• Title/Summary/Keyword: Electronic Medical Records

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Manual Aspiration Thrombectomy Using Penumbra Catheter in Patients with Acute M2 Occlusion : A Single-Center Analysis

  • Park, Jung Soo;Kwak, Hyo Sung
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.352-356
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    • 2016
  • Objective : The efficacy and safety of manual aspiration thrombectomy using Penumbra in an acute occlusion of large intracranial arteries has been proven in many previous studies. Our study aimed to retrospectively assess the efficacy and safety of manual aspiration thrombectomy using Penumbra in patients with small vessel occlusions (M2 segment of the MCA). Methods : We conducted a retrospective review of 32 patients who underwent manual aspiration thrombectomy using the Penumbra 4 MAX Reperfusion Catheter for treatment of an M2 occlusion between January 2013 and November 2014. We evaluated immediate angiographic results and clinical outcomes through review of patient electronic medical records. Results : There were slightly more men in this study (M : F=18 : 14) and the median age was 72.5 (age range : 41-90). The rate of successful recanalization (TICI grade ${\geq}2b$) was 84% (27/32). NIHSS at discharge and favorable clinical outcomes at 3 months were significantly improved than baseline. Median initial NIHSS score was 10 (range : 4-25) and was 4 (range : 0-14) at discharge. Favorable clinical outcomes (mRS score ${\leq}2$ at 3 months) were seen in 25 out of 32 patients (78%). There were no procedure-related symptomatic intracerebral hemorrhages. One patient expired after discharge due to a cardiac problem. Conclusion : Manual aspiration thrombectomy might be safe and is capable of achieving a high rate of successful recanalization and favorable clinical outcomes in patients with distal cerebral vessel occlusion (M2).

The Usefulness of the Admission Base Deficit as a Marker of Mortality in Severely Injured Patients with Blunt Trauma (둔상성 중증 외상환자에서 내원 초기에 시행한 동맥혈 염기결핍과 예후의 관계)

  • Yu, Byung-Chul;Chung, Min;Lee, Gil-Jae;Lee, Jung-Nam
    • Journal of Trauma and Injury
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    • v.26 no.1
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    • pp.1-5
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    • 2013
  • Purpose: The base deficit (BD) at admission in severely injured patients has been shown to predict the adequacy of resuscitation and outcome, but this relationship is not well established in the Korean experience. The purpose of this study was to define the association between arterial blood gas (ABG) values and the mortality for patients with severe blunt trauma at a developing trauma center in Korea. Methods: A retrospective review of 415 adult patients with severe blunt trauma was conducted using electronic medical records from Jan. 2010 to Dec. 2011. Results: A total of 256 patients had ABG drawn within 1 hour of arrival. Patients who expired displayed a higher lactate level (4.86 vs. 3.31, p<0.0001), a worse BD (-7.99 vs. -5.37, p=0.001), and a lower pH (7.31 vs. 7.34, p=0.011) at arrival compared with those who survived. A statistically significant association was also observed between BD and blood product usage (p=0.001). Conclusion: The base deficit at admission is a useful marker of mortality and outcome in severely injured patients with blunt trauma in Korea.

Cost-Effective MapReduce Processing in the Cloud (클라우드 환경에서의 비용 효율적인 맵리듀스 처리)

  • Ryu, Wooseok
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2018.10a
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    • pp.114-115
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    • 2018
  • This paper studies a mechanism for cost-effective analysis of big data in the cloud environment. Recently, as a storage of electronic medical records can be managed outside the hospital, there is a growing demand for cloud-based big data analysis in small-and-medium hospitals. This paper firstly analyze the Amazon Elastic MapReduce which is a popular cloud framework for big data analysis, and proposes a cost model for analyzing big data using Amazon EMR with less cost. Using the proposed model, the user can construct a cost-effective computing cluster, which maximize the effectiveness of the analysis per operational cost.

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Risk Factors of Unplanned Readmission to Intensive Care Unit (중환자실 환자의 비계획적 재입실 위험 요인)

  • Kim, Yu Jeong;Kim, Keum Soon
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.2
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    • pp.265-274
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    • 2013
  • Purpose: The aim of this study was to determine the risk factors contributed to unplanned readmission to intensive care unit (ICU) and to investigate the prediction model of unplanned readmission. Methods: We retrospectively reviewed the electronic medical records which included the data of 3,903 patients who had discharged from ICUs in a university hospital in Seoul from January 2011 to April 2012. Results: The unplanned readmission rate was 4.8% (n=186). The nine variables were significantly different between the unplanned readmission and no readmission groups: age, clinical department, length of stay at 1st ICU, operation, use of ventilator during 24 hours a day, APACHE II score at ICU admission and discharge, direct nursing care hours and Glasgow coma scale total score at 1st ICU discharge. The clinical department, length of stay at 1st ICU, operation and APACHE II score at ICU admission were the significant predictors of unplanned ICU readmission. The predictive model's area under the curve was .802 (p<.001). Conclusion: We identified the risk factors and the prediction model associated with unplanned ICU readmission. Better patient assessment tools and knowledge about risk factors could contribute to reduce unplanned ICU readmission rate and mortality.

Protocol Development of Cardiopulmonary Resuscitation Nursing Tasks targeting Patients with Ventricular Fibrillation Generation (심실세동 환자의 심폐소생술 간호업무 프로토콜 개발)

  • Oh, Suk-Hee;Jang, Keum-Seong;Choi, Ja-Yun
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.2
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    • pp.203-215
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    • 2009
  • Purpose: In order to improve resuscitation rate of CPR through providing qualitative nursing while performing CPR in hospital ward and to enhance quality of emergency nursing in the ward, the author embarked on the research as a way of developing ventricular fibrillation protocol about CPR. Method: Collected data were analyzed by using the SPSS/PC14.0 program while the routes of final protocol developed in this research are as follows. Result: Based on analysis results of literature study and CPR electronic hospital records, a total of 22 items and 53 specific contents were confirmed through the gathering of opinions from panels, and the allotment of roles and tasks with a standard of 2 nurses was designated. As the result of specialists' verification on validity, the final protocol composed of a total of 23 items and 45 specific contents was confirmed. At the result of the pertinency evaluation of confirmed protocol, it was evaluated as relatively pertinent with its average score 2.89-3.32. Conclusion: The protocol developed in this research is seen as to contribute to nurses participating in CPR to avoid the overlapping of tasks and to develop CPR through effective teamwork of medical teams by presenting clear roles and tasks.

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Development and Analysis of System Dynamics Model for Predicting on the Effect of Patient Transfer Counseling with Nurses (간호사의 전원상담 효과 예측을 위한 시스템다이내믹스 모델 개발 및 분석)

  • Byun, Hye Min;Yun, Eun Kyoung
    • Journal of Korean Academy of Nursing
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    • v.48 no.5
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    • pp.554-564
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    • 2018
  • Purpose: This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process. Methods: Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology. Results: The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period. Conclusion: The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.

Glycated Hemoglobins and Chronic Complications of Diabetes Mellitus, based on the Smoking Status of Patients with Type 2 Diabetes Mellitus (제 2형 당뇨병 환자의 흡연여부에 따른 당화혈색소와 당뇨병성 만성합병증)

  • Song, Min Sun;Lee, Mi Hyang
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.23 no.2
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    • pp.139-146
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    • 2016
  • Purpose: This research seeks to identify differences between general characteristics, disease-related characteristics, glycated hemoglobin (HbAlc) levels, and aspects of chronic complications of diabetes mellitus in type 2 diabetes. Methods: This research was conducted from the 1st to the 15th of February in 2016, on 263 in patients. Patients' electronic medical records were used to identify their general characteristics, disease-related characteristics, HbAlc, and chronic diabetic complications. Chi-square test, ANOVA, ANCOVA, and the Cochran-Mantel-Haenszel test were used for data analysis. Results: Statistical significance was observed for general characteristics, based on smoking status, such as age, and education level; disease-related characteristics differed according to the duration of diabetes. Smoking status did not differ according to HbAlc level. In term of chronic diabetic complications, statistically significance was observed for diabetic nephropathy, based on smoking status. Conclusion: Patients who had a history of smoking, but were not currently smoking, were likely to display higher HbAlc levels and diabetic nephropathy. Therefore, there is need for regular checkups for diabetic complications among patients with a history of smoking and it is important to emphasize smoking cessation.

Demand on Nursing Services in 7 Korean Diagnostic-Related Group (7개 포괄수가 질환군 대상 간호요구도 분석)

  • Choi, Youn Jeong;Lee, Youngjin;Seo, Young Min;Lim, Ji Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.24 no.2
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    • pp.151-159
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    • 2017
  • Purpose: The purpose of this study was to identify nursing demands according to general characteristics and diseases of inpatients to whom comprehensive payment systems apply. Methods: This study was designed as a retrospective research study using the electronic medical records of Hospital Information Systems (HIS). Participants were 836 subjects who received seven Diagnostic-Related Group diagnoses among inpatients of one tertiary hospital from January 1, 2015 to June 30, 2015. Data were analyzed using SPSS 23.0. Results: Nursing demand among inpatients'seven Diagnostic-Related Group diagnoses was relatively higher for appendectomy, cataract surgery, and hysterectomy, while there was a significant difference depending on the age, duration of admission, admission path, hospital entry method and Diagnostic-Related Group. Conclusion: The results can be utilized as basic data on accurate nursing demands that reflect various features of patients.

A Study on the Assistive System for Body Correction (신체 교정을 위한 보조 시스템에 관한 연구)

  • Kim, Ho-Joon;Chung, Jae-Pil
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.4 no.4
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    • pp.231-235
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    • 2011
  • In these day, the number of people who have an abnormal posture caused by bad habit are increasing. Therefore, people suffer various disease and symptoms. For correcting the posture to cure, we need continuous monitor, expenditure of time and money. In this study, we develop a posture correcting aid system in other to monitor a posture continuously and leads to pose correctly and records postural variation which are attached to the neck and the waist. The devised system showed good potential for the correct posture guide and a cure of postural defect.

User-friendly Application for operability with HL7 in mobile agent of Ubiquitous Health Environment

  • Lee, JeongHoon;Kwock, DongYeup;Moon, KangNam;sahama, Tony;Kim, Jung-Tae
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2009.10a
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    • pp.866-870
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    • 2009
  • Mobile Health (M-Health) system is a recent term for medical and public health practice supported by mobile devices, such as mobile phones, PDAs, and other wireless devices. Mobile Health system has been successfully establishing at few general hospital in Korea. However, to use diverse devices manufactured by various company cause inoperability, and lack of security disappoints customers often. Although the outstanding health environment, most of hospitals are unavailable to share electronic patient records due to lack of standard protocol to handle the interoperability each other. Health Level 7 (HL7) is the best solution for the problem. In this paper, we will analyse a current M-Health service in terms of security and mobile device, and suggest iPhone for the best device against hospital environment. Also, for keep confidentiality of health information and patient privacy, enhanced security mechanism is introduced. As a consequence, interoperable standard, and most appropriate device for supporting staffs and M-Health performance, and enhanced securirty mechanism will be integrated in order to propose improved M-health model.

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