January 15 to January 22. 2003 by questionnaire. The data were analyzed by using the SPSS/PC +. Result: 1) As to the previous information about a hospital based home care service. those who have been familiar to it were 85.9% of the physicians. and 98.8% of the nurses. 55.4% of the physicians and 55.1% of the nurses responded that they are willing to refer their patients to the home health care only if their patients and families want to. 47.8% of the physicians and 44.4% of the nurses perceived the present cost of a hospital based home care service to be moderate. 2) Most of the physicians and nurses reported that the most available service was 'wound dressing' (98.4%, 92.6%) and the least available service was 'incision and drainage'(1l7.4%, 42.8%). 3) As to the necessity of home nursing business and the anticipated effects. nurses perceived higher than physicians($3.46\pm.74$). and both showed a significant difference according to age of subjects. Conclusion: For the stabilization and successful implementation of a hospital based home care service. it should be accompanied with education programs about home care for physicians. in particular junior staff.

• Journal of Trauma and Injury
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• 제32권3호
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• pp.172-175
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• 2019

Although thoracic endovascular aortic repair (TEVAR) has grown to become the standard of care to treat blunt thoracic aortic injury (BTAI), the long-term effects of TEVAR are still unclear. We here present a 72-year-old man with BTAI due to a traffic accident. He successfully underwent TEVAR and was transferred to another rehabilitation hospital 2 months after the accident. However, 1 month later, he underwent gastroscopy with fever and hematemesis and was diagnosed with aorto-esophageal fistula (AEF). After being re-transferred to Niigata University Medical and Dental Hospital, we tried to convince him to undergo surgical treatment, but he strongly refused. He received palliative care and died due to rupture of the aortic pseudoaneurysm 3 days after the hospital transfer. Fatal complications like AEF may occur after TEVAR, so clinicians need to carefully follow patients who underwent TEVAR.

• 임상간호연구
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• 제21권1호
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• pp.43-52
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• 2015

Purpose: This study was aimed to develop the multicomponent intervention for preventing delirium among postoperative patients in a surgical intensive care unit (SICU). Methods: Using a quasi-experimental pre & post-test design with a non-equivalent control group, a total of 88 hospitalized patients in a SICU participated in this study. The 44 patients were allocated in each experimental and control group. The experimental group received the multicomponent intervention for delirium prevention including a delirium assessment and nursing intervention using a checklist, whereas the control group was provided with a standard care. The primary outcome of this study was the delirium incidence during the course of hospitalization. Results: There were no significant differences in the demographic and clinical characteristics between the two groups. The delirium occurred in 19.2% in the experimental group, whereas 38.6% in the control group ($x^2=4.526$, p<.05). Conclusion: The findings of the study demonstrated an effect of the multicomponent delirium prevention intervention in decreasing the delirium incidence rate over the standard care among the patients in SICU.

• 한국병원경영학회지
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• 제16권3호
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• pp.1-18
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• 2011

In this study, population census(2005 & 2008) from Statistics Korea and the statistical data of the number of hospital beds by healthcare facilities classification from Ministry of Health and Welfare were used. For analyzing distribution of hospital beds, hospital beds were classified as acute care beds, long-term care beds and all hospital beds, which is including acute and long-term care beds. Regional areas, which are city(si), county(goon) for the study and district(gu) were reclassified as metropolitan city, city(si) and county(goon). Because there were 165 regional areas in 2005 and 2008, 84 and 81 areas were classified as metropolitan city and/or city and county, respectively. Gini index were calculated for hospital beds from each year, and Lorenz curves were drawn. The following summary presents the findings of this study. Compared to the year 2005 and 2008, the Gini index was 0.24472, and hospital bed numbers increased slightly by 0.80% than in 2005. In case of acute care beds, the Gini index was 0.23797(0.13%), and there was no big difference; however, the Gini index for long-term care beds was 0.41091, and there was a 30.25% decrease, which shows improvement to reduce disparities. It might result from an increase in long-term care beds up to 476.2%. For geographical equality of hospital beds, the Gini index and Lorenz curve, which can be compared the degree of inequality in the distribution of hospital beds reasonably and possibly show statistical data, should be used. Through this study, the distribution policy of hospital beds should be established.