• Title/Summary/Keyword: Clinical Setting

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Current status of routine use of Patient-Reported Outcome in the tertiary hospital clinical setting in Republic of Korea (대한민국 상급 종합병원 임상현장에서 환자자기평가결과(Patient-Reported Outcome)의 일상적인 사용 현황)

  • Bang, Garam;Kang, Danbee;Cho, Juhee
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.2
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    • pp.74-83
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    • 2022
  • Objective: There is a growing movement to introduce Patient-Reported Outcome (PRO) to clinical settings. This study aimed to investigate the routine use of PRO in tertiary hospital clinical settings. Methods: From January 2016 to December 2018, the usage status of Patient-Reported Outcome Measures (PROMs) submitted to the electronic medical record of a tertiary hospital clinical setting was investigated. Descriptive analysis was conducted to investigate the usage status of PROMs by 42 departments. Also, the most frequently used PROMs by departments, the purpose of measurement, the use rate of verified PROMs were investigated. Results: The PROMs accounted for 66% (98) of the 148 Instruments. Of the 98 PROMs, 64% (63) were using a validation Korean version of PROMs. Only about 1% of total outpatient visits applied PROMs, and among them, it was frequently used in urology (13%), orthopedics (8%), and otolaryngology (5%). The use rate of the validated PROMs was found to be 64%. Conclusions: The use of PROMs in domestic clinical settings was found to be very limited and frequently used only in specific departments. It is essential to use a PROMs that has been validated according to guidelines, as the use of validated PROMs will provide beneficial information to health professionals and also for the patient health improvement by objectively measuring the patient's health status.

Evaluation of Autochemical Analyzer Toshiba 120 FR (자동화학 분석기 Toshiba 120 FR의 평가)

  • Park, Jum Gi
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.2
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    • pp.98-109
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    • 2004
  • The lower limit of detection, precision, setting method of target value, reportable range determination, recovery, linearity, and comparison study with another equipment was evaluated for the Toshiba-120FR chemistry autoanalyzer which was newly introduced at the Daejeon Veteran Hospital in Dec. 2003. Nineteen kinds of test for AST, ALT, ALP, LDH, GGT, TP, ALB, GLU, T-cho, T-bil, TG, UA, CAL, IP, AMY, HDL-C, LDL-C, Cre and BUN were performed to evaluate the lower limit of detection, precision, setting method of target value, reportable range determination, recovery, linearity, and comparison study with other equipment according to the NCCLS guidelines(EP5-A, EP6-P, EP9-A). The Toshiba-120FR autochemical analyzer showed good precision for all tested items. The data concerning the lower limit of detection, precision(total CV 0.47%~3.65%), setting method of target value, reportable range determination, recovery(93%~111%), linearity($R^2=0.997{\sim}0.999$), and comparison study(r=0.977~0.999) with other equipment was acceptable for all tested items. The results of evaluation for the Toshiba-120FR autochemical analyzer showed that this equipment could be used as an alternative to other equipment.

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ADA Levels in Body Fluids as the Preferred Test to Rule Out Tuberculosis in Limited-resource Settings: Data from a Tertiary Care Hospital in Northern India

  • Rasool, Rafia;Rashid, Gowhar;Mir, Shafat Ahmad;Rather, Tahseen Bilal;Mudassar, Syed
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.3
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    • pp.167-172
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    • 2022
  • In clinical practice, the diagnosis of tuberculosis (TB) continues to be a challenge. The goal of this study was to evaluate the reliability and impact of adenosine deaminase (ADA) enzyme testing as a biochemical marker in the continued management of suspected tuberculosis in a limited resource setting hospital. The retrospective data were collected from 2018 to 2021 and comprised the results of all ADA test assays done in the laboratory. All types of body fluids received for ADA testing were analyzed. Over the course of two years, 1461 samples for ADA assay testing were received. The average age of the study population was 56.69±11.7 years, with males accounting for the majority of the subjects (55.72%). Pleural fluid (N=817, 55.92%) was the most common type of sample received for the ADA assay. 114 (13.95%) of the 817 pleural fluid samples were found to be positive. A survey was conducted to obtain physician's response regarding reliability on ADA testing. 100% of them reported the supportive role of ADA levels in the workup of patients with suspected tuberculosis. In a limited resource setting, the ADA test, in conjunction with clinical and other laboratory findings, can help physicians to initiate early treatment in hospitals for the benefit of patients.

Immunotherapy in Head and Neck Squamous Cell Cancer

  • Denaro, Nerina;Merlano, Marco Carlo
    • Clinical and Experimental Otorhinolaryngology
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    • v.11 no.4
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    • pp.217-223
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    • 2018
  • Prognosis in relapsed metastatic head and neck squamous cell cancer (RM-HNSCC) is dismal. Platinum based chemotherapy in combination with Cetuximab is used in first-line setting, while no further validated options are available at progression. Immunotherapy has produced durable clinical benefit in some patients with RM-HNSCC although the premises are several patients are nonresponders. Studies are ongoing to determine predictive factors and the ideal setting/combination of novel immunotherapies. In this paper, we discuss the past and present of immunotherapy in head and neck cancer and provide an up-to-date information regarding the potential ways to improve immunotherapy outcomes in HNSCC.

A Study on the Relationship between Self-esteem, Self-efficacy and Clinical Practice Performance, Academic Achievement, Decision Making of Major Field in Clinical Practice (간호학생의 자아존중감 및 자기효능감과 임상실습수행, 학업성취, 전공실습결정과의 관계)

  • Kim, Young-Sook;Kim, Myung-Soon;Cho, Won-Sun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.8 no.1
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    • pp.51-60
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    • 2002
  • The purpose of this study was to identify the relationship between self-esteem, self- efficacy and clinical practice performance, academic achievement, decision making of major field in clinical practice . The study subjects consisted with 244 students from G. junior nursing college that will adapt a new majoring program of clinical nursing practice funded by Ministry of human and resources development. Data were analyzed using descriptive statistics, and t-test, Pearson correlation, and multiple regression. The results of this study were summarized as follows: 1. The students were relatively performed well in clinical practice setting (total M :3.78). The item of student's personal relationship between patients, patient's family, and professional staff showed high score (M=3.96). However students did not feel comfortable to communicate with patients, patient's family and professional staffs in clinical setting(mean=3.56). 2. Students who had experiences of temporal absence from school showed significant difference in the variable of academic achievement and decision making of major field in clinical practice Students who entered to nursing school with self-motive revealed statistically significant difference in the variable of clinical practice performance, academic achievement, self-esteem, self-efficacy, and decision making of major field in clinical practice. 3. There was a significant correlation between self-esteem and clinical practice performance, (r=.512, p<.000). And the relation between self-esteem and decision making of major field in clinical practice was significantly correlated(r=.377, p<.000). Self-efficacy and clinical practice performance(r=.567, p<.000), and decision making of major field in clinical practice (r=.441, p<.000) showed significant correlations. Also relation between academic achievement and self-esteem reveled a significant correlation(r=.129, p<.05) but correlation between self-efficacy and academic achievement was not significant. 4. Correlation between clinical practice performance and decision making of major field in clinical practice also identified a significant relation(r=.498, p<.000). 5. Self-esteem and self-efficacy variables predicted clinical practice performance and explained 37.7% of clinical practice performance. 6. Aptitude and personal interests(m=4.07) reveled important factor affecting to select majoring area in clinical practice, and advice from parents reflected low percentage on selecting places(m=2.42). In conclusion, the variables of self-esteem and self-efficacy showed significant correlations with the variables of student's clinical practice performance, academic achievement, and decision making of major field in clinical practice. Thus it is recommended that student's affective domain of self-esteem and self-efficacy should be developed by nursing intervention before clinical nursing education.

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Development of Evidence Based Clinical Practice Guideline to Improve Quality of Critical Care Nursing (중환자 간호실무 질 향상을 위한 근거중심 임상실무지침서의 개발)

  • Park, Myong-Hwa
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.68-78
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    • 2009
  • Evidence based clinical practice guideline are designed to help healthcare practitioners evaluate and implement the increasing amount of evidence on best practice. Critical care area is one of the clinical sites where evidence based clinical practice guideline is needed most. This paper reviewed the definition of evidence based clinical practice guidelines, the development method of evidence based clinical practice guideline, and the current trends in guideline developing. Traditional method of guideline development is consensus based but it moves into evidence based development. Evidence based guideline is based on best available evidence and uses the strongest method to determine its effect on clinical outcomes. The current trends in guidelines is to develop the guideline at regional/national level and do subsequent modification to suit local circumstances. There is an urgent need of exploring the method of guideline development and adaptation which are appropriate for Korean clinical setting.

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What is the Most Effective Strategy for Improving the Cancer Screening Rate in Japan?

  • Sano, Hiroshi;Goto, Rei;Hamashima, Chisato
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2607-2612
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    • 2014
  • Background: Cancer screening rates in Japan are much lower than those in Western countries. This study evaluated the relationship between cancer screening rates and strategies used to improve screening rates, and determined which strategy is the most effective. Materials and Methods: All municipalities are responsible for conducting gastric, lung, colorectal, cervical, and breast cancer screenings in Japan. Of the 1,746 municipalities in total, 92-99% were included in the analyses for each cancer screening. Using national data in 2009, the correlations between cancer screening rates and strategies for improving screening rates of all municipalities, both large (populations of over 30,000) and small (populations of under 30,000), were determined. The strategies used were as follows: sending personal invitation letters, personal visits by community health workers, use of a clinical setting for screening, and free screening. Results: Of all four strategies used to improve cancer screening rates, sending personal invitation letters had the highest correlations with all screening rates, with the exception of breast cancer screening. The partial correlation coefficients linking this strategy with the screening rates in all municipalities were 0.28, 0.32, 0.30, and 0.26 for gastric, lung, colorectal, and cervical cancer screening, respectively. In large municipalities, the correlations between the number of examinees in a clinical setting and the screening rates were also relatively high, particularly for cervical cancer screening (r=0.41). Conclusions: Sending personal invitation letters appears to be particularly effective in improving cancer screening rates in all municipalities. All municipalities should implement a system that sends personal invitation letters for cancer screening. In large municipalities, increasing the availability of screening in a clinical setting is also effective in improving cancer screening rates.

Transition of Simulation-Based Learning in Nursing Schools: A Concept Analysis (간호대학 시뮬레이션 교육의 이행(transition)에 대한 개념 분석)

  • Ha, Yi Kyung;Bang, Hwal Lan;Lee, Yeon Hee
    • Journal of Korean Critical Care Nursing
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    • v.12 no.2
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    • pp.50-60
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    • 2019
  • Purpose : The purpose of this study was to identify the attributes, antecedents, and consequences of the transition of simulation-based learning (SBL) in nursing schools. Methods : The study was conducted in accordance with Walker and Avant's conceptual analysis process. We searched MEDLINE, CINAHL, EMBASE, Google Scholar, and RISS (Korean Education and Research Information Service) databases, resulting in nine studies for an in-depth review. Results : The attributes of transition of SBL include (1) preparing for a professional role, (2) practicing in a real clinical setting, and (3) progressing toward expected competency. Antecedents of the concept include novice status, changing roles, clinical experience in controlled settings, and expected competency in the clinical setting. Conclusion : The transition of SBL includes the important feature of progression toward expected competency. Further research is needed to identify graduate nurses' experiences during this transition to establish a strategy for improving it and developing a measurement tool that reflects attributes of the concept.

A Feasibility Study of Acupuncture for Chronic Pain in Patients with Osteoporotic Thoracolumbar Compression Fracture: A Prospective Case Series

  • Bae, Ji min;Choi, Ji won;Kim, Dae hun;Yang, Gi Young;Kim, Kun hyung
    • Journal of Acupuncture Research
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    • v.35 no.2
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    • pp.75-80
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    • 2018
  • Background: The aim of this study was to assess the feasibility of conducting a clinical study of using acupuncture for chronic pain in patients with osteoporotic thoracolumbar vertebral compression fractures (VCFs) in the outpatient setting. Methods: A prospective case-series attempting to recruit 20 participants was performed from February 11, 2016, to December 31, 2016. We provided Manual and electrical acupuncture was provided one 1 to three 3 times a week, for 6 weeks, up to 18 sessions. The primary clinical outcome was the average pain intensity as measured by the visual analog scale (VAS) at 6 weeks. Secondary outcomes included back-specific dysfunction (Oswestry disability index), quality of life (quality of life questionnaire-26), patient-reported improvement, use of other healthcare resources, and adverse events at 6 weeks. Use of healthcare resources and adverse events were additionally followed-up at 12 weeks by telephone. Results: Of 33 patients screened, a total of 7 were enrolled in the study. Manual and electrical acupuncture was provided 1 to 3 times a week, for 6 weeks, up to 18 sessions. We observed reduced pain intensity at 6 weeks in all participants. The change in the quality of life and back-specific dysfunction was inconsistent among participants. Mild, temporary adverse events were observed in three patients. Conclusion: In our clinical setting, it was not feasible to recruit sufficient participants and to assess the efficacy of acupuncture for chronic pain after osteoporotic thoracolumbar VCFs under a year. Strategies to improve recruitment and to identify barriers to participation are required for future clinical trials.

A Study on the Development of Cooperative Clinical Nursing Education Model (산학공조형(Co-op) 간호실습교육 운영모형 개발)

  • Cho, Kap-Chul;Boo, Eun-Hee;Roh, Young-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.11 no.2
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    • pp.127-134
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    • 2005
  • Purpose: The purpose of the study was to develop a cooperative clinical nursing education model in response to the challenge to provide quality clinical instruction for nursing students. Method: A hypothesized model was developed based on literature review and Cho's partnership model of preservice teacher. Final model was refined with cooperative committee meetings, workshop and post clinical education meetings. Results: A Cooperative clinical nursing education model was developed with three phases(collaboration, planning, redefinition of major roles) and ten constructs(organization of cooperative committee, goal setting, partnership contract, planning objectives, and operating manual). Conclusion: The Cooperative clinical nursing education model support the need for continued collaborative partnership between nursing college and hospitals to foster quality clinical instruction.

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