• Title/Summary/Keyword: Clinical Decision-Making

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A Descriptive Study for Fever Management in Adult Febrile Patients (성인 발열환자의 발열관리 실태 조사)

  • Kim, Hyun Jung;Shin, Yong Soon;Kim, Sung Reul;Yoo, Sung Hee;Kim, Sun Hwa;Kim, Jeoung Hee;Na, Ra;Chae, Jee Sun;Lee, Hye Jin;An, Young Hee
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.1
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    • pp.96-104
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    • 2013
  • Purpose: The specific aims of this study were to define fever from the nurse's and physician's perspectives, describe fever management method and decision-making, and identify differences of definition of fever and fever managements between nurses and physicians. Methods: A cross-sectional survey using a 23-item questionnaire was used. A total of 305 nurses and physicians were surveyed, and 246 useful questionnaires were returned. Results: Body temperature of $36.5{\sim}38.3^{\circ}C$ were considered as adult febrile, and fever managements were initiated when the temperature was $37.0{\sim}38.0^{\circ}C$. More than half of the nurses and physicians, made a clinical decision regarding fever managements based on their own experiences. The most frequently used interventions in nursing practice were antipyretics, intravenous hydration, and external cooling. Nurses provided external cooling to lower body temperature than physicians (Z=-4.67, p<.001). Most participants reported that they needed a fever management protocol. Conclusion: Based on the information obtained, nurses respond with sensitivity to lower body temperature. We found significant differences among nurses, between nurses and physicians in approaching care of adult febrile patients.

Clinical Diagnosis for Orthopaedic Manual Therapy (정형물리치료를 위한 임상진단)

  • Bae Sung-Soo;Chae Yun-Won
    • The Journal of Korean Physical Therapy
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    • v.10 no.1
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    • pp.155-171
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    • 1998
  • Interest in mannual therapy appears to continue to grow among physical therapists. The term 'mannual therapy' has traditionally been associated with physical therapists who examine and treat Patients who have disorders related to the neuro-muscular-articular system.. The manipulative means skilled and specialised use of manual and/or mechanically applied movement techniques, as a part of comprehensive orthopaedic physical therapy for disorders of the moving parts of body. Physical therapists use a large variety of manually applied examination procedures as part of the clincal decision-making process. The purpose of this article is to define and clarify the basic concepts of mannual therapy by comparing the geneal concepts and evaluation schemes of James Cyriax, John McM. Mennell, Geoffrey Maitland, Freddy Kaltenborn, Robin McKenzie, and Ola Grimsby. This article stresses the importance of developing stills in evaluation. Gimsby's approch is presented as a example of modem mannual therapy.

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Quality Assurance for Radiation Oncology (치료방사선과 영역의 적정관리)

  • Kim, Gwi-Eon
    • Quality Improvement in Health Care
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    • v.2 no.1
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    • pp.110-117
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    • 1995
  • The Comprehensive quality assurance for radiation oncology provides an overall organizational structures, responsibilities, procedures, processes and resources for assuring the quality of patient management by radiation treatment. Superior performance of modern radiotherapy equipment will be essential part of quality assurance in radiation oncology, which high degree of accuracy and consistency should be maintained under the optimal quality assurance program. Besides quality control of all radiation equipment, this review also emphasizes quality assurance of clinical aspect such as adequacy of the medical decision-making which eventually leads to the treatment prescription, accuracy of treatment procedure from treatment preparation to radiation delivery, and the significance of assessment of treatment outcomes with structure and process.

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Transfusion practice in neonates

  • Kim, Do-Hyun
    • Clinical and Experimental Pediatrics
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    • v.61 no.9
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    • pp.265-270
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    • 2018
  • Neonates, especially extremely low birth weight infants, are among the groups of patients undergoing transfusion frequently. Since they are exposed to higher specific transfusion risks compared to the patients of other age groups, there are many special aspects that must be considered for transfusion therapy in neonates. The transfusion risks in neonates include adverse outcomes specific for preterm infants as well as increased metabolic, immunologic, and infectious complications. To reduce the risks of transfusion-transmitted cytomegalovirus infection and transfusion-associated graft-versus-host disease, leukoreduced and irradiated cellular blood products should be used for all neonates. This review summarizes the risks of neonatal transfusion therapy, specific methods to reduce risk, and current trends and practices of red blood cell and platelet transfusions in neonates, to facilitate decision-making for neonatal transfusion.

An Introduction to Data Analysis (자료 분석의 기초)

  • Pak, Son-Il;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.26 no.3
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    • pp.189-199
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    • 2009
  • With the growing importance of evidence-based medicine, clinical or biomedical research relies critically on the validity and reliability of data, and the subsequent statistical inferences for medical decision-making may lead to valid conclusion. Despite widespread use of analytical techniques in papers published in the Journal of Veterinary Clinics statistical errors particularly in design of experiments, research methodology or data analysis methods are commonly encountered. These flaws often leading to misinterpretation of the data, thereby, subjected to inappropriate conclusions. This article is the first in a series of nontechnical introduction designed not to systemic review of medical statistics but intended to provide the journal readers with an understanding of common statistical concepts, including data scale, selection of appropriate statistical methods, descriptive statistics, data transformation, confidence interval, the principles of hypothesis testing, sampling distribution, and interpretation of results.

Nurses' Experience of Practice in Nursing Homes (노인요양시설 간호사의 실무 경험)

  • Chung, Seung-Eun;Lee, Soon-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.1
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    • pp.116-127
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    • 2009
  • Purpose: This article aimed to identify nurses' experience of practice in nursing homes. Method: Using phenomenological approach for qualitative research, the participants were 8 nurses who were working at nursing homse in C city. The data was analyzed by using phenomenological methodology by Colaizzi. Results: Five theme clusters were derived from the data. They were: burden (independent decision making in clinical situations, tension of as a multifunctional member); lowered self-esteem (exhaustion, relative self-evaluation is low, comparing with others); conflict (negative image of elderly, communication break with elderly family, monitoring of nursing home staff); worth (slight improvement of elderly health state, trust and recognition, intimacy); and self-reflection (need for knowledge extension, effort towards enhancing virtue, perception of importance in their health management). Conclusion: The results showed that nursing home nurses experienced negative aspects of various nursing practice, suggesting the ways to solve their negative experience.

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Charaterization of an Escherichia coli O157:H7 Strain Producing Verotoxin 2Isolated from a Patient in Korea

  • Park, Wan;Sohn, Chang-Kyu;Wan Huh;Kim, Byung-Chun
    • Journal of Microbiology
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    • v.38 no.2
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    • pp.93-98
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    • 2000
  • Nine hundred patients diagnosed with diarrhea or hemorrhagic uremic syndrome in the Kyungpook Province, Korea, were examined from November 1998 to February 2000. One patient in Kumi appeared to possess the Escherichia coli O157:H7 strain, which is very important in clinical decision making and public health action. The isolated strain, an E. coli O157:H7 KM, contained a 60 MDa plasmid and typical virulence genes including the verotoxin 2 gene, ehxA gene (encoding enterohemorrhagic hemolysin), and eae (encoding attaching and effacing protein-intimin) gene. This strain produced only verotoxin 2. Pulsed field gel electrophoretic analysis showed that the genomic organization of the E. coli O157:H7 KM strain may differ greatly from those of representative strains previously reported in the United States and Japan.

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Surgical Informed Consent Process in Neurosurgery

  • Park, Jaechan;Park, Hyojin
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.385-390
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    • 2017
  • The doctrine of informed consent, as opposed to medical paternalism, is intended to facilitate patient autonomy by allowing patient participation in the medical decision-making process. However, regrettably, the surgical informed consent (SIC) process is invariably underestimated and reduced to a documentary procedure to protect physicians from legal liability. Moreover, residents are rarely trained in the clinical and communicative skills required for the SIC process. Accordingly, to increase professional awareness of the SIC process, a brief history and introduction to the current elements of SIC, the obstacles to patient autonomy and SIC, benefits and drawbacks of SIC, planning of an optimal SIC process, and its application to cases of an unruptured intracranial aneurysm are all presented. Optimal informed consent process can provide patients with a good comprehension of their disease and treatment, augmented autonomy, a strong therapeutic alliance with their doctors, and psychological defenses for coping with stressful surgical circumstances.

Artificial Intelligence: Will It Replace Human Medical Doctors? (인공지능: 미래의사의 역할을 대체할 것인가)

  • Choi, Yoon Sup
    • Korean Medical Education Review
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    • v.18 no.2
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    • pp.47-50
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    • 2016
  • Development of artificial intelligence is expected to revolutionize today's medicine. In fact, medicine was one of the areas to which advances in artificial intelligence technology were first applied. Recently, state-of-the-art artificial intelligence, especially deep learning technology, has been actively utilized to treat cancer patients and analyze medical image data. Application of artificial intelligence has the potential to fundamentally change various aspects of medicine, including the role of human doctors, the clinical decision-making process, and even overall healthcare systems. Facing such fundamental changes is unavoidable, and we need to prepare to effectively integrate artificial intelligence into our medical system. We should re-define the role of human doctors, and accordingly, medical education should also be altered. In this article, we will discuss the current status of artificial intelligence in medicine and how we can prepare for such changes.

A Clinically, Radiologically Malignant, but Histopathologically Benign Lesion in Oral Cavity (구강내 발생한 임상적, 방사선학적 악성 및 조직병리학적 양성 병소)

  • Oh, Hyun Jun;Jeon, Jae-ho;Myoung, Hoon
    • The Korean Journal of Oral and Maxillofacial Pathology
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    • v.42 no.6
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    • pp.199-204
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    • 2018
  • Differential diagnosis of the malignant lesion and the benign lesion is critically important for the precise treatment. A clinician should diagnose in a comprehensive manner considering clinical, radiological, and histopathological perspectives. The lesion in the oral cavity in this study was clinically and radiologically malignant. However, the lesion was histopathologically benign. Surgical intervention was not performed except biopsy. The lesion improved after about one month of supportive medication after the biopsy. The importance of decision making process was emphasized in this report.