• Quality Improvement in Health Care
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• v.12 no.1
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• pp.114-123
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• 2006

Background : Patients who were discharged from the emergency department(ED) may revisit. These patients are divided into two groups; one is expected scheduled condition, the other is unexpected condition. These patients of inappropriate revisits to the ED would be unsatisfied, difficult to make rapport and take legal action as a result of additional medical charges. The purpose of this study was to reduce inappropriate revisits to the ED with a new method which was developed by analyzing inappropriate revisits in 2002. Methods : This study was conducted in a tertiary hospital consisting of 1,278 beds. The most common cause of inappropriate revisits was the medical team's lack of explanation about a disease. Thus we decided that the effective method was to offer full explanations to patients to understand the clinical pathway of a disease. We made four types of stickers to explain most common 4 diseases in 2003. An emergency physician completed 'discharge explanation report' and explained it to patients in 2004. Results : In 2002 inappropriate revisited patients were 164, patients with four diseases were 79. During the same period of 2003, inappropriate revisited patients were 56 (-65.9%), four disease patients were 6 (-92.4%) and in 2004 inappropriate revisited patients were 52, four disease patients were 19. Causes of revisits were lack of explanation about a disease in 35 patients (44.3%) in 2003, and 5 patients (83.3%) in 2003, and 16 patients (84.2%). Conclusions : Application of 'explanation stickers' at discharge reduced inappropriate revisits from 34.5% in 2002 to 15.9% in 2003. Application of 'Discharge explanation report' by emergency physician reduced inappropriate revisits from 15.9% in 2003 to 13.5% in 2004. Reduction of inappropriate revisits elevated the quality of medical treatment, and decreased patients' dissatisfaction in ED.

• Korean Journal of Adult Nursing
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• v.15 no.4
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• pp.573-584
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• 2003

Purpose: This study was conducted to investigate the level of nausea & vomiting, anorexia and food intake during the periods of chemotherapy and 14 days after discharge. Method: The subjects were 40 cancer patients(cervix cancer : 20 patients, stomach cancer: 20 patients) who had chemotherapy with Cisplatin & 5-Fu. Data were analyzed by mean & standard deviation, ANCOVA. Result: 1. The severity of nausea & vomiting with anorexia in cancer patients receiving chemotherapy was the highest at the 3rd day and then it gradually decreased. At the 14th day after discharge, nausea & vomiting with anorexia still remained with very low levels. 2. The amount of food intake was the lowest on the 3rd day and then gradually increased. However, it was 53.3-72.5% of the ordinary food intake on the 14th day after discharge. Calorie intake was 625.31 Kcal on the 3rd day and 1130.92 Kcal on the 7th day after discharge. 3. There were no significant differences in nausea & vomiting, anorexia, food intake, calory intake between those with cervix cancer and stomach cancer. Conclusion: In cancer patients nausea & vomiting and anorexia were severe and food intake was very poor during chemotherapy but afterwards they were gradually improved, but were not completely recovered on the 14th day after discharge. Therefore the nursing intervention regarding the increase of food intake was necessary during chemotherapy and after discharge.

• Journal of Gastric Cancer
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• v.22 no.4
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• pp.395-407
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• 2022

Purpose: This study aimed to investigate the relationship between clinical and laboratory parameters and complication status to predict which patients can be safely discharged from the hospital on the third postoperative day (POD). Materials and Methods: Data from a prospectively maintained database of 2,110 consecutive patients with gastric adenocarcinoma who underwent curative surgery were reviewed. The third POD vital signs, laboratory data, and details of the course after surgery were collected. Patients with grade II or higher complications after the third POD were considered unsuitable for early discharge. The performance metrics were calculated for all algorithm parameters. The proposed algorithm was tested using a validation dataset of consecutive patients from the same center. Results: Of 1,438 patients in the study cohort, 142 (9.9%) were considered unsuitable for early discharge. C-reactive protein level, body temperature, pulse rate, and neutrophil count had good performance metrics and were determined to be independent prognostic factors. An algorithm consisting of these 4 parameters had a negative predictive value (NPV) of 95.9% (95% confidence interval [CI], 94.2-97.3), sensitivity of 80.3% (95% CI, 72.8-86.5), and specificity of 51.1% (95% CI, 48.3-53.8). Only 28 (1.9%) patients in the study cohort were classified as false negatives. In the validation dataset, the NPV was 93.7%, sensitivity was 66%, and 3.3% (17/512) of patients were classified as false negatives. Conclusions: Simple clinical and laboratory parameters obtained on the third POD can be used when making decisions regarding the safe early discharge of patients who underwent gastrectomy.

• Journal of East-West Nursing Research
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• v.16 no.1
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• pp.1-10
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• 2010

Purpose: This study tested the effects of Nei-Guan acupressure on nausea, vomiting, and anorexia of lung cancer patients on chemotherapy. Methods: A nonequivalent control group pre-post test design was used to identify the effect of Nei-Guan acupressure on nausea, vomiting, and anorexia of lung cancer patients on chemotherapy. The participants were 60 patients who were admitted to a hospital for chemotherapy from February 1 to October 28, 2009. The patients were randomly assigned to the control group (n=30) or experimental group (n=30). The data were analyzed using Mann-Whitney test. Results: Nausea, vomiting, and anorexia were significantly decreased in the experiment group compared to the control group on the day of discharge from the hospital. However, the levels of nausea, vomiting, and anorexia between two groups were not statistically significant seven days after the discharge. Conclusions: Nei-Guan acupressure is effective in decreasing nausea, vomiting and anorexia of the patients with lung cancer on chemotherapy on the on the day of the discharge while the effectiveness is not certain 7 days after the discharge. Further study is needed to confirm these findings.

• The Korean Journal of Rehabilitation Nursing
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• v.14 no.1
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• pp.13-23
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• 2011

Purpose: The purpose of this study was to explore and describe the essence of hospital life concerning discharge from rehabilitation facility as defined by clients with complete quadriplegia. Method: This was a qualitative research using Giorgi's descriptive phenomenology. Four participants with complete quadriplegia were participated. Results: The lived experience of discharge from rehabilitation facility among clients with complete quadriplegia was structured by 10 components and was defined as a life event which those patients felt fears and worries to leave the therapeutic environment and to return to their community with various changes due to their disability. During their hospital stay, the patients with quadriplegia were concerning to prepare proper living conditions and their health conditions so that they could keep their life independent and worthy. They also cherished a hope for cure for their cervical injury even at the moment of discharge. Conclusion: This study suggests developing a discharge program which relieves the clients' emotional burden for discharge from inpatient rehabilitation facility and helps them to take an active role in preparing for returning to their daily life.

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.7-21
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• 1998

An analysis of 101 stroke patients who were enrolled in 10 hospitals of Cities of Pusan, Taegu, and Andong from November 1, 1996 to April 31. 3997 was conducted using the modified Barthel Index(BI) and the adapted PULSES profile index(PS) to evaluate their function. Patients were examined at the following intervals: Initial assessment, one month after initial. at discharge, and one month after discharge. The mean BI score of patients initial assessment was 27.18, and that of PS was 17.54. There were statistically significant between initial score and one month after initial (21.39: p<0.001), at discharge(37.47: p<0.001), one month after discharge(46.49: p<0.001). PS scores were also improved .significantly(-2.62, -4.52. and -6.26(p<0.001). And the score between dischange and one month after discharge was significant (9.01: p<0.001) and in PS score(-1.73: p<0.001). Age and BE score were significantly associated with the improved in BI score between initial and discharge(T3-T1)(p<0.05). Below age forty the Bower initial BI score showed significantly higher improvement(T3-T1) after physical therapy(p<0.05). Initial Bl score, patients' attitude for physical therapy after discharge, age, and surgical operation were significantly associated with the improvement of BI score between initial and one month after discharge(T4-T1)(p<0.05). The lower initial BI score, patients' positive attitude for physical therapy after discharge, below age forty. and no surgical operation showed significantly higher improvement(p<0.05). BI score at discharge, side of hemiparesis and religion were significantly associated with the improvement of BI score between at discharge and one month after discharge(T4-T3) (p<0.05). The lower BI score at discharge. left aide of hemiparesis, with religion showed significantly higher improvement (p<0.05). Age, initial PS score were significantly associated with the improved in PS score between initial and discharge(T3-T1)(p<0.05). The higher initial PS score and below age forty showed significantly higher improvement(T3-T1)(p<0.05). Initial PS score, patient' attitude for physical therapy after discharge, age, educational level, physical therapy hour after discharge, and surgical operation were significantly associated with the improvement of PS score between initial and one month after discharge(T4-T1)(p<0.05). The higher initial PS score, patients' positive attitude for physical therapy after discharge, below age forty, higher education, the shorter physical therapy hour, and no surgical operation showed significantly higher improvement(T4-T1)(p<0.05). PS score at discharge, educational level, patient' attitude far physical therapy after discharge, physical therapy hour after discharge, and gender were significantly associated with the improvement of PS score between discharge and une month after discharge(T4-T3) (p<0.05), The higher PS non at discharge, higher education, patients' positive attitude for Physical therapy after discharge, the shorter physical therapy hour, and male showed significantly higher improvement (T4-T3)(p<0.05). In conclusion, initial BI score and age were significantly associated with BI score improvement and initial PS score, age, and educational level were also significantly associated with PS score improvement in stoke patients.

• Tuberculosis and Respiratory Diseases
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• v.83 no.2
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• pp.147-156
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• 2020

Background: Limited studies have been performed to assess readmission following hospitalization for community-acquired pneumonia (CAP) in an Asian population. We evaluated the rates, reasons, and risk factors for 30-day readmission following hospitalization for CAP in the general adult population of Korea. Methods: We performed a retrospective observational study of 1,021 patients with CAP hospitalized at Yeungnam University from March 2012 to February 2014. The primary end point was all-cause hospital readmission within 30 days following discharge after the initial hospitalization. Hospital readmission was classified as pneumonia-related or pneumonia-unrelated readmission. Results: During the study period, 862 patients who survived to hospital discharge were eligible for inclusion and among them 72 (8.4%) were rehospitalized within 30 days. In the multivariable analysis, pneumonia-related readmission was associated with para/hemiplegia, malignancy, pneumonia severity index class ≥4 and clinical instability ≥1 at hospital discharge. Comorbidities such as chronic lung disease and chronic kidney disease, treatment failure, and decompensation of comorbidities were associated with the pneumonia-unrelated 30-day readmission rate. Conclusion: Rehospitalizations within 30 days following discharge were frequent among patients with CAP. The risk factors for pneumonia-related and -unrelated readmission were different. Aspiration prevention, discharge at the optimal time, and close monitoring of comorbidities may reduce the frequency of readmission among patients with CAP.

• Journal of Korean Critical Care Nursing
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• v.7 no.1
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• pp.24-32
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• 2014

Purpose: The purpose of this study was to examine the effects of discharge planning on patient satisfaction, the readmission rate and preparedness for discharge in the elderly admitted to the emergency room (ER) for pulmonary disease. Methods: A quasi-experimental intervention study design was used. Older adults with pulmonary health problems in the ER in one general hospital were randomly allocated to either an experimental (n=21, 74.2 years) or control group (n=19, 70.7 years). The experimental group participated in a discharge planning program by a geriatric nurse practitioner. Data were collected from medical records, physical measurements and structured questionnaires including information on demographics, patient satisfaction, readmission, and preparedness for discharge. Results: Participants in the experimental group had significantly better outcomes with regard to patient satisfaction with nursing services (p=.003) and preparedness for discharge (p=.034). However, there was no significant effect on the readmission rate (p=.392) Conclusion: The results suggested that a discharge planning program could bolster nursing service satisfaction and preparedness for discharge in older patients admitted to the ER for pulmonary health problems. To clarify the effects of discharge planning on older patients admitted to the ER, a larger sample population, better instruments for various measures, a new manual on discharge planning and frequent follow-up will be necessary.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.13 no.1
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• pp.76-85
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• 2006

Purpose: The purpose of this study was to identify the relationship between psychosocial factors and symptom experience of patients with cardiovascular disease over a 6-month follow-up period. Method: Baseline data for each of the 138 patients were collected. Eighteen patients were dropped for a final total of 120 patients in the present study. To monitor patients' symptom experience after discharge, each patient was interviewed by telephone, and interviewed directly with a questionnaire at each clinic visit. Results: Mean scores for hostility, anger, anxiety, and depression were 51.63, 22.87, 48.95, and 41.21, respectively. Mean scores for the level of symptom experience at discharge, 3 months and 6 months after discharge were 32.83, 24.79, and 26.70, respectively. There were significant differences in the level of hostility by gender, BMI, job, and monthly income. Also the differences in the level of anxiety and depression were statistically significant according to gender and existence of spouse. In the regression analysis, depression was identified as the significant factor associated with symptom experience at discharge, 3 months, and 6 months after discharge. Conclusion: This study presented baseline data to elucidate whether psychosocial factors were associated with the progression of cardiovascular diseases. Accordingly, it suggests that nurses need to take into consideration psychosocial factor as well as physiological factor in symptom management for patients with cardiovascular disease.

• Journal of Technologic Dentistry
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• v.33 no.4
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• pp.539-550
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• 2011

Purpose: The aim of this study was to investigate distribution of the admitted patients with disease of oral cavity, salivary glands and jaws, current clinical treatment condition and clinical dental practice. Methods: The subject were 4,564 patients with disease of oral cavity, salivary glands and jaws of the Korean National Hospital Discharge Injury Survey 2004-2008 data. This study was carried out using the administrative database including patients' characteristics and comorbidity. The statistical analysis for ratio, gender, age, region, primary diagnosis, comorbidity, operation, hospital location and bed size of inpatients in Korean National Hospital Discharge Injury Survey was conducted by frequency analysis. Results: Among the total discharge injury patients in 2004-2008, the trend showed decrease of ratio of patients with disease of oral cavity, salivary glands and jaws. The portion of male was higher than female, and 20~29 age group was the highest portion compared with other age groups. Seoul-Gyunggi region was the highest among the other residences. patients with Dentofacial anomalies[including malocclusion] as primary diagnosis, digestive system as comorbidity and operations on facial bones and joins showed the highest portion respectively. Seoul-Gyunggi region was the highest portion compared with other residences. 500~999 bed size showed the highest portion. Conclusion: In this study showed that distribution of patients with disease of oral cavity, salivary glands and jaws, current dental clinical treatment condition using the Korean National Hospital data.