• Title/Summary/Keyword: Critical Patient

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Erlotinib-Related Spontaneous Pneumothorax in Patient with Primary Lung Cancer

  • Nam, Hae-Seong;Lee, Hyeon-Jeong;Kim, Min-Su;Park, Sung-Wook;Jeon, Sang-Hoon;Cho, Jae-Hwa;Kwak, Seung-Min;Lee, Hong-Lyeol;Ryu, Jeong-Seon
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.465-468
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    • 2010
  • Spontaneous pneumothorax (SPTx) associated with primary lung cancer is quite rare, but has been reported as the initial presentation or a complication of disease progression. Moreover, chemotherapy-related SPTx in primary lung cancer occurs at a very low frequency, accounting for less than 0.05% of all cases. Here, we report the first case of erlotinib-related SPTx in a patient with advanced lung adenocarcinoma in Korea. After 3 cycles of cisplatin-based chemotherapy as first-line therapy, erlotinib was administered as second-line treatment. Asymptomatic SPTx accompanied by a significant decrease in tumor size was observed in the left lung 7 weeks later. The patient received continuous administration of erlotinib, without additional treatment. This case showed that SPTx can occur in patients with primary lung cancer receiving erlotinib, and asymptomatic chemotherapy-related SPTx in primary lung cancer may not require therapeutic intervention.

Allergic Bronchopulmonary Aspergillosis Coupled with Sinusitis in a Nonasthmatic Patient

  • Park, Sung-Woon;Choi, Jae-Chol;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui;Shin, Jong-Wook
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.4
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    • pp.278-281
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    • 2011
  • Allergic bronchopulmonary aspergillosis (ABPA) is a complex clinical entity resulting from an allergic immune response to Aspergillus species, and most often occurs in patients with asthma. ABPA is rarely observed in the absence of asthma, which is, in fact, the principal criterion for its diagnosis. Our patient was a 53-year-old woman with no history of bronchial asthma. She presented with a 1-month history of cough, mucopurulent nasal discharge, and localized pulmonary consolidation. Peripheral blood eosinophilia and elevated serum IgE were observed. Sinus radiography showed right maxillary sinusitis. Pathologic examination of bronchoscopic biopsy specimens revealed conglomerates of fungal hyphae. Pulmonary function and bronchial provocation tests were within normal ranges. The patient was successfully treated for 3 months with itraconazole and oral prednisolone. There has been no evidence of recurrence over a 7-month follow-up. ABPA coupled with sinusitis in a nonasthmatic patient is a very rare occurrence and warrants reporting.

Study on Educational Needs of Patient Safety Nursing Activities in Intensive Care Units: Utilizing Importance-Performance Analysis (중환자실 간호사의 환자안전간호활동 교육요구도 조사 : IPA 활용)

  • Lee, Seung Hee;Park, Nam Hee
    • Journal of Korean Critical Care Nursing
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    • v.15 no.3
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    • pp.1-11
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    • 2022
  • Purpose : The purpose of this study was to not only examine the importance and performance status of patient safety nursing activities in the intensive care unit but also to understand nurses' educational needs in this respect. Methods : In this descriptive study, 196 nurses working in the intensive care units of university hospitals located at B City and G Province were enrolled. They completed the Importance-Performance Analysis (IPA) questionnaire, and the data were statistically analyzed. Results : Mean±standard deviation item scores of importance and performance of patient safety nursing activities were 4.75±0.33 and 4.48±0.38, respectively. In the IPA results, a total of 10 items were included in the second quadrant, including 1 item related to 'transfer,' 1 to 'infection,' and 1 to 'firefighting surveillance.' As the second quadrant contains the high-importance, low-performance items, these 10 items resemble the nurses' educational needs that should be prioritized. Conclusion : The results of this study can be used as a basis for the development of nursing educational programs for patient safety in the intensive care unit.

The Effects of Simulation Practicum using a Standardized Patient on Nursing Students' Communication Skills, Problem-Solving Skills, Critical Thinking Dispositions, and Clinical Competency (표준화 환자를 적용한 시뮬레이션 수업이 간호대학생의 의사소통능력, 문제해결능력, 비판적 사고성향 및 임상수행능력에 미치는 효과)

  • Chung, Su Kyoung;Kim, Kyoung Ah;Jeong, Eun Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.23 no.2
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    • pp.186-194
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    • 2016
  • Purpose: The purpose of this study was to evaluate the effects of standardized patient simulation on nursing students' communication skills, problem-solving skills, critical thinking dispositions, and clinical competency. Methods: A one-group pretest-posttest design was used. Data were collected from a convenient sample of 47 junior nursing students at W University. Scenarios to train SP and checklists to evaluate the students''competence were developed by our research team. The collected data were analyzed with descriptive analysis t-test, Pearson's Correlation Coefficient and Cronbach's ${\alpha}$ using SPSS WIN 21.0 Program. Results: The simulation practicum using a standardized patient was conducted based on four steps, namely, selections of scenario modules, standard patient training, implementation, and evaluation. The differences between the pre and post-test scores of problem-solving skills(t=-2.94, p=.005) and clinical competency(t=-2.84, p=.007) were statistically significant. But communication skill(t=-.32, p=.747) and critical thinking(t=-.68, p=.498) was not different in group. Conclusion: Standardized patient simulation in nursing education may be useful the improvement of problem-solving skills and clinical competency.

The Effect of Operating Room Nursing and Medical Staff Teamwork and Perception of Patient Safety Culture on the Performance of Surgical Patient Safety Protocol (수술실 의료진의 팀워크와 환자안전문화에 대한 인식이 수술환자안전 프로토콜 수행에 미치는 영향)

  • Ahn, Shin-Ae;Lee, Nam-Ju
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.27-39
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    • 2016
  • Purpose: The purpose of this study lies in investigating nursing and medical staff perceptions on the importance of surgical patient safety protocol, teamwork, and patient safety culture, and how their grasp of the factors affects the degree of their performance of the protocol. Methods: A survey was conducted on 249 nurses and medical staff participating in the operating rooms of one higher general hospital in Seoul, using a 5-point scale self-reported questionnaire. Logistic regression analyses were used. Results: Operating room nurses yielded the highest scores on both the importance of the patient safety protocol and its performance. In patient safety culture, the operating medical staff yielded significantly higher scores than those of operating room nurses. Perception of the importance of the patient safety protocol and teamwork had a significant effect on the nurses' complete performance of the protocol. Conclusion: It is important to create a safety culture, where all the staff can actively and freely communicate with one another through team-based training programs. By enhancing teamwork and patient safety culture, it will be possible to establish the surgical patient safety protocol and to improve the performance of the protocol by health professionals.

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Development of the Critical Pathway for Cesarean Section Patient (제왕절개술 환자를 위한 Critical Pathway 개발)

  • Chung Kyung-Hee;Jang Keum-Seung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.4 no.1
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    • pp.66-80
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    • 1998
  • With the opening of healthcare market, the health care environment in Korea is anticipating a drastic change. In this Internationally open market environment, it is necessary to introduce a systematic health care plan and DRG system which offer qualitative medical services as well as reduced cost. Purpose of this study is to develop and test the critical pathway for Cesarean section patient in the way to be possible the integrated inpatient management. It was adopted the process of six phases to develop the critical pathway as the theoretical framework implemented by Johns Hopkins Hospital, Maryland, U.S.A. In the first phase, make a selection of diagnosis/procedures to develop. In the second phase, organize a development team consisted of eight expertises working in maternity nursing area. In the third phase, analyze the overall medical service offered to patient through review medical records and decided the service content and the implementation period for the Cesarean section patient. In the forth phase, make out a preliminary critical pathway after verification of expert group on content validity. In the fifth phase, validity operate to ten Cesarean section patients to test implementation in practice by using the preliminary critical pathway, In the sixth phase, defined the final critical pathway. The result of this study was as follows. 1. There were classified 8 categories as monitoring/assesment, treatment, medication, activity, diet, test, consult, education/discharge plan for vertical axis and showed hospital stayed from admission to discharge for horizontal axis of critical pathway through analysis 68 Cesarean section patients medical records. 2. After critical review 68 medical records to make out a preliminary critical pathway, hospital stays for horizontal axis were showed 6 days, mean hospital stays were 7.5 days, 2.1 days were to be taken operation after admission and 4.2 days were stayed until discharge after operation. 3. After making out a questionare in 90 items of a medical service content of eight categories and verifying the content validity of expertises, the 85 items of the preliminary critical pathway were selected by expertises agreement over 88% and modified or deleted 5 items showing agreement below 75%. 4. After verifying a validity to 10 patients for 4 weeks, hospital stays were 5.9 days. There were deleted 1 item and modified or supplemented the 9 items of the 10 items.

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The Unique Relationship between Neuro-Critical Care and Critical Illness-Related Corticosteroid Insufficiency : Implications for Neurosurgeons in Neuro-Critical Care

  • Yoon Hee Choo;Moinay Kim;Jae Hyun Kim;Hanwool Jeon;Hee-Won Jung;Eun Jin Ha;Jiwoong Oh;Youngbo Shim;Seung Bin Kim;Han-Gil Jung;So Hee Park;Jung Ook Kim;Junhyung Kim;Hyeseon Kim;Seungjoo Lee
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.618-631
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    • 2023
  • The brain houses vital hormonal regulatory structures such as the hypothalamus and pituitary gland, which may confer unique susceptibilities to critical illness-related corticosteroid insufficiency (CIRCI) in patients with neurological disorders. In addition, the frequent use of steroids for therapeutic purposes in various neurological conditions may lead to the development of steroid insufficiency. This abstract aims to highlight the significance of understanding these relationships in the context of patient care and management for physicians. Neurological disorders may predispose patients to CIRCI due to the role of the brain in hormonal regulation. Early recognition of CIRCI in the context of neurological diseases is essential to ensure prompt and appropriate intervention. Moreover, the frequent use of steroids for treating neurological conditions can contribute to the development of steroid insufficiency, further complicating the clinical picture. Physicians must be aware of these unique interactions and be prepared to evaluate and manage patients with CIRCI and steroid insufficiency in the context of neurological disorders. This includes timely diagnosis, appropriate steroid administration, and careful monitoring for potential adverse effects. A comprehensive understanding of the interplay between neurological disease, CIRCI, and steroid insufficiency is critical for optimizing patient care and outcomes in this complex patient population.

Gastric necrosis after gastric artery embolization in a patient with blunt abdominal trauma: a case report

  • Gil Hwan, Kim;Sung Jin, Park;Chan Ik, Park
    • Journal of Trauma and Injury
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    • v.35 no.4
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    • pp.287-290
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    • 2022
  • Gastric artery bleeding after blunt trauma is rare. In such cases, if vital signs are stable, angiographic embolization may be performed. Although gastric artery embolization is known to be safe due to its anatomical properties, complications may occur. We report a case of gastric necrosis after gastric artery embolization in a patient with blunt abdominal trauma. The 55-year-old male patient was found with gastric arterial bleeding after a traffic accident. His vital signs were stable, and gastric artery embolization was performed. Gastric necrosis was subsequently found, which was treated surgically.

Factors Related to Intensive Care Unit Nurses' Patient Centered Communication Competency (중환자실 간호사의 대상자 중심(Patient Centered) 의사소통 역량수준 및 관련요인)

  • Park, Young-Su;Oh, Eui Geum
    • Journal of Korean Critical Care Nursing
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    • v.11 no.2
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    • pp.51-62
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    • 2018
  • Purpose : This study aimed to provide primary data for developing a program to enhance communication competence by identifying the patient-centered communication competency level of Intensive Care Unit (ICU) nurses and the related factors. Method : Data were collected from August 28th to October 8th, 2015, from 199 ICU nurses working in 30 tertiary hospitals. The study questionnaire included items assessing the patient-centered communication competency of ICU nurses, nursing organizational culture, types of communication, the Teamwork Measurement Tool, the Perceived Nursing Work Environment tool, and the Wong & Law Emotional Intelligence Scale. The collected data were analyzed using descriptive statistics, a correlation test, and a multiple regression. Results : The ICU nurses' mean score on patient-centered communication competency was 3.97 points. The factors influencing the patient-centered communication competency level of ICU nurses were professionalism (p =.002), innovation-oriented organizational culture (p =.015), and emotional intelligence (p<.001). These variables explained 42.2% of the total variance in the patient-centered communication competency of ICU nurses. Conclusion : These findings suggest the need for developing a patient-centered communication competency improvement program that focuses on improving ICU nurses' professionalism and emotional intelligence, and facilitates the creation of an innovation-oriented organizational culture.