• Journal of Korean Biological Nursing Science
• /
• v.20 no.4
• /
• pp.228-235
• /
• 2018

Purpose: This study aimed to investigate the clinical alarm occurrence and management of nurses toward clinical alarms in the intensive care unit (ICU). Methods: This observational study was conducted with 40 patients and nurses cases in two ICUs of a university hospital. This study divided 24 hours into the unit of an hour and conducted two times of direct observation per unit hour for 48 hours targeting the medical devices applied to 40 patients. Data were analyzed using IBM SPSS Statistics 23. Results: On average, 3.8 units of medical devices were applied for each patient and the ranges of alarm settings were wide. During 48 hours, 184 cases of clinical alarm were occurred by four types of medical devices including physiological monitors, mechanical ventilators, infusion pumps, and continuous renal replacement therapy. Among them, false alarm was 110 cases (59.8%). As for the alarm management by ICU nurses, two-minute alarm mute took up most at 38.0% (70 cases), and no response was second most at 32.6% (60 cases). When valid alarm sounded, nurses showed no response at 43.2%. Conclusion: The findings suggest that a standard protocol for alarm management should be developed for Korean ICU settings. Based on the protocol, continuous training and education should be provided to nurses for appropriate alarm management.

• Journal of Korean Academy of Nursing Administration
• /
• v.20 no.5
• /
• pp.535-544
• /
• 2014

Purpose: This study was done to develop a schematized alarm-managing manual for continuous renal replacement therapy (CRRT) and to investigate its effects in maintaining continuity in the patients' treatment and promptly resolving alarms when CRRT is being carried out. Methods: Sixtynurses from two medical intensive care units (ICUs) (one experimental and one control) at one hospital were asked to answer a questionnaire including their CRRT nursing competency and satisfaction with the manual. Data on alarm resolution rate were collected by analyzing existing data, such as the details of each alarm and the number of resolutions around the clock in the CRRT device. Results: The alarm resolution rate and some of CRRT nursing competency scores in the experimental group were higher than those in the control group. The experimental group was also satisfied with the manual. Conclusion: The study confirmed that the schematized alarm-managing manual can be useful for ICU nurses to resolve alarms and can be used as a guideline. Application of this manual to clinical practices and its use can therefore, be encouraged through continuous education and promotion.

• Journal of Korean Public Health Nursing
• /
• v.21 no.1
• /
• pp.46-56
• /
• 2007

Purpose: This study attempted to identify the sexual function (ALARM: Activity, Libido, Arousal and orgasm, Resolution, Medical history) of patients who have had an ostomy for the development of an ALARM sexual counseling program. Method: Subjects for this descriptive study were recruited from the outpatient clinic of a university affiliated medical center and peer group. Fifty-two subjects who have had an ostomy and lived with their spouse were selected. Instruments were developed by researchers based on the ALARM model by Anderson (1990). Results: In the subject group, 32.7% patients were not sexually active and 76.9% hesitated to have sexual activity because of the stoma. The mean score of resolution was 13.2 (range: 8-32), with a higher score for couple's intimacy indicating a higher level of libido and resolution. Conclusion: This study presents a series of clinical guidelines that nurses can use to accurately assess sexual health issues and select appropriate sexual counseling for patients with an ostomy.

• Clinics in Shoulder and Elbow
• /
• v.26 no.4
• /
• pp.416-422
• /
• 2023

Background: Advancements in airport screening measures in response to 9/11 have resulted in increased false alarm rates for patients with orthopedic and metal implants. With the implementation of millimeter-wave scanning technology, it is important to assess the changes in airport screening experiences of patients who underwent total shoulder arthroplasty (TSA). Methods: Here, 197 patients with prior anatomic and reverse TSA completed between 2013 and 2020 responded to a questionnaire regarding their experiences with airport travel screening after their operation. Of these patients, 86 (44%) stated that they had traveled by plane, while 111 (56%) had not. The questionnaire addressed several measures including the number of domestic and international flights following the operation, number of false alarm screenings by the millimeter-wave scanner, patient body habitus, and presence of additional metal implants. Results: A total of 53 patients (62%) responded "yes" to false screening alarms due to shoulder arthroplasty. The odds of a false screening alarm for patients with other metal implants was 5.87 times that of a false screening alarm for patients with no other metal implants (P<0.1). Of a reported 662 flights, 303 (45.8%) resulted in false screening alarms. Greater body mass index was not significantly lower in patients who experienced false screening alarms (P=0.30). Conclusions: Patients with anatomic and reverse TSA trigger false alarms with millimeter-wave scanners during airport screening at rates consistent with prior reports following 9/11. Patient education on the possibility of false alarms during airport screening is important until improvements in implant identification are made. Level of evidence: IV.

• Journal of Computing Science and Engineering
• /
• v.10 no.3
• /
• pp.75-84
• /
• 2016

Medical cyber-physical systems (MCPS) integrate sensors, actuators, and software to improve patient safety and quality of healthcare. These systems introduce major challenges to safety analysis because the patient's physiology is complex, nonlinear, unobservable, and uncertain. To cope with the challenge that unidentified physiological parameters may exhibit short-term variances in certain clinical scenarios, we propose a novel run-time predictive safety monitoring technique that leverages a maximal model coupled with online training of a computational virtual subject (CVS) set. The proposed monitor predicts safety-critical events at run-time using only clinically available measurements. We apply the technique to a surgical glucose control case study. Evaluation on retrospective real clinical data shows that the algorithm achieves 96% sensitivity with a low average false alarm rate of 0.5 false alarm per surgery.

• Journal of the Korean Institute of Telematics and Electronics B
• /
• v.30B no.11
• /
• pp.47-55
• /
• 1993

This paper is to design an autobalancing system based-on microprocessor for hemodiafiltration (HDF) system. The proposed system consist of motor control part, thermostatic control part, alarm system and electronic scale which ar automatically controlled by microprocessor. Conventional hemodialysis system can not remove medium molecular articles but hemodialysis system with the proposed system can remove and infuse substitute to the patient. This system can be easily interfaced with any other conventional HD system. The results obtained from performance evaluation of the proposed system are suitable for clinical supporting system.

• Neonatal Medicine
• /
• v.17 no.2
• /
• pp.245-249
• /
• 2010

Purpose: Numerous false alarms by pulse oximetry, which is widely used in neonatal intensive care unit, can delay response to true alarms. Masimo $SET^{(R)}$ was introduced lately, to overcome false alarms by motion. We compared the clinical performance of two devices (Nellcor $N-595^{(R)}$ and Masimo $SET^{(R)}$) for the evaluation of the false alarm frequency during usual motion artifacts and stable state. Methods: A total of 20 preterm infants weighing 1,000-2,500 g were enrolled in the study. The sensors of two devices were placed on the different feet on the same infants, and both devices were programmed to emit an alarm for episode of hypoxemia (SpO2$\leq$85%). The false alarms were defined as episodes of poor correlation with ECG heart rate, poor waveforms, and the absence of obvious signs of hypoxia. We compared the frequency of false alarms between the two devices. Results: The mean chronological age was 20.8 days and the mean body weight was 1,668 g on the study day. The frequency of total false alarm was significantly fewer for Masimo $SET^{(R)}$ pulse oximetry (48 in Nellcor $N-595^{(R)}$, 27 in Masimo $SET^{(R)}$) although the false alarm during usual motion artifacts was not significantly between two devices (32 in Nellcor $N-595^{(R)}$, 19 in Masimo $SET^{(R)}$). Conclusion: The Masimo $SET^{(R)}$ pulse oximetry has fewer false alarm rates and identified more true hypoxic events than Nellcor $N-595^{(R)}$ pulse oximetry. Therefore, it is useful for adequate oxygen therapy and helps to decrease unnecessary handling by clinicians and nurses.

• Clinical and Experimental Pediatrics
• /
• v.51 no.11
• /
• pp.1140-1146
• /
• 2008

Nocturnal enuresis is a heterogeneous disorder with various underlying pathophysiological mechanisms and causes a mismatch between the nocturnal bladder capacity and the amount of urine produced during sleep at night. It is associated with a simultaneous failure of conscious arousal in response to the sensation of bladder fullness. Generally, a complete history and physical examination, with a specific focus on the genitourinary, gastrointestinal, and neurologic systems, is sufficient to evaluate a patient with enuresis. The therapeutic focus is directed toward a differential approach based on the underlying mechanism and toward combination therapies such as alarm devices and desmopressin as well as anticholinergic agents and desmopressin. Children with increased nocturnal urine production usually have a good response to desmopressin therapy. Patients with a small bladder generally show a poor response to desmopressin treatment, but they would benefit more from combination therapy with enuretic alarm, urotherapy, and antimuscarinic agents in addition to desmopressin. Different types of bladder dysfunction, which result in a small nocturnal bladder capacity, probably contribute significantly to the pathogenesis of nocturnal enuresis, particularly in those with treatment failure and refractory symptoms. Because different clinical subgroups may show different responses to treatment, it is necessary to distinguish these subgroups before a decision on the specific treatment protocol can be made.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.1 no.1
• /
• pp.61-71
• /
• 2006

Objectives : To introduce Total Body Modification(TBM) technique system developed by Dr. Victor Frank DC, DO, ND through combining chiropractic manipulation with osteopathy, acupuncture meridian system, and naturopathy based on his long-time clinical experiences and insights. Methods : After investigating the art, philosophy and science of TBM thechnique, and applying TBM practice under private clinical situation, we compared It with Chuna Korean manual medicine and oriental medicine system. Results : This system deals with correcting human body's functional physiology to potentiate in a favorable manner. TBM uses a neuromuscular reflex test and body access meridian points to tap into the body's biocomputer and read functional programs. Corrections are usually made by means of special respiratory spinal adjustment, cranial, soft tissue, or specific joint manipulation. Conclusions : We found similarities between TBM and Chuna system in the view of Korean Traditional meridian concept. The special combinations and sequences of various alarm points and associated points have clinical effects on the treatment of chronic spinal subluxation pattern. This suggests TBM has significance In the point of the future evolution of Chuna manual medicine in Korea.

• The Journal of Pediatrics of Korean Medicine
• /
• v.29 no.4
• /
• pp.90-96
• /
• 2015

Objectives The purpose of this study was to report 35 children who had sleep disorder like night crying or night terror after traffic accidents. Methods This clinical study had been carried out with 35 infants and children, who visited to the department of Pediatrics, ${\bigcirc}{\bigcirc}$ Oriental Medical Hospital from January 2012 to June 2015. Results The study group had similar sex the ratio between boys and girls and the group had more of 1-3 year-old children. The number of patients who were diagnosed as night crying were 24, night terror were 7 and palpitation due to alarm were 4. All patients took herb medicine and 15 patients were treated by acupuncture. During the treatment, symptom of night crying and terror were disappeared. Conclusions This result showed that the oriental medical treatment was effective in children who suffered from night crying or night terror after traffic accidents.