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Path Analysis for Delirium on Patient Prognosis in Intensive Care Units (섬망이 중환자실 환자결과에 미치는 영향: 경로 분석)

  • Lee, Sunhee;Lee, Sun-Mi
    • Journal of Korean Academy of Nursing
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    • v.49 no.6
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    • pp.724-735
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    • 2019
  • Purpose: This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model. Methods: This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24. Results: In the final model, admission via emergency department (Β=.06, p=.019), age over 65 years (Β=.11, p=.001), unconsciousness (Β=.18, p=.001), dependent activities (Β=.12, p=.001), abnormal vital signs (Β=.12, p=.001), pressure ulcer risk (Β=.12, p=.001), enteral nutrition (Β=.12, p=.001), and use of restraint (Β=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (Β=.06, p=.038), hospital length of stay (Β=5.06, p=.010), and discharge to another facility (not home) (Β=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium. Conclusion: The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.

Study on the Development of Home Care Nursing Intervention Protocol for Stroke Patients (뇌졸중 환자의 가정간호중재 프로토콜 개발)

  • Yoo Ji-Soo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.122-136
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    • 2000
  • Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

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Laryngotracheal stenosis in burn patients with inhalation injury (흡인화상환자에서 발생하는 후두 및 기관 협착)

  • Park Il-Seok;Chang Jai-Hyuk;Kim Beom Gyu;Kim Yong Bok;Rho Young Soo;Ahn Hwoe Young;Kim Jong Hyun
    • Korean Journal of Bronchoesophagology
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    • v.11 no.1
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    • pp.10-14
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    • 2005
  • Background and Objectives : Laryngotracheal stenosis in bum patients with inhalation have features distinct from other stenosis after intubation or tracheostomy. However few studies have been reported and the incidence was reported variable. The purpose of this study is to evaluate the clinical manifestation and the incidence of laryngotracheal stenosis in bum patients with inhalation. Methods We retrospectively analyzed 138 bum Patients diagnosed inhalation injury who admitted to Hangang Sacred Heart Hospital from July 2002 to June 2004. Result : 5 patients were developed laryngotracheal stenosis. The incidence of Laryngotracheal stenosis in bum patients with inhalation was $3\%$. Symptom developed early in 2 patients, late in 3 patients.4 patients required trachostomy as initial airway support. The location of stenosis is subglottic region except 1 patient. Montgomery T-tube was inserted in 3 patients, and Single-stage laryngotracheal reconstruction was performed in 1 patient. Conclusion Incidence of laryngotracheal stenosis in our study is lower than other reports due to late presentation of symptom and early discharge after acute bum stage. Inhalation injury may lead to severe complication and sequelae, therefore physicians should be have a awareness for early diagnosis and all burn patients who have a history of inhalation injury should be followed closely.

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Observation of Light-Propagation along the Tube of Cold Cathode Fluorescent Lamp (냉음극 형광램프의 광 전파)

  • Cho, Y.H.;Jin, D.J.;Kim, J.H.;Han, S.H.;Cho, G.S.
    • Journal of the Korean Vacuum Society
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    • v.20 no.2
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    • pp.114-126
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    • 2011
  • The light propagation along a long positive column has been observed in a cold cathode fluorescent lamp. The optical signals are observed with the DC and AC voltage power during lamp operation. The light propagating is observed in the operation with the DC-rippled voltage as well as the AC-voltage. The optical signals propagate from the high voltage side to the ground. These signals show two kinds of features according to the before and after Townsend breakdown. At the dark current before Townsend breakdown, the optical intensity is damped and the propagation velocity is $10^4{\sim}10^5m/s$. At the high current of normal glow after Townsend breakdown, the propagation velocity is 1$10^5{\sim}10^6m/s$ without damping.

A Survey of Hospital-Based Home Healthcare Utilization in Patients using Home Mechanical Ventilator (가정용 인공호흡기 적용 환자의 가정간호서비스 이용실태)

  • Lee, Mi Kyoung;Song, Chong Rye;Oh, Eun Kyung;Yoon, Young Mi
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.24 no.2
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    • pp.210-220
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    • 2017
  • Purpose: The study aimed to describe the utilization of home healthcare in patients using home mechanical ventilator(HMV) Method: A descriptive cross-sectional design was used in this study. A Questionnaires were sent to nation wide home healthcare agencies to assess their utilization status of home healthcare. A convenience sample of 158 patients data was reviewed. Result: A total of 88(55.7%) men with the mean age of 51.94(${\pm}19.52$) years were included in the study. Approximately 55.1% of patients at the outpatient department were referred to the home healthcare services after discharge. The underlying diseases were as follows : 129 amyotrophic lateral sclerosis and 27 muscular dystrophies. A total of 155 patients have invasive HMV. Efficient home healthcare nursing activities provided by a highly skilled home healthcare advanced practice nurses(HHCAPN) were tracheotomy and gastrostomy tube management and urinary catheterization. The average frequency of home visit for one patient was 2.52times per month. The duration of home healthcare utilization with >1 year was 82.9%. HHCAPNs have limited knowledge and skill for HMV. Conclusion: The government support is required to provide sufficient home healthcare services to the patients discharged with HMV. HHCAPNs should be properly educated on the effective HMV care.

Residual Voltage Reduction of Coaxial Surge Arrestor Using Ceramic Filler (세라믹 필터를 이용한 동축 서지어레스터의 잔류전압 저감)

  • Eom, Ju-Hong;Cho, Sung-Chul;Lee, Tae-Hyung;Lee, Young-Chul
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.21 no.2
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    • pp.46-53
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    • 2007
  • Extension of the mobile communication and the rapidly developing services connected with wireless multimedia(W-CDMA, DMB, Wibro, and so on) need great many base station transceiver systems, antennas, and many signal transmission line to embody these services. The min communication appliances system is exposed always in danger of transient overvoltage by direct stroke or induced lightning surge flowing in through antenna because the antenna of base station transceiver system or relay equipment is combined with expensive communication network equipments through signal transmission line. Now, gas discharge tube(GDT) or narrow band stub arrestor which is used by the surge protector for communication use is exposing limitations as for lightning surge protective means of the communication facility with high speed and wide frequency band. Therefore, for improving performance of surge arrestor, we applied ceramic filter which can reduce lightning surge invading from antenna effectively, and proved that ceramic filter is effective in residual voltage reduction through the experimental research.

Optical Diagnostics for Pulse-discharged Plasma by Marx Generator and Its Application for Modifications of Hemoglobin and Myoglobin Proteins

  • Park, Ji Hoon;Attri, Pankaj;Hong, Young June;Park, Bong Sang;Jeon, Su Nam;Choi, Eun Ha
    • Proceedings of the Korean Vacuum Society Conference
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    • 2013.08a
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    • pp.176.2-176.2
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    • 2013
  • Property of optical diagnostics for pulse-discharged plasma in liquid and its biological applications to proteins are investigated by making use of high voltage Marx generator. The Marx generator has been consisted of 5 stages, where each charging capacitor is 0.5 ${\mu}F$, to generate a high voltage pulse with rising time of $1{\mu}s$. We have applied an input voltage of 6 kV to the each capacitor of 0.5 ${\mu}F$. High voltage pulsed plasma has been generated inside a polycarbonate tube by a single-shot operation, where the breakdown voltage is measured to be 7 kV, current of 1.2 kA, and pulse width of ~ 1 ${\mu}s$ between the two electrodes of anode-cathode whose material is made of tungsten pin, which are immersed into the liquids. We have investigated the emitted hydrogen lines for optical diagnostics of high voltage pulsed plasma. The emission line of 656.3 nm from $H-{\alpha}$ and 486.1 nm from $H-{\beta}$ have been measured by a monochromator. If we assumed that the focused plasma regions satisfy the local thermodynamic equilibrium conditions, the electron temperature and density of the high voltage pulsed plasma in liquid could be obtained by the Stark broadening of optical emission spectroscopy. For the investigation of the influence of pulsed plasma on biological proteins, we have exposed it onto the proteins such as hemoglobin and myoglobin. The structural changes in these proteins and their analysis have also been obtained by circular dichroism (CD) and ultraviolet (UV) visible spectroscopy.

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Synthesis of size-controlled ZnO tetrapods sizes using atmospheric microwave plasma system and evaluation of its photocatalytic property (대기압 마이크로웨이브 플라즈마를 이용한 다양한 크기의 ZnO tetrapod 합성 및 광촉매 특성 평가)

  • Heo, Sung-Gyu;Jeong, Goo-Hwan
    • Journal of the Korean institute of surface engineering
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    • v.54 no.6
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    • pp.340-347
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    • 2021
  • Among various metal oxide semiconductors, ZnO has an excellent electrical, optical properties with a wide bandgap of 3.3 eV. It can be applied as a photocatalytic material due to its high absorption rate along with physical and chemical stability to UV light. In addition, it is important to control the morphology of ZnO because the size and shape of the ZnO make difference in physical properties. In this paper, we demonstrate synthesis of size-controlled ZnO tetrapods using an atmospheric pressure plasma system. A micro-sized Zn spherical powder was continuously introduced in the plume of the atmospheric plasma jet ignited with mixture of oxygen and nitrogen. The effect of plasma power and collection sites on ZnO nanostructure was investigated. After the plasma discharge for 10 min, the produced materials deposited inside the 60-cm-long quartz tube were obtained with respect to the distance from the plume. According to the SEM analysis, all the synthesized nanoparticles were found to be ZnO tetrapods ranging from 100 to 600-nm-diameter depending on both applied power and collection site. The photocatalytic efficiency was evaluated by color change of methylene blue solution using UV-Vis spectroscopy. The photocatalytic activity increased with the increase of (101) and (100) plane in ZnO tetrapods, which is caused by enhanced chemical effects of plasma process.

Influence Analysis on the Number of Ruptured SG u-tubes During mSGTR in CANDU-6 Plants (중수로 증기발생기 다중 전열관 파단사고시 파단 전열관 수에 대한 영향 분석)

  • Seon Oh Yu;Kyung Won Lee
    • Transactions of the Korean Society of Pressure Vessels and Piping
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    • v.18 no.2
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    • pp.37-42
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    • 2022
  • An influence analysis on multiple steam generator tube rupture (mSGTR) followed by an unmitigated station blackout is performed to compare the plant responses according to the number of ruptured u-tubes under the assumption of a total of 10 ruptured u-tubes. In all calculation cases, the transient behaviour of major thermal-hydraulic parameters, such as the discharge flow rate through the ruptured u-tubes, reactor header pressure, and void fraction in the fuel channels is found to be overall similar to that of the base case having a single SG with 10 u-tubes ruptured. Additionally, as the conditions of low-flow coolant with high void fraction in the broken loop continued, causing the degradation of decay heat removal, the peak cladding temperature (PCT) would be expected to exceed the limit criteria for ensuring nuclear fuel integrity. However, despite the same total number of ruptured u-tubes, because of the different connection configuration between the SG and pressurizer, a difference is foud in time between the pressurizer low-level signal and reactor header low-pressure signal, affecting the time to trip the reactor and to reach the PCT limit. The present study is expected to provide the technical basis for the accident management strategy for mSGTR transient conditions of CANDU-6 plants.

Implementing of Ozonated Olive Oil Manufacturing Device to Ensure Biocompatibility (생체 적합성이 확보를 위한 오존화 올리브오일 제조 장치 구현)

  • Duck-Sool Kim
    • Journal of the Institute of Convergence Signal Processing
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    • v.24 no.3
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    • pp.153-159
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    • 2023
  • As research results showed that ozonated olive oil has excellent therapeutic effects on skin diseases, attempts were made to develop cosmetics manufacturing technology using ozone. Ozone is harmful to the human body, so a separate facility must be prepared to manufacture ozonated olive oil as a cosmetic raw material. The manufacturing device developed in this study was designed as an optimized process for manufacturing cosmetics while ensuring the safety of workers involved in production. To verify the ozonated olive oil produced from the implemented device, a toxicity test was conducted on animals. After applying ozonated oil (high concentration) to the rabbit's back for 24 hours, mortality, general symptoms and symptoms were measured. A skin irritation evaluation was performed. As a result of the experiment, as a result of evaluating the test substance treatment area after a certain period of time, it was confirmed that no skin irritation was observed in all animals, confirming the safety of the ozonated oil production process and the safety of the product.