• 제목/요약/키워드: Critical Pathway

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Factors Affecting Discharge Delay in Lumbar Spinal Surgery Patients Who were Treated according to a Critical Pathway (표준진료지침을 적용한 요추 수술 환자의 퇴원 지연에 영향을 미치는 요인)

  • Kim, Jeoung Hee;Lee, Eun Ha;Kim, Su Ran;Kim, Sung Reul
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.43-52
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    • 2016
  • Purpose: The aim of this study was to identify demographic, clinical, physical, and psychosocial factors affecting discharge delay in lumbar spinal surgery patients who were treated according to a critical pathway. Methods: A sample of 170 patients with lumbar spinal surgery agreed to participate in the study, between April 1, 2014 and August 30, 2015. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test, ANCOVA, and logistic regression analysis using SPSS 22.0 program. Results: Approximately fifty-nine percent of the participants was delayed discharge. On logistic regression analysis, female gender (OR=2.63, 95% CI=1.40~4.94), age (OR=1.03, 95% CI=1.01~1.05), spondylolisthesis (OR=4.49, 95% CI=1.90~10.61), and spinal fusion operation (OR=4.14, 95% CI=1.89~9.05) were significant factors predicting discharge delay of the participants. However, discharge delay was not related with pain, physical function, depression, or family support. Conclusion: An analysis of discharge delay may assist in evaluating and revising critical pathway for optimal care. In addition, nurses need to understand the factors affecting discharge delay of the given population who were treated according to a critical pathway.

Minimal systems analysis of mitochondria-dependent apoptosis induced by cisplatin

  • Hong, Ji-Young;Hara, Kenjirou;Kim, Jun-Woo;Sato, Eisuke F.;Shim, Eun Bo;Cho, Kwang-Hyun
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.4
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    • pp.367-378
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    • 2016
  • Recently, it was reported that the role of mitochondria-reactive oxygen species (ROS) generating pathway in cisplatin-induced apoptosis is remarkable. Since a variety of molecules are involved in the pathway, a comprehensive approach to delineate the biological interactions of the molecules is required. However, quantitative modeling of the mitochondria-ROS generating pathway based on experiment and systemic analysis using the model have not been attempted so far. Thus, we conducted experiments to measure the concentration changes of critical molecules associated with mitochondrial apoptosis in both human mesothelioma H2052 and their ${\rho}^0$ cells lacking mitochondrial DNA (mtDNA). Based on the experiments, a novel mathematical model that can represent the essential dynamics of the mitochondrial apoptotic pathway induced by cisplatin was developed. The kinetic parameter values of the mathematical model were estimated from the experimental data. Then, we have investigated the dynamical properties of this model and predicted the apoptosis levels for various concentrations of cisplatin beyond the range of experiments. From parametric perturbation analysis, we further found that apoptosis will reach its saturation level beyond a certain critical cisplatin concentration.

A Study on the Development and Application of Korean Medical Critical Pathway of Childhood Anorexia (소아 식욕부진의 한의표준임상경로 개발 및 시범 적용 연구)

  • Choi Seo Yeon;Jeong Yoon Kyoung;Bang Miran;Chang Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.37 no.3
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    • pp.1-16
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    • 2023
  • Objectives We aimed to investigate the effectiveness of the Korean medical critical pathway (CP) in treating childhood anorexia. Methods In total, 21 patients who met the criteria and agreed to provide information were assigned to the CP group, while 24 patients who met the criteria, agreed to provide information, but disagreed with CP application were assigned to the non-CP group. Demographic, clinical, and economic indices were compared between the two groups. Clinical indices before and after treatment were also compared between the two groups. Results In the CP group, height, weight, body mass index (BMI), BMI percentile, and food approach (FAP) increased significantly after treatment, and numeric rating scale (NRS) and food avoidance (FAV) scores decreased significantly. In the non-CP group, height, weight, weight percentile, BMI, BMI percentile, and FAP increased significantly, whereas NRS and FAV decreased significantly after treatment. Compared to the non-CP group, CP application increased FAP and decreased FAV, medical expenses per consultation, and the total treatment period. Conclusions The application of the Korean medical critical pathway for childhood anorexia is an effective cure system that decreases overall medical expenses with good-quality treatment by means of the standardization of medical practices.

Development of a Critical Pathway for a Korean Medicine Hospital Inpatient with Stroke (중풍 입원 환자 관리를 위한 임상경로 개발)

  • Kim, Mikyung;Han, Chang-ho
    • The Journal of Korean Medicine
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    • v.42 no.2
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    • pp.62-71
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    • 2021
  • Objectives: This study was aimed to share the development process of the critical pathway (CP) for the treatment and management of stroke patients admitted to a Korean medicine hospital. Methods: A draft CP was prepared based on a review of relevant literature and medical records in the hospital, and its validity was reviewed by the in-hospital CP review committee. Each member evaluated all items in the CP on a 5-point Likert scale. Items with an average score of 3.5 or higher or an agreement rate of more than 80% were considered valid. In addition, free described opinions to improve the CP were also received from the review committee. Results: The horizontal axis of the CP was composed of a time domain, including 7 time points from hospitalization to discharge. The vertical axis was composed of 9 domains of medical practice. All items in the CP satisfied the validity criteria. The CP was revised, supplemented, and completed by reflecting the opinions of the committee. Conclusions: This CP will be taught to in-hospital users and will continue to be used with regular monitoring and a feedback plan. This study is expected to serve as a useful reference for standardizing the treatment process and delivering measures to improve the adequacy of Korean medicine treatment for stroke patients.

The Role of Hippo Pathway in Cancer Stem Cell Biology

  • Park, Jae Hyung;Shin, Ji Eun;Park, Hyun Woo
    • Molecules and Cells
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    • v.41 no.2
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    • pp.83-92
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    • 2018
  • The biological significance and deregulation of the Hippo pathway during organ growth and tumorigenesis have received a surge of interest in the past decade. The Hippo pathway core kinases, MST1/2 and LATS1/2, are tumor suppressors that inhibit the oncogenic nuclear function of YAP/TAZ and TEAD. In addition to earlier studies that highlight the role of Hippo pathway in organ size control, cell proliferation, and tumor development, recent evidence demonstrates its critical role in cancer stem cell biology, including EMT, drug resistance, and self-renewal. Here we provide a brief overview of the regulatory mechanisms of the Hippo pathway, its role in cancer stem cell biology, and promising therapeutic interventions.

Effects of a Standardized Critical Pathway for Laparoscopic Gastrectomy Patients in a General Hospital (일개 종합병원 복강경 위절제술 환자의 표준진료지침 적용효과)

  • Park, Hyo-Jin;Park, Jong;Ryu, So-Yeon;Choi, Seong-Woo
    • The Journal of the Korea Contents Association
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    • v.16 no.9
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    • pp.649-657
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    • 2016
  • This study is aim to investigate how applying a critical pathway(CP) to stomach cancer patients affects their recovery and treatment. The subjects were 165 patients over the age of 20 who were diagnosed with stomach cancer at the gastrointestinal clinic of C hospital and who underwent laparoscopic subtotal gastrectomy. The case group inclueded 102 patients who underwent laparoscopic subtotal gastrectomy with applying the CP from October 2008 to September 2009. The control group included 63 patients who underwent laparoscopic subtotal gastrectomy without applying the CP from September 2007 to September 2008. Pain at the time of discharge was significantly lower in the CP applicated group than in the non-applicated group (Odds ratio [OR], 0.07; 95% Confidence interval [CI], 0.03-0.21). The CP applied group was significantly lower than non-applied group in total hospitalization days (CP applied group: 8.95[1.33], non-applied group: 10.69[4.04], p<0.001) and in postoperative hospitalization days (CP applied group: 7.16[0.94], non-applied group: 8.79[3.90], p<0.001). In conclusion, application of a critical pathway to laparoscopic subtotal gastrectomy reduced pain at the time of discharge, total hospitalization days and postoperative hospitalization days.

The Survey on Contents Validity of 'Preliminary Critical Pathway for Acute Postoperative Pain after Back Surgery' ('요추 수술 후 급성기 통증 환자의 예비 표준임상경로지 내용타당도 설문' 조사 보고)

  • Lim, Kyeong-Tae;Heo, In;Kim, Byung-Jun;Shin, Byung-Cheul;Son, Dong-Wuk;Kim, Chan-Young;Park, Soo Ah;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.4
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    • pp.77-83
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    • 2016
  • Objectives The aim of this study is to investigate the possibility of making Korean Medicine-Western Medicine collaboration Critical Pathway for Acute Postoperative Pain after Back Surgery. Methods This preliminary Critical Pathway (CP) was composed of 9 Index of vertical axis (assesment, treatment, patient movements, consultation, diet, other, administration, examination, education) and 5 hospitalization periods of horizontal axis through a review of the literature and reference data of medical records. This preliminary CP's Content Validity Index (CVI) survey was carried out by 20 personnel of two different medical institutions from 06, June, 2016 to 15, June, 2016. All data were double-cross checked and analyzed. Results Of those questioned, there were 13 males and 7 females in age, 6 professors, 7 medical residents, 7 nurses in position of 20 personnel. According to the survey, among the 62 contents, 32 contents are above 80 percent agreements, 12 contents were between 70 to 80 percent and 18 contents below 70 percent agreements. Especially, Most contents in treatment index were below fixed validity. Overall Contents Validity in Index, Treatments (72.7%), Diet (100.0%), Other (100.0%), Administration (75.0%) and Examination (100.0%) were in high validity. On the other hands, Assessments (29.4%), Patient movements (0.0%), Consultation (30.0%) and Education (33.3%) were in low position. Conclusions This survey results can be evidence of possibility to develop New Korean Medicine-Western Medicine Collaboration Critical Pathway for Acute Postoperative Pain after Back Surgery.

Standard Clinical Procedure(Critical Pathway) on Dental Conscious Sedation for the Disabled Children (장애아동 진정치료에 대한 표준진료지침의 개발)

  • Kim, Minsu;Bae, Youngeun;Kim, Jiyeon;Jo, Anna;Yoon, Hyunseo;Song, Eunju;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.3
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    • pp.226-232
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    • 2015
  • Critical pathway (CP) defines the optimal care process, sequencing and timing of intervention by multidisciplinary health care teams for a particular diagnosis and procedure. The aim of the study was to evaluate the clinical usefulness and the satisfaction of patients and dental staff after implementation of a critical pathway for the dental treatment of disabled children and adolescents under conscious sedation. Thirty patients are divided in two groups (Pre-CP and CP) at the department of Pediatric Dentistry of Pusan National University Dental Hospital. The satisfaction levels of patients/guardians and the staff members were collected by survey questionnaire. The parents' satisfaction was significantly improved after the implementation of CP. Also, medical/dental staff members were highly satisfied with its usefulness. The application of a critical pathway for disabled children and adolescents might be useful and improve the satisfaction of the parents and medical/dental staff members.