• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.85-98
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• 2010

Purpose: This study was aimed to investigate the awareness and attitudes towards withdrawal of the life-sustaining treatment among nurses, physicians, and the families of intensive care unit (ICU) patients in general hospitals. Methods: The data were collected using a questionnaire from 80 ICU nurses, 80 physicians, and 80 families of ICU patients in general hospitals. Data were collected from February 22nd to May 31st, 2010. Rusults: ICU nurses, physicians, and families of ICU patients felt that objective and ethical guidelines were needed in making a decision to withdraw the life-sustaining treatment. The main reason for withdrawal of the life-sustaining treatment was found that the patients could not recovered despite many efforts. The role of nurses in decision making process on withdrawal of the life-sustaining treatment was considered very positive from the view of physicians and family members. The most important role of nurses for those patients in ICU was found to try their best to care for the patients. Conclusion: ICU nurses should play a major coordinating role in communication among patients, their families, and medical teams. Also, an appropriate roles of nurses in the process of the withdrawal of the life-sustaining treatment should be established.

• Perspectives in Nursing Science
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• v.5 no.1
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• pp.17-31
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• 2008

Purpose: The purpose of this study was to evaluate the usability of a prototype personal digital assistant (PDA)-based decision support system for the management of obesity through usability testing with end-users (Advanced Practice Nurses [APNs]) prior to its implementation in clinical settings. Methods: This descriptive study used observational and think aloud techniques to address the research question: what usability problems are perceived by end-users? Five APNs were provided with the scenarios and the list of tasks to evaluate the application. Their verbalizations were recorded through Morae usabil ity software. Data analysis was based on the data captured through Morae, transcriptions, notes, and the end-user survey. Results: End-users completed all the required tasks without encountering a severe usability problem, and agreed that the system was easy to use. clear, concise, and useful. Usability issues that were unrecognized by the developer or usability experts were identified by APNs. The usability problems were categorized according to positive characteristics, negative characteristics, and recommendations. The usability issues were discussed with the project team members, and solutions were suggested to improve the user interface of the PDA-based decision support system before the final implementation. Conclusions: This approach had an important impact on making the system easier to use and more useful from the perspective of design and content. The results of this evaluation provided iterative feedback regarding the design and implementation of the PDA-based decision support system for the management of obesity.

• Journal of Korean Neurosurgical Society
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• v.39 no.6
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• pp.471-474
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• 2006

Objective : Neuroimaging data are of paramount importance in making correct diagnosis. We herein evaluate the clinical usefulness of image transfer using cellular phones to facilitate neurological diagnosis and decision-making. Methods : Selected images from CT, MRI scans, and plain films obtained from 50 neurosurgical patients were transferred by cellular phones. A cellular phone with a built-in 1,300,000-pixel digital camera was used to capture and send the images. A cellular phone with a 262,000 color thin-film transistor liquid crystal display was used to receive the images. Communication between both cellular phones was operated by the same wireless protocol and the same wireless internet service. We compared the concordance of diagnoses and treatment plans between a house staff who could review full-scale original films and a consultant who could only review transferred images. These finding were later analyzed by a third observer. Results : The mean time of complete transfer was $2{\sim}3\;minutes$. The quality of all images received was good enough to make precise diagnosis and to select treatment options. Transferred images were helpful in making correct diagnosis and decision making in 49/50 [98%] cases. Discordant result was caused in one patient by improper selection of images by the house staff. Conclusion : The cellular phone system was useful for image transfer and delivery patient's information, leading to earlier diagnosis and initiation of treatment. This usefulness was due to sufficient resolution of the built-in camera and the TFT-LCD, the user-friendly features of the devices, and their low cost.

• Journal of East-West Nursing Research
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• v.23 no.2
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• pp.124-133
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• 2017

Purpose: The purpose of this study was to identify factors that affect nursing students' clinical practice ability. Methods: The data were collected from 303 nursing students who had more than 500 hours of experience in clinical practicum at 4 universities in Seoul and the metropolitan area. The instruments consisted of 27 items of critical thinking, 19 items of professionalism, 40 items of self reported leadership, 20 items of communication evaluation tool, and 61 items of nursing practice performance evaluation. Results: For the clinical practicum, most difficult for nursing students were cardiopulmonary resuscitation, fecal enema, stoma care, and blood transfusion. Clinical practice abilities were positively correlated with nursing professionalism(r=.26, p<.001), leadership (r=.16, p=.007) and critical thinking(r=.12, p=.031). Professionalism(${\beta}=.32$, p=.001) was the most significant factor influencing the clinical practice ability of nursing students. Critical thinking was the second largest factor but not significant(${\beta}=.16$, p=.058). Conclusion: The findings suggest that the nursing curriculum should include nursing knowledge and nursing skills as well as various case-based or field-based decision making training programs to cultivate professionalism, critical thinking and other abilities for clinical practice.

• Journal of Preventive Medicine and Public Health
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• v.57 no.5
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• pp.508-510
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• 2024

Population aging is a global health priority due to the dramatic increase in the proportion of older persons worldwide. It is also expected that both global life expectancy and disability-free life expectancy will increase, leading to a significant rise in the proportion of individuals with extreme longevity, such as non-agenarians and centenarians. The inaccuracy of clinical evidence on therapeutic interventions for this demographic could lead to biased decision-making, influenced by age-related beliefs or misperceptions about their therapeutic needs. This represents a potential clinical ageism scenario stemming from gaps in clinical evidence. Such biases can result in 2 significant issues that adversely affect the health status and prognosis of older persons: polypharmacy and therapeutic inertia. To date, documents on polypharmacy in non-agenarians and centenarians account for less than 0.35% of the overall available evidence on polypharmacy. Furthermore, evidence regarding therapeutic inertia is non-existent. The purpose of this letter is to discuss polypharmacy and therapeutic inertia as potential clinical ageism scenarios resulting from the clinical evidence gaps in extreme longevity.

• Journal of Korean Academy of Nursing
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• v.36 no.4
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• pp.652-661
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• 2006

Purpose. The purposes of this study were to apply data mining tool to nursing specific knowledge discovery process and to identify the utilization of data mining skill for clinical decision making. Methods. Data mining based on rough set model was conducted on a large clinical data set containing NMDS elements. Randomized 1000 patient data were selected from year 1998 database which had at least one of the five most frequently used nursing diagnoses. Patient characteristics and care service characteristics including nursing diagnoses, interventions and outcomes were analyzed to derive the meaningful decision rules. Results. Number of comorbidity, marital status, nursing diagnosis related to risk for infection and nursing intervention related to infection protection, and discharge status were the predictors that could determine the length of stay. Four variables (age, impaired skin integrity, pain, and discharge status) were identified as valuable predictors for nursing outcome, relived pain. Five variables (age, pain, potential for infection, marital status, and primary disease) were identified as important predictors for mortality. Conclusions. This study demonstrated the utilization of data mining method through a large data set with stan dardized language format to identify the contribution of nursing care to patient's health.

• International Journal of Computer Science & Network Security
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• v.24 no.7
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• pp.11-23
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• 2024

Triage is a practice of accurately prioritizing patients in emergency department (ED) based on their medical condition to provide them with proper treatment service. The variation in triage assessment among medical staff can cause mis-triage which affect the patients negatively. Developing ED triage system based on machine learning (ML) techniques can lead to accurate and efficient triage outcomes. This study aspires to develop a triage system using machine learning techniques to predict ED triage levels using patients' information. We conducted a retrospective study using Security Forces Hospital ED data, from 2021 through 2023 during Hajj period in Saudia Arabi. Using demographics, vital signs, and chief complaints as predictors, two machine learning models were investigated, naming gradient boosted decision tree (XGB) and deep neural network (DNN). The models were trained to predict ED triage levels and their predictive performance was evaluated using area under the receiver operating characteristic curve (AUC) and confusion matrix. A total of 11,584 ED visits were collected and used in this study. XGB and DNN models exhibit high abilities in the predicting performance with AUC-ROC scores 0.85 and 0.82, respectively. Compared to the traditional approach, our proposed system demonstrated better performance and can be implemented in real-world clinical settings. Utilizing ML applications can power the triage decision-making, clinical care, and resource utilization.

• Proceedings of the Korea Information Processing Society Conference
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• 2012.11a
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• pp.450-451
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• 2012

The need of Clinical Decision Support System (CDSS) in healthcare setup is increasing day by day. EHR Meaningful Use advocates CDSS as an important component of EHR/EMR systems. CDSS can be ranged from a simple to a very sophisticated system. The more complex CDSS systems need more attention to develop because of many reasons including its Knowledge Base (KB) structure/maintenance/evolution, inference capabilities and usability. Above all the KB maintenance and evolution is very crucial and important from the perspective of useful decision capabilities. Also the richness of the KB is important to cover the decision gaps handling a particular situation in the course of patient care. It cannot be expected from the clinicians to remember everything in regard to patient diagnosis and treatment. Similarly, it is also crucial for clinicians to keep themselves updated with the new research in the area. That is the reason they frequently require accessing to the online knowledge resources. Literature proved that online knowledge resources are capable providing answers to questions that might not be answered rely only on clinician wisdom and experience. This paper provides the theme of meaningful utilization of online knowledge resources in the context of diagnosis and treatment process for cancer patients more specifically Head and Neck cancer.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.181-186
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• 2016

Background: There has been on increasing emphasis on the importance of monitoring the safety of participants in a clinical trial to protect patients and maintain the integrity of the trial. The independent data monitoring committee (IDMC) has become common component of randomized clinical trials in recent years. Methods: It is important to consider the implications of different approaches that are being used in various countries. IDMC guidelines in Korea, US, and Europe were reviewed and compared to provide the objective, composition and operation of IDMC in detail. Results: IDMC is a group of experts in related subject are as who perform interim data monitoring to make a recommendation to the sponsor or organizer regarding appropriateness of trial continuation and the need for modifications of the trial. Independence of IDMC is preferred in order to minimize influence of factors unrelated to scientific, medical and ethical considerations that should underlie decision-making. Conclusion: IDMC has become an increasingly important component of clinical trials in recent years. Practical operating procedures need to be developed considering the future regulatory status of data monitoring committees.

• Korean Journal of Adult Nursing
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• v.27 no.5
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• pp.604-611
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• 2015

Purpose: Knowledge, clinical reasoning, and self-confidence are the basis for undergraduate education, and determine students' level of competence. The purpose of this study was to assess the effects of the addition of a one-time simulation experience to the didactic curriculum on nursing students' knowledge acquisition, clinical reasoning skill, and self-confidence. Methods: Using a quasi-experimental crossover design consisted of intervention and wait-list control groups. Participants were non-randomly assigned to the first intervention group (Group A, n=48) or the wait-list control group (Group B, n=46). Knowledge level was assessed through a multiple choice written test, and clinical reasoning skill was measured using a nursing process model-based rubric. Self-confidence was measured using a self-reported questionnaire. Results: Results indicated that students in the simulation group scored significantly higher on clinical reasoning skill and related knowledge than those in the didactic lecture group; no difference was found for self-confidence. Conclusion: Findings suggest that undergraduate nursing education requires a simulation-based curriculum for clinical reasoning development and knowledge acquisition.