• Title/Summary/Keyword: Critical Patient

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A Case of Nonspecific Interstitial Pneumonitis Improved After Cyclosporin Therapy (Cyclosporin 치료로 호전된 비특이성 간질성 폐렴 1예)

  • Ahn, Sang Mi;Jo, Suk Kyoung;Lim, Seung Kwan;Song, Young Jun;Choi, Jun Hyuk;Sheen, Seung Soo;Oh, Yun Joung;Choi, Young Hwa;Park, Kwang Ju;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.631-635
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    • 2003
  • Idiopathic interstitial pneumonia is a group of lung disease classified by clinical, radiological and pathologic findings. Steroid is described in many reports as an effective treatment for the idiopathic interstitial pneumonitis. For the treatment of steroid non-responders, immuno-suppressive or cytotoxic agents are used as second line drug of choice. We experienced a case of nonspecific interstitial pneumonitis who was treated initially with glucocorticoid and antibiotics without effects, but later did respond to cyclosporin treatment. This 63 year-old patient was admitted due to dyspnea, cough, and sputum production. He was started on glucocorticoid and antibiotics after he was diagnosed as having nonspecific interstitial pneumonitis by open lung biopsy. The initial steroid treatment was not effective, however, after cyclosprin treatment, the patient showed clinical and radiologic improvements.

Obstructive Fibrinous Tracheal Pseudomenbrane Mimicking Tracheal Stents

  • Kim, Ju-Sang;Yu, Ji-Hyun;Kim, Yu-Seung;Kim, Il;Ahn, Joong-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.1
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    • pp.59-61
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    • 2011
  • Obstructive Fibrinous Tracheal Pseudomenbrane (OFTP) is a rarely known but potentially fatal complication of endotracheal intubation. Sudden respiratory failure shortly after extubation is not infrequent in the ICU. However, these cases are commonly diagnosed as laryngospasm, retention of secretion or laryngeal edema. A 68-year-old woman presented with a 6-day history of progressive dyspnea. She had undergone invasive ventilator care for 24 hours. The patient was discharged from the hospital with improvement after having an extubation. However, after 3 days she revisited the emergency department with progressive dyspnea. The patient was diagnosed with OFTP from the results of chest CT and bronchoscopy. This is the first case studied in detail using CT images, pulmonary function test, and bronchoscopy.

Emergency Room Nurses' Recognition of Patient Safety Culture and their Safety Management Activity (응급실 간호사의 환자안전문화에 대한 인식과 환자안전관리활동)

  • Lee, Ji-Eun;Lee, Eun-Nam
    • Journal of Korean Critical Care Nursing
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    • v.6 no.1
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    • pp.44-56
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    • 2013
  • Purpose: The purpose of this study was to investigate emergency room nurses' recognition of patient safety culture and their performance of safety management activity. Methods: Data were collected from July 1 to August 31, 2012 on 292 emergency room nurses working at 25 general hospitals located in B city in G province. The Hospital Survey on Patient Safety Culture was used to measure patient safety culture, and an 82-item questionnaire was developed to measure safety management activity. Results: the performance of safety management activity were significantly associated with the total career years, whether the nurses had undergone safety training, and whether the nurses has been working in the regional emergency care facility. Of 6 subcategories of the patient safety culture, the perception of a directly commanding senior/manager, frequency of accident reports, and hospital environment were associated with the performance of safety management activity. Conclusion: For improving performance of safety management activity among emergency room nurses, it is necessary to develop an educational program of safety management activity by their level of performance.

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Survey of ICU Nurses' Knowledge of the Specific Moments of Hand Hygiene (일 대학병원 중환자실 간호사의 손 위생 수행 시점에 대한 지식 조사)

  • Jung, Eunha;Ha, Yikyung;Park, Namjeong;Kim, Hyun Hee
    • Journal of Korean Critical Care Nursing
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    • v.10 no.2
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    • pp.56-70
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    • 2017
  • Purpose: This study was conducted to identify ICU nurses' knowledge of the five moments of hand hygiene and the ambiguity of these moments when demonstrating hand hygiene. Methods: The subjects were 200 intensive care unit nurses at a university hospital. Data was collected using self-report questionnaires, translated according to the instructions of training films developed by WHO, and analyzed using descriptive statistics and ranking tests. Results: The highest number of correct answers was regarding the moment before contact with a patient and the lowest was regarding the moment after contact with a patient. The rate of providing wrong answers regarding required moments of hand hygiene was high. Conclusion: The study identified ICU nurses' knowledge of specific moments of hand hygiene; they had difficulty differentiating between the moments that happened simultaneously, i.e. after touching a patient, and that patient's surroundings, and there was ambiguity concerning patient areas and medical treatment areas. It was concluded that it is necessary to educate nurses regarding both required and unrequired moments of hand hygiene and to ensure that they can distinguish between these moments.

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A Concept Analysis on Patient-Centered Care in Hospitalized Older Adults with Multimorbidity (복합질환을 가진 입원노인 대상 환자중심간호 개념분석)

  • Son, Youn-Jung;Yoon, Heun-Keung
    • Journal of Korean Critical Care Nursing
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    • v.12 no.2
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    • pp.61-72
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    • 2019
  • Purpose : The aim of this study was to explore the attributes, antecedents, and consequences of patient-centered care (PCC) for older adults with multimorbidity in acute care hospitals. Methods : The concept analysis performed by Walker and Avant was used to analyze PCC. Fifteen studies from the literature related to PCC appear in systematic literature reviews in the fields of theology, medicine, psychology, and nursing. Results : PCC in acute care hospitals was defined according to the five attributes of 'maintaining patient autonomy', 'empowering self-care', 'individualized and relationship-based care', 'shared decision-making', and 'creating a homelike environment'. Antecedents of PCC were found to be a respect for patients' preferences, qualifications of the nursing staff, care coordination and integration, and organizational support. Consequences of effective PCC were a functional status; health-related quality of life; satisfaction with care, mortality, and medical costs from the perspective of the patient and family; and quality of care and therapeutic relationships from nurses' viewpoints. Conclusion : PCC as defined by the results of this study will contribute to the foundation of institutionalization and the creation of a safe and healthy acute care hospital culture focused on patients' preferences and values.

Comparison of Intensive Care Unit Nurses' and Family Members' Priorities of Patient and Family-centered Care in Ghana

  • Mohammed, Shaibu;Tak, Sunghee H.
    • Journal of Korean Critical Care Nursing
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    • v.15 no.1
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    • pp.13-23
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    • 2022
  • Purpose : Life-threatening illnesses represent a crisis for individual patients and their families. Little has been made to understand the priorities or perspectives in developing a care plan. This results in poor outcomes, and patients and families return home without being satisfied with the care provided. This study aimed to address nurses' and families' care priorities on patient and family-centered care principles and compare those priorities. Methods : A quantitative comparative descriptive research was conducted. The data were part of a study that was carried out to elicit and compare nurses' and families' perceptions of complying with patient and family-centered care (PFCC) principles in intensive care units (ICU) in Ghana. The respondents were ICU nurses (n=123) and family members of hospitalized patients in the ICU (n=111). The tool for the study was a "modernized version of a hospital self-assessment inventory on PFCC," and data analyses were performed using SPSS version 20.0. Results : Nurses and families differed significantly in their priorities of care based on the principles of PFCC. The means and p-values were significantly different for the definition, pattern of care and access to information/education, and the overall total scores of the patient and family-centered care principles (PFCCP) Conclusion : To render care that aligns with the care priority of families and patients in the ICU, nurses must plan care in consultation with their families.

A Case of Bronchoesophageal Fistula Mimicking Pulmonary Tuberculosis (폐 결핵으로 오인된 기관지식도루 1예)

  • Oh, Dong Wook;Ra, Seung Won;Lee, Kwang Ha;Park, Tae Sun;Kim, Sun Young;Na, Soo Young;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.303-308
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    • 2008
  • Benign bronchoesophageal fistula is a rare disease and it may be characterized by nonspecific symptoms that can cause a delayed diagnosis. We misdiagnosed a patient with recurrent aspiration, which was due to bronchoesophageal fistula, as active pulmonary tuberculosis. The patient was 44 year old female who had suffered from chronic cough, especially during eating liquid meals, since 1982 when she had been treated for tuberculous lymphadenitis. Computed tomography showed an irregular mass with surrounding centrilobular nodules in the superior segment of the right lower lobe (RLL). She was diagnosed as having active pulmonary tuberculosis and treated with anti-tuberculosis medication, but she continued to complain of persistent cough even after anti-tuberculosis treatment. Thus, we reexamined the patient, and bronchoesophageal fistula between the esophagus and the superior segment of the RLL was finally confirmed by esophagography. After the fistula was surgically treated, the patient became asymptomatic and she then experienced good health.

Development of Korean Patient Classification System for Critical Care Nurses (한국형 중환자간호 분류도구 개발)

  • Yoo, Cheong Suk;Sim, Mi Young;Choi, Eun Ha
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.3
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    • pp.401-411
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    • 2015
  • Purpose: This study was performed to develop a valid and reliable Korean Patient Classification System for Critical Care Nurses (KPCSC). Methods: Tertiary and general hospitals with various levels of ICU nurse staffing were included. To verify interrater reliability, data collectors and staff nurses of 15 ICUs in 11 hospitals classified 262 patients. To verify construct validity, the staff nurses classified 457 patients according to KPCSC comparing difference by medical department and type of stay in ICU. For conversion index, 195 patients from 10 ICUs in 7 hospitals were classified and nursing time was measured by 174 nurses, 7 head nurses, 18 charge nurses, 37 nurse aids and 1 secretary. Results: The developed KPCSC has 11 categories, 82 nursing activities and 115 criterias. Reliability was found to have high agreement (r=.96). Construct validity was verified by comparing differences in medical department and type of stay in ICU. According to scores, four groups in the KPCSC were identified. One score on the KPCSC indicates 6.12 minutes of nursing time. Conclusion: The findings show that the KPCSC can be used to measure new and complex nursing demands including rehabilitation and the safety of ICU patients.

Complex Regional Pain Syndrome (CRPS type-1) in an Adolescent Following Extravasation of Dextrose Containing Fluid-an Underdiagnosed Case

  • Subedi, Asish;Bhattarai, Balkrishna;Biswas, Binay K.;Khatiwada, Sindhu
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.112-114
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    • 2011
  • Due to its complex pathophysiology and wide spectrum of clinical manifestations, the diagnosis of CRPS is often missed in the early stage by primary care physicians. After being treated by a primary care physician for 5 months for chronic cellulitis, a 16-year-old girl was referred to our hospital with features of type-1 CRPS of the right upper extremity. Inability to diagnose early caused prolonged suffering to the girl with all the consequence of CRPS. The patient responded well with marked functional recovery from multimodal therapy. Ability to distinguish CRPS from other pain conditions, referral for specialty care at the appropriate time and full awareness of this condition and its clinical features among various healthcare professionals are essential in reducing patient suffering and stopping its progression towards difficult-to-treat situations.